Latino vs. Non-Latino Disparities in Advance Care Planning & End-of-Life Care

The specific aims of this study are as follows: Specific Aim 1: Mediators/Moderators of Latino-non-Latino disparities in ACP & EOL care Specific Aim 1. Determine the beliefs (medical, religious, and familial) that significantly explain (mediate or moderate) disparities in: 1a) ACP (eg, Do Not Resuscitate, DNR, Do Not Hospitalize, DNH, orders; Living Wills; Durable Power of Attorney for Healthcare) and, 1b) EOL care (intensive care; palliative/hospice care; value-consistent care). Rationale: This will generate a list of significantly influential beliefs to target in the development of an intervention to reduce Latino-non-Latino disparities in ACP and EOL care. Specific Aim 2: Develop and pilot a belief-modification intervention to reduce Latino-non Latino disparities in ACP & EOL care Phase I: Conduct focus groups with relevant Latino stakeholders to discuss beliefs found to explain disparities in ACP & EOL care. Latino stakeholders (eg, cancer patient caregivers) will be asked to offer input on potential approaches to belief modification (eg, those in Table 1) to determine which they find most acceptable and likely to be effective. Phase II: Design a belief-modification intervention to reduce Latino-non-Latino disparities in ACP & EOL care that incorporates elements identified in Phase I. Vet the intervention with a separate group of Latino stakeholders. Phase III: Evaluate feasibility and potential efficacy of the belief-modification intervention developed in Phase II for the reduction of Latino-non-Latino disparities in ACP.