Advance Care Planning Interventions in Faith Communities: A Literature Review
Nadine Cline, RN, MSN, ANP-BC, AOCNP, ACHPN, Health Arnett, Lafayette, IN, Purdue University, West Lafayette, IN
Introduction:
Americans have low rates of advance directive completion. Faith communities have been identified as promising venues to assist individuals in the advance care planning process. This review’s purpose is to summarize the advance care planning interventions that have been employed in all types of faith-based communities to inform researchers and community leaders interested in educating communities and evaluating effectiveness of faith-based interventions.
Methods:
A literature search of two databases including PubMed and CINAHL was performed by a student in May and June 2023 limited to publications from the year 2000 to most recent in the English language. Search terms related to faith-based communities and advance directives were used. Articles that employed an intervention in a faith-based group were included; articles of an editorial nature and those that did not include an intervention were excluded.
Results:
The initial search produced 530 results. Nine articles met inclusion criteria. Studies included interventions in African American, Muslim, Asian-American, Latino, and White populations. All were provided in Christian communities except for the Muslim study. Interventions varied from one-time events to more lengthy educational sessions over weeks with community support. Rates of advance directive completion after intervention ranged from 13.9% to 71.8%. Increase in knowledge and readiness to complete advance directives or have conversations with loved ones regarding end-of-life wishes was also found.
Discussion:
All educational interventions in faith-based communities reviewed were tailored to the population. Uptake of the information and advance directive completion was low in an African American controlled trial despite a prolonged intervention. Having staff present to assist with document completion produced increased completion rates in studies included in this review. More studies assessing the effectiveness of interventions in all populations is needed as advance directive rates overall in the United States remain low.
Americans have low rates of advance directive completion. Faith communities have been identified as promising venues to assist individuals in the advance care planning process. This review’s purpose is to summarize the advance care planning interventions that have been employed in all types of faith-based communities to inform researchers and community leaders interested in educating communities and evaluating effectiveness of faith-based interventions.
Methods:
A literature search of two databases including PubMed and CINAHL was performed by a student in May and June 2023 limited to publications from the year 2000 to most recent in the English language. Search terms related to faith-based communities and advance directives were used. Articles that employed an intervention in a faith-based group were included; articles of an editorial nature and those that did not include an intervention were excluded.
Results:
The initial search produced 530 results. Nine articles met inclusion criteria. Studies included interventions in African American, Muslim, Asian-American, Latino, and White populations. All were provided in Christian communities except for the Muslim study. Interventions varied from one-time events to more lengthy educational sessions over weeks with community support. Rates of advance directive completion after intervention ranged from 13.9% to 71.8%. Increase in knowledge and readiness to complete advance directives or have conversations with loved ones regarding end-of-life wishes was also found.
Discussion:
All educational interventions in faith-based communities reviewed were tailored to the population. Uptake of the information and advance directive completion was low in an African American controlled trial despite a prolonged intervention. Having staff present to assist with document completion produced increased completion rates in studies included in this review. More studies assessing the effectiveness of interventions in all populations is needed as advance directive rates overall in the United States remain low.