# Culturally tailoring an advance care planning intervention for American Indians

> **NIH NIH R21** · WESTERN CAROLINA UNIVERSITY · 2022 · $181,722

## Abstract

The long-term goal of our research program is to, in collaboration with American Indian and Alaska Native
communities, test the efficacy and effectiveness of an advance care planning (ACP) program designed to be
culturally-tailored to their end-of-life values and beliefs. Our project builds upon a 20-year collaborative
relationship between one of the Principal Investigators and the participating tribe, the Eastern Band of Cherokee
Indians, and the other Principal Investigator's 20-year clinical experience as a hospice and palliative care social
worker and bereavement coordinator and her Make Your Wishes About You (MY WAY) intervention design and
research experience. Our objective in this application is to culturally tailor the MY WAY ACP curriculum and
patient education guide using a community-based participatory approach through qualitative and quantitative
methods engaging community members, a Community Advisory Board, and a Professional Advisory Board. Our
approach is informed by the Consolidated Framework for Implementation Research of how interventions, without
tailoring for the target population, are usually a poor fit. Our rationale for this project is that its successful
completion will provide the necessary incremental step in developing the evidence for the culturally-tailored MY
WAY. Our project has three specific aims: (1) culturally tailor the content of the MY WAY ACP curriculum and
patient education guide for the Eastern Band of Cherokee Indians; (2) assess the feasibility of the culturally-
tailored MY WAY ACP curriculum and patient education guide with the Eastern Band of Cherokee Indians; and
(3) examine preliminary outcomes of the culturally-tailored MY WAY ACP curriculum and patient education guide
with 70 Eastern Band of Cherokee Indian members. At the successful completion of this project, we expect to
have developed a feasible culturally-tailored MY WAY that through a quasi-experimental waitlist design shows
promise as an efficacious program with respect to self-efficacy, readiness, and ACP completion that increases
facilitators and decreases barriers to ACP. We will be well-positioned to pursue R01 funding to support a
randomized controlled trail of the culturally-tailored MY WAY to assess its efficacy. Importantly, we expect to be
among the first to have created an ACP program for American Indians that will lead to dissemination with other
American Indian as well as Alaska communities to ensure that all are given the opportunity to express and
document their care wishes. Our results can be expected to have a long term positive impact for clinical and
public health practice at the Eastern Band of Cherokee Indians and other Native communities through the
implementation of the MY WAY ACP curriculum and patient guide that is responsive to the diversity of cultural
values as well as beliefs and practices with respect to end-of-life and death across Indian Country.

## Key facts

- **NIH application ID:** 10369055
- **Project number:** 5R21NR019910-02
- **Recipient organization:** WESTERN CAROLINA UNIVERSITY
- **Principal Investigator:** Elizabeth Bagwell Anderson
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $181,722
- **Award type:** 5
- **Project period:** 2021-03-09 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10369055

## Citation

> US National Institutes of Health, RePORTER application 10369055, Culturally tailoring an advance care planning intervention for American Indians (5R21NR019910-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10369055. Licensed CC0.

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