# Exploring the Interaction Between Race and Sexual Orientation in Advance Care Planning

> **NIH NIH R36** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2022 · $64,766

## Abstract

Project Summary/Abstract
Advance care planning (ACP) is “a process that supports adults at any age or stage of health in understanding
and sharing their personal values, life goals, and preferences regarding future medical care” to ensure that
people receive medical care that is consistent with their values, goals, and preferences. ACP may lead to
identifying a health care proxy and developing an advance directive. Sexual minorities (e.g., lesbian/gay), who
have a history of discrimination and stigma in healthcare settings, may face challenges in engaging in ACP.
Early negative healthcare experiences and different social structures may present challenges in ACP decision-
making. Despite the positive outcomes associated with ACP, research has shown that Black Americans are
less likely to complete ACP due to mistrust of the healthcare system, religious/spiritual factors, and lack of
adequate and congruent information regarding ACP. Given these known disparities among these two groups,
no study to date has examined racial differences in ACP within the sexual minority (SM) population. The main
objective of this proposed project is to investigate racial differences among older lesbian and gay adults’
behaviors and beliefs about ACP and relevant care preferences. Data for this project will be collected from
online surveys of White and Black lesbian and gay adults ages 50 and older. Participants will be recruited
through organizations/centers that serve older adults, SM older adults, and SM older adults of color. Logistic
and stepwise linear regression models will be used to examine: 1) differences in ACP discussion and
subsequent documentation between racial groups and 2) difference in preference for aggressive medical
treatment between racial groups. Results from the proposed project will expand knowledge of ACP within the
diverse SM population and foster future investigation into the specific needs of SM individuals for end-of-life-
care.

## Key facts

- **NIH application ID:** 10527846
- **Project number:** 1R36AG075198-01A1
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Mekiayla Singleton
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $64,766
- **Award type:** 1
- **Project period:** 2022-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10527846

## Citation

> US National Institutes of Health, RePORTER application 10527846, Exploring the Interaction Between Race and Sexual Orientation in Advance Care Planning (1R36AG075198-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10527846. Licensed CC0.

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