Katherine Waite|Alex D. Federman|Danielle M. McCarthy|Rebecca L. Sudore|Laura M. Curtis|David W. Baker|Elizabeth A. Wilson|Romana Hasnain?Wynia|Michael S. Wolf|Michael K. Paasche?Orlow
Literacy and Race as Risk Factors for Low Rates of Advance Directives in Older Adults
Northwestern University|Icahn School of Medicine at Mount Sinai|Northwestern University|University of California, San Francisco|Northwestern University|Northwestern University|Northwestern University|Northwestern University|Northwestern University|Boston University
examine effect relationship literacy individuallevel factors advance directive adfacetoface structured interviewparticipants recruited academic general internal medicine clinic one four federally qualified health centers chicagoseven hundred eightyfour adults aged 55 74assessment participant literacy sociodemographic factors ad medical careoneeighth 124 participants low literacy 266 marginal literacy 495 adequate literacy reported ad p 001 multivariable analyses literacy race independently associated less likelihood ad specifically participants limited literacy risk ratio rr 045 95 confidence interval ci 022095 african americans rr 064 95 ci 047088 less likely ad exploratory analyses showed significant interaction effect literacy racelimited literacy africanamerican race significant risk factors ad cohort older adults literacy race probably represent two separate important causal pathways need understood improve healthcare system ascertains protects individuals advance care preferences