| Employing a cross-sectional mixed-method design, this study demonstrated how a trans-theoretical model can be applied quantitatively and qualitatively to characterize Chinese Americans' behavioral change regarding advance care planning. Major outcomes of this study include: (1) categorizations and dense descriptions of the stage of readiness, decisional balance, and self-efficacy; (2) identification of socio-cultural, knowledge, quality of life, spiritual, and demographical factors significantly contributing to engagement in such planning; and (3) explorations of preferable strategies to enhance Chinese Americans' future participation in intervention programs.;Although the majority of the Chinese American population may be precontemplators with a lack of basic awareness of advance care planning, our results are optimistic and suggestive that they are highly motivated, prepared, and capable of executing advance directives and communicating their end-of-life treatment and care preferences with loved ones. In addition, findings from this relatively homogeneous sample suggest significant determinants of readiness, including factors of knowledge, gender (female), levels of education, cultural beliefs, and age, respectively. To serve the large diverse group of Chinese Americans, insights have been provided for health care providers to incorporate the Transtheoretical theory principles and develop a cultural intervention program. However, before intervention studies can be conducted and tested for this cultural group, in light of the paucity of literature, it is essential to have prospective and comprehensive research to determine the fit of Transtheoretical Model as a theoretical framework for such behavioral change and explore additional determinants of the readiness in other heterogeneous Chinese American groups. |
