JMIR Publications

ABSTRACT

Background:

Chinese immigrants face difficulties engaging in advance care planning (ACP) discussions with their family caregivers. Avoiding such discussions and failing to complete advance directives can delay palliative and hospice care. Yet timely palliative care is essential to maintaining quality of life at the end of life. Currently, there is a lack of interventions to help Chinese immigrants diagnosed with cancer or heart disease overcome the barriers to engaging in ACP discussions via effective use of resilience.

Objective:

The purpose of the study is to develop a culturally tailored resilience-building intervention for Chinese immigrants with cancer or heart disease.

Methods:

Development of this intervention will be guided by the 3-phase multiphase optimization strategy. In the first phase, preparation, we will examine the prespecified components of the intervention through pilot studies to understand the necessity of each component. First, a qualitative study will be conducted to understand the experiences of 10 religious leaders who have provided pastoral or spiritual care to Chinese immigrants in Chicago. The interview findings will be categorized as facilitators and barriers and integrated into the development of the intervention’s resilience-building guide. Second, a cross-sectional study will be conducted to assess the readiness of Chinese Americans to engage in ACP discussions with their family using surveys. Third, think-aloud interviews will be conducted to understand the experiences of 18 pairs of Chinese immigrants and their family caregivers regarding the prototype of the culturally tailored resilience-building intervention. Finally, we will examine the feasibility and acceptability of the intervention prototype along with issues related to the study’s implementation process.

Results:

Recruitment for the qualitative study began in November 2023. As of March 2024, 7 participants have been recruited, enabling a preliminary qualitative analysis to evaluate the coding guide developed from the literature. Recruitment for the cross-sectional study is underway, and the potential participant recruitment lists for the think-aloud interviews have been received, enabling recruitment to begin after the preliminary qualitative analysis is completed.

Conclusions:

The proposed culturally tailored resilience-building intervention is innovative in facilitating ACP discussions among Chinese immigrants, particularly with a focus on individuals diagnosed with serious chronic diseases within this population. The findings from all 3 study methods will inform the development of the proposed intervention and identify effective recruitment strategies for this underserved and hard-to-reach population to be used in future research. Clinical Trial: NCT06247215