{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T23:53:08Z","timestamp":1780357988903,"version":"3.54.1"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["R\u20101609\u201036381"],"award-info":[{"award-number":["R\u20101609\u201036381"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advance care planning (ACP) supports seriously ill individuals in identifying and communicating their values and preferences for future care. However, disparities in ACP engagement persist, particularly among African American older adults. This study examined racial differences and predictors of readiness to engage in ACP among seriously ill African American and White older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional analysis used baseline data from the EQUAL ACP cluster randomized trial testing two ACP interventions. Participants included 792 community\u2010dwelling, non\u2010Hispanic African American (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009428) and White (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009364) adults aged 65 and older with serious illness or multimorbidity, recruited from 10 primary care clinics across five Southern U.S. states. Readiness to engage in ACP was measured using a four\u2010item scale assessing willingness to discuss and document care preferences. Predictor variables included religiosity, beliefs about death and dying, perceived discrimination and trust, provider communication, treatment preferences, and self\u2010rated health. Mixed\u2010effects regression models were used to examine predictors of ACP readiness in the overall sample and racial subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall ACP readiness did not significantly differ by race. Across racial groups, greater comfort discussing death was associated with greater ACP readiness. Among African American participants, frequent religious service attendance was associated with higher ACP readiness (mean difference\u2009=\u20090.28; 95% CI: 0.08\u20130.47). Among White participants, a preference for pain relief over life extension in their current health status was associated with higher readiness (mean difference\u2009=\u20090.25; 95% CI: 0.05\u20130.45). Trust in providers, experiences of discrimination, and ratings of provider communication were not significantly associated with ACP readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although mean readiness scores were similar, predictors varied by race. Religious attendance may facilitate ACP readiness among African American patients, while comfort\u2010focused treatment preferences appear more influential among White patients. Culturally tailored strategies are needed to equitably support ACP engagement among older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70331","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T15:54:45Z","timestamp":1770998085000},"page":"1012-1024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Readiness to Engage in Advance Care Planning Among Older Adults With Serious Illness: Baseline Findings From the\n                    <scp>EQUAL ACP<\/scp>\n                    Study"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4617-2433","authenticated-orcid":false,"given":"Deborah","family":"Ejem","sequence":"first","affiliation":[{"name":"School of Nursing University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona L.","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, O'Donnell School of Public Health University of Texas at Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2519-9107","authenticated-orcid":false,"given":"Anupama","family":"Gangavati","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Internal Medicine University of Texas at Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Barrett","sequence":"additional","affiliation":[{"name":"Atrium Health\/Wake Forest Comprehensive Cancer Center Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Bakitas","sequence":"additional","affiliation":[{"name":"School of Nursing, Heersink School of Medicine Center for Palliative and Supportive Care University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisette","family":"Hasan","sequence":"additional","affiliation":[{"name":"South Carolina Coalition for the Care of the Seriously Ill  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronit","family":"Elk","sequence":"additional","affiliation":[{"name":"Heersink School of Medicine Division of Geriatrics, Gerontology, and Palliative Care, Center for Palliative and Supportive Care University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raegan W.","family":"Durant","sequence":"additional","affiliation":[{"name":"Heersink School of Medicine Division of General Internal Medicine and Population Science University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenisha","family":"Bethea","sequence":"additional","affiliation":[{"name":"Clinical and Translational Science Institute Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammie","family":"Quest","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine; 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