{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:52:58Z","timestamp":1781513578270,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rates of advance care planning (ACP) are lower and preferences for life\u2010prolonging treatment are higher among Black compared to White older adults. We examined whether these differences persisted during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between February 2021 and September 2022, we conducted a cross\u2010sectional COVID\u201019\u2013focused survey of seriously ill adults \u2265\u200965\u2009years in 10 primary care clinics participating in a clinical trial of two ACP interventions. Logistic regression models examined associations between COVID\u201019 related ACP discussion (defined as discussions with family, friends, or doctors about COVID\u2010related medical care) and treatment preferences if very sick with COVID\u201019 (life\u2010prolonging treatment, comfort care, trial of life\u2010prolonging with transition to comfort care if no improvement) overall and by race, controlling for baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 428 participants (55.9% Black, 44.2% White; mean age 74.6), 25% reported discussing COVID\u201019 treatment preferences with family\/friends and 6% with doctors. Most reported no change in willingness to participate in ACP due to the pandemic, though increased willingness was more common among Black than White participants (22.4% vs. 14.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). Despite this, COVID\u201019\u2010related ACP discussion did not differ by race (family\/friends: 22.7% vs. 28.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.19; doctors: 6.9% vs. 4.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.37). Most seriously ill older adults preferred a time\u2010limited trial of life\u2010prolonging treatment (71% White, 56.2% Black); though preferences varied by race (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001); Black participants compared to White participants more often preferred life\u2010prolonging treatment (28.5% vs. 10.3%). In adjusted models, race was not associated with COVID\u201019\u2010related ACP discussion (OR 0.72, 95% CI 0.44\u20131.18), while preferences for life\u2010prolonging treatments predicted greater COVID\u201019 related ACP discussion (OR 1.98, 95% CI 1.14\u20133.44).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In contrast to pre\u2010pandemic ACP research, no racial differences were observed in COVID\u201019\u2010related ACP discussion, though differences in treatment preferences persisted. These findings underscore the need for culturally responsive, context\u2010sensitive ACP approaches among seriously ill older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70509","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:10:07Z","timestamp":1778656207000},"page":"1722-1728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disparities in Advance Care Planning: Did\n                    <scp>COVID<\/scp>\n                    \u201019 Change Anything?"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2519-9107","authenticated-orcid":false,"given":"Anupama","family":"Gangavati","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Geriatric Medicine University of Texas at Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly S.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine Duke University, Geriatric Research Education and Clinical Center, Durham Veterans Affairs Health Care System  Durham North Carolina 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":"Maren","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raegan W.","family":"Durant","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Population Science Heersink School of Medicine, University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4617-2433","authenticated-orcid":false,"given":"Deborah","family":"Ejem","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Alabama at Birmingham  Birmingham Alabama 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":"Rowena","family":"Dolor","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherone N.","family":"Williams\u2010Bryant","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Geriatric 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":"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":"Tammie","family":"Quest","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Emory University  Atlanta Georgia USA"},{"name":"Department of Preventive Medicine Emory University  Atlanta Georgia 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":"Kenisha","family":"Bethea","sequence":"additional","affiliation":[{"name":"Clinical and Translational Science Institute, Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Rhodes","sequence":"additional","affiliation":[{"name":"University of Texas at Southwestern Medical Center Department of Internal Medicine, Division of Geriatric Medicine, O'Donnell School of Public Health  Dallas Texas 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