• Sarah Nouri, Lingsheng Li, Carrie Huang, Anni Chung, StokesSandy ChenSCChinese American Coalition for Compassionate Care (S.C.S., S.P.), Cupertino, California, USA., Shirley Pan, Elizabeth C Wong, Jeffrey Newman, Joseph W Woo, Joyce Cheng, Charissa H Tan, Molly Wertz, Elyse Wood-Hughes, Mara Quinn, Steven Z Pantilat, Courtney R Lyles, Christine S Ritchie, and Rebecca L Sudore.
• Division of Palliative Medicine, Department of Medicine (S.N., M.Q., S.Z.P.), University of California San Francisco, San Francisco, California, USA. Electronic address: sarah.nouri@ucsf.edu.
• J Pain Symptom Manage. 2023 Nov 1; 66 (5): 551560.e1551-560.e1.

ContextDespite the association of advance care planning (ACP) with improved patient and caregiver outcomes, Chinese American elders have low rates of ACP.ObjectivesAssess ACP facilitators/barriers in the San Francisco (SF) Chinese community and codesign, implement, and test community-based ACP-promoting pilot events.MethodsA Chinese Community Committee (N = 19 community-based organization leaders, health system representatives, community members) conducted focus groups in Cantonese and English with Chinese older adults (age ≥55), caregivers, and community leaders. The Committee designed and implemented pilot events in-person and online. We analyzed focus group data using thematic analysis; assessed pre-to-post-event readiness to engage in ACP (validated survey; 14 scale, 4 = most ready); and assessed event acceptability.ResultsA total of 34 people participated in six focus groups. Themes described Chinese community-specific importance of ACP (e.g., reduces family burden), barriers (e.g., younger generations lack tools to discuss ACP with elders and vice versa), and facilitators (e.g., intergenerational events, culturally/linguistically appropriate materials). Based on focus groups findings, the Committee developed a novel ACP tool and designed intergenerational events. A total of 195 participants attended 10 events; 95% were Chinese, 90% spoke Chinese languages, 80% were women. ACP readiness increased significantly (1.66 [SD 0.84] vs. 2.03 [SD 0.85]; P < 0.001); 94% of participants were comfortable attending and 96% would recommend events.ConclusionCommunity-developed intergenerational events that highlight the value of ACP and address barriers are acceptable and increase ACP engagement in the Chinese community.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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