Advance Directive Completion and Its Associated Factors Among Older Chinese Americans

Kaipeng Wang, Yanqin Liu, Fei Sun, Dexia Kong, Lin Jiang, Bei Wu

Research output: Contribution to journalArticlepeer-review


Objectives: To examine the factors of advance directive (AD) completion among older Chinese Americans. Design: Cross-sectional survey. Setting and Participants: Data came from 435 Chinese Americans aged 55 years and older living in 2 metropolitan areas through self-administered questionnaires and research assistant–administered interviews in 2018. Participants' average age was 75 years (standard deviation = 9.4). Methods: Logistic regression was used to examine factors associated with AD completion. Results: Approximately 14% of participants completed an AD. Older age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02-1.12], higher level of acculturation (OR 2.15, 95% CI 1.39-3.33), higher expectation for intergenerational support (OR 1.52, 95% CI 1.02-2.27), and having US citizenship (OR 3.02, 95% CI 1.26-7.23) were positively associated with AD completion. Physical and mental health needs were not significantly associated with AD completion. Conclusions and Implications: This study is among the first focusing on AD completion among Chinese Americans, one of the fastest-growing older minority populations in the United States. Findings highlight the influence of socioeconomic and cultural factors on AD completion and illustrate the importance of developing culturally sensitive interventions to promote end-of-life care decision making among older Chinese Americans.

Original languageEnglish (US)
Pages (from-to)344-348
Number of pages5
JournalJournal of the American Medical Directors Association
Issue number2
StatePublished - Feb 2021


  • Advance directive
  • Chinese Americans
  • end-of-life care

ASJC Scopus subject areas

  • General Nursing
  • Health Policy
  • Geriatrics and Gerontology


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