Background: Advance care planning (ACP) is important, however ethnic minorities have half the completion rates in the United States compared to Caucasian counterparts, and in Australia only 3.5% of advance directives were completed by those overseas-born.Educational intervention improves ACP knowledge and subsequent uptake. We evaluated immediate and longer-term outcomes of a co-designed ACP education toolkit in Chinese-speaking people in Victoria, Australia. Methods: We conducted a cross-sectional survey of Chinese-speaking community members who participated in a co-designed Chinese ACP educational workshop. A self-selected subgroup were subsequently contacted 6 months later to determine longer-term outcomes. Results: Of 519 attendees across 17 workshops, 325 (63%) completed the evaluation. The majority (63%;n = 206) were previously unaware of ACP. Perception of receipt of useful information positively correlated with motivation to undertake ACP ( r = 0.3486, p < 0.001). Of the 70 participants who consented to follow up, 36% (n = 26) agreed to participate in structured telephone interviews. English speakers were more likely to have undertaken ACP (n = 6 vs n = 3). ACP completion was not associated with being a carer or suffering from cancer or chronic illness. Conclusions: This first Australian study evaluating ACP co-design education implementation outcomes in Chinese-speaking people supports that motivation to undertake ACP is related to knowledge, albeit a modest ACP uptake in a small follow up sample. Clinicians should note that this assists with ACP uptake, with likely downstream improved health outcomes. This co-designed toolkit could be helpful in increasing ACP uptake. Future engagement by Chinese language societies to overcome further barriers to ACP is needed.
People rely on transportation every day to access food, work, and social activities. Transportation insecurity—the lack of regular access to adequate transportation—can therefore cause significant disruptions to livelihoods. Understanding how people experience transportation insecurity in metropolitan areas may contribute to building better transportation systems and help formulate ways to alleviate persistent and underlying transportation issues. In this study, the researchers interviewed San José residents who experience transportation insecurity to better understand their experiences and identify the major ways that they cope with lack of adequate transportation. The researchers then used inductive techniques for thematic text analysis to identify patterns major themes in people's experiences and coping strategies. Findings suggest that people experience transportation insecurity as excess time consumption through congested traffic, convoluted travel schedules, and service complications, which causes worry, anxiety, and missed opportunities due to wasting or losing personal time. Overall, people's experiences and reactions allude to what could be improved in San José’s transportation infrastructure.
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