The informal discussion of advance care planning among Chinese older adults: Do education and social media use matter?

This study aimed to examine and compare the associations between education, social media use, and advance care planning (ACP) discussion among Chinese older adults in mainland China (Wuhan), Taiwan (Taichung), and the United States (Honolulu). Community-dwelling older adults (>= 55) were recruited from 2017 to 2018. The ACP discussion rate in Wuhan, Taichung, and Honolulu were 15.2 %, 19.2 %, and 31.3 %, respectively. Logistic regression models revealed that education was positively associated with ACP discussion in Taichung and Honolulu. Social media use was positively associated with ACP discussions in Wuhan and Honolulu, and it attenuated the association between education and ACP discussion in Honolulu. The present study contributes to previous studies by comparing the associations between education, social media use, and ACP discussion in different settings within the same ethnicity. Policy and practice implications were also discussed.(c) 2023 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to compare the associations between education, social media use, and advance care planning discussion among Chinese older adults. The findings showed positive associations between education and ACP discussion in Taiwan and Honolulu, as well as positive associations between social media use and ACP discussion in Wuhan and Honolulu. Social media use attenuated the association between education and ACP discussion in Honolulu.