Advance Directive Completion Among Older Southeast Asian Americans: The Case of Vietnamese and Filipino Populations

The Southeast Asian American population aged 55 or above remains understudied in research on advance directives (AD), despite their importance for end-of-life decision-making and quality of care. This study examined factors associated with AD completion among older Vietnamese and Filipino Americans, guided by Andersen's Health Service Use Model. Using a cross-sectional survey among 192 Vietnamese Americans and 140 Filipino Americans aged 55 or above, this study found that older age was significantly associated with higher odds of AD completion, whereas greater family conflict and lower income were associated with lower odds of AD completion. Acculturation was positively associated with AD completion among Filipino Americans, whereas a favorable AD attitude was positively associated with AD completion among Vietnamese Americans. These findings underscore the importance of addressing economic barriers and family conflict in AD completion. By recognizing different patterns of acculturation, AD attitude, and AD completion between the two ethnic groups, the findings highlight the importance of acknowledging heterogeneity within Asian Americans to develop culturally tailored approaches to promote advance care planning effectively.