Living Well with Living Wills: Application of Protection Motivation Theory to Living Wills Among Older Caucasian and African American Adults

Abstract

Using protection motivation theory, we examined racial differences in intent to complete a living will, rational problem solving (e.g., information seeking), and maladaptive coping responses (i.e., wishful thinking) to a health crisis. Sixty healthy, older adults without living wills responded to written vignettes, including information about living wills as an effective coping mechanism to avoid a health crisis. Use of adaptive coping responses predicted intent to execute a living will. A significant race-by-threat interaction predicted use of rational problem solving, with Caucasians more likely to seek information in response to perceived threat in comparison with African Americans. A significant race-by-adaptive-coping interaction predicted maladaptive coping, indicating that Caucasians were more variable in their maladaptive responses. The effectiveness of health care messages regarding living wills for older adults may be enhanced by focusing on racial differences in response to perceived health threat and perceived adaptive coping information.

KEYWORDS:

• living wills
• race/ethnicity and health
• protection motivation theory
• preventive health

Acknowledgments

Portions of this article were presented at the 56^th annual scientific meeting of the Gerontological Society of America, San Diego, CA, November 2003. Funding from the National Institute on Aging (K01AG00943) to Rebecca S. Allen partially supported data collection for this project and preparation of this manuscript. Additionally, funding for data collection was provided by the Department of Psychology at The University of Alabama as part of Dorothy Pekmezi's undergraduate honors thesis.

Notes

1. We recognize in this manuscript that “race” is a physiological term that does not apply well to psychosocial phenomena; however, because our sample is limited in “ethnicity” to Caucasian and African American adults, we use the term “race” throughout the manuscript.

Cruzan v. Director of the Missouri Department of Health, Vol 497 (1990).

Omnibus Budget Reconciliation Act of 1990, P. L. 101–508, §4206, and 4715, codified at 42 U.S.C. §§ 1395cc (a) (1) (q), 1395 mm (c) (8), 1395cc (f), 1396a (57), (58), 1396a (w).