Tuesday, July 1, 2025 7/1/2025

I kua na'u "Let Me Carry Out Your Last Wishes" Advance Care Planning for NativeHawaiian Elders

Award Number: R01NR018400
ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/20/2020
PERIOD OF PERFORMANCE END DATE: 02/28/2026

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I kua na'u "Let Me Carry Out Your Last Wishes" Advance Care Planning for NativeHawaiian Elders - Communication surrounding serious illness decision making is formalized in Advance Care Planning (ACP), a process involving verbal or written information designed to inform patients of possible medical options including palliative and hospice care services. Numerous studies have suggested that improved ACP rates better align health care delivery with patient preferences. Despite expansion of ACP services in the health care system, Native Hawaiians (NHs) consistently have negligible rates of ACP and low use of palliative and hospice care services. To address these shortcomings, our multi-disciplinary community and research group has partnered to create the I kua na'u Let Me Carry Out Your Last Wishes ACP video intervention. Our Community-Based Collaborative Approach will create, develop and test the I kua na'u comprehensive video-based ACP program honoring the history, opinions, and culture of NHs. Indeed, NH culture is primarily an oral tradition in which the spoken word permeates the life of NHs and is the normal way of interacting with neighbors, including in its most recent adaptation with the use of video media. The I kua na'u program will include videos tailored for the different settings in which older NHs live and get medical care. The videos will explain the importance of ACP, empower NHs to tell their story ('olelo Kama'ilio; Talk Story ) by allowing the recording of personal video declarations of ACP wishes, and the ability to share the personal video declaration with family, friends and clinicians. The overall objective is to conduct a five-year program that includes two years of development of the I kua na'u ACP video program with focus group testing, and then three years of implementation in the NH community. Demonstrating the effectiveness of using the video program in NHs represents an essential step to implement this tool in practice. The Specific Aims are: (1) To conduct focus groups and group interviews of NH elders, their families, and their providers to inform the creation and pilot-testing of NH ACP videos that would embrace the NH concept of I kua naʻu - Let me help carry out your last wishes among three different types of organizations serving NH elders and their families (NH Homestead, Group Assisted Living, and Ambulatory Care). (2) To compare the ACP engagement, knowledge, decisional conflict, and ACP completion rates in 220 NHs over the age of 55 in: (a) a pre-post study design in 110 people living on Homestead or Assisted Living using the video intervention, and (b) a randomized trial of 110 people recruited from Ambulatory Clinics. (3) To conduct a qualitative assessment of personal video declarations from 165 NHs using the intervention. (4) To compare ACP documentation and end-of-life health care utilization of NHs compared to non-NHs living in Hawaiʻi before and after the intervention program using electronic health records and/or insurance data. Conventional ACP programs do not meet the unique needs of NHs. Creating and implementing a unique video-based intervention for NHs can help support decision making in this community and decrease disparities in serious illness care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $670,687 )
2025	2025	TUFTS MEDICAL CENTER PARENT, INC.	800 WASHINGTON ST	BOSTON	MA	02111	SUFFOLK	USA	Nursing Research	001	5	6/3/2025	NON-COMPETING CONTINUATION	$670,687
2025	2023	TUFTS MEDICAL CENTER PARENT, INC.	800 WASHINGTON ST	BOSTON	MA	02111	SUFFOLK	USA	Nursing Research	000	4	3/7/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
														Subtotal = $670,687

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	TUFTS MEDICAL CENTER PARENT, INC.	800 WASHINGTON ST	BOSTON	MA	02111	SUFFOLK	USA	Nursing Research	000	4	12/12/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2024	2023	TUFTS MEDICAL CENTER PARENT, INC.	800 WASHINGTON ST	BOSTON	MA	02111	SUFFOLK	USA	Nursing Research	001	4	3/27/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $793,299 )
2023	2023	TUFTS MEDICAL CENTER, INC.	800 WASHINGTON ST	BOSTON	MA	02111	SUFFOLK	USA	Nursing Research	001	4	3/7/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$793,299
2023	2023	TUFTS MEDICAL CENTER PARENT, INC.	800 WASHINGTON ST	BOSTON	MA	02111	SUFFOLK	USA	Nursing Research	005	4	7/11/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$761,458
2023	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	000	3	3/6/2023	NON-COMPETING CONTINUATION	$0
2023	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	003	3	6/20/2023	NON-COMPETING CONTINUATION	-$679,220
2023	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	004	2	7/11/2023	NON-COMPETING CONTINUATION	-$5,206
2023	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	002	2	6/20/2023	NON-COMPETING CONTINUATION	-$77,031
														Subtotal = $793,299

Issue Date FY: 2022 ( Subtotal = $679,220 )
2022	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	000	3	2/10/2022	NON-COMPETING CONTINUATION	$611,298
2022	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	001	3	4/20/2022	NON-COMPETING CONTINUATION	$67,922
														Subtotal = $679,220

Issue Date FY: 2021 ( Subtotal = $699,871 )
2021	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	000	2	3/29/2021	NON-COMPETING CONTINUATION	$699,871
														Subtotal = $699,871

Issue Date FY: 2020 ( Subtotal = $765,603 )
2020	2020	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Nursing Research	000	1	5/20/2020	NEW	$765,603
														Subtotal = $765,603

Grand Total All Awards = $3,608,680

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I kua na'u "Let Me Carry Out Your Last Wishes" Advance Care Planning for NativeHawaiian Elders

Award Number: R01NR018400

ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/20/2020

PERIOD OF PERFORMANCE END DATE: 02/28/2026

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