Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice based on learnings. Lack of time and patient discomfort with end-of-life topics were identified as barriers to changing practice regarding advance care planning. Educational interventions on advance care planning for clinicians were effective and may help to increase patient access to this important component of care. Advance care planning is a crucial antecedent to receiving patient-centered care at the end of life, particularly for vulnerable populations.
","abstract_html":"<p>Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice based on learnings. Lack of time and patient discomfort with end-of-life topics were identified as barriers to changing practice regarding advance care planning. Educational interventions on advance care planning for clinicians were effective and may help to increase patient access to this important component of care. Advance care planning is a crucial antecedent to receiving patient-centered care at the end of life, particularly for vulnerable populations. </p>","abstract_has_math":false,"creators":["Hubbell, Sarah A"],"institution":null,"degree_name":"Doctor of Nursing Practice (DNP)","degree_level":"Project","degree_discipline":"Nursing","degree_department":null,"school":null,"contributors":["Jo Loomis","Timothy Godfrey"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017-05-19T07:00:00Z","date_published":"2017-05-19T07:00:00Z","updated_at":"2026-07-24T05:43:52Z","subjects":["homeless persons","death","decision making","vulnerable populations","Family Practice Nursing","Nursing","Public Health and Community Nursing"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://repository.usfca.edu/dnp/93","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Jo Loomis","Timothy Godfrey"]},{"key":"dc:creator","label":"Author","values":["Hubbell, Sarah A"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2017-05-18T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Project"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Nursing Practice (DNP)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["homeless persons","death","decision making","vulnerable populations","Family Practice Nursing","Nursing","Public Health and Community Nursing"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://repository.usfca.edu/dnp/93"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice based on learnings. Lack of time and patient discomfort with end-of-life topics were identified as barriers to changing practice regarding advance care planning. Educational interventions on advance care planning for clinicians were effective and may help to increase patient access to this important component of care. Advance care planning is a crucial antecedent to receiving patient-centered care at the end of life, particularly for vulnerable populations.
"]},{"key":"dc:title","label":"Title","values":["Promotion of Advance Care Planning for Individuals Experiencing Homelessness"]}]}],"canonical_facts":{"dc:contributor":["Jo Loomis","Timothy Godfrey"],"dc:creator":["Hubbell, Sarah A"],"dc:date.available":["2017-05-18T07:00:00Z"],"dc:description.abstract":["Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet healthcare needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to discuss end-of-life preferences. A Doctor of Nursing Practice project consisted of designing, implementing, and evaluating an educational intervention in two settings for nurse practitioners and other clinicians on advance care planning with individuals experiencing homelessness. The intervention was associated with increased knowledge and confidence in advance care planning ability. Participants expressed positive intention to change individual practice based on learnings. Lack of time and patient discomfort with end-of-life topics were identified as barriers to changing practice regarding advance care planning. Educational interventions on advance care planning for clinicians were effective and may help to increase patient access to this important component of care. Advance care planning is a crucial antecedent to receiving patient-centered care at the end of life, particularly for vulnerable populations.
"],"dc:identifier":["https://repository.usfca.edu/dnp/93"],"dc:subject":["homeless persons","death","decision making","vulnerable populations","Family Practice Nursing","Nursing","Public Health and Community Nursing"],"dc:title":["Promotion of Advance Care Planning for Individuals Experiencing Homelessness"],"thesis:degree_discipline":["Nursing"],"thesis:degree_level":["Project"],"thesis:degree_name":["Doctor of Nursing Practice (DNP)"]},"updated_at":"2026-07-24T05:43:52Z"}