African Americans are less likely to receive quality end-of-life (EoL) care. Addressing disparities in EoL care will need efforts to support a better understanding of African American patients' EoL cultural values and preferences for EoL communication and the impact of historical and ongoing care delivery inequities in healthcare settings.
Our proposed "Caring for Older African Americans" training program is designed to empower clinicians to improve goal-concordant EoL care delivery by using community-developed storytelling videos to create empathy with experiences of racism in EoL care, guidelines for culturally concordant EoL care delivery, and an implicit bias recognition and management training to mitigate bias in goals of care communication.
Self-identified as African American (i.e., born, raised, and lived primarily in the US)
Non-Hispanic or Latino
Age ≥60 years
English-speaking
Self-identified as African American (i.e., born, raised, and lived primarily in the US)
Non-Hispanic or Latino
Age ≥60 years
English-speaking
Parallel
AA Communities Speak to Healthcare Professionals
BehavioralThe training program is designed to empower clinicians to improve goal-concordant EoL care delivery by using community-developed storytelling videos to create empathy with experiences of racism in EoL care, guidelines for culturally concordant EoL care delivery, and implicit bias recognition and management training to mitigate bias in goals of care communication.
Human Connection Scale (patient/family reported)
The Human Connection (THC) Scale is a summary score of item responses such that a higher total score indicates greater therapeutic alliance. Possible scores range from 16 to 64. The 16-item THC scale had a high degree of internal consistency (Cronbach α= 90).
Human Connection Scale (patient/ family reported)
The Human Connection (THC) Scale is a summary score of item responses such that a higher total score indicates greater therapeutic alliance. Possible scores range from 16 to 64. The 16-item THC scale had a high degree of internal consistency (Cronbach α= 90).
Goal Concordant Care (patient/family reported)
Goal Concordant Care will be measured based on responses to the following two questions, each with a dichotomous outcome: 1. Family member reports that the patient's end-of-life wishes were adequately discussed with the family respondent 2. Family member's satisfaction that patient's end-of-life were met. Johnson, S.B., Butow, P.N., Bell, M.L. et al. A randomized controlled trial of an advance care planning intervention for patients with incurable cancer. Br J Cancer 119, 1182-1190 (2018). https://doi.org.10.1038/s41416-018-0303-7
Goal Concordant Care (patient/family reported)
Goal Concordant Care will be measured based on responses to the following two questions, each with a dichotomous outcome: 1. Family member reports that the patient's end-of-life wishes were adequately discussed with the family respondent 2. Family member's satisfaction that patient's end-of-life were met. Johnson, S.B., Butow, P.N., Bell, M.L. et al. A randomized controlled trial of an advance care planning intervention for patients with incurable cancer. Br J Cancer 119, 1182-1190 (2018). https://doi.org.10.1038/s41416-018-0303-7
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University of Alabama at Birmingham
Lead sponsor
Montefiore Medical Center
Collaborator
University of Massachusetts, Worcester
Collaborator
National Institute on Aging (NIA)
Collaborator
Hospice of Henderson County, Inc.
Collaborator
