Community-Based Conversations about Advance Care Planning for Underserved Populations Using Lay Patient Navigators

Area of Science:

• Public Health
• Health Disparities
• Community Health

Background:

• Widespread community engagement is crucial for effective advance care planning (ACP).
• Barriers in rural populations, including limited English proficiency and healthcare access, hinder ACP implementation.
• Lay patient navigators can bridge these gaps in underserved communities.

Purpose of the Study:

• To develop, implement, and evaluate a community-based ACP model for rural populations.
• To address low English language fluency and healthcare access challenges.
• To utilize bilingual lay patient navigators to facilitate ACP.

Main Methods:

• A statewide initiative trained bilingual patient navigators to facilitate group ACP sessions.
• Sessions covered surrogate decision-making and advance directive (AD) completion, providing bilingual materials.
• Participant engagement was measured via an ACP Engagement Survey (ACP-4) and program evaluations.

Main Results:

• 74 ACP sessions engaged 1034 diverse participants over 18 months.
• Post-session, 29% planned to name a decision-maker and 22% were ready to complete an AD within 30 days.
• 98% of participants were satisfied, and patient navigators effectively engaged underserved rural populations.

Conclusions:

• Community-based ACP models utilizing lay patient navigators are effective in engaging underserved populations.
• This approach can improve advance care planning and be adapted for other diverse groups.
• Patient navigators successfully facilitated ACP discussions and material completion in community settings.