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Considerations for Fostering Palliative Care Awareness in Developing Contexts: Strategies From Locally Initiated
Nainwant Singh1, Karleen F Giannitrapani1, Aanchal Satija2
1Division of Primary Care and Population Health (N.S., K.F.G., T.H., K.A.L.), Stanford University School of Medicine, Palo Alto, California, USA; VA HS R&D Center for Innovation to Implementation (Ci2i) (N.S. K.F.G., R.G., K.A.L.), Menlo Park, California, USA.
Context:
Lack of palliative care (PC) awareness is a barrier to its utilization in developing contexts.
Objectives:
To identify and understand strategies that changed awareness of the concepts and value of palliative care in a multi-site quality improvement project in India.
Methods:
The Palliative Care - Promoting Assessment and Improvement of the Cancer Experience (PC-PAICE) evaluation team conducted 44 semi-structured interviews with clinician and organization stakeholders at seven geographically dispersed sites. We used inductive and deductive approaches in this secondary analysis to identify emerging themes.
Results:
We identified the following strategies to improve awareness of concepts and value of palliative care. Strategy 1: Educate medical trainees, staff, and the community about palliative care and its concepts. Sub-strategies: Participate in community events. Integrate PC concepts into early medical education. Standardize training for practitioners. Strategy 2: Design and disseminate India-specific research to reinforce awareness of the value of palliative care. Sub-strategies: Publish and use India-specific palliative care research. Strategy 3: Facilitate communication between providers and departments to improve awareness of palliative care services and its concepts. Sub-strategies: Create referral frameworks and network with providers referring to palliative care to change awareness of available services and palliative care concepts.
Conclusion:
To increase palliative care utilization, program development can include community and provider-focused efforts on awareness of the concepts and value of palliative care. These three strategies held salience across sites representing diverse Indian geographic and cultural settings; as such, they may be applicable to other contexts.
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