Strategies to Engage Diverse Population in Home-Based Palliative Care: A Qualitative Study in Hawaii

Area of Science:

• Palliative Care Research
• Health Equity Studies
• Cultural Competency in Healthcare

Background:

• Racial and cultural disparities in palliative care access are well-documented.
• Home-based palliative care programs are expanding globally.
• Understanding barriers for diverse populations is critical for equitable access.

Purpose of the Study:

• Identify barriers to enrolling diverse patients in home-based palliative care.
• Elicit successful strategies for engaging diverse populations.
• Determine best practices for communicating palliative care benefits.

Main Methods:

• Qualitative study utilizing nine focus groups with home-based palliative care agency staff in Hawaii.
• Interviews conducted via video conferencing and audio recorded.
• Thematic analysis to identify challenges and best practices in engaging minority populations.

Main Results:

• Key barriers include perceptions of 'giving up,' lack of knowledge, cultural values, language, and healthcare accessibility issues.
• Facilitators include community leader involvement, patient/family-centered care, trust-building, and continuity.
• Recommendations emphasize multilingual staff/materials and in-person discussions, involving families in decision-making.

Conclusions:

• Cultural factors significantly impact palliative care provision.
• Culturally sensitive, patient-centered approaches are essential for hospice and palliative care.
• Addressing diverse needs enhances equitable access to palliative care services.