Community-Based Conversations about Advance Care Planning for Underserved Populations Using Lay Patient Navigators.
Background: Widespread community engagement in advance care planning (ACP) is needed to overcome barriers to ACP implementation. Objective: Develop, implement, and evaluate a model for community-based ACP in rural populations with low English language fluency and health care access using lay patient...
| Publicado en: | Journal of Palliative Medicine Vol. 23; no. 7; pp. 907 - 915 |
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| Autores principales: | , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Jul2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144345201&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 144345201 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10966218 C1U jtl: Journal of Palliative Medicine issn: 10966218 maglogo: N pubinfo: dt: Jul2020 vid: 23 iid: 7 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 144345201 144345201 144345201 10.1089/jpm.2019.0470 144345201 ppf: 907 ppct: 8 formats: tig: atl: Community-Based Conversations about Advance Care Planning for Underserved Populations Using Lay Patient Navigators. aug: au: Fink, Regina M. Kline, Danielle M. Bailey, F. Amos Handel, Daniel L. Jordan, Sarah R. Lum, Hillary D. Fischer, Stacy M. affil: Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA. sug: subj: Advance Care Planning Medically Underserved Patient Navigation Communities Conversation Human Program Evaluation Questionnaires Male Female Descriptive Statistics Implementation Science Thematic Analysis Interviews Rural Areas Urban Areas Goal-Setting Multilingualism Male Female ab: Background: Widespread community engagement in advance care planning (ACP) is needed to overcome barriers to ACP implementation. Objective: Develop, implement, and evaluate a model for community-based ACP in rural populations with low English language fluency and health care access using lay patient navigators. Design: A statewide initiative to improve ACP setting/subjects—trained in a group session approach, bilingual patient navigators facilitated 1-hour English and Spanish ACP sessions discussing concerns about choosing a surrogate decision maker and completing an advance directive (AD). Participants received bilingual informational materials, including Frequently Asked Questions, an AD in English or Spanish, and Goal Setting worksheet. Measurement: Participants completed a program evaluation and 4-item ACP Engagement Survey (ACP-4) postsession. Results: For 18 months, 74 ACP sessions engaged 1034 participants in urban, rural, and frontier areas of the state; 39% were ethnically diverse, 69% female. A nurse or physician co-facilitated 49% of sessions. Forty-seven percent of participants completed an ACP-4 with 29% planning to name a decision maker in the next 6 months and 21% in the next 30 days; 31% were ready to complete an AD in the next 6 months and 22% in the next 30 days. Evaluations showed 98% were satisfied with sessions. Thematic analysis of interviews with facilitators highlighted barriers to delivering an ACP community-based initiative, strategies used to build community buy-in and engagement, and ways success was measured. Conclusion: Patient navigators effectively engaged underserved and ethnically diverse rural populations in community-based settings. This model can be adapted to improve ACP in other underserved populations. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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