Implementation Barriers and Recommendations for a Multisite Community Health Worker Intervention in Palliative Care for African American Oncology Patients: A Qualitative Study.
Background: Palliative care remains underutilized by African American patients with advanced cancer. Community health workers (CHWs) may help improve palliative care outcomes among this patient population. Objectives: To explore barriers to success of a proposed CHW intervention and synthesize desig...
| Publicado en: | Journal of Palliative Medicine Vol. 27; no. 9; pp. 1125 - 1135 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2024
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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=179713999&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 179713999 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10966218 C1U jtl: Journal of Palliative Medicine issn: 10966218 maglogo: N pubinfo: dt: Sep2024 vid: 27 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 179713999 179713999 179713999 10.1089/jpm.2023.0703 179713999 ppf: 1125 ppct: 10 formats: tig: atl: Implementation Barriers and Recommendations for a Multisite Community Health Worker Intervention in Palliative Care for African American Oncology Patients: A Qualitative Study. aug: au: Woods, Alison P. Monton, Olivia Fuller, Shannon M. Siddiqi, Amn Errichetti, Cheryl Lyn Masroor, Taleaa Joyner Jr., Robert L. Elk, Ronit Owczarzak, Jill Johnston, Fabian M. affil: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. sug: subj: Neoplasms Therapy Palliative Care Methods Community Health Workers African Americans Psychosocial Factors Cancer Patients Psychosocial Factors Implementation Science Health Services Accessibility Evaluation Healthcare Disparities Evaluation Attitude of Health Personnel Evaluation Human Male Female Adult Middle Age Qualitative Studies Semi-Structured Interview Purposive Sample Alabama Maryland Program Implementation Models, Theoretical Conceptual Framework Thematic Analysis Health Knowledge Workflow Data Analysis Software Descriptive Statistics Funding Source Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: Palliative care remains underutilized by African American patients with advanced cancer. Community health workers (CHWs) may help improve palliative care outcomes among this patient population. Objectives: To explore barriers to success of a proposed CHW intervention and synthesize design and implementation recommendations to both optimize our intervention and inform others working to alleviate palliative care disparities. Design: Semi-structured qualitative interviews. Setting/Subjects: Key informants were health care professionals across clinical, leadership, and community health fields. Participants were recruited through purposive sampling from Baltimore, Maryland; Birmingham, Alabama; and Salisbury, Maryland. Measurements: Interviewers used an interview guide grounded in established implementation science models. Data were analyzed through a combined abductive/deductive approach by independent coders. A framework methodology was used to facilitate thematic analysis. Results: In total, 25 professionals completed an interview. Key informants discussed multiple barriers, including at the patient level (lack of knowledge), clinician and facility level (decreased workflow efficiency), and health system level (limited funding). Recommendations related to the intervention's design included high quality preintervention CHW training and full integration of CHWs into the care team to "bridge" divides between outpatient, inpatient, and at-home settings. Intervention delivery recommendations included clearly defining care team roles and balancing flexibility and standardization in CHW support approaches. These recommendations were then used to adapt the planned intervention and its implementation process. Conclusions: Clinicians, cancer center leaders, and CHWs identified multilevel potential barriers to the intervention's success but also described recommendations that may mitigate these barriers. Key informant input represents an important step prior to initiating CHW-based interventions. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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