Adapting Advance Care Planning Interventions for Hispanic Communities Across the U.S.

Context: Health inequities in Hispanic populations require community-engaged solutions. Engaging Hispanic communities in research related to advance care planning (ACP) is critical to inform the development and evaluation of culturally appropriate interventions. Objectives: To understand how to best...

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Publicado en:American Journal of Hospice & Palliative Medicine Vol. 42; no. 12; pp. 1290 - 1298
Autores principales: Costigan, Heather J., VanDyke, Erika, Calo, William A., Tucci, Amy, Van Scoy, Lauren J.
Formato: pictorial research tables/charts Journal Article
Publicado: Sage Publications Inc. Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
      vid: 42
      iid: 12
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Adapting Advance Care Planning Interventions for Hispanic Communities Across the U.S.
      aug:
        au:
          Costigan, Heather J.
          VanDyke, Erika
          Calo, William A.
          Tucci, Amy
          Van Scoy, Lauren J.
        affil: Penn State College of Medicine, Hershey, PA, USA
      sug:
        subj:
          Advance Care Planning
          Hispanic Americans United States
          Spanish Language
          Program Implementation
          Implementation Science
          Human
          Funding Source
          United States
          Medical Practice, Evidence-Based
          Semi-Structured Interview
          Thematic Analysis
          Interpreter Services
          Health Inequities
          Culture
          Social Norms
          Communication Barriers
          Research Subjects
          Multilingualism
          Models, Theoretical
          Community Health Services
          Descriptive Statistics
          Qualitative Studies
          Data Analysis Software
          Interrater Reliability
          Nomenclature
          Trust
          Health Status Disparities
          Healthcare Disparities
          Advance Directives
      ab: Context: Health inequities in Hispanic populations require community-engaged solutions. Engaging Hispanic communities in research related to advance care planning (ACP) is critical to inform the development and evaluation of culturally appropriate interventions. Objectives: To understand how to best adapt and implement Spanish-language ACP interventions in Hispanic communities across the US. Methods: We apply the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions (FRAME) to detail experiences during implementation of the national Project Talk Trial (PTT) that delivers two ACP interventions using a community-based delivery model. Semi-structured interviews with Hispanic community event hosts and research assistants (RAs) were conducted to explore challenges and solutions to implementation. Thematic analysis was applied to transcripts. Results: Three themes from the community hosts (n = 9) were: (1) certified translation professional services were inadequate to successfully adapt interventions for diverse Hispanic communities; (2) a lack of Spanish-speaking RAs undermined the intention to address health inequities in the research; and (3) cultural norms, such as RSVP systems, differ in Hispanic populations. Themes from the RA interviews (n = 7) include: (1) discomfort with being unable to communicate appropriately with the research participants; and (2) improved connection and event flow when bilingual RAs attended events. Conclusion: Our work highlights the value of a strong community-based delivery model, attention to local dialects and cultural nuances, the need for Spanish-speaking workforce and for balancing fidelity across national sites with adaptability when conducting rigorous research. Trial registered: The trial titled "Engaging underserved communities in end-of-life conversations: a cluster, randomized controlled trial" is registered at clinicaltrials.gov [NCT04612738].
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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