Background: The number of Asian older adults, potentially at risk for chronic/advanced illness, is expected to increase by 145% nationally, presenting major challenges to providing culturally sensitive care and eliminating healthcare disparities, particularly in palliative care (PC) and advance care planning (ACP). Asians are less likely to access PC, are less knowledgeable about ACP, and report receiving poorer quality PC. Barriers include lack of interpreters and community outreach. As Nevada’s Asian population has more than doubled over the past 15 years, the team’s project will focus on engaging Asian communities in PC and ACP in Nevada.
Objectives: The aims are to develop and disseminate culturally appropriate PC education that is relevant to Asian seniors (patients) and families, and disseminating best practices/current evidence to Asian community healthcare providers who can guide patients and families. The long-term objectives are to develop community stakeholder partnerships/infrastructure to increase awareness and informed decision making regarding PC and ACP and to provide individuals and families with the evidence they need to make better-informed healthcare decisions regarding PC and ACP in the Asian community in Nevada.
Activities: Using interviews, questionnaires, and roundtable discussions, specific needs and cultural perspectives on PC and ACP will be identified and applied to inform the adaptation/development of an educational program in multiple Asian languages. Community advocates will be recruited and trained from each of the predominant Asian communities (Chinese, Filipino, Korean, and Vietnamese). An educational program focused on best practices/current evidence on the benefits of PC will be offered to providers in the Asian community. Other activities include integration of culturally appropriate PC education through health fairs, senior community programs, and faith-based meetings.
Outcomes: The project’s goals include development of a learning community with a common agenda related to determining disparities in perception and attitudes of PC; adapting effective and culturally appropriate approaches for engaging Asian communities; developing culturally appropriate PC/ACP training curricula; and disseminating evidence-based findings on PC. Deliverables include culturally appropriate materials in the four languages and engagement activities through community health fairs, roundtable discussions, faith-based senior gatherings, and local Asian media publications. The ability of Asian community members to make better-informed decisions on PC and ACP and increased Asian providers’ referral to PC and ACP are the anticipated long-term outcomes.
Engagement Plan: Patients/stakeholders include Asian seniors, families, community leaders, and healthcare providers. Engagement will occur through the Asian Community Development Center events and Asian healthcare provider organizations. Representatives will serve on a steering committee and meet monthly to develop a common agenda, facilitate the adaptation of culturally appropriate educational approaches, and identify needs of and barriers to PC access and ACP. An advisory council consisting of patient/caregiver and other stakeholders will meet two to four times a year and help design/implement the project. Community advocates will work on participant recruitment, language translation, and dissemination.
Project Collaborators: UNLV educators, the Asian Community Development Council the Korean American Medical Association, the Philippine Nurses Association, and healthcare providers who work with the Asian community.
Project Resource: Advanced Care Planning in the Asian Community Workbook