RPD309 - Message Matters: Efficacy Results of a Culture-Centric Palliative Care Message

Key Message : Culture-centric messages that are co-developed with American Indian communities embed cultural values, reduce barriers to palliative care acceptance, and can improve health literacy and health outcomes, ultimately enhancing quality of life for American Indians with serious illness.

Abstract: Background/Rationale: Palliative care can reduce symptom burden and improve quality of life for reservation-dwelling American Indians with serious illness. Yet knowledge about and use of palliative care among American Indians lags significantly behind whites.
Objectives/

Purpose: Our purpose was to test the efficacy of a culture-centric palliative care message among Great Plains American Indians to improve palliative care knowledge and intentions to discuss palliative care.
Methods/Approach: We conducted a randomized, complete block, posttest-only control group design. We recruited participants using Facebook, where those who consented were randomized to view either the culture-centric palliative care video message, a general message, or no message and then completed the survey. We used generalized linear models to evaluate outcome differences by message condition, controlling for reservation, age, education, and sex.

Results: N=320 American Indians completed the survey; distributions of participant characteristics were indistinct across messaging groups. Both the culture-centric (p < 0.0001) and general messages (p = 0.0001) increased palliative care knowledge compared to no message groups. Males and persons with greater than a high school education were more likely to discuss palliative care; however, none were significant. Participants viewing the culture-centric message were more likely to understand the characters and to feel the characters’ emotions in the narrative.
Conclusion/Implications: Both messages increased knowledge and intentions to communicate about palliative care compared to no message, indicating that a palliative care message matters. Embedding cultural values and ways of understanding serious illness care can break down barriers in palliative care acceptance and provide opportunities to improve quality of life for American Indians with serious illness. Future research is needed to identify effective dissemination approaches to accelerate implementation of palliative care in resource-limited rural settings and improve outcomes for American Indians.

References: 1. Johnson KS. Racial and ethnic disparities in palliative care. J Palliat Med. 2013;16(11):1329-1334. doi:10.1089/jpm.2013.9468
2. Hwang J, Shen J, Kim SJ, et al. Ten-year trends in utilization of palliative care services and life-sustaining treatments and hospital costs associated with patients with terminally lung cancer in the United States from 2005-2014. Am J Hosp Palliat Care. 2019;36(2):1105-1113. doi:https://doi.org10.1177/1049909119852082
3. Hunter KM, Johnson G, Le Beaux, Isaacson MJ. “You do what you have to do, and you don’t ask for help”: American Indian reservation community Talking Circles about barriers to palliative care. Qualitative Research Reports in Communication.1-11. doi:10.1080/17459435.2024.2425080