Training program to improve end-of-life care for older African Americans

African Americans (AA) Communities Speak: Partnering With AA in the North and South to Train Palliative Care Clinicians to Address Interpersonal and Systemic Racism and Provide Culturally Aligned Care.

This study is testing a training program for healthcare providers to improve end-of-life care for older African Americans by focusing on their cultural values and experiences.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 60 (estimated)
• Sex: All
• Sponsor: University of Alabama at Birmingham (other)
• Locations: 2 sites (Birmingham, Alabama and 1 other locations)
• Trial ID: NCT05908487 on ClinicalTrials.gov

What this trial studies

This initiative aims to enhance the quality of end-of-life (EoL) care for older African Americans by addressing cultural values and preferences in EoL communication. The program utilizes community-developed storytelling videos to foster empathy regarding experiences of racism in healthcare. It includes guidelines for culturally appropriate EoL care and training to recognize and manage implicit bias among clinicians. The goal is to empower healthcare providers to deliver goal-concordant care that aligns with the values of African American patients and their families.

Who should consider this trial

Good fit: Ideal candidates include African American individuals aged 60 and older with serious illnesses or bereaved family members who have lost a loved one within the last year.

Not a fit: Patients who do not identify as African American or those who are younger than 60 years may not benefit from this program.

Why it matters

Potential benefit: If successful, this program could significantly improve the quality of end-of-life care for older African Americans, ensuring their preferences and values are respected.

How similar studies have performed: Other studies have shown promise in improving EoL care through culturally tailored interventions, suggesting that this approach could be effective.

Eligibility criteria

Inclusion Criteria: Aim 1.1

Person with serious Illness:

* Self-identified as African American (i.e., born, raised, and lived primarily in the US)
* Non-Hispanic or Latino
* Age ≥60 years
* English-speaking
* Has been diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro-degenerative disease, renal disease, stroke, sepsis, hepatic disease)
* Callahan Six-Item Screener score ≥4
* Able to complete baseline surveys.

Bereaved family member:

* Self-identified as African American (i.e., born, raised, and lived primarily in the US)
* Non-Hispanic or Latino
* Age ≥60 years
* English-speaking
* Loved one dies in the last 12 months and was diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro- degenerative disease, renal disease, stroke, sepsis, hepatic disease)
* Callahan Six-Item Screener score ≥4
* Able to complete baseline surveys.

Exclusion Criteria

Person with serious illness:

-Cannot be receiving hospice care

Bereaved Family Member:

-Cannot be a paid "sitter"

Inclusion Criteria: Aim 1.2

Bereaved Family member:

* Self-identified as African American (i.e., born, raised, and lived primarily in the US)
* Non-Hispanic or Latino
* Age ≥60 years
* English-speaking
* Loved one dies in the last 12 months and was diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro- degenerative disease, renal disease, stroke, sepsis, hepatic disease)
* Callahan Six-Item Screener score ≥4
* Able to complete baseline surveys

Pastors:

* Self-identifying as African American
* White, Non-Hispanic or Latino
* Sged ≥18 years old.

Inclusion Criteria: Aim 3

Clinician eligibility:

* Practice at a University of Alabama at Birmingham (UAB) or Montefiore/Einstein site that provides care to patients eligible for outcomes surveys
* At least 3 months of clinical practice at the study site prior to the intervention training to measure pre-intervention patient surveys

Exclusion criteria:

-Lack of at least 3 months of clinical practice at the study site prior to the intervention training.

Patient eligibility:

* Self-identified as African American (i.e., born, raised, and lived primarily in the US)
* Non-Hispanic or Latino, 3. age ≥60 years
* English-speaking
* Has been diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro-degenerative disease, renal disease, stroke, sepsis, hepatic disease)
* Callahan Six-Item Screener score ≥4
* Able to complete baseline surveys.

Exclusion criteria include:

-Currently receiving hospice care.

Family member eligibility:

* Age ≥ 18 years
* English-speaking
* Community-dwelling
* Unpaid care provider of a person with a serious illness.

Exclusion criteria: 1. Cannot be a paid "sitter".

Where this trial is running

Birmingham, Alabama and 1 other locations

• UAB — Birmingham, Alabama, United States (RECRUITING)
• Albert Einstein/Montefiore — The Bronx, New York, United States (RECRUITING)

Study contacts

• Principal investigator: Jennifer Tjia, MD, MSCE — University of Massachusetts, Worcester
• Study coordinator: Ronit Elk, PhD

Conditions: Healthy Aging, Health Knowledge, Attitudes, Practice, Social Responsibility, Care Eliciting Behavior, Racism, Systemic, goal concordant care older African American CBPR end-of-life