Latino health disparities are prevalent in end-of-life (EoL) care and are associated with negative patient outcomes, including Latino patients being less likely than non-Latino patients to engage in advance care planning (ACP). To improve engagement in ACP among Latino cancer patients (which has been shown to reduce EOL care disparities), it is critical to find effective strategies for allowing individuals’ to work within their belief system to accept their medical realities. One way to do this is to develop an intervention designed to help patients and their family caregivers reframe their beliefs in a way that allows patients to accept their medical realities and engage in ACP while also maintaining their beliefs. “Reframe” is here defined as: “to look at, present, or think of (beliefs) in a new or different way.” The goal of this Pre-Career Award is to develop a reframing intervention designed to aide Latino advanced cancer patients in thinking of their beliefs in a way that also allows them to accept (and/or plan for) their medical realities of dying. A mixed-methods approach will be used in conjunction with a recently funded R01 (R01 MD007652-01A1) designed to assess Latino/non-Latino disparities in ACP and EOL care. First, we explore how beliefs might be reframed to be compatible with Latino cancer patients’ and caregivers’ beliefs about ACP through assessments about beliefs and semi-structured interviews with Latino stakeholders. Second, we will design potential reframing interventions (utilizing feedback from patients, caregivers, and key stakeholders) designed to reduce Latino/non-Latino EoL care disparities.
Megan Shen, PhD
Department of Medicine Pre-Career Award