Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;25(4):643-649.
doi: 10.1089/jpm.2021.0451. Epub 2022 Jan 25.

Utilizing the Consolidated Framework for Implementation Research to Explore Palliative Care Program Implementation for American Indian and Alaska Natives throughout the United States

Alexander E Soltoff  1 , Mary J Isaacson  2 , Mark Stoltenberg  3   4 , Tinka Duran  5 , Leroy J R LaPlante  6 , Daniel Petereit  7   8 , Katrina Armstrong  1   4 , Bethany-Rose Daubman  3   4
Affiliations

Utilizing the Consolidated Framework for Implementation Research to Explore Palliative Care Program Implementation for American Indian and Alaska Natives throughout the United States

Alexander E Soltoff et al. J Palliat Med. 2022 Apr.

Abstract

Background: A significant shortage of palliative care (PC) services exists for American Indian and Alaska Native people (AI/ANs) across the United States. Using an implementation science framework, we interviewed key individuals associated with AI/AN-focused PC programs to explore what is needed to develop and sustain such programs. Objectives: To identify facilitators of implementation and barriers to sustainability associated with the development of PC programs designed for AI/ANs across the United States. Methods: We interviewed 12 key individuals responsible for the implementation of AI/AN-focused PC services. The Consolidated Framework for Implementation Research (CFIR) guided data coding and interpretation of themes. Results: We identified nine themes that map to CFIR constructs. Facilitators of implementation include high tension for change and respecting cultural values. Barriers to program sustainability include a lack of administrative leadership support. Discussion: AI/AN-focused PC programs should be congruent with community needs. PC program developers should focus on sustainability well before initial implementation.

Keywords: Alaska Natives; American Indians; Tribal Nations; implementation; palliative care; quality improvement.

PubMed Disclaimer

References

    1. Gebauer S, Knox Morley S, Haozous EA, et al. : Palliative care for American Indians and Alaska Natives: A review of the literature. J Palliat Med 2016;19:1331–1340. - PubMed
    1. Kelley ML: An indigenous issue: Why now? J Palliat Care 2010;26:5. - PubMed
    1. Kitzes JA, Domer T: Palliative care: An emerging issue for American Indians and Alaskan Natives. J Pain Palliat Care Pharmacother 2003;17:201–210. - PubMed
    1. Domer T, Kaur JS: Palliative practice in Indian health. S D Med 2008;Spec No.:36–40. - PubMed
    1. U.S. Department of the Interior Indian Affairs: Frequently Asked Questions. 2017. https://www.bia.gov/frequently-asked-questions (Last accessed June 30, 2021).

LinkOut - more resources