African American Communities Speak to Clinician 1. Program Creation and Implementation Feasibility

Abstract

Context: Lack of appreciation of cultural differences compromises care for seriously ill African American patients, yet training programs for clinicians in providing culturally appropriate care is lacking. The goals of this study were to partner with a southern, African American community to create a training program for clinicians on how to communicate in a culturally congruent and respectful way with older southern, African Americans with serious illness and at end of life, and test program delivery feasibility.

Methods: Community Based Participatory Research guided the equitable partnership with the Community Advisory Board (CAB), the creation and implementation of two focus groups and the training videos created by the CAB The videos were incorporated into a training program based on Kolb's Adult-based Learning Theory, and Donabedian's model was used to determine program delivery feasibility.

Results: The CAB guided the study, and based on focus group feedback on cultural values and lived experiences, developed four videos, each highlighting a key message for clinicians- cultural, religious, and demand for equal care. These were ensconced within the training model, and a facilitation guide created for the three-hour training. Two pilot training sessions were held, with high rate of clinician attendance. Three months post-training clinicians reported a high rate of adhering to the community recommendations.

Conclusion: The first training program developed by African American community members for clinicians was feasible to implement and demonstrated moving participants from a defensive posture to one of recognizing systemic injustice within healthcare systems, and changing practice through empowerment and advocacy.

Keywords: African American; clinician training; community-recommendations; health equity; practice change; serious illness.