Culturally Adapting an Advance Care Planning Communication Intervention With American Indian and Alaska Native People in Primary Care.
Kate M Lillie, Lisa G Dirks, J Randall Curtis and 3 others
PMID 31258037WHAT IT FOUND
Participants asked for plain words, questions about culture, and who should be involved in advance care planning conversations with American Indian and Alaska Native patients.
Cognitive interview participants found the adapted tool clear, but whether it improves conversations was not tested.
Key findings
01Focus group participants asked for simpler language, an 'I don't know' option, questions about culture, and questions about who should be involved in advance care planning conversations.
0210 patients or caregivers completed cognitive interviews and found the revised tool clear, understandable, and easy to follow, with suggestions to shorten wording and add open-ended responses.
03Thirty-five people enrolled, including 19 patients or caregivers and 16 health professionals.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a development and acceptability study, not a test of whether the adapted tool improves advance care planning conversations or patient outcomes. Data came from urban Indian health care systems in Alaska and New Mexico, so rural American Indian and Alaska Native communities may not be represented. The sample was small (Thirty-five people, including 19 patients or caregivers and 16 health professionals), and only 10 patients or caregivers tested the revised tool. The study included providers and administrators as well as patients and caregivers, so patient and family preferences may be blended with professional views.
Declared interests
The supplied text does not state a conflict-of-interest declaration. The publication types note NIH extramural research support.
The easy way to misread this
Do not read this as evidence that the adapted advance care planning tool improves conversations or patient outcomes. The study tested adaptation and acceptability, and the authors say effectiveness will be evaluated in the next phase.