African Americans and Decisions About Hospice Care: Implications for Health Message Design

Abstract

Despite the widespread use and acceptance of hospice care in the United States, African Americans underuse these services when faced with life-limiting illnesses. Many scholars have identified the barriers that may limit hospice enrollment and have called for the development of outreach campaigns to educate African Americans about hospice services. The design and implementation of such campaigns requires that campaign planners understand the issues that are most relevant to African American patients and families in making decisions about hospice care. This study focused on identifying such issues through a qualitative meta-ethnography. Three broad third-order themes were identified as relevant to African Americans’ decisions regarding hospice care: necessary knowledge of hospice services, the role of family members, and religious/spiritual considerations. These themes are discussed in terms of designing culturally appropriate health messages to promote informed decisions about hospice enrollment.

KEYTERMS:

• African American
• decision-making
• hospice
• message design

Acknowledgments

A version of this paper was presented at the Annual Meeting of the National Communication Association in New Orleans, LA, November 2011.

Notes

Similar to Atkins et al. (2008), it was necessary in many instances to move beyond a study's abstract because it failed to adequately describe the purpose and/or methods of the study. In each of these cases, the full text of the article was accessed to apply the inclusion/exclusion criteria.

Because they provided potentially important information regarding the focus of this analysis, studies that involved participants who did not identify as African American were also included. Studies that fell into this category were included in this analysis if they clearly attributed specific ideas and experiences to African American participants.