TY - JOUR
T1 - Community Tele-pal
T2 - A community-developed, culturally based palliative care tele-consult randomized controlled trial for African American and White Rural southern elders with a life-limiting illness
AU - Watts, Kristen Allen
AU - Gazaway, Shena
AU - Malone, Emily
AU - Elk, Ronit
AU - Tucker, Rodney
AU - McCammon, Susan
AU - Goldhagen, Michele
AU - Graham, Jacob
AU - Tassin, Veronica
AU - Hauser, Joshua
AU - Rhoades, Sidney
AU - Kagawa-Singer, Marjorie
AU - Wallace, Eric
AU - McElligott, James
AU - Kennedy, Richard
AU - Bakitas, Marie
N1 - Publisher Copyright:
© 2020 The Author(s).
PY - 2020/7/23
Y1 - 2020/7/23
N2 - Background: Patients living in rural areas experience a variety of unmet needs that result in healthcare disparities. The triple threat of rural geography, racial inequities, and older age hinders access to high-quality palliative care (PC) for a significant proportion of Americans. Rural patients with life-limiting illness are at risk of not receiving appropriate palliative care due to a limited specialty workforce, long distances to treatment centers, and limited PC clinical expertise. Although culture strongly influences people's response to diagnosis, illness, and treatment preferences, culturally based care models are not currently available for most seriously ill rural patients and their family caregivers. The purpose of this randomized clinical trial (RCT) is to compare a culturally based tele-consult program (that was developed by and for the rural southern African American (AA) and White (W) population) to usual hospital care to determine the impact on symptom burden (primary outcome) and patient and care partner quality of life (QOL), care partner burden, and resource use post-discharge (secondary outcomes) in hospitalized AA and White older adults with a life-limiting illness. Methods: Community Tele-pal is a three-site RCT that will test the efficacy of a community-developed, culturally based PC tele-consult program for hospitalized rural AA and W older adults with life-limiting illnesses (n = 352) and a care partner. Half of the participants (n = 176) and a care partner (n = 176) will be randomized to receive the culturally based palliative care consult. The other half of the patient participants (n = 176) and care partners (n = 176) will receive usual hospital care appropriate to their illness. Discussion: This is the first community-developed, culturally based PC tele-consult program for rural southern AA and W populations. If effective, the tele-consult palliative program and methods will serve as a model for future culturally based PC programs that can reduce patients' symptoms and care partner burden.
AB - Background: Patients living in rural areas experience a variety of unmet needs that result in healthcare disparities. The triple threat of rural geography, racial inequities, and older age hinders access to high-quality palliative care (PC) for a significant proportion of Americans. Rural patients with life-limiting illness are at risk of not receiving appropriate palliative care due to a limited specialty workforce, long distances to treatment centers, and limited PC clinical expertise. Although culture strongly influences people's response to diagnosis, illness, and treatment preferences, culturally based care models are not currently available for most seriously ill rural patients and their family caregivers. The purpose of this randomized clinical trial (RCT) is to compare a culturally based tele-consult program (that was developed by and for the rural southern African American (AA) and White (W) population) to usual hospital care to determine the impact on symptom burden (primary outcome) and patient and care partner quality of life (QOL), care partner burden, and resource use post-discharge (secondary outcomes) in hospitalized AA and White older adults with a life-limiting illness. Methods: Community Tele-pal is a three-site RCT that will test the efficacy of a community-developed, culturally based PC tele-consult program for hospitalized rural AA and W older adults with life-limiting illnesses (n = 352) and a care partner. Half of the participants (n = 176) and a care partner (n = 176) will be randomized to receive the culturally based palliative care consult. The other half of the patient participants (n = 176) and care partners (n = 176) will receive usual hospital care appropriate to their illness. Discussion: This is the first community-developed, culturally based PC tele-consult program for rural southern AA and W populations. If effective, the tele-consult palliative program and methods will serve as a model for future culturally based PC programs that can reduce patients' symptoms and care partner burden.
KW - African Americans
KW - Community-based participatory research
KW - Culturally based
KW - Palliative care
KW - Rural hospitals
KW - Tele-consultation
KW - Tele-health
KW - Whites
UR - http://www.scopus.com/inward/record.url?scp=85088534381&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088534381&partnerID=8YFLogxK
U2 - 10.1186/s13063-020-04567-w
DO - 10.1186/s13063-020-04567-w
M3 - Article
C2 - 32703245
AN - SCOPUS:85088534381
SN - 1745-6215
VL - 21
JO - Trials
JF - Trials
IS - 1
M1 - 672
ER -