Hospice Access and Use by African Americans: Addressing Cultural and Institutional Barriers through Participatory Action Research

This article describes a participatory action research project addressing the problem of African American access to and use of hospice. Qualitative interviews conducted with six African American pastors resulted in the identification of major themes used for development of a scale to measure barrier...

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Bibliographic Details
Published in:	Social work (New York) Vol. 44; no. 6; pp. 549 - 559
Main Authors:	Reese, Dona J., Ahern, Robin E., Nair, Shankar, O'Faire, Joleen D., Warren, Claudia
Format:	Journal Article
Language:	English
Published:	United States Oxford University Press 01-11-1999 National Association of Social Workers
Subjects:	Access Action Research African American Attitudes African American culture African American studies African Americans African Americans - psychology Barriers Beliefs Black American people Black communities Black people Black White Differences Blacks Care and treatment Caregivers Caseworker Approach Churches Communication Barriers Communities Comparative analysis Constraints Cultural aspects Cultural Diversity Culture Death diversity Economic Factors Evaluation Health aspects Health Care Utilization Health Services Health Services Accessibility hospice Hospice care Hospice Care - utilization Hospices Hospices (Terminal Care) Humans Institutional aspects Literature Reviews Medical care Medical sector Medical Services Organizational Policy Pastors Patient Advocacy Patient Participation Patients Philosophy Physicians Referral Research Projects Social Action Social service Social work Social workers Sociocultural Factors spirituality State Policy strengths perspective Terminal care Terminally ill United States USA White people Whites Work with Blacks United States diversity action research hospice spirituality strengths perspective
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Summary:	This article describes a participatory action research project addressing the problem of African American access to and use of hospice. Qualitative interviews conducted with six African American pastors resulted in the identification of major themes used for development of a scale to measure barriers to hospice. A subsequent quantitative study documenting these barriers was conducted with 127 African Americans and European Americans. Results of both studies, which were used to further social action efforts in the community, indicated the cultural barriers of differences in values regarding medical care and differences in spiritual beliefs between African Americans and European Americans. Results also indicated institutional barriers, including lack of knowledge of services, economic factors, lack of trust by African Americans in the health care system, and lack of diversity among health care staff. Implications for social work practice and policy are discussed.
Bibliography:	ark:/67375/HXZ-RK1QNP7B-1 istex:93968949D56440DEC7109EA2F513108E9875BF75 The authors thank the residents of the city of Champaign, IL; Professor Ruppert Downing, the University of Illinois School of Social Work, Urbana-Champaign; Marion Keenan and Lynn Conboy of Coastal Hospice in Salisbury, MD; Ruth Madawick and Martha Cooper of Covenant Hospice in Champaign, IL; Vivian Granger of Grady Hospice in Atlanta, GA; Rev. W.B. Keaton of the Ministerial Alliance in Champaign; Pastor Ronald Baker of the Jericho Missionary Baptist Church in Urbana, IL; Rev. Ronald Brown of the St. Luke CME Church in Champaign, IL; Rev. Ben Elton Cox, Sr., of the Alternative School in Jackson, TN; Rev. Claude E. Shelby of the Salem Baptist Church in Champaign; Janet Ward of Sinai Hospice in Baltimore; Rev. Roger Jenks of the University Place Christian Church in Champaign; Gladys Turner and Kathy Hayes of the VA Hospice in Dayton, OH; and Darla Krom, Petra Clemens, and the Department of Social Work, University of North Dakota, Grand Forks, for their support and participation in this project. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 ObjectType-Feature-3 ObjectType-Review-1
ISSN:	0037-8046 1545-6846
DOI:	10.1093/sw/44.6.549