Advance Care Planning With Black Women with Breast Cancer: A Community Health Worker Model

Authors: Marcia M Tan, Dario M Villamar, Clarissa Huard, Lian Nicholson, Heidy N Medina, Patricia I Moreno

This study sought to examine multilevel facilitators and barriers to successful advance care planning (ACP) conversations among Black women from the perspective of providers and CHWs who serve this community. Providers and CHWs were recruited from an academic medical center in a large urban city, and focus groups and interviews were conducted on barriers and facilitators to ACP conversations. Subsequent results showed that all providers working primarily with Black patients identified stigma and time constraints as major barriers to ACP discussions. In conjunction, CHWs reported having a trusted relationship with their patients and flexibility in their care that would allow for ongoing ACP conversations, noting their ability to serve as a bridge between the patient and provider. These findings suggest that CHWs are uniquely qualified to overcome multilevel barriers to ACP and establish trusting relationships with patients in order to facilitate earlier and ongoing communication between patients and providers.