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Theory-driven role model stories improve palliative care knowledge among a diverse older population

Published online by Cambridge University Press:  02 June 2020

Deborah F. Hoe Open the ORCID record for Deborah F. Hoe [Opens in a new window] ,
Kayla Johari ,
Anna Rahman  and
Susan Enguidanos
Deborah F. Hoe*
Affiliation:
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
Kayla Johari
Affiliation:
Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA
Anna Rahman
Affiliation:
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
Susan Enguidanos
Affiliation:
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
*
Author for correspondence: Deborah F. Hoe, University of Southern California, Leonard Davis School of Gerontology, 3715 McClintock Avenue, Los Angeles, CA 90089, USA. E-mail: [email protected]
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Abstract

Objective

To test the effectiveness of theoretically driven role model video stories in improving knowledge of palliative care among a diverse sample of older adults.

Method

We developed three 3–4 min long theoretically driven role model video stories. We then recruited cognitively intact, English-speaking adults aged 50 and older from senior centers, assisted living, and other community-based sites in the greater Los Angeles area. Using a pretest–posttest study design, we surveyed participants using the 13-item Palliative Care Knowledge Scale (PaCKS) and also asked participants about their intentions to enroll in palliative care should the need arise. Participants first completed the pretest, viewed the three videos, then completed the posttest comprised of the same set of questions.

Results

PaCKS score improved from an average of 4.5 at baseline to 10.0 following video screening (t(126) = 12.0, p < 0.001). Intentions to enroll oneself or a family member in palliative care rose by 103% (χ2 = 7.8, p < 0.01) and 110% (χ2 = 7.5, p < 0.01), respectively. Regression analysis revealed that participants who believed the role models are real people (β = 2.6, SE = 1.2, p < 0.05) significantly predicted higher change in PaCKS score. Conversely, participants with prior knowledge of, or experience with, palliative care (β = −5.9, SE = 0.8, p < 0.001), non-whites (β = −3.6, SE = 0.9, p < 0.001), and widows (β = −2.9, SE = 1.1, p < 0.01) significantly predicted lower changes in PaCKS score.

Significance of results

This study suggests that theoretically driven role model video stories may be an effective strategy to improve palliative care knowledge. Role model video stories of diverse palliative care patients provide one way to mitigate health literacy barriers to palliative care knowledge.

Keywords

Health literacyOlder adultsPalliative carePalliative care knowledge
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 1 , February 2021 , pp. 34 - 40
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

REFERENCES

Ajzen, I and Fishbein, M (1980) Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Aldridge, MD, Hasselaar, J, Garralda, E, et al. (2016) Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliative Medicine 30(3), 224–239.CrossRefGoogle ScholarPubMed
Bandura, A (1977) Social Learning Theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Bekker, HL, Winterbottom, AE, Butow, P, et al. (2013) Do personal stories make patient decision aids more effective? A critical review of theory and evidence. BMC Medical Informatics and Decision Making 13(2), S9.CrossRefGoogle ScholarPubMed
Berkley-Patton, J, Goggin, K, Liston, R, et al. (2009) Adapting effective narrative-based HIV-prevention interventions to increase minorities’ engagement in HIV/AIDS services. Health Communication 24(3), 199–209.CrossRefGoogle ScholarPubMed
Bokhour, BG, Fix, GM, Gordon, HS, et al. (2016) Can stories influence African-American patients’ intentions to change hypertension management behaviors? A randomized control trial. Patient Education and Counseling 99(9), 1482–1488.CrossRefGoogle ScholarPubMed
Bradley, CT, Webb, TP, Schmitz, CC, et al. (2010) Structured teaching versus experiential learning of palliative care for surgical residents. The American Journal of Surgery 200(4), 542–547.CrossRefGoogle ScholarPubMed
Center to Advance Palliative Care (2011) 2011 Public Opinion Research on Palliative Care: A Report Based on Research by Public Opinion Strategies. New York: Center to Advance Palliative Care.Google Scholar
Corby, NH, Enguídanos, SM and Kay, LS (1996) Development and use of role model stories in a community level HIV risk reduction intervention. Public Health Reports 111(Suppl 1), 54.Google Scholar
Cunningham, C, Travers, K, Chapman, R, et al. (2016) Palliative Care in the Outpatient Setting: A Comparative Effectiveness Report. Retrieved from: https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101704627-pdf.Google Scholar
Davis, MP, Temel, JS, Balboni, T, et al. (2015) A review of the trials which examine early integration of outpatient and home palliative care for patients with serious illnesses. Annals of Palliative Medicine 4(3), 99–121.Google ScholarPubMed
Enguidanos, S, Kogan, AC, Lorenz, K, et al. (2011) Use of role model stories to overcome barriers to hospice among African Americans. Journal of Palliative Medicine 14(2), 161–168.CrossRefGoogle ScholarPubMed
Gade, G, Venohr, I, Conner, D, et al. (2008) Impact of an inpatient palliative care team: A randomized controlled trial. Journal of Palliative Medicine 11(2), 180–190.CrossRefGoogle Scholar
Gardner, DS, Doherty, M, Bates, G, et al. (2018) Racial and ethnic disparities in palliative care: A systematic scoping review. Families in Society 99(4), 301–316.CrossRefGoogle Scholar
Goddu, AP, Raffel, KE and Peek, ME (2015) A story of change: The influence of narrative on African-Americans with diabetes. Patient Education and Counseling 98(8), 1017–1024.CrossRefGoogle ScholarPubMed
Guo, PJ, Kim, J and Rubin, R (2014) How video production affects student engagement: An empirical study of MOOC videos. Paper presented at the Proceedings of the First ACM Conference on Learning@ Scale Conference, March 4–5, 2014, Atlanta, Georgia, USA.CrossRefGoogle Scholar
King, W, Nu'Man, J, Fuller, TR, et al. (2008) The diffusion of a community-level HIV intervention for women: Lessons learned and best practices. Journal of Women's Health 17(7), 1055–1066.CrossRefGoogle ScholarPubMed
Kozlov, E, Carpenter, BD and Rodebaugh, TL (2017) Development and validation of the palliative care knowledge scale (PaCKS). Palliative and Supportive Care 15(5), 524–534.CrossRefGoogle Scholar
Liu, M, Cardenas, V, Zhu, Y and Enguidanos, S (2019) YouTube videos as a source of palliative care education: A review. Journal of Palliative Medicine 22(12), 1568–1573.CrossRefGoogle ScholarPubMed
LoPresti, MA, Dement, F and Gold, HT (2016) End-of-life care for people with cancer from ethnic minority groups: A systematic review. American Journal of Hospice and Palliative Medicine 33(3), 291–305.CrossRefGoogle ScholarPubMed
Morrison, RS, Augustin, R, Souvanna, P, et al. (2011) America's care of serious illness: A state-by-state report card on access to palliative care in our nation's hospitals. Journal of Palliative Medicine 14(10), 1094–1096. doi:10.1089/jpm.2011.9634CrossRefGoogle ScholarPubMed
Murphy, ST, Frank, LB, Chatterjee, JS, et al. (2013) Narrative versus nonnarrative: The role of identification, transportation, and emotion in reducing health disparities. Journal of Communication 63(1), 116–137.CrossRefGoogle Scholar
Perrin, A and Anderson, M (2019) Share of U.S. Adults Using Social Media, Including Facebook, Is Mostly Unchanged Since 2018. Washington, DC. Retrieved from: https://www.pewresearch.org/fact-tank/2019/04/10/share-of-u-s-adults…ing-social-media-including-facebook-is-mostly-unchanged-since-2018/.Google Scholar
Pew Reseach Center (2019) Internet/Broadband Fact Sheet. Washington, DC. Retrieved from: https://www.pewresearch.org/internet/fact-sheet/internet-broadband/.Google Scholar
Reininger, BM, Barroso, CS, Mitchell-Bennett, L, et al. (2010) Process evaluation and participatory methods in an obesity-prevention media campaign for Mexican Americans. Health Promotion Practice 11(3), 347–357.CrossRefGoogle Scholar
Scibetta, C, Kerr, K, Mcguire, J, et al. (2016) The costs of waiting: Implications of the timing of palliative care consultation among a cohort of decedents at a comprehensive cancer center. Journal of Palliative Medicine 19(1), 69–75.CrossRefGoogle Scholar
Shalev, A, Phongtankuel, V, Kozlov, E, et al. (2018) Awareness and misperceptions of hospice and palliative care: A population-based survey study. American Journal of Hospice and Palliative Medicine 35(3), 431–439.CrossRefGoogle ScholarPubMed
Snyder, S, Hazelett, S, Allen, K, et al. (2013) Physician knowledge, attitude, and experience with advance care planning, palliative care, and hospice: Results of a primary care survey. American Journal of Hospice and Palliative Medicine 30(5), 419–424.CrossRefGoogle ScholarPubMed
StataCorp (2015) Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.Google Scholar
Suarez, L, Nichols, DC and Brady, CA (1993) Use of peer role models to increase Pap smear and mammogram screening in Mexican-American and black women. American Journal of Preventive Medicine 9(5), 290–296.CrossRefGoogle ScholarPubMed
Volandes, AE, Ferguson, LA, Davis, AD, et al. (2011) Assessing end-of-life preferences for advanced dementia in rural patients using an educational video: A randomized controlled trial. Journal of Palliative Medicine 14(2), 169–177. doi:10.1089/jpm.2010.0299CrossRefGoogle ScholarPubMed
Wadhwa, D, Popovic, G, Pope, A, et al. (2018) Factors associated with early referral to palliative care in outpatients with advanced cancer. Journal of Palliative Medicine 21(9), 1322–1328.CrossRefGoogle ScholarPubMed
Whittaker, R, Maddison, R, McRobbie, H, et al. (2008) A multimedia mobile phone–based youth smoking cessation intervention: Findings from content development and piloting studies. Journal of Medical Internet Research 10(5), e49.CrossRefGoogle ScholarPubMed
Zimmermann, C, Swami, N, Krzyzanowska, M, et al. (2014) Early palliative care for patients with advanced cancer: A cluster-randomised controlled trial. The Lancet 383(9930), 1721–1730.CrossRefGoogle ScholarPubMed