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

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.