African Americans Communities Speak to Healthcare Providers: Clinical Practice Outcomes (RP322)

Outcomes 1. Recognizing the importance, and feasibility, of communities providing their own recommendations for culturally concordant care communication by developing training programs for clinicians.2. Upon completion of this talk learners should be able to appreciate practice change to providing culturally concordant care communication to African Americans by participating in an African American-community-developed training. Key Message A training on delivering culturally concordant care to southern African Americans (AA) was developed in full partnership with a southern, rural AA community, using a CBPR approach, based on the community's cultural values and lived experience of racism. The training was effective in changing clinician practice to providing culturally-concordant care. Importance Lack of knowledge and respect for cultural differences may compromise care for minority patients. Objective(s) Determine outcome of African American community-developed culturally-concordant training on 1) providers' knowledge of AA cultural values relevant to serious illness, 2) their confidence to change practice and 3) self-reported level of practice change 3-6 months following training. Scientific Methods Utilized The program was based on the AA's community's cultural and religious values and lived experience of racism. Community partners determined the messages to send to providers based on community input (through focus groups). They incorporated these into 3 training videos; they developed the script and in which they acted. The videos were ensconced within an evidence-based training model that fosters effective behavior change. A presentation on the relevance of the AA churches was added. The 3-hour training was delivered via zoom. The training included watching each video followed by processing in small groups facilitated by trained communication experts Results 189 providers (44% MD/DO) participated in the training. There was a significant increase on knowledge of all 18 items of cultural values of significance to AA during serious illness and EoL (p < 0.001). Confidence to change practice was rated 75% very good-excellent on 13/14 items. Change in practice ranged from 87.8% -97.3% on 3/4 recommendations made by the community. (Always have family present when discussing goals of care; Always emphasize hope; Make explicit sentence that you're providing best care.) Proactively planning for clergy presence when discussing goals of care was 75%. Conclusion(s) A training developed by AA community members for healthcare providers was very effective in changing clinician practice to providing culturally-concordant care. Impact This study serves as a model for other cultural and ethnic groups: Researchers need to partner with different cultural or ethnic group for those groups to develop training guidelines based on their cultural and religious values and their lived experiences. This study will soon be replicated in a southern (Birmingham) and northern (Bronx) urban setting. Keywords Cultural diversity/Under served, under resourced populations