African Americans (AA) Communities Speak

NCT05908487 | Recruiting

• 1 other identifier: IRB300007677
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 3

Brief Summary

African Americans are less likely to receive quality end-of-life (EoL) care. Addressing disparities in EoL care will need efforts to support a better understanding of African American patients' EoL cultural values and preferences for EoL communication and the impact of historical and ongoing care delivery inequities in healthcare settings. Our proposed "Caring for Older African Americans" training program is designed to empower clinicians to improve goal-concordant EoL care delivery by using community-developed storytelling videos to create empathy with experiences of racism in EoL care, guidelines for culturally concordant EoL care delivery, and an implicit bias recognition and management training to mitigate bias in goals of care communication.

Conditions

Healthy Aging; Health Knowledge, Attitudes, Practice; Social Responsibility; Care Eliciting Behavior; Racism, Systemic

Keywords

goal concordant care older African American CBPR end-of-life

Outcome Measures

Primary Outcomes (2)

• Human Connection Scale (patient/family reported)

  The Human Connection (THC) Scale is a summary score of item responses such that a higher total score indicates greater therapeutic alliance. Possible scores range from 16 to 64. The 16-item THC scale had a high degree of internal consistency (Cronbach α= 90).

  up to 3 months before the intervention

• Human Connection Scale (patient/ family reported)

  The Human Connection (THC) Scale is a summary score of item responses such that a higher total score indicates greater therapeutic alliance. Possible scores range from 16 to 64. The 16-item THC scale had a high degree of internal consistency (Cronbach α= 90).

  up to 3 months after intervention

Secondary Outcomes (2)

• Goal Concordant Care (patient/family reported)

  up to 3 months before the intervention

• Goal Concordant Care (patient/family reported)

  up to 3 months after the intervention

Study Arms (4)

Clinician Trainees- Cluster 1

OTHER

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period.

Behavioral: AA Communities Speak to Healthcare Professionals

Clinician Trainees- Cluster 2

OTHER

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period

Behavioral: AA Communities Speak to Healthcare Professionals

Clinician Trainees- Cluster 3

OTHER

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period

Behavioral: AA Communities Speak to Healthcare Professionals

Clinician Trainees- Cluster 4

OTHER

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period

Behavioral: AA Communities Speak to Healthcare Professionals

Interventions

AA Communities Speak to Healthcare Professionals BEHAVIORAL

The training program is designed to empower clinicians to improve goal-concordant EoL care delivery by using community-developed storytelling videos to create empathy with experiences of racism in EoL care, guidelines for culturally concordant EoL care delivery, and implicit bias recognition and management training to mitigate bias in goals of care communication.

Also known as: Clinician Training

Clinician Trainees- Cluster 1; Clinician Trainees- Cluster 2; Clinician Trainees- Cluster 3; Clinician Trainees- Cluster 4

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Person with serious Illness:
• Self-identified as African American (i.e., born, raised, and lived primarily in the US)
• Non-Hispanic or Latino
• Age ≥60 years
• English-speaking
• Has been diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro-degenerative disease, renal disease, stroke, sepsis, hepatic disease)
• Callahan Six-Item Screener score ≥4
• Able to complete baseline surveys.
• Bereaved family member:
• Self-identified as African American (i.e., born, raised, and lived primarily in the US)
• Non-Hispanic or Latino
• Age ≥60 years
• English-speaking
• Loved one dies in the last 12 months and was diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro- degenerative disease, renal disease, stroke, sepsis, hepatic disease)
• Callahan Six-Item Screener score ≥4

You may not qualify if:

• Person with serious illness:
• Cannot be receiving hospice care
• Bereaved Family Member:
• Cannot be a paid "sitter"
• Bereaved Family member:
• Self-identified as African American (i.e., born, raised, and lived primarily in the US)
• Non-Hispanic or Latino
• Age ≥60 years
• English-speaking
• Loved one dies in the last 12 months and was diagnosed with a condition that fits into one of 3 illness paradigms including cancer, cardiac disease, pulmonary disease, neuro- degenerative disease, renal disease, stroke, sepsis, hepatic disease)
• Callahan Six-Item Screener score ≥4
• Able to complete baseline surveys
• Pastors:
• Self-identifying as African American
• White, Non-Hispanic or Latino

Sponsors & Collaborators

• University of Alabama at Birmingham: lead
• Montefiore Medical Center: collaborator
• University of California, San Francisco: collaborator
• University of Massachusetts, Worcester: collaborator

Study Sites (3)

UAB

Birmingham, Alabama, 35233, United States

RECRUITING

University of Alabama at Birmingham

Birmingham, Alabama, 35233, United States

RECRUITING

Albert Einstein/Montefiore

The Bronx, New York, 10461, United States

NOT YET RECRUITING

MeSH Terms

Conditions

Behavior; Systemic Racism

Condition Hierarchy (Ancestors)

Racism; Prejudice; Social Behavior; Social Discrimination

Study Officials

• Jennifer Tjia, MD, MSCE

  University of Massachusetts, Worcester

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ronit Elk, PhD

CONTACT

205.996.1702; relk@uabmc.edu

Tametria V Heard, PhD

CONTACT

205.934.7905; tvheard@uabmc.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Director, Center of Palliative and Supportive Care

Study Record Dates

• First Submitted: June 1, 2023
• First Posted: June 18, 2023
• Study Start: February 27, 2025
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): July 1, 2028
• Last Updated: May 2, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (3)