Literature Review

Developing competencies to advance health care access and quality for Latino, Hispanic, and Spanish origin populations-A consensus statementJAMA Network Open; by Débora H. Silva, John A. Davis Rodríguez, Hector Rasgado-Flores, Pilar Ortega, Deion Ellis, Fernando Sánchez Mendoza, Victor Cueto, Fabiola Quintero-Rivera, Norma Iris Poll-Hunter, Minerva Romero Arenas, Kenneth Lee Dominguez, Juan Emilio Carrillo, José E. Rodríguez, John Paul Sánchez; 8/25Question: What competencies and milestones are essential for advancing health equity for Latina, Latino, Latinx, Latine, Hispanic, and Spanish Origin (LHS+) populations? Since the 1970s, the LHS+ population has increased 6-fold and grown to be the largest ethnic or racial group in the US and accounts for approximately 20% of the US population. The LHS+ health equity competencies and milestones resulting from this study add to prior work by creating a blueprint for standardization and broader application of such educational experiences on a national level. As a tool to enhance CBME [competency-based medical education ] efforts aligned with care for LHS+ populations, the competencies may aid educators and institutions through an LHS+–informed lens in conducting gap analyses for the development of local curricula, developing teaching and assessment materials, supporting the professional development of learners and faculty, and facilitating educational scholarship. 

Serious illness and end of life in LGBTQIA+ older adultsDelaware Journal of Public Health; by Sarah Matthews; 7/25Gender-affirming care is just as important during serious illness and end of life. Typically, gender-affirming hormone therapy is maintained throughout life to provide masculinizing or feminizing effects as desired. At end-of-life, it may be the person’s wish to continue hormones even if the medication poses additional risk. Whenever possible, gender expression preferences of LGBTQIA+ elders should be honored. TRANSforming Choices Healthcare Decisions Starter Guide is an excellent resource for transgender, gender-diverse, and gender-expansive people to make choices about their healthcare including gender-affirming care. Funeral directives are available to ensure that LGBTQIA+ elders’ funeral wishes are followed, including name, pronouns, and presentation of the body.

The Faith Care Family Project: A pilot intervention for African American dementia family caregiversAmerican Journal of Alzheimer's Disease and Other Dementias; Noelle L Fields, Ling Xu, Ishan C Williams, Fayron Epps, Samantha Tinker; 8/25The Faith Care Family (FCF) Project was a telephone based, volunteer-led intervention for African American Alzheimer’s disease and related dementias (AD/ADRD) family caregivers that was piloted in one predominantly African American church. Church volunteers indicated overall significant improvements knowledge of AD/ADRD after the training as well as after the intervention. Quantitative results indicated that caregivers increased their knowledge of dementia, reported improved coping skills, and reported increased positive aspects of caregiving. Feeling a connection, normalizing the challenges of caregiving, gaining or reinforcing knowledge, and sharing community resources were themes from qualitative interviews with the family caregivers.

NorthStar Care Community announces partnership with Beads of Courage Fox 17 - West Michigan;by Nicole Stoner; 8/19/25 Beads Of Courage is an organization that helps pediatric patients document their health journey through beads of different sizes, shapes, and colors. ... NorthStar Care Community, already established for their compassion in pallative and hospice care, has announced a partnership with Beads Of Courage. This time, the partnership honors patients entering hospice care through their own treatment stages, milestones, and moments of courage. ... In addition, the Carry A Bead Initiative invites the public to support these patients on their journey during end-of-life care by carrying a NorthStar Bead with them, then returning it with a message of encouragement. The bead is then gifted to someone in hospice care, ensuring that these patients are not alone in their health journey.

Opportunities and barriers to artificial intelligence adoption in palliative/hospice care for underrepresented groups-A technology acceptance model–based reviewJournal of Hospice and Palliative Nursing; by Xu, Tuzhen; Rose, Gloria M.; 8/25Underrepresented groups (URGs) in the United States, including African Americans, Latino/Hispanic Americans, Asian Pacific Islanders, and Native Americans, face significant barriers to accessing hospice and palliative care. Factors such as language barriers, cultural perceptions, and mistrust in healthcare systems contribute to the underutilization of these services. Recent advancements in artificial intelligence (AI) offer potential solutions to these challenges by enhancing cultural sensitivity, improving communication, and personalizing care. However, barriers such as limited generalizability, biases in data, and challenges in infrastructure were noted, hindering the full adoption of AI in hospice settings.

Black and white older adults’ end-of-life experiences: Does hospice use mitigate racial disparities? The Journals of Gerontology; by Clifford Ross, Brina Ratangee, Emily Schuler, Zheng Lian, Benmun Damul, Deborah Carr, Lucie Kalousová; 7/25Racial disparities in end-of-life care are well documented, but less is known about how these inequalities shape assessments of death quality. Proxies for Black decedents reported higher perceived death quality than those for White decedents, despite evidence of greater structural disadvantage. However, perceived care concordance was significantly lower among Black decedents. Hospice care was associated with improved perceived death quality for Black decedents but not for Whites. When accounting for socioeconomic and death experience controls, hospice care did not moderate perceived care concordance.

Sex and racial/ethnic differences in end-of-life care in decedents with lung cancer in TexasJournal of Palliative Medicine; by Myrna Katalina Serna, Efstathia Polychronopoulou, Aimee Rodriguez, Anjali Ramachandran, Margaret Goodrich, Sean O'Mahoney, Mukaila Raji, Yong-Fang Kuo; 7/25The lung cancer five-year survival rate is lower for Texans compared with the national average. We assessed sex and racial/ethnic differences in end-of-life care among decedents with lung cancer in Texas [and found that] ... males had more health care utilization and less hospice enrollment. Non-Hispanic Blacks and Hispanics had more health care utilization and less hospice enrollment ... Billed ACP [advance care planning] was low across all groups.

Closing the gap: Addressing social determinants of health and racial disparities in hospice care Teleios Collaborative Network (TCN); by Alyson Cutshall; 8/4/25... While Americans’ health trajectories are inevitable at the time they become eligible for hospice services, SDOH (Social Determinants of Health) still play a major role for the patients and families our field is privileged to serve. ... [To] fully impact health equity, we must be cognizant of other examples of SDOH, such as racism and implicit bias.  Unfortunately, our collective field has not been as successful in addressing access to hospice care across differing racial and ethnic groups. ... Certainly, there are some pockets of improved access.  One Teleios member organization, Ancora Compassionate Care, recognized the alarming disparities within its community and set about to create change. Ancora leaders recognized that the Black community in their service area typically placed high trust in their religious leaders. To better understand their needs and preferences regarding end-of-life care and services, Ancora embarked on a "listening tour" to gather feedback and insights from these religious leaders. Using the wisdom imparted, Ancora adapted their care delivery to be more inclusive to the Black community.  As such, the organization is making incremental improvements in lessening the racial divide in access to hospice care.

Evaluating a large language model in translating patient instructions to Spanish using a standardized frameworkJAMA Pediatrics; Mondira Ray, MD, MBI; Daniel J. Kats, MD, MBI; Joss Moorkens, PhD; Dinesh Rai, MD; Nate Shaar, BA; Diane Quinones, MS, RN, CPNP; Alejandro Vermeulen, BFA, CMI; Camila M. Mateo, MD, MPH; Ryan C. L. Brewster, MD; Alisa Khan, MD, MPH; Benjamin Rader, PhD; John S. Brownstein, PhD; Jonathan D. Hron, MD; 7/25Patients and caregivers who use languages other than English in the US encounter barriers to accessing language-concordant written instructions after clinical visits. Large language models (LLMs), such as OpenAI’s GPT-4o ... can translate Spanish translations of real-world personalized written patient instructions that are comparable in quality to those generated by professional human translators. Independent professional medical translators preferred the GPT-4o–generated translations over the human translations, and error analysis revealed a higher rate of mistranslation errors in the human translations. These findings demonstrate GPT-4o’s ability to produce quality translations in Spanish ...

Effectiveness of an educational intervention in enhancing end-of-life care understanding and decision-making in African AmericansPalliative & Supportive Care; Delicia Pruitt, Megan Reilly, Stephen Zyzanski, Neli Ragina; 7/25AA [African American] patients are more likely than other ethnic groups to choose life-sustaining measures at the end of their lives, leading to patients not receiving care to help them die peacefully. This decision is partly based on lack of knowledge of the available EOL [end of life] care options. An educational tool like the one developed in this study may be helpful and lessen the time of education so that physicians can answer questions at the end of the session and empower individuals and communities to take an active role in creating a culture of wellness at the EOL and decreasing morbidity.

Understanding the influence of culture on end-of-life, palliative, and hospice care: A narrative review Cureus; by Veena Hira, Sainamitha R. Palnati, and Saajan Bhakta; 7/15/25 ... This narrative review included 25 relevant publications related to influence of culture and patient demographics on end-of-life care, hospice, and palliative care. As each culture has its own unique views on death and dying, it is crucial to note these cultural differences when assisting with end-of-life care to best align with patients’ beliefs and values. Themes such as cultural barriers, communication preferences and family roles emerged from the publications. ... This narrative review offered a snapshot of how culture influences end-of-life decisions worldwide, specifically in East Asia, South Asia, the Middle East, Europe, and North America, while highlighting themes of 1) truth disclosure and communication preferences, 2) patient autonomy and family involvement, and 3) perception of illness and death. ... Central to providing effective end-of-life care is open, culturally tailored communication that respects patients’ and families’ values, facilitated through shared decision-making discussions. ... Ultimately, integrating cultural understandings of death and dying into end-of-life care planning is not simply a matter of sensitivity, but it is a matter of quality and equity. Health systems must not only provide choices but ensure those choices are intelligible, meaningful, and respectful within the patient’s worldview.Editor's Note: Pair this today's post, My health and my politics walk into a doctor’s office …

Addressing the underutilization of hospice care in Asian American communities: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; Tuzhen Xu, PhD, APRN, FNP-C; Dan Song, PhD, RN; Gloria M. Rose, PhD, NP-C; 6/25Despite national improvements in hospice care, utilization remains low among Asian American (AA) communities. Identified barriers to hospice utilization included language and communication challenges; cultural values and beliefs surrounding death; family-centered decision-making and filial piety; religious influences such as beliefs in karma and suffering; and broader issues like low acculturation and mistrust of the healthcare system. Comprehensive cultural competence training is needed for healthcare providers, especially physicians, nurse practitioners, registered nurses, and social workers involved in hospice and palliative care.

Examining education models for clinical staff working with people with intellectual and developmental disabilities in hospice and palliative care: A narrative literature reviewAmerican Journal of Hospice and Palliative Care; Caitlyn M Moore; 5/25Despite individuals with intellectual and developmental disabilities (IDD) living longer with serious illness, healthcare professionals report inadequate training in this area. Additionally, IDD specialists consistently express discomfort and limited knowledge regarding HAPC [hospice and palliative care]. Findings indicate that while several studies demonstrate positive outcomes regarding knowledge, self-efficacy, and satisfaction among participants, there is a lack of standardized training and patient-centered metrics. Existing interventions largely focused on improving the knowledge of IDD staff regarding HAPC, with limited attention given to educating HAPC professionals on the nuances and complexities needs of people with IDD. This review underscores the importance of developing and implementing evidence-based and standardized training programs that encompass the needs of both HAPC and IDD specialists.