Hospice access and use by African Americans: Addressing cultural and institutional barriers through participatory action research

This article describes a participatory action research project addressing t he problem of African American access to and use of hospice. Qualitative in terviews conducted with six African American pastors resulted in the identi fication of major themes used for development of a scale to measure barrier s to hospice. A subsequent quantitative study documenting these barriers wa s conducted with 127 African Americans and European Americans. Results of b oth studies, which were used to further social action efforts in the commun ity, indicated the cultural barriers of differences in values regarding med ical care and differences in spiritual beliefs between African Americans an d European Americans. Results also indicated institutional barriers, includ ing lack of knowledge of services, economic factors, lack of trust by Afric an Americans in the health care system, and lack of diversity among health care staff. Implications for social work practice and policy ave discussed.