Culturally Tailored Palliative Care Communication for Pancreatic Cancer Patients and Their Caregivers: A Bilingual Community Health Worker Intervention.

Abstract

Pancreatic cancer patients in linguistically diverse communities face significant barriers to timely palliative care engagement, compounded by limited health literacy and cultural communication gaps. California's Inland Empire, home to a large Hispanic population, exemplifies this challenge. Investigators developed and evaluated a bilingual, community health worker (CHW)-delivered palliative care intervention for pancreatic cancer patients and caregivers using a community-centered approach. Educational videos and handouts were created incorporating physician expertise, CHW cultural knowledge, and plain-language health literacy principles, covering diagnosis, treatment, and end-of-life care. Bilingual CHWs delivered navigation and education through home visits, video calls, and telephone contact. Three in-depth case studies, representative of the broader participant group, were analyzed. Findings illustrate how culturally tailored communication delivered across multiple formats and reinforced by trusted CHWs facilitated progressive palliative care engagement despite initial resistance, complex family dynamics, and social challenges, including homelessness. Observed outcomes included increased advance directive completion and greater acceptance of palliative care consultations. This pilot demonstrates that bilingual, culturally adapted educational resources paired with CHW support can reduce communication barriers and support patients and caregivers in navigating a serious diagnosis. The approach shows promise for improving timely palliative care engagement and warrants larger-scale evaluation.