• "Intra-community communication influencing African-American hospice utilization"

      Rickelman, Lauren S.
      Members of the African-American community make end-of-life decisions to not utilize hospice services to the same extent as other populations. Prior research has indicated that reasons for underutilization include lack of knowledge, misinformation, and cultural/religious barriers (e.g. Cort, 2004; Taxis, 2006; Reese, Ahern, Nair, O'Faire, & Warren, 1999; Winston, Leshner, Kramer, & Allen, 2005). This paper examines this issue from the standpoint of communication within the African-American community and how this communication influences the decision-making process at the end of life. Qualitative methods of focus groups with key community influencers and structured interviews with family members of deceased African-American hospice patients were employed and revealed data themes that affirmed lack of knowledge, misinformation, and cultural/religious norms act as barriers to hospice utilization among members of African-American communities. Social Identity Theory (Tajfel & Turner, 1979), offers a view of this intra-community communication through the lens of in-group/out-group behaviors, and recognizes implications for future improvement in hospice outreach.