title: Knowledge, attitudes, and beliefs about end-of-life care among inner-city African Americans and Latinos.
abstract: OBJECTIVE
  This project explored end-of-life care preferences and barriers among low-income, urban African Americans and Latino/Hispanic Americans (Latinos) to uncover factors that may influence hospice utilization.
  
  
  METHODS
  Focus groups were conducted separately for African Americans (4 groups, n = 26) and Latinos (4 groups, n = 27). Transcripts were coded and analyzed using consensus and triangulation to identify primary themes.
  
  
  RESULTS
  Four preference themes and four barriers were identified. Results were largely similar across the two groups. Both preferred having families provide care for loved ones but expressed desire to reduce caretaker burden. Groups emphasized spirituality as the primary means of coping and valued the holistic well-being of the patient and family. Barriers reported were closely tied to access to care. Participants reported low hospice utilization because of lack of awareness of hospice and the prohibitive cost of health care. Latinos were more likely to report language barriers, while African Americans were more likely to report mistrust of the system.
  
  
  CONCLUSIONS
  African Americans and Latinos in this study were highly receptive to end-of-life care that would provide relief for patients and caregivers and emphasize spirituality and family consensus. Improving awareness of hospice services would likely increase utilization.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. wborn@kumc.edu
authors.forename: Wendi
authors.initials: W
authors.lastname: Born
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
authors.forename: Eldonna
authors.initials: E
authors.lastname: Sylvia
authors.forename: James
authors.initials: J
authors.lastname: Butler
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001364:Awareness; D003258:Consumer Behavior / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology*; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011203:Poverty / Q000208:ethnology; D029181:Spirituality; D013727:Terminal Care / Q000379:methods / Q000523:psychology*; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*