title: What are Hospice Providers in the Carolinas Doing to Reach African Americans in Their Service Area?
abstract: BACKGROUND
  Experts and national organizations recommend that hospices work to increase service to African Americans, a group historically underrepresented in hospice.
  
  
  OBJECTIVE
  The study objective was to describe strategies among hospices in North and South Carolina to increase service to African Americans and identify hospice characteristics associated with these efforts.
  
  
  METHODS
  The study was a cross-sectional survey using investigator-developed scales to measure frequency of community education/outreach, directed marketing, efforts to recruit African American staff, cultural sensitivity training, and goals to increase service to African Americans. We used nonparametric Wilcoxon tests to compare mean scale scores by sample characteristics.
  
  
  RESULTS
  Of 118 eligible hospices, 79 (67%) completed the survey. Over 80% were at least somewhat concerned about the low proportion of African Americans they served, and 78.5% had set goals to increase service to African Americans. Most were engaged in community education/outreach, with 92.4% reporting outreach to churches, 76.0% to social services organizations, 40.5% to businesses, 35.4% to civic groups, and over half to health care providers; 48.0% reported directed marketing via newspaper and 40.5% via radio. The vast majority reported efforts to recruit African American staff, most often registered nurses (63.75%). Nearly 90% offered cultural sensitivity training to staff. The frequency of strategies to increase service to African Americans did not vary by hospice characteristics, such as profit status, size, or vertical integration, but was greater among hospices that had set goals to increase service to African Americans.
  
  
  CONCLUSIONS
  Many hospices are engaged in efforts to increase service to African Americans. Future research should determine which strategies are most effective.
authors: 1 Department of Medicine, Duke University , Durham, North Carolina.|2 Division of Geriatrics, Duke University , Durham, North Carolina.|3 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.|4 Duke Palliative Care, Duke University , Durham, North Carolina.|5 Geriatrics Research, Education and Clinical Center, Veterans Affairs Medical Center , Durham, North Carolina.
authors: Kimberly S
authors: KS
authors: Johnson
authors: 1 Department of Medicine, Duke University , Durham, North Carolina.|2 Division of Geriatrics, Duke University , Durham, North Carolina.|3 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.|6 Duke Divinity School, Duke University , Durham, North Carolina.
authors: Richard
authors: R
authors: Payne
authors: 3 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.|7 Department of Biostatistics and Bioinformatics, Duke University , Durham, North Carolina.
authors: Maragatha N
authors: MN
authors: Kuchibhatla
mesh_terms: D001741:Black or African American; D003159:Community-Institutional Relations; D003430:Cross-Sectional Studies; D006738:Hospices; D006801:Humans; D008389:Marketing of Health Services / Q000379:methods*; D009657:North Carolina; D013022:South Carolina; D011795:Surveys and Questionnaires