Facilitating Conversations About Advance Care Planning with Latino Leaders Using the Hello Game

Abstract

North Carolina has a growing Latino population with an increasing cancer mortality rate. Latinos have disproportionately low engagement in advance care planning (ACP) compared to White and Black adults. For some population groups, the Hello Game, an interactive community tool that facilitates end-of-life (EoL) conversations, breaks down barriers and encourages ACP engagement. The game has not been studied with Latinos. This qualitative descriptive study was based on a parent study, initiated in 2020, that trained Latino leaders in palliative care principles to share information with Latinos with cancer. In the present study, we explored how Latino leaders viewed EoL care through the Hello Game. A total of 10 Latino leaders participated in one of three focus groups. Transcripts were read, coded, and analyzed by three research team members. The themes that promoted conversation were: Identifying Kinship Networks; Preferring Homecare at the EoL; and Passing of the “Thank You Chips.” Themes that hindered conversations were Separation from Home Country and Minimal Clinician Input. Kinship networks were both healthy and strained, and more expansive than extended family. Homecare at the EoL was hindered by distance from home country. Passing the “Thank you chips” represented support of ACP conversations. These leaders did not mention the role of the nurses in ACP conversations and there were vague mentions of physicians. The collective nature of the Hello Game created a trusting environment to discuss ACP. Results suggest ways for nurses to address Latino health inequities in ACP by identifying healthy kinship networks and discussing EoL preferences. Nurses can partner with advocacy groups to carry out the Hello Game in Latino communities.