Objectives/Purpose
This study examined perceptions of the appropriateness of Advance Care Planning (ACP) among Culturally and Linguistically Diverse (CALD) populations in oncology. It aimed to explore preferences regarding who needs to do what, where, when, and to whom across the phases of ACP, to support culturally safe and equitable ACP practices.
Sample and Setting
Participants include CALD consumers of Indian and Chinese backgrounds, and key healthcare stakeholders across three Victorian cancer services: Peter MacCallum Cancer Centre, Latrobe Regional Hospital, and Barwon Health. Up to 40 CALD consumers (including English and non-English speakers of Mandarin, Cantonese, and Punjabi) with lived experience of cancer—as patients or carers—are being recruited in partnership with community organisations. In parallel, up to 24 multidisciplinary healthcare professionals and interpreters involved in ACP delivery across participating services are contributing through a stakeholder reference group.
Procedures
Using qualitative methods informed by implementation science, we are conducting focus groups with CALD consumers and healthcare professionals. The Action, Actor, Context, Target, Time (AACTT) framework is used to map ACP behaviours across four phases: preparing for the conversation, having the conversation, creating the document, and enacting the document. This structured approach enables comparison of perspectives and identification of potential preference-practice gaps.
Results
Preliminary findings suggest variation in how ACP is perceived and experienced by CALD communities. Emerging themes point to possible misalignments between provider practices and consumer preferences regarding timing, communication styles, and the role of clinicians versus family. These insights will guide the development of culturally safe strategies to improve ACP engagement.
Conclusion and Clinical Implications
This is the first known study to systematically map ACP preferences among CALD populations using the AACTT framework. Findings will inform development of inclusive, patient-centred ACP strategies and support policy and practice reforms to reduce disparities in oncology care.