. 2020 Mar 26;4(1):52–83. doi: 10.1089/heq.2019.0120

Table 2.

Theme: Lack of Trust in the Health Care System

Sub-theme(s)	Phase 1: focus groups	Phase 2: recommendations
(A) Distrust of medical system and physicians	“… that death hospital. That's what I call the hospital in O [small town in South Carolina] the death hospital. If you wanna’ die, go there. You will die.” I just wish I would have known honestly, what my grandfather died of, just put it on the paper …. Was it some sort of medication that you guys gave him that called it, you know, the end?”	X	Role of CAG (1) AA CAG member will be the first to meet and greet the AA hospitalized patients eligible to participate in the culturally based tele-consult and their families. (2) CAG members will explain how the study program was developed by the community for their community by incorporating culturally appropriate values and preferences. (3) After a short discussion and answering questions, CAG members will introduce the patient and family to the Study Coordinator. Role of Physician (1) Never call the patient and/or family member by first name, unless invited to do so. (2) Build in additional time to get to know the patient and family. Learn something about the patient and the family and during the consult conversation, discuss it so that the family knows you heard it and it was not just a rote gesture. (3) During the conversation, talk about something local to indicate familiarity with region where the patient resides (an indication that the physician knows something about the area).	Role of CAG (1) Although this theme did not arise in the White group, the recommendations were the same for the CAG, that is, CAG members will be the first to greet the eligible hospitalized patients and their families, although the ethnicity of the CAG member meeting with the patient and family was not specified. (2) Physician: Establish relationship with patient and family as a first step.

Sub-theme(s)

Phase 1: focus groups

Phase 2: recommendations

White

(A) Distrust of medical system and physicians

“… that death hospital. That's what I call the hospital in O [small town in South Carolina] the death hospital. If you wanna’ die, go there. You will die.”
I just wish I would have known honestly, what my grandfather died of, just put it on the paper …. Was it some sort of medication that you guys gave him that called it, you know, the end?”

Role of CAG

(1)
AA CAG member will be the first to meet and greet the AA hospitalized patients eligible to participate in the culturally based tele-consult and their families.
(2)
CAG members will explain how the study program was developed by the community for their community by incorporating culturally appropriate values and preferences.
(3)
After a short discussion and answering questions, CAG members will introduce the patient and family to the Study Coordinator.

Role of Physician

(1)
Never call the patient and/or family member by first name, unless invited to do so.
(2)
Build in additional time to get to know the patient and family. Learn something about the patient and the family and during the consult conversation, discuss it so that the family knows you heard it and it was not just a rote gesture.
(3)
During the conversation, talk about something local to indicate familiarity with region where the patient resides (an indication that the physician knows something about the area).

Role of CAG

(1)
Although this theme did not arise in the White group, the recommendations were the same for the CAG, that is, CAG members will be the first to greet the eligible hospitalized patients and their families, although the ethnicity of the CAG member meeting with the patient and family was not specified.
(2)
Physician: Establish relationship with patient and family as a first step.

CAG, Community Advisory Group.