Table 1.

Literature Based Recommendations to address racism in care of African Americans

CATEGORY AUTHOR, YEAR	TITLE	RECOMMENDATIONS TO ERADICATE RACISM
Increase culturally responsive end-of-life programs
Gross et al. [57]	“As a Community, We Need to be More Health Conscious”: Pastors’ Perceptions on the Health Status of the Black Church and African American Communities	1. Interventions using cultural considerations or adaptations promote participation amongst African Americans 2. Interventions should also promote holistic practices and involve key community members, such as pastors
Elk et al. [19]	Social Inequalities in Palliative Care for Cancer Patients in the United States: A Structured Review	1. Palliative care programs should aim to be concordant with cultural preferences for treatment 2. Future research must be directed towards assessing barriers to care
Gardner et al. [44]	Racial and Ethnic Disparities in Palliative Care: A Systematic Scoping Review	1. Practice ought to be directed towards understanding cultural context as a barrier for care at EOL 2. Policies have to be aimed at promoting high quality programs for disadvantaged populations 3. Further research needs to be targeted towards identifying continued barriers to care for minorities
Hart and Matthews [54]	End-of-Life Interventions for African Americans with Serious Illness: A Scoping Review	1. There needs to be a standardized integration of culturally centered EOL programs for African Americans 2. Culturally relevant programs should be used to promote awareness and positive behavioral outcomes
Honest communication from the healthcare team
Cardona et al. [58]	Dissonance on perceptions of end-of-life needs between health-care providers and members of the public: Quantitative cross-sectional surveys	1. Policies are needed to safeguard a supportive environment for EOL discussions 2. EOL discussions should happen early and timely 3. Educational interventions for clinicians can assist in encouraging these conversations
Balaban [61]	A Physician’s Guide to Talking About End-of-Life Care	1. There must be an understanding of how patients and families experience the end-of-life process 2. Providers need to acquire skills that allows for sensitivity in communication, in order for effective communication to evolve naturally
Pfeifer and Head [71]	Which Critical Communication Skills Are Essential for Interdisciplinary End-of-Life Discussions	1. Engage professionals from various disciplines to draw in and have honest conversations with patients and families 2. Provide patients with multiple opportunities for ongoing discussions about prognosis 3. Acknowledge that giving difficult advice is not the end to having prognostic conversations with patients, there must be an opportunity for exploration
Elk et al. [72]	African American Communities Speak to Palliative Care Clinicians: Evaluation of an Innovative Community-Developed Communication Skills Training Program	1. Promote the implementation of provider training programs to increase culturally competent communication 2. Understand the language of communication style from community participants is key to effective conversation
Community based participatory research (CBPR)
Devia et al. [78]	Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S	1. Use CBPR to partner with communities and systems to provide equitable distribution of resources 2. Use partnerships to develop strategies to address social determinants of health
Sofolahan-Oladeinde et al. [80]	Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities	1. Partner with communities in order to eliminate healthcare disparities in care 2. CBPR is a longstanding and proven method and should be used to achieve patient centered outcomes
Elk et al. [45]	Developing and Testing the Feasibility of a Culturally Based Tele-Palliative Care Consult Based on the Cultural Values and Preferences of Southern, Rural African American and White Community Members: A Program by and for the Community	1. Palliative care programs should be developed in partnership with community members 2. Promote engagement between the community and the healthcare team 3. Programs should be built by and with the community to promote satisfaction with its members