• Nainwant Singh, Karleen F Giannitrapani, Aanchal Satija, Archana Ganesh, Raziel Gamboa, Soraya Fereydooni, Tayler Hennings, Shivani Chandrashekaran, Odette Spruijt, Sushma Bhatnagar, and Karl A Lorenz.
• Division of Primary Care and Population Health (N.S., K.F.G., T.H., K.A.L.), Stanford University School of Medicine, Palo Alto, California, USA; VA HS R&D Center for Innovation to Implementation (Ci2i) (N.S. K.F.G., R.G., K.A.L.), Menlo Park, California, USA. Electronic address: nainwant@stanford.edu.
• J Pain Symptom Manage. 2022 Oct 1; 64 (4): 370-376.

ContextLack of palliative care (PC) awareness is a barrier to its utilization in developing contexts.ObjectivesTo identify and understand strategies that changed awareness of the concepts and value of palliative care in a multi-site quality improvement project in India.MethodsThe Palliative Care - Promoting Assessment and Improvement of the Cancer Experience (PC-PAICE) evaluation team conducted 44 semi-structured interviews with clinician and organization stakeholders at seven geographically dispersed sites. We used inductive and deductive approaches in this secondary analysis to identify emerging themes.ResultsWe identified the following strategies to improve awareness of concepts and value of palliative care. Strategy 1: Educate medical trainees, staff, and the community about palliative care and its concepts. Sub-strategies: Participate in community events. Integrate PC concepts into early medical education. Standardize training for practitioners. Strategy 2: Design and disseminate India-specific research to reinforce awareness of the value of palliative care. Sub-strategies: Publish and use India-specific palliative care research. Strategy 3: Facilitate communication between providers and departments to improve awareness of palliative care services and its concepts. Sub-strategies: Create referral frameworks and network with providers referring to palliative care to change awareness of available services and palliative care concepts.ConclusionTo increase palliative care utilization, program development can include community and provider-focused efforts on awareness of the concepts and value of palliative care. These three strategies held salience across sites representing diverse Indian geographic and cultural settings; as such, they may be applicable to other contexts.Copyright © 2022. Published by Elsevier Inc.

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