{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:12:43Z","timestamp":1789827163441,"version":"4.0.1"},"reference-count":88,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Primary palliative care (PPC) is widely recognized as essential for equitable palliative care access, yet evidence on its integration across Latin America and the Caribbean (LAC) remains limited. This scoping review synthesized evidence on strategies, opportunities, and challenges shaping PPC integration throughout the region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Guided by the PRISMA Extension for Scoping Reviews and Joanna Briggs Institute methodology, peer-reviewed and gray literature published from 2014 to February 2025 were searched across eight databases and relevant sources. Using population-concept-context criteria, articles addressing PPC integration within primary health care (PHC) in LAC were included. Directed content analysis was framed by the World Health Organization (WHO) Conceptual Model of Palliative Care Development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-six articles representing 30 LAC countries met inclusion criteria. Available evidence suggested uneven progress in PPC integration across settings. Common strategies included workforce development and task-sharing approaches; nurse- and community health worker-led care models; incorporation of PPC into chronic disease management and home-based care pathways; and evolving policy frameworks supporting PHC-based delivery. Persistent barriers involved limited workforce capacity; fragmentation between primary and specialist services; restricted availability of essential palliative medicines, particularly opioids; and sociocultural and regulatory constraints. Although findings mapped onto all domains of the WHO model, several region-specific subcomponents emerged: (a) tailored and structured caregiver engagement, (b) academic-policy partnerships and benchmarking mechanisms, (c) telehealth-enabled and networked PPC models, (d) advanced practice nurse- and nurse-led mentoring structures, (e) standardized screening linked to actionable PHC responses, and (f) early PPC pathways adapted to regional disease burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Integration of PPC is progressing yet remains constrained by structural, regulatory, and implementation gaps. Bridging policy commitments with routine PHC delivery requires strengthened workforce capacity, improved access to essential medicines, and implementation-focused research to inform scalable, context-sensitive, and equitable PPC models across diverse LAC health systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261486731","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:34:21Z","timestamp":1789634061000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Strengthening Capacity in Primary Palliative Care: A Scoping Review from Latin America and the Caribbean"],"prefix":"10.1177","author":[{"given":"Rebecca L.","family":"Edwards","sequence":"first","affiliation":[{"name":"School of Nursing, PAHO\/WHO Collaborating Centre for International Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds Carlos","family":"Lopes-J\u00fanior","sequence":"additional","affiliation":[{"name":"Departamento de Enfermagem, Centro Ci\u00eancias da Sa\u00fade, Universidade Federal do Esp\u00edrito Santo, Vitoria, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisca","family":"Marquez Doren","sequence":"additional","affiliation":[{"name":"School of Nursing, Pontificia Universidad Cat\u03cclica de Chile, Santiago, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina Aparecida","family":"Garcia de Lima","sequence":"additional","affiliation":[{"name":"Department Maternal Infant Nursing and Public Health, PAHO\/WHO Collaborating Centre for Nursing Research Development, University of S\u00e3o Paulo at Ribeir\u00e3o Preto College of Nursing, Ribeir\u00e3o Preto, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aintzane","family":"Gallastegui-Bra\u00f1a","sequence":"additional","affiliation":[{"name":"School of Nursing, Pontificia Universidad Cat\u03cclica de Chile, Santiago, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanchana","family":"Bandara-Coore","sequence":"additional","affiliation":[{"name":"Manuchant Medical Centre, Kingston, Jamaica."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Cox","sequence":"additional","affiliation":[{"name":"Caura Hospital Palliative Care Unit, Champ Fleurs, Trinidad &amp; Tobago."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Reville","sequence":"additional","affiliation":[{"name":"Harvard Medical School Center for Palliative Care, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Theus","sequence":"additional","affiliation":[{"name":"School of Nursing, PAHO\/WHO Collaborating Centre for International Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Billings","sequence":"additional","affiliation":[{"name":"Libraries, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stoltenberg","sequence":"additional","affiliation":[{"name":"Division of Palliative Care &amp; Geriatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2038-3139","authenticated-orcid":false,"given":"Adelais","family":"Markaki","sequence":"additional","affiliation":[{"name":"School of Nursing, PAHO\/WHO Collaborating Centre for International Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.04.027"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.03.030"},{"key":"e_1_3_3_4_1","unstructured":"3.Connor SR. 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