{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T16:50:13Z","timestamp":1764175813637,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["RSG-22-128-01-HOPS"],"award-info":[{"award-number":["RSG-22-128-01-HOPS"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Dartmouth Class of 1974 Health Equity Scholars Program","award":["RSG-22-128-01-HOPS"],"award-info":[{"award-number":["RSG-22-128-01-HOPS"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups.<\/jats:p>","DOI":"10.3390\/cancers17132209","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T05:28:28Z","timestamp":1751347708000},"page":"2209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["End-of-Life Cancer Care Interventions for Racially and Ethnically Diverse Populations in the USA: A Scoping Review"],"prefix":"10.3390","volume":"17","author":[{"given":"Carolyn J.","family":"Yee","sequence":"first","affiliation":[{"name":"Department of Anthropology, Dartmouth College, Hanover, NH 03755, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aashritha","family":"Penumudi","sequence":"additional","affiliation":[{"name":"Thomas Jefferson High School for Science and Technology, Alexandria, VA 22312, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri","family":"Lewinson","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8354-6006","authenticated-orcid":false,"given":"Inas S.","family":"Khayal","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA"},{"name":"Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA"},{"name":"Department of Computer Science, Dartmouth College, Hanover, NH 03755, USA"},{"name":"Cancer Population Sciences Program, Dartmouth Cancer Center, Lebanon, NH 03756, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fang, M.L., Sixsmith, J., Sinclair, S., and Horst, G. (2016). A knowledge synthesis of culturally-and spiritually-sensitive end-of-life care: Findings from a scoping review. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0282-6"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1111\/jocn.13572","article-title":"Cultural and religious beliefs and values, and their impact on preferences for end-of-life care among four ethnic groups of community-dwelling older persons","volume":"26","author":"Ohr","year":"2017","journal-title":"J. Clin. Nurs."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Pujanes-Mantor, N., and Buga, S. (2023). Cultural Competency models at the end of life. Understanding End of Life Practices: Perspectives on Communication, Religion and Culture, Springer.","DOI":"10.1007\/978-3-031-29923-0_2"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Schweda, M., Schicktanz, S., Raz, A., and Silvers, A. (2017). Beyond cultural stereotyping: Views on end-of-life decision making among religious and secular persons in the USA, Germany, and Israel. BMC Med. Ethics, 18.","DOI":"10.1186\/s12910-017-0170-4"},{"key":"ref_5","unstructured":"Huffman, J.L., and Harmer, B. (2023). End-of-Life Care. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1089\/109662104773709332","article-title":"Development of a medical subspecialty in palliative medicine: Progress report","volume":"7","author":"Lupu","year":"2004","journal-title":"J. Palliat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.jpainsymman.2016.12.331","article-title":"Defining advance care planning for adults: A consensus definition from a multidisciplinary Delphi panel","volume":"53","author":"Sudore","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.cger.2004.07.007","article-title":"Hospice care at the end of life","volume":"20","author":"Herbst","year":"2004","journal-title":"Clin. Geriatr. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1177\/1049909114565658","article-title":"End-of-life care for people with cancer from ethnic minority groups: A systematic review","volume":"33","author":"LoPresti","year":"2016","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jamda.2020.12.005","article-title":"Racial\/ethnic disparities in nursing home end-of-life care: A systematic review","volume":"22","author":"Estrada","year":"2021","journal-title":"J. Am. Med Dir. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e248","DOI":"10.1016\/j.jpainsymman.2021.04.025","article-title":"Advance care planning, palliative care, and end-of-life care interventions for racial and ethnic underrepresented groups: A systematic review","volume":"62","author":"Jones","year":"2021","journal-title":"J. Pain Symptom Manag."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1089\/jpm.2013.9468","article-title":"Racial and ethnic disparities in palliative care","volume":"16","author":"Johnson","year":"2013","journal-title":"J. Palliat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"309","DOI":"10.21037\/apm-23-459","article-title":"Disparities in end-of-life care for racial minorities: A narrative review","volume":"13","author":"Jawed","year":"2024","journal-title":"Ann. Palliat. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100331","DOI":"10.1016\/j.ssmph.2018.100331","article-title":"Racial and ethnic differences in end-of-life care in the United States: Evidence from the Health and Retirement Study (HRS)","volume":"7","author":"Orlovic","year":"2019","journal-title":"SSM-Popul. Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.jpainsymman.2020.09.017","article-title":"Racial disparities in end-of-life care between black and white adults with metastatic cancer","volume":"61","author":"Perry","year":"2021","journal-title":"J. Pain Symptom Manag."},{"key":"ref_16","unstructured":"Baciu, A., Negussie, Y., Geller, A., and Weinstein, J.N. (2017). Communities in Action: Pathways to Health Equity, National Academies Press."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/j.jpainsymman.2021.05.018","article-title":"End-of-life planning depends on socio-economic and racial background: Evidence from the US Health and Retirement Study (HRS)","volume":"62","author":"Orlovic","year":"2021","journal-title":"J. Pain Symptom Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1089\/jpm.2017.0374","article-title":"Racial and ethnic differences in advance care planning: Results of a statewide population-based survey","volume":"21","author":"Clark","year":"2018","journal-title":"J. Palliat. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Periyakoil, V.S., Neri, E., and Kraemer, H. (2015). No easy talk: A mixed methods study of doctor reported barriers to conducting effective end-of-life conversations with diverse patients. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122321"},{"key":"ref_20","first-page":"141","article-title":"Guidance for conducting systematic scoping reviews","volume":"13","author":"Peters","year":"2015","journal-title":"JBI Evid. Implement."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: Advancing the methodology","volume":"5","author":"Levac","year":"2010","journal-title":"Implement. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1200\/JCO.23.01290","article-title":"Systematic review of interventions addressing racial and ethnic disparities in cancer care and health outcomes","volume":"42","author":"Grant","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Noyes, J., Booth, A., Cargo, M., Flemming, K., Harden, A., Harris, J., Garside, R., Hannes, K., Pantoja, T., and Thomas, J. (2019). Qualitative evidence. Cochrane Handbook for Systematic Reviews of Interventions, Wiley.","DOI":"10.1002\/9781119536604.ch21"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1177\/1090198112461252","article-title":"Circles of care: Development and initial evaluation of a peer support model for African Americans with advanced cancer","volume":"40","author":"Hanson","year":"2013","journal-title":"Health Educ. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1177\/1090198113512127","article-title":"Circles of care: Implementation and evaluation of support teams for African Americans with cancer","volume":"41","author":"Hanson","year":"2014","journal-title":"Health Educ. Behav."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2972","DOI":"10.1136\/spcare-2023-004527","article-title":"Palliative Care Curriculum and Training Plan for community health workers","volume":"14","author":"Monton","year":"2023","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1017\/S1478951522001298","article-title":"Acceptability of a Serious Illness Conversation Guide to Black Americans: Results from a focus group and oncology pilot study","volume":"21","author":"Sanders","year":"2023","journal-title":"Palliat. Support. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1002\/pon.5313","article-title":"Puente para cuidar (bridge to caring): A palliative care patient navigator and counseling intervention to improve distress in Latino\/as with advanced cancer","volume":"29","author":"Bekelman","year":"2020","journal-title":"Psycho-oncology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1001\/jamaoncol.2018.4014","article-title":"Effect of Apoyo con Cari\u00f1o (support with caring) trial of a patient navigator intervention to improve palliative care outcomes for Latino adults with advanced cancer: A randomized clinical trial","volume":"4","author":"Fischer","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1177\/10499091211060008","article-title":"Using participatory action research to sustain palliative care knowledge and readiness among Latino community leaders","volume":"39","author":"Johnson","year":"2022","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/01.NAJ.0000944912.42194.33","article-title":"Can a Palliative Care Lay Health Advisor\u2013Nurse Partnership Improve Health Equity for Latinos with Cancer?","volume":"123","author":"Larson","year":"2023","journal-title":"AJN Am. J. Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1007\/s13187-023-02270-3","article-title":"Adaptation of a multimedia chemotherapy educational intervention for Latinos: Letting patient narratives speak for themselves","volume":"38","author":"Leiter","year":"2023","journal-title":"J. Cancer Educ."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Shen, M.J., Cho, S., De Los Santos, C., Yarborough, S., Maciejewski, P.K., and Prigerson, H.G. (2023). Planning for your advance care needs (PLAN): A communication intervention to improve advance care planning among latino patients with advanced cancer. Cancers, 15.","DOI":"10.3390\/cancers15143623"},{"key":"ref_35","unstructured":"Givler, A., Bhatt, H., and Maani-Fogelman, P.A. (2018). The Importance of Cultural Competence in Pain and Palliative Care. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1089\/pmr.2020.0124","article-title":"Cultural considerations in palliative care provision: A scoping review of Canadian literature","volume":"2","author":"Monette","year":"2021","journal-title":"Palliat. Med. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1017\/jme.2021.32","article-title":"Engaging social justice methods to create palliative care programs that reflect the cultural values of African American patients with serious illness and their families: A path towards health equity","volume":"49","author":"Elk","year":"2021","journal-title":"J. Law Med. Ethics"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1089\/jpm.2023.0124","article-title":"Palliative Care Clinical Trials in Underrepresented Ethnic and Racial Minorities: A Narrative Review","volume":"27","author":"Sy","year":"2024","journal-title":"J. Palliat. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/hpm.3509","article-title":"Patient engagement in healthcare planning and evaluation: A call for social justice","volume":"37","author":"Snow","year":"2022","journal-title":"Int. J. Health Plan. Manag."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"256","DOI":"10.7326\/0003-4819-153-4-201008170-00008","article-title":"Redefining the \u201cplanning\u201d in advance care planning: Preparing for end-of-life decision making","volume":"153","author":"Sudore","year":"2010","journal-title":"Ann. Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e543","DOI":"10.1016\/S1470-2045(17)30582-X","article-title":"Definition and recommendations for advance care planning: An international consensus supported by the European Association for Palliative Care","volume":"18","author":"Rietjens","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1071\/PY17082","article-title":"The power of talk and power in talk: A systematic review of Indigenous narratives of culturally safe healthcare communication","volume":"24","author":"Jennings","year":"2018","journal-title":"Aust. J. Prim. Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1089\/jpm.2016.0504","article-title":"Implementing an advance care planning intervention in community settings with older Latinos: A feasibility study","volume":"20","author":"Carrion","year":"2017","journal-title":"J. Palliat. Med."},{"key":"ref_44","unstructured":"Institute of Medicine, and Committee on Approaching Death: Addressing Key End-of-Life Issues (2015). Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, National Academies Press."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Scherer, K.A., B\u00fcdenbender, B., Blum, A.K., Gr\u00fcne, B., Kriegmair, M.C., Michel, M.S., and Alpers, G.W. (2025). Power asymmetry and embarrassment in shared decision-making: Predicting participation preference and decisional conflict. BMC Med. Inform. Decis. Mak., 25.","DOI":"10.1186\/s12911-025-02938-4"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s13063-021-05064-4","article-title":"Randomized trial of community health worker-led decision coaching to promote shared decision-making for prostate cancer screening among Black male patients and their providers","volume":"22","author":"Makarov","year":"2021","journal-title":"Trials"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12939-021-01462-x","article-title":"Cultural adaptation of health interventions including a nutrition component in Indigenous peoples: A systematic scoping review","volume":"20","author":"Vincze","year":"2021","journal-title":"Int. J. Equity Health"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Baker, R., Camosso-Stefinovic, J., Gillies, C., Shaw, E.J., Cheater, F., Flottorp, S., Robertson, N., Wensing, M., Fiander, M., and Eccles, M.P. (2015). Tailored interventions to address determinants of practice. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD005470.pub3"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1002\/nop2.733","article-title":"Culturally tailored interventions for ethnic minorities: A scoping review","volume":"8","author":"Joo","year":"2021","journal-title":"Nurs. Open"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1186\/s13643-024-02679-x","article-title":"Characteristics of interventions that address racism in the United States and opportunities to integrate equity principles: A scoping review","volume":"13","author":"DiPetrillo","year":"2024","journal-title":"Syst. Rev."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/13\/2209\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:02:15Z","timestamp":1760032935000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/13\/2209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":50,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["cancers17132209"],"URL":"https:\/\/doi.org\/10.3390\/cancers17132209","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}