Achieving cultural relevancy in an end of life decision making initiative: MOLST in Massachusetts

Although all health care providers hope for survival of persons with serious illness, even with the most advanced treatment a proportion will need to make plans for advancing illness and eventually consider whether or not they would choose life-sustaining treatment at the end of life. When this occurs, how can we ensure that persons of various cultural and ethnic backgrounds will have access to culturally relevant and linguistically appropriate information and materials during this most vulnerable time? Based on their experiences both with Medical Orders for Life-Sustaining Treatment (MOLST, a demonstration project established through the enactment of Massachusetts health care reform Section 43 of the Acts of 2008) and with an esatblished community end of life coalition, the presentation will: a) describe MOLST, a program in Massachusetts that encourages persons with life-limiting illnesses to consider life-sustaining treatment options at the end of life; b) review community engagement strategies, such as community outreach, key informant interviews, and focus groups, for eliciting multicultural, multi-population community input; c) discuss strategies for recruiting and conducting focus groups; and d) identify cultural and population adaptations that can be made in order to refine health educational materials.