A modified world café approach to identify the core components of palliative care models for underserved populations

Background: Palliative care is becoming increasingly important for many health systems worldwide, driven by ageing populations and the increasing prevalence of chronic conditions. Access to and use of palliative care are not uniform across populations and are particularly limited among people of culturally and linguistically diverse communities, people of low socioeconomic status, and people residing in rural areas. To address these disparties, models of palliative care are required to meet the needs of these populations. The aim of this study was to identify stakeholder perspectives on the core components of palliative care models for these underserved populations that have the potential to improve their access to and use of palliative care. Methods: Using a modified world café approach, facilitated discussions were held with stakeholders at two palliative care forums held in Australia in 2023. Targeted discussions were held on the factors that helped and hindered access to and use of palliative care, and the types of palliative care models for the three underserved populations. Participants summarised their discussions and identified three priority areas. Thematic analysis was used to identify patterns in the data collected from the forums. Results: Over one hundred stakeholders contributed to this study (n = 109). The barriers to palliative care among the underserved populations included (mis)understandings of palliative care services, such as beliefs about dying, geographical or social isolation, the limited cultural appropriateness of services, and limited resources that restricted access to and use of palliative care services. Participants identified features that enabled the underserved populations to access palliative care, including communication and relationships to aid shared understanding, education for service providers and recipients, resources to promote and sustain community engagement, and cultural appropriateness to ensure communication was tailored to the needs and preferences of these populations. Conclusions: Palliative care services for underserved populations should demonstrate choice, appropriateness, and connectedness, and be well-resourced. These core components might be used to underpin palliative care services for these populations to improve their access to and use of these services.