# Advance Care Planning in Multicultural Communities: A Document Analysis of Resources to Support Healthcare Staff and Consumers in Australia

## TL;DR

This study analyzes available resources in Australia to support advance care planning for multicultural communities, highlighting gaps in culturally tailored support.

## Contribution

The study identifies specific gaps in resources for culturally and linguistically diverse communities in advance care planning.

## Key findings

- 30 resources were identified, with 70% from government sources and 70% targeting consumers.
- Only a few resources included co-design with communities or specific recommendations for CALD populations.
- Four key themes emerged for improving ACP engagement with CALD communities: cultural sensitivity, communication support, staff training, and multidisciplinary collaboration.

## Abstract

Advance care planning (ACP) provides a person‐centric approach for discussing future care wishes that is responsive to individual preferences and needs. People from culturally and linguistically diverse (CALD) backgrounds have substantially lower opportunities for engagement in ACP, contributing to less person‐centred care, particularly towards the end of life. This study aimed to identify and describe the currently available resources in Australia that support healthcare staff and people from CALD backgrounds in engaging with ACP.

Altheide's document analysis approach was used to systematically search and select eligible publicly available resources published between January 2013 and June 2023 from websites of government health departments and registered non‐government organisations that focused on facilitating ACP with people from CALD backgrounds. A narrative synthesis was performed to report the characteristics and scope of resources. Thematic analysis was employed with the content to identify considerations and recommendations for engaging with individuals from CALD backgrounds in ACP.

A total of 30 eligible resources were identified, of which 21 resources (70%) originated from government sources. Most of the resources targeted consumers (21/30, 70%), and a total of 91 community languages were covered across 15 resources that were offered in translated versions. Five resources were available in easy‐to‐read English. Thematic analysis of the ten resources that included considerations or recommendations for CALD populations identified four themes: practising culturally sensitive and person‐centred approach, supporting communication needs, staff recruitment and training, and provision of collaborative and multidisciplinary support.

Whilst a large number of resources have been developed to facilitate uptake of ACP among the general population, a limited number of resources provide specific recommendations or support for working with CALD communities. Few resources reported the use of co‐design with communities despite recommendations to do so. Targeted information both for consumers and care providers is required to provide culturally relevant and inclusive support that promotes engagement in ACP towards person‐centric care.

The iCanCare Project described includes consumer investigators who have contributed to conceptualisation and design of the project, in addition to a Project Steering Group including consumer members who have guided the research process.