"You do what you have to do, and you don't ask for help": American Indian Reservation Community Talking Circles about Barriers to Palliative Care.

Great Plains American Indians living in reservation communities suffer some of the highest mortality disparities in the US, but culture-centric palliative care can ease the burdens of serious illness and improve end-of-life decision-making. Common misunderstandings about palliative care, as well as historical and cultural barriers, stand as obstacles to its widespread use. Therefore, the aims of this interdisciplinary report (American Indian and non-American Indian researchers) are to share results from reservation community Talking Circles used to guide the design of a culture-centric message to promote and educate about palliative care within three Great Plains Tribal communities. This deductive content analysis employed the three characteristics of Larkey and Hecht's (2010) narrative as culture-centric health promotion model: engaging stories, engaging characters, and cultural embeddedness. Our participants' narratives corresponded with all three tenets of the model and may serve as an effective guide for creating palliative care messages. Therefore, the model served as a valuable mechanism to gather stories that can serve in the development of culture-centric messages that promote and educate about palliative care for these three Great Plains Tribal communities.