Collaborative Implementation Planning to Jumpstart Advance Care Planning with Alaska Native and American Indian peoples in Primary Care.

Background: Palliative care, including advance care planning (ACP), ensures a patient's medical care aligns with their values, goals, and priorities throughout serious illness or injury. The Alaska Native and American Indian (AN/AI) population is greatly increasing and less likely to have documentation on ACP conversations. AN/AI peoples are more likely to engage in ACP when it is culturally-tailored to their specific needs. Jumpstart AN/AI is a culturally-tailored tool to assist providers and customer-owners with starting ACP conversations. We conducted a qualitative study to gather feedback from customer-owners and employees to inform implementation of Jumpstart AN/AI within primary care at Southcentral Foundation (SCF), a Tribal health system. Methods: We conducted a qualitative, descriptive study using a community-based participatory research approach. Semi-structured interviews and focus groups were conducted with customer-owners (n=14) and SCF employees (n=16). We used template analysis, a rapid qualitative data reduction technique, to analyze results from the qualitative interviews and focus groups. Results were then presented to the research team and SCF leadership to finalize implementation plans for Jumpstart AN/AI within SCF. Results: All participant groups were in favor of implementing Jumpstart AN/AI and expressed the importance of ACP conversations for AN/AI peoples. SCF employees stated Jumpstart AN/AI delivery would need to be flexible and meet the needs of customer-owners as well as providers and staff. Customer-owners reported they trust their care teams to deliver Jumpstart AN/AI and would also value patient-facing materials so they could ask their provider about Jumpstart AN/AI. Conclusions: Qualitative data collected from SCF employees and customer-owners, rapid template analysis, and collaboration with Tribal health system leaders resulted in successfully and quickly developing a flexible implementation plan to integrate Jumpstart AN/AI into the Tribal health system. Implementation of Jumpstart AN/AI will contribute to the limited evidence base for AN/AI-tailored ACP interventions and inform implementation research and practice.For clinical trials, the trial registry name and URL, and registration number must be included at the end of the abstract.