Exploring the influence of ethnic background, culture and faith on perceptions towards advance care planning conversations with British Muslim communi

Background and rationale: In the UK, there is evidence of lower uptake of Advance Care Planning (ACP) and palliative care among minoritised ethnic groups. These are people who do not self-identify as belonging to the White ethnic group (Saltus and Pithara, 2015). Population projections suggest that people from minoritised ethnic groups aged 65+ will reach 1.3 million by 2026 (Calanzani et al., 2013). Almost 1 in 3 of minoritised ethnic groups are British Muslims (The Muslim Council of Britain, 2015). Older British Muslims (65+) have higher prevalence of chronic illnesses such as diabetes, heart conditions and high blood pressure compared to the rest of the UK population. While older Muslim women being twice as likely to report having "bad" or "very bad" compared to the rest of the population of women in England (Sherif et al., 2019). Highlighting the need for ensuring ACP conversations around preference and future care are tailored for this group.
Healthcare professionals describe challenges around ACP conversations that are inclusive of patients and families values and beliefs (Sherif et al., 2019, De Vries et al., 2019). Among people from minoritised ethnic groups, a number of barriers to conversations around ACP have been identified. These include limited awareness of ACP, mistrust of healthcare systems and apprehension about possible distress discussions about dying may cause for patients and families (Canny et al., 2022). From research with minoritised ethnic groups and British Muslims, there is a need for culturally competent and accessible ACP resources (Canny et al., 2022, Sherif et al., 2019, Moss et al., 2022), developed in collaboration with people from communities (Ahmed and Siddiqi, 2016). This can facilitate explorations of what is important to people from minoritised ethnic backgrounds and to deliver palliative and end of life care that gives them the best possible end of life experiences.
Aims: The aims of this doctoral study will be: (1) to explore the influence of ethnic background, culture and faith on attitudes towards ACP conversations for British Muslims; (2) to co-produce a resource for patients and families and a guide or communication tool for healthcare professionals to support culturally competent ACP conversations with people from the British Muslim community.
Methods: The PhD will consist of four phases. (Phase 1) A literature review to explore existing evidence on barriers and facilitators to ACP for Muslims. (Phase 2) Peer research in collaboration with Muslim Council of Britain to undertake interviews with others from the British Muslim community to explore understanding of palliative care, ACP and the potential influences of culture and faith on openness and attitudes towards this process. (Phase 3) Co-design workshops for developing recommendations. (Phase 4) Co-producing and disseminating a resource for patients and families and a guide or communication tool for health care practitioners.
Expected Outcomes: This research will raise awareness and facilitate access to ACP for patients and families with British Muslim communities. A resource for patients and families to support them in engaging with ACP conversations, and a guide or communication tool that is culture and faith sensitive to support health care practitioners in palliative care settings in having ACP conversations with British Muslim communities. These will be co-produced with people from the British Muslim community and health care practitioners. Centering upon the voices of British Muslims and families will enable valuable insights into what culturally competent palliative care may look like.
Plans for dissemination: As this project represents a collaboration between University College London, University of Leeds, Marie Curie and The Muslim Council of Britain, the outputs from this research have clear pathways to impact via the wide ranging reach and influence of the organisations involved.