Disparities in access to palliative care persist, particularly among underserved populations. We elicited recommendations for integrating community health workers (CHWs) into clinical care teams, by exploring perspectives on potential barriers and facilitators, ultimately aiming to facilitate equitable access to palliative care.

Twenty-five stakeholders were recruited for semi-structured interviews through purposive snowball sampling at three enrollment sites in the USA. Interviews were conducted to understand perspectives on the implementation of a CHW palliative care intervention for African American patients with advanced cancer. After transcription, primary and secondary coding were conducted. Framework analysis was utilized to refine the data, clarify themes, and generate recommendations for integrating CHWs into palliative care teams.

Our sample comprised 25 key informants, including 6 palliative care providers, 6 oncologists, 5 cancer center leaders, 2 cancer care navigators, and 6 CHWs. Thematic analysis revealed five domains of recommendations: (1) increasing awareness and understanding of the CHW role, (2) improving communication and collaboration, (3) ensuring access to resources, (4) enhancing CHW training, and (5) ensuring leadership support for integration. Informants shared barriers, facilitators, and recommendations within each domain based on their experiences.

Barriers to CHW integration within palliative care teams included limited awareness of the CHW role and inadequate training opportunities, alongside practical and logistical challenges. Conversely, promoting CHW engagement, providing adequate training, and ensuring support from leadership have the potential to aid integration.

Disaster Medicine (DM) is the clinical specialty whose expertise includes the care and management of patients and populations outside conventional care protocols. While traditional standards of care assume the availability of adequate resources, DM practitioners operate in situations where resources are not adequate, necessitating a modification in practice. While prior academic efforts have succeeded in developing a list of core disaster competencies for emergency medicine residency programs, international fellowships, and affiliated health care providers, no official standardized curriculum or consensus has yet been published to date for DM fellowship programs based in the United States.

The objective of this work is to define the core curriculum for DM physician fellowships in the United States, drawing consensus among existing DM fellowship directors.

A panel of DM experts was created from the members of the Council of Disaster Medicine Fellowship Directors. This council is an independent group of DM fellowship directors in the United States that have met annually at the American College of Emergency Physicians (ACEP)’s Scientific Assembly for the last eight years with meeting support from the Disaster Preparedness and Response Committee. Using a modified Delphi technique, the panel members revised and expanded on the existing Society of Academic Emergency Medicine (SAEM) DM fellowship curriculum, with the final draft being ratified by an anonymous vote. Multiple publications were reviewed during the process to ensure all potential topics were identified.

The results of this effort produced the foundational curriculum, the 2023 Model Core Content of Disaster Medicine.

Members from the Council of Disaster Medicine Fellowship Directors have developed the 2023 Model Core Content for Disaster Medicine in the United States. This living document defines the foundational curriculum for DM fellowships, providing the basis of a standardized experience, contributing to the development of a board-certified subspecialty, and informing fellowship directors and DM practitioners of content and topics that may appear on future certification examinations.