The proposed pilot study will design and test the feasibility of a Lay Health Advisor intervention with the overall objective of improving treatment for pain and suffering for African American patients with cancer. To achieve this objective, we will utilize a successful research partnership between the UNC-CH School of Medicine and Shaw University, a historically black university. An interdisciplinary group of faculty with expertise in palliative care and in community-based research will recruit 30 Palliative Care Lay Health Advisors (PCLHA) from 6 African American churches. PCLHA will receive training in 3 content areas - palliative care, spiritual care giving, and lay health advisor skills. CLHA will then be paired with 60 African American cancer patients to provide counseling about pain and symptom management, local palliative care resources and spiritual care. ? Specific aims of this proposal are: 1. To explore the acceptability and comprehensiveness of an existing measure of quality of life at the end of life (QUAL-E) in focus groups of African-American cancer patients and family caregivers, 2. To test the feasibility of proposed methods for recruiting and training Palliative Care Lay Health Advisors from African-American churches, 3. To test the feasibility of proposed methods for pairing Palliative Care Lay Health Advisors with African-American patients with pain and suffering from cancer, and 4. To describe the impact of Palliative Care Lay Health Advisors on these cancer patients': ? a) knowledge of providers of pain and symptom treatment, ? b) communication about life-sustaining treatment choices, ? c) quality of life, and ? d) perceived unmet need for treatment of pain and suffering. ? ?
