Community capacity building in palliative care: An illustrative case study in rural Northwestern Ontario

Abstract

Despite the increasing need for palliative care, it is well recognized that people who are dying in rural and remote areas have less access to palliative care services than their urban counterparts. Barriers to accessing palliative care for rural residents include geographic isolation, shortage of human resources, and lack of palliative care education and training for rural health care providers. Community capacity development has become an accepted practice approach to developing rural health services, essentially 'building on what already exists'. This case study research conducted in northwestern Ontario, Canada, examined the application of a four phase community capacity development model as an intervention to develop a palliative care program in a rural community. Data were collected over the three-year period using a participatory action research approach. Findings illustrated the applicability of the model to guide rural palliative care development and provided details of the community change process. Conclusions support the applicability of the model for use as a theory of change to guide and evaluate rural palliative care service development. Keywords: rural health, rural palliative care, palliative care, community capacity development, participatory action research, rural health teamwork, end-of-life care.