Towards theory-based behavioral interventions to improve timely initiation of palliative care for persons with cancer.

Although palliative care (PC) leads to improved quality of life in people with cancer, it is often initiated too late or not initiated at all. Current studies focusing on timely initiation of PC are doing so from a health service and health professional perspective and rarely from a health promotion perspective focusing on the pertinent role that behavior of the patient can play. The change of certain behaviors of patients could improve the timely initiation of PC in the disease trajectory. Theory-based behavioral research and interventions are needed to understand patient behaviors and to realize patient behavioral change. Within this proposal, people with a non-curable cancer starting a conversation about palliative care with a treating health professional is the defined behavior to be examined and assumed to be contributing to more timely initiation of PC. In this innovative research project we will detect the underlying determinants facilitating or hindering this behavior in people with a non-curable cancer. Additionally, we will develop a behavioral intervention targeting the most important determinants of starting a conversation about PC with a health professional (detected in part 1) and evaluate the feasibility and preliminary effects. The use of a theoretically grounded focus on the role of behaviors to palliative care is highly innovative: it
is almost unexplored although behavioral theories have proven their worth in other domains of health promotion research.