Applying the 3D Model of Culturally Congruent Care to Address Prolonged Grief Disorder: An Embedded Mixed-Methods Study

Population health is a relatively new concept that is integral to primary care. It requires healthcare providers to think differently about health issues and solutions by considering the individual, family, and community. Moreover, Prolonged grief disorder (PGD), also a newly introduced diagnostic condition in DSM-5-TR, is a persistent and pervasive response that affects beyond an individual's cultural, social, and religious norms and significantly impacts crucial areas (personal, family, and occupation) of functioning. Moreover, when PGD-bereaved familial caregivers are treated using Internet-based cognitive behavioral therapy (ICBT), gold standard retention has remained a significant issue among multicultural populations despite the steady rise in culturally adapted ICBT interventions. Therefore, to resolve this issue and build the trust gap between the healthcare provider and the participant dyad, I propose to develop a “Wave of Hope” framework by applying the 3D mode of culturally congruent care model. Thus, this dissertation involves a mixed-method approach to identify individual-level domains and integrate them into the existing framework using a cultural humility lens, which will act as a source to improving retention in the existing interventions. This research will create insights to guide future empirical work in this area. The specific aims are to:1. identify gaps in retention strategies in PGD effectiveness studies among familial caregivers.2. comprehensively explore the culturally relevant grief experiences of (racially/ethnically) diverse bereaving caregivers.3. identify individual-level cultural domains that can help enhance the retention of ICBT for PGD and integrate them into the existing 3-D model of Culturally Congruent care.