The evolution of the Kelley community capacity development model for palliative care.

This oral presentation will describe the conceptual evolution of the Kelley model for Community Capacity Development [2000-2016]. It will illustrate how and why the model changed to become a powerful Canadian example of a public health approach to developing community based palliative care programs. Based on conducting participatory action research in rural, First Nations communities and long-term care homes, the perspective of "community" gradually expanded beyond health care professionals to include natural helpers, front line care providers, formal and informal community leaders, and social services. The Kelley model has potential to be applied internationally since it builds a context specific palliative care program that is grounded in the local community and uses existing informal and formal resources. The Kelley model is a theory of change and can be used to guide a process of developing community-based palliative care programs. The model includes a series of four incremental but non-linear phases. Development is a bottom-up process that is grounded in the unique needs, vision, culture and values of a specific community. Community change is made from inside the community and not from outside. Development builds on existing resources, relationships, strengths and assets. Based on participatory action research and applying the model in rural communities, First Nations communities and long term care homes, the definition of the "community" in the model gradually expanded from registered health care providers and health services only. Supportive community members, often taken for granted by health care professionals but critical to the success of community palliative care, gradually became more visible through the research. The Kelley model of the palliative care community grew to include natural helpers, front line providers such as personal support workers, formal and informal community leaders, and social services. The Kelley model is a Canadian model that can be used to guide community based palliative care development in many diverse geographic, organizational or cultural communities. It can be applied internationally since it creates a palliative care program that is grounded in a unique local community and uses existing informal and formal resources.