Grant: Project Grant

Palliative care (PC) is a highly effective and evidence-based intervention that reduces symptom burden, hospitalizations, and system costs for those facing serious illness. Yet in Canada, PC remains underused and often introduced only in the final weeks of life. Patients with non-cancer diagnoses and marginalized communities are especially underserved. Although clinician education programs have proliferated, they have had limited impact on behavior change and do not address the public's stigma that PC is associated with death and hopelessness. This study directly targets these public barriers through the Waiting Room Revolution (WRR)-a patient-family education program designed to activate individuals from the moment of diagnosis. The WRR employs a framework of "7 keys" to demystify and empower proactive engagement with PC principles without relying on the term itself, fostering illness understanding, advance care planning, and psychosocial support. While uptake of WRR materials has been widespread, its impact on patient-reported outcomes (PROs), implementation success, and equity across diverse communities has not been formally evaluated. This grant uses a hybrid Type II effectiveness-implementation design to evaluate the WRR program's impact on hope, preparedness, quality of life, and health system navigation, as well as to document how partner organizations adapt the curriculum for the populations they serve. Through validated frameworks such as FRAME and Proctor's implementation taxonomy, the study will generate actionable evidence on tailoring and scaling public-facing PC education. Ultimately, the WRR program reimagines early PC by placing patients and families at the center-not as passive recipients, but as agents of change. This approach aligns with the international public health palliative care movement, promoting scalable, equitable, and sustainable access to high-quality, person-centered care for all Canadians living with serious illness.