Public Awareness Campaigns on Palliative Care: Applying a Multidimensional Model to Understand the Reception by the General Public

Public awareness campaigns on palliative care aim to tackle limited public knowledge and negative perceptions of palliative care. However, little is known about their public reception. This study examined how existing campaigns are interpreted, evaluated, and engaged with by members of the general public. Three public campaigns, launched in Flanders or the Netherlands between 2020 and 2023, were discussed in 10 focus groups (total of 65 participants). The analysis was guided by Schrøder's multidimensional audience reception model. Our results show that campaigns were interpreted, evaluated, and engaged with in highly divergent ways. People with personal experiences surrounding serious illness were generally more open toward campaign messages, while a sense of personal relevance was lacking for others. Campaigns that centered on the perspectives of seriously ill individuals while portraying them in active and resilient positions were more positively evaluated. Moreover, they were more successful in broadening perceptions of palliative care beyond being hospital-based end-of-life care for severely ill and care-dependent persons. Conversely, materials that neglected the patient's voice while framing palliative care as enabling moments of joy "despite serious illness" generally fortified prior perceptions and were often rejected. Additionally, a preference for highlighting the social context surrounding the patient was repeatedly expressed. We conclude that diversified strategies, optimizing a sense of personal relevance, are needed to more effectively influence public understanding and engagement toward palliative care. Destigmatizing palliative care also involves destigmatizing persons with serious illness, and representing them with an emphasis on their agency and strength is vital to this shift.