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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 29 Research Studies DisplayedPeipert JD, Lad T, Khosla PG
A low literacy, multimedia health information technology intervention to enhance patient-centered cancer care in safety net settings increased cancer knowledge in a randomized controlled trial.
In this study, the investigators tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I-III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings.
AHRQ-funded; HS017300.
Citation: Peipert JD, Lad T, Khosla PG .
A low literacy, multimedia health information technology intervention to enhance patient-centered cancer care in safety net settings increased cancer knowledge in a randomized controlled trial.
Cancer Control 2021 Jan-Dec;28:10732748211036783. doi: 10.1177/10732748211036783..
Keywords: Health Literacy, Patient-Centered Healthcare, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT)
Wing SE, Hu H, Lopez L
Recall of genomic testing results among patients with cancer.
Genomic testing of somatic and germline DNA has transformed cancer care. However, low genetic knowledge among patients may compromise care and health outcomes. Given the rise in genomic testing, we sought to understand patients' knowledge of their genetic test results. The investigators conducted a survey-based study with 85 patients at a comprehensive cancer center and compared self-reported recall of (a) having had somatic/germline testing and (b) their specific somatic/germline results to the genomic test results documented in the medical record.
AHRQ-funded; HS024984.
Citation: Wing SE, Hu H, Lopez L .
Recall of genomic testing results among patients with cancer.
Oncologist 2021 Dec;26(12):e2302-e05. doi: 10.1002/onco.13928..
Keywords: Cancer, Genetics, Health Literacy
Greenzang KA, Kelly CA, Al-Sayegh H
Thinking ahead: parents' worries about late effects of childhood cancer treatment.
This study examined parental perceived likelihood, impact, and worry about late effects of treatment for childhood cancer. The authors surveyed 96 parents of pediatric cancer patients at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center within a year of diagnosis. Most parents (96%) valued information about late effects, and 93% considered late effects in their treatment decision-making. However, 24% could not recall receiving information about late effects, and only 51% felt well-prepared for potential late effects. Only one-fifth of parents consider late effects to be likely for their child, while 61% were extremely/very worried about late effects.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Kelly CA, Al-Sayegh H .
Thinking ahead: parents' worries about late effects of childhood cancer treatment.
Pediatr Blood Cancer 2021 Dec;68(12):e29335. doi: 10.1002/pbc.29335..
Keywords: Children/Adolescents, Cancer, Education: Patient and Caregiver, Health Literacy, Caregiving
Santana S, Brach C, Harris L
AHRQ Author: Brach C
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.
The US Department of Health & Human Services (HHS) updates the Healthy People objectives each decade based on the most current science. For the development of HP2030, the HHS drew on recommendations from the Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (Secretary's Advisory Committee), an independent advisory committee of national health experts, to update the 20-year old individual-focused Healthy People definition of health literacy. This paper discusses that process.
AHRQ-authored.
Citation: Santana S, Brach C, Harris L .
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.
J Public Health Manag Pract 2021 Nov-Dec;27(Suppl 6):S258-S64. doi: 10.1097/phh.0000000000001324..
Keywords: Health Literacy, Public Health, Health Promotion
Abujarad F, Peduzzi P, Mun S
Comparing a multimedia digital informed consent tool with traditional paper-based methods: randomized controlled trial.
This study compared informed consent using the traditional paper method versus a digital health tool called Virtual Multimedia Interactive Informed Consent (VIC) and participants’ comprehension of medical information. VIC was put on an iPad. The study was a randomized controlled trial with participants recruited from the Winchester Chest Clinic at Yale New Haven Hospital, and healthy individuals recruited from the community using fliers. A total of 50 participants were recruited and the informed consent method was randomized (VIC n = 25; paper, n = 25). Participants in both groups had high comprehension, but VIC participants reported higher satisfaction, higher perceived ease of use, higher ability to complete the consent independently, and shorter perceived time to complete the consent process.
AHRQ-funded; HS023987.
Citation: Abujarad F, Peduzzi P, Mun S .
Comparing a multimedia digital informed consent tool with traditional paper-based methods: randomized controlled trial.
JMIR Form Res 2021 Oct 19;5(10):e20458. doi: 10.2196/20458..
Keywords: Health Literacy, Health Information Technology (HIT)
Lopez-Olivo MA, Lin H, Rizvi T
Randomized controlled trial of patient education tools for patients with rheumatoid arthritis.
This randomized controlled trial compared results of patient education tools for patients with rheumatoid arthritis using a written booklet or a written booklet along with a newly developed video tool. Outcomes were measured immediately before and after review of the materials, and 3 and 6 months later. One-hundred eleven participants received an educational video and booklet and one-hundred ten a booklet alone. Mean age of participants was 50.8 years, mean disease duration 4.8 years, 85% were female, and 24% had limited health literacy levels. Both groups had improved outcomes up to 6 months after educational materials were delivered and used, with no statistically significant difference between the two groups. Patients receiving the video and booklet were more likely to rate the presentation as “excellent".
AHRQ-funded; HS0193554.
Citation: Lopez-Olivo MA, Lin H, Rizvi T .
Randomized controlled trial of patient education tools for patients with rheumatoid arthritis.
Arthritis Care Res 2021 Oct;73(10):1470-78. doi: 10.1002/acr.24362..
Keywords: Education: Patient and Caregiver, Health Literacy, Arthritis, Patient Self-Management
Kruse J, Toledo P, Belton TB
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
The internet is a frequently used resource for providing patient education materials (PEMs). The aim of this study was to evaluate the readability, content, and quality of web-based PEMs on COVID-19 from US academic medical centers. Despite availability of web-based PEMs for COVID-19, the readability was significantly higher than the National Institute of Health and US Department of Health and Human Services recommended sixth grade reading level and actionability of PEMs was low.
AHRQ-funded; HS025267; HS026169.
Citation: Kruse J, Toledo P, Belton TB .
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
Am J Infect Control 2021 Jun;49(6):690-93. doi: 10.1016/j.ajic.2020.11.023..
Keywords: COVID-19, Education: Patient and Caregiver, Health Literacy, Public Health, Infectious Diseases
Brach C, Harris LM
AHRQ Author: Brach C
Healthy People 2030 health literacy definition tells organizations: make information and services easy to find, understand, and use.
This AHRQ-authored article discusses the expanded definition of health literacy as part of the framework for the newly released HHS Healthy People 2030. The new definition includes a new organizational component that recognizes the essential role organizations that provide health-related information and services play in improving health literacy (Organizational Health Literacy). Previously health literacy was defined solely in terms of an individuals’ capacity to understand health information (now called Personal Health Literacy). The emphasis in Organizational Health Literacy is on physicians, as well as clinicians and organizational leaders to help their organizations become health literate.
AHRQ-authored.
Citation: Brach C, Harris LM .
Healthy People 2030 health literacy definition tells organizations: make information and services easy to find, understand, and use.
J Gen Intern Med 2021 Apr;36(4):1084-85. doi: 10.1007/s11606-020-06384-y..
Keywords: Health Literacy, Education: Patient and Caregiver
MacEwan SR, Gaughan A, Hefner JL
Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members.
Health literacy is a fundamental contributor to an individual's ability to self-manage their health and appropriately use health care services. Tools that positively impact health literacy therefore have potential to improve health outcomes. Inpatient portals are a tool that provides patients an opportunity to cultivate health literacy skills during hospitalization. This study investigated how inpatient portal use could impact attributes of health literacy.
AHRQ-funded; HS024091; HS024767; HS024379.
Citation: MacEwan SR, Gaughan A, Hefner JL .
Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members.
Patient Educ Couns 2021 Apr;104(4):836-43. doi: 10.1016/j.pec.2020.09.028..
Keywords: Health Literacy, Health Information Technology (HIT), Hospitalization, Inpatient Care
Eber MR, Sunstein CR, Hammitt JK
The modest effects of fact boxes on cancer screening.
Investigators explored the effects of providing participants using published fact boxes on the benefits and harms of common cancer screening procedures. They found that participants updated their beliefs about the net benefits of screening modestly, but they observed little change in participants’ stated preferences to seek screening. Those who scored higher on a numeracy test updated their beliefs about screening benefits more in response to the fact boxes than did participants who scored lower on the numeracy test.
AHRQ-funded; HS000055.
Citation: Eber MR, Sunstein CR, Hammitt JK .
The modest effects of fact boxes on cancer screening.
J Risk Uncertain 2021 Feb;62(1):29-54. doi: 10.1007/s11166-021-09344-x..
Keywords: Cancer, Screening, Education: Patient and Caregiver, Health Literacy
Brown W, Balyan R, Karter AJ
Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: the ECLIPPSE study.
In the National Library of Medicine-funded ECLIPPSE Project (Employing Computational Linguistics to Improve Patient-Provider Secure Emails exchange), the researchers attempted to create novel, valid, and scalable measures of both patients' health literacy (HL) and physicians' linguistic complexity by employing natural language processing techniques and machine learning. They identified 23 challenges and associated approaches that emerged from three overarching process domains. They suggested that investigators undertaking similar research in HL or using computational linguistic methods to assess patient-clinician exchange may find their solutions helpful when designing and executing health communications research.
Citation: Brown W, Balyan R, Karter AJ .
Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: the ECLIPPSE study.
AHRQ-funded; HS026383..
Keywords: Health Literacy, Electronic Health Records (EHRs), Health Information Technology (HIT), Communication, Clinician-Patient Communication
McCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
RIchmond J, Mangrum R, Wang G
An informed public's views on reducing antibiotic overuse.
The purpose of this study was to understand public attitudes about and recommendations to address antibiotic overuse by employing public deliberation (a method for eliciting informed input on value-laden issues). The investigators concluded that when informed about individual and social consequences of antibiotic overuse, patients may be more receptive to antibiotic prescription limits. They suggest that community-physician-government partnerships are needed to create solutions.
AHRQ-funded; 290201000005C.
Citation: RIchmond J, Mangrum R, Wang G .
An informed public's views on reducing antibiotic overuse.
Health Serv Res 2019 Dec;54(6):1283-94. doi: 10.1111/1475-6773.13175..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Health Literacy, Education: Patient and Caregiver
Palmer JA, Parker VA, Barre LR
Understanding implementation fidelity in a pragmatic randomized clinical trial in the nursing home setting:a mixed-methods examination.
This randomized clinical trial called Pragmatic Trial of Video Education in Nursing Homes (PROVEN) was one of the largest trials to be conducted in nursing homes on education of residents in Advanced Care Planning (ACP). The trial used videos with champions promoting ACP education across two large health-care systems. The trial length was 18 months, with champions offering video education to the residents every six months. At the end of the study 28 interviews involving 33 champions were analyzed. The researchers found different patterns between high- and low-adherence nursing homes. High-adherence nursing homes had more family and patient willingness to engage in the program and champions were better at recruitment. Champions also supplemented the video with ACP conversations.
AHRQ-funded; HS000011.
Citation: Palmer JA, Parker VA, Barre LR .
Understanding implementation fidelity in a pragmatic randomized clinical trial in the nursing home setting:a mixed-methods examination.
Trials 2019 Nov 28;20(1):656. doi: 10.1186/s13063-019-3725-5..
Keywords: Nursing Homes, Long-Term Care, Education: Patient and Caregiver, Health Literacy, Patient and Family Engagement, Elderly
Rice WS, Stringer KL, Sohail M
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
Limited studies to date assess barriers to and facilitators of pre-exposure prophylaxis (PrEP) uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. In this study, the investigators examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama.
AHRQ-funded; HS013852.
Citation: Rice WS, Stringer KL, Sohail M .
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
AIDS Behav 2019 Nov;23(11):2966-79. doi: 10.1007/s10461-019-02591-9..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Utilization, Patient-Centered Healthcare, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Access to Care, Health Promotion
McCarthy DM, Russell AM , Effler MR
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
The authors assessed implementation of a patient-centered "PRN" (as needed) label entitled "Take-Wait-Stop" (TWS) with three deconstructed steps replacing traditional wording. They found that exact intervention adherence was not achieved in the majority of cases, limiting impact, but that community pharmacies were responsive to new instructions, with higher implementation reliability requiring additional supports.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Russell AM , Effler MR .
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
Pharmacoepidemiol Drug Saf 2019 Sep;28(9):1251-57. doi: 10.1002/pds.4795..
Keywords: Opioids, Patient Safety, Health Literacy, Medication, Provider: Pharmacist, Provider
Glick AF, Brach C, Yin HS
AHRQ Author: Brach C
Health literacy in the inpatient setting: implications for patient care and patient safety.
This article considers how health literacy plays a part in events that lead up to children's hospitalizations both during hospital admission and after discharge. The authors discussed interventions that incorporate health-literacy-informed strategies and that target patients, families, and health care systems that should be implemented to improve patient outcomes and patient-centered and family-centered care.
AHRQ-authored.
Citation: Glick AF, Brach C, Yin HS .
Health literacy in the inpatient setting: implications for patient care and patient safety.
Pediatr Clin North Am 2019 Aug;66(4):805-26. doi: 10.1016/j.pcl.2019.03.007..
Keywords: Children/Adolescents, Health Literacy, Hospital Discharge, Hospitalization, Hospitals, Inpatient Care, Patient Safety
Brega AG, Hamer MK, Albright K
AHRQ Author: Brach C
Organizational health literacy: quality improvement measures with expert consensus.
The investigators sought to identify and evaluate existing organizational health literacy (OHL)-related quality improvement (QI) measures. They identified 22 OHL-related QI measures that have the support of experts in the field, and recommended additional measure development and testing. However, they note that their Consensus OHL QI Measures are appropriate for immediate use.
AHRQ-authored; AHRQ-funded; 233201500025I.
Citation: Brega AG, Hamer MK, Albright K .
Organizational health literacy: quality improvement measures with expert consensus.
Health Lit Res Pract 2019 Jul 1;3(2):e127-e46. doi: 10.3928/24748307-20190503-01..
Keywords: Health Literacy, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures
Tieu L, Hobbs A, Sarkar U
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
This study compared the acceptability of low-literacy tablet-based and traditional paper-based patient experience surveys in English and Spanish. The Consumer Assessment of Healthcare Providers & Systems Clinician & Group Survey (CG-CAHPS) was adapted for a pilot survey using low-literacy questions in Spanish and English. The majority of interview participants preferred the tablet version over the traditional paper-based survey. This was especially true for the younger and Latino respondents.
AHRQ-funded; HS022408.
Citation: Tieu L, Hobbs A, Sarkar U .
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S140-s48. doi: 10.1097/mlr.0000000000001030..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Health Literacy, Patient Experience, Primary Care, Quality of Care, Quality Improvement, Racial and Ethnic Minorities, Urban Health
Lor M, Koleck TA, Bakken S
Association between health literacy and medication adherence among Hispanics with hypertension.
This study examined the association between health literacy and medication adherence among Hispanic adults with hypertension. A cross-sectional survey of 1355 Hispanic adults, mostly Dominicans who self-report hypertension was conducted. After controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance inadequate health literacy was associated with a lower adherence score.
AHRQ-funded; HS019853; HS022961.
Citation: Lor M, Koleck TA, Bakken S .
Association between health literacy and medication adherence among Hispanics with hypertension.
J Racial Ethn Health Disparities 2019 Jun;6(3):517-24. doi: 10.1007/s40615-018-00550-z..
Keywords: Blood Pressure, Health Literacy, Patient Adherence/Compliance, Medication, Racial and Ethnic Minorities
Pack AP, Golin CE, Hill LM
Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data.
This study looked into the value of using graphical display prototypes of hypothetical daily drug concentrations measured in hair for patients to assess their medication adherence. Investigators surveyed 30 HIV-positive patients and 29 clinicians to assess their preferences for three different prototypes. Patients and clinicians generally found the prototypes acceptable, but clinicians largely preferred daily drug concentrations in bar graph display. Patients with lower health literacy had trouble understanding the link between medication-taking and drug concentrations in hair and also preferred pictographs over bar or line graphs.
AHRQ-funded; HS000032.
Citation: Pack AP, Golin CE, Hill LM .
Patient and clinician perspectives on optimizing graphical displays of longitudinal medication adherence data.
Patient Educ Couns 2019 Jun;102(6):1090-97. doi: 10.1016/j.pec.2018.12.029..
Keywords: Clinician-Patient Communication, Communication, Health Literacy, Medication, Patient Adherence/Compliance, Provider, Provider: Clinician
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Hirsh J, Wood P, Keniston A
Limited health literacy and patient confusion about rheumatoid arthritis patient global assessments and model disease states.
The objective of this study was to understand the perspectives of vulnerable patients regarding patient global assessment visual analog scales (PGA-VAS) and model disease states. The investigators found that vulnerable patients perceived difficulty with PGA-VAS and did not reliably rate a model disease state VAS. The authors suggest that these patients are potentially at risk for disease activity misclassification because of literacy and other barriers in completing VAS.
AHRQ-funded.
Citation: Hirsh J, Wood P, Keniston A .
Limited health literacy and patient confusion about rheumatoid arthritis patient global assessments and model disease states.
Arthritis Care Res 2019 May;71(5):611-19. doi: 10.1002/acr.23692..
Keywords: Arthritis, Health Literacy
Armstrong MJ, Rastgardani T, Gagliardi AR
Barriers and facilitators of communication about off periods in Parkinson's disease: qualitative analysis of patient, carepartner, and physician Interviews.
This article discusses barriers and facilitators of communication with Parkinson’s disease patients, care partners, and their physicians specifically during off periods. Twenty persons with Parkinson’s and their care partners, and 20 physicians participated in interviews using a semi-structured questionnaire. Communication barrier levels were identified as patient-level, caregiver-level, and physician-level. For patients cognitive impairment and reluctance to discuss symptoms was the largest barrier. Caregiver absence was also a barrier. For physicians barriers were distraction by technology and lack of appreciation of off period burdens. Various tools such as home diaries, questionnaires and mobile phone videos can be used to aid communication regarding off periods. Patients and their caregivers stressed the need for more formal educational materials and improved educational tools.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Rastgardani T, Gagliardi AR .
Barriers and facilitators of communication about off periods in Parkinson's disease: qualitative analysis of patient, carepartner, and physician Interviews.
PLoS One 2019 Apr 18;14(4):e0215384. doi: 10.1371/journal.pone.0215384..
Keywords: Communication, Clinician-Patient Communication, Neurological Disorders, Caregiving, Education: Patient and Caregiver, Health Literacy, Patient and Family Engagement
Russell AM, Patel DA, Curtis LM
Test-retest reliability of the Newest Vital Sign health literacy instrument: in-person and remote administration.
The objective of this study was to determine the reliability of the Newest Vital Sign (NVS) by examining test-retest properties of the measure. The NVS assessment was conducted in-person at baseline, and in-person or via telephone at follow-up. Intraclass correlation coefficients were employed to assess the test-retest reliability by using raw NVS scores categorized by mode of administration of the second NVS assessment. The findings indicated that the test-retest properties of the NVS are similar by mode of administration. The authors conclude that their data suggests the NVS measure can be reliably administered by telephone.
AHRQ-funded; HS023459.
Citation: Russell AM, Patel DA, Curtis LM .
Test-retest reliability of the Newest Vital Sign health literacy instrument: in-person and remote administration.
Patient Educ Couns 2019 Apr;102(4):749-52. doi: 10.1016/j.pec.2018.11.016..
Keywords: Education: Patient and Caregiver, Health Literacy