National Healthcare Quality and Disparities Report
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Topics
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (1)
- Cancer (3)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (2)
- Caregiving (3)
- Case Study (1)
- Children/Adolescents (5)
- Chronic Conditions (2)
- Clinician-Patient Communication (13)
- Communication (8)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Critical Care (2)
- Cultural Competence (1)
- Diabetes (2)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Patient and Caregiver (5)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Emergency Department (3)
- Genetics (1)
- Guidelines (1)
- Healthcare Delivery (8)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (9)
- Health Literacy (3)
- Health Promotion (2)
- Health Services Research (HSR) (2)
- Heart Disease and Health (1)
- Hospitalization (3)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Infectious Diseases (1)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (1)
- Low-Income (1)
- Medical Devices (1)
- Medication (1)
- Osteoporosis (1)
- Patient-Centered Healthcare (8)
- Patient-Centered Outcomes Research (6)
- (-) Patient and Family Engagement (49)
- Patient Experience (7)
- Patient Safety (1)
- Patient Self-Management (3)
- Policy (1)
- Practice Patterns (1)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Quality Improvement (3)
- Quality of Care (2)
- Racial and Ethnic Minorities (1)
- Research Methodologies (3)
- Shared Decision Making (14)
- Stroke (1)
- Telehealth (2)
- Tools & Toolkits (2)
- Transplantation (1)
- Vaccination (1)
- Vulnerable Populations (1)
- Web-Based (5)
- Women (2)
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 49 Research Studies DisplayedSmith MA, Bednarz L, Nordby PA
Increasing consumer engagement by tailoring a public reporting website on the quality of diabetes care: a qualitative study.
The goal of this study was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care. It concluded that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions.
AHRQ-funded; HS021899.
Citation: Smith MA, Bednarz L, Nordby PA .
Increasing consumer engagement by tailoring a public reporting website on the quality of diabetes care: a qualitative study.
J Med Internet Res 2016 Dec 21;18(12):e332. doi: 10.2196/jmir.6555.
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Keywords: Chronic Conditions, Shared Decision Making, Diabetes, Patient and Family Engagement, Web-Based
Vandigo J, Oloyede E, Aly A
Continuous patient engagement in cardiovascular disease clinical comparative effectiveness research.
The Patient-Centered Outcomes Research Institute has created an Engagement Rubric to guide meaningful engagement in the research process. A 10-step systematic framework to enhance patient engagement throughout the comparative effectiveness research process also has been proposed. This special report identifies the relationship between these two approaches to patient engagement and describes examples of how patients could be engaged in a hypothetical CVD study.
AHRQ-funded; HS022135.
Citation: Vandigo J, Oloyede E, Aly A .
Continuous patient engagement in cardiovascular disease clinical comparative effectiveness research.
Expert Rev Pharmacoecon Outcomes Res 2016;16(2):193-8. doi: 10.1586/14737167.2016.1163222.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Patient and Family Engagement
Gordon HS, Street RL
How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician-patient communication.
The purpose of this study was to compare several different measures of physician-patient communication. Communication was measured with rating scales completed by patients and physicians and by two groups of external observers who used rating scales or coded the frequency of communication behaviors. The findings highlight the potential for using observers' ratings as an alternate measure of communication to more labor intensive frequency measures.
AHRQ-funded; HS010876.
Citation: Gordon HS, Street RL .
How physicians, patients, and observers compare on the use of qualitative and quantitative measures of physician-patient communication.
Eval Health Prof 2016 Dec;39(4):496-511. doi: 10.1177/0163278715625737.
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Keywords: Communication, Shared Decision Making, Patient and Family Engagement, Clinician-Patient Communication
Traino HM, Siminoff LA
Keep it going: maintaining health conversations using relational and instrumental approaches.
The researchers examined how elements of relational and instrumental communication occurring within the first five minutes of the request impacted the length of the discussion. Sixteen U.S. tissue banking organizations and their staff making telephone requests for donation to families of tissue-donation eligible patients agreed to participate in the research. The researchers concluded that aspects of both relational and instrumental communication were associated with discussion length.
AHRQ-funded; HS013152.
Citation: Traino HM, Siminoff LA .
Keep it going: maintaining health conversations using relational and instrumental approaches.
Health Commun 2016;31(3):308-19. doi: 10.1080/10410236.2014.950020.
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Keywords: Communication, Patient and Family Engagement, Clinician-Patient Communication
Cram P, Wolinsky FD, Lou Y
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
In a clinical trial of 7749 patients, the researchers tested whether usual care augmented by a tailored patient-activation DXA result letter accompanied by an educational brochure would improve guideline-concordant pharmacological treatment compared to usual care only. They found that treatment rates did not improve.
AHRQ-funded; HS023009.
Citation: Cram P, Wolinsky FD, Lou Y .
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
Osteoporos Int 2016 Dec;27(12):3513-24. doi: 10.1007/s00198-016-3681-9.
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Keywords: Education: Patient and Caregiver, Guidelines, Medication, Osteoporosis, Patient and Family Engagement
Prey JE, Qian M, Restaino S
Reliability and validity of the patient activation measure in hospitalized patients.
The objectives of this article are to describe the internal consistency reliability and construct validity of the PAM-13 for hospitalized cardiology and oncology patients and to examine the predictors of low patient activation in the same population. The authors found that patients with unplanned admissions were more likely to have low activation than patients with planned admissions. They also found that PAM-13 was modestly correlated with each of the PROMIS Global Health components: global, physical and mental health. They concluded that this study demonstrates the PAM-13 is a reliable and valid measure for use in the inpatient hospital setting and that type of admission is an important predictor of patient activation.
AHRQ-funded; HS021816.
Citation: Prey JE, Qian M, Restaino S .
Reliability and validity of the patient activation measure in hospitalized patients.
Patient Educ Couns 2016 Dec;99(12):2026-33. doi: 10.1016/j.pec.2016.06.029.
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Keywords: Cancer, Cardiovascular Conditions, Hospitalization, Inpatient Care, Patient and Family Engagement
Castaneda-Guarderas A, Glassbereg J, Grudzen CR
Shared decision making with vulnerable populations in the emergency department.
The authors introduce a research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses to address questions of shared decision making (SDM) among vulnerable groups at a disadvantage in the healthcare system, as well as changes that are needed, and how to cultivate and teach these competencies.
AHRQ-funded; HS024172.
Citation: Castaneda-Guarderas A, Glassbereg J, Grudzen CR .
Shared decision making with vulnerable populations in the emergency department.
Acad Emerg Med 2016 Dec;23(12):1410-16. doi: 10.1111/acem.13134.
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Keywords: Cultural Competence, Shared Decision Making, Emergency Department, Patient and Family Engagement, Vulnerable Populations
Mayberry LS, Berg CA, Harper KJ
The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes.
Through user-centered design and iterative usability/feasibility testing, the researchers developed a mobile Health intervention for disadvantaged adults with type 2 diabetes (T2D) called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs reported FAMS increased self-care and both PPs and support persons reported FAMS improved support for and communication about diabetes.
AHRQ-funded; HS022990.
Citation: Mayberry LS, Berg CA, Harper KJ .
The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes.
J Diabetes Res 2016;2016:7586385. doi: 10.1155/2016/7586385.
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Keywords: Diabetes, Low-Income, Patient and Family Engagement, Patient Self-Management, Telehealth
McAlearney AS, Sieck CJ, Hefner JL
High touch and high tech (HT2) proposal: transforming patient engagement throughout the continuum of care by engaging patients with portal technology at the bedside.
This study measures how access to a patient portal tailored to the inpatient stay can improve patient experience and increase patient engagement by (1) improving patients' perceptions of the process of care while in the hospital; (2) increasing patients' self-efficacy for managing chronic conditions; and (3) facilitating continued use of a patient portal for care management after discharge.
AHRQ-funded; HS024091.
Citation: McAlearney AS, Sieck CJ, Hefner JL .
High touch and high tech (HT2) proposal: transforming patient engagement throughout the continuum of care by engaging patients with portal technology at the bedside.
JMIR Res Protoc 2016 Nov 29;5(4):e221. doi: 10.2196/resprot.6355.
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Keywords: Electronic Health Records (EHRs), Patient and Family Engagement, Patient Experience, Patient Experience, Patient Self-Management
Lee JL, Beach MC, Berger ZD
A qualitative exploration of favorite patients in primary care.
This study ascertained whether physicians have favorite patients, their experiences with such patients, and how such relationships may influence patients and physicians. It found that most participants (22/25) reported having favorite patients. For many physicians, favorite patients were not necessarily the most compliant patients, or those most similar to them. Instead, favorite patients were often very sick patients and/or those who have known their physicians for a long time.
AHRQ-funded; HS000029.
Citation: Lee JL, Beach MC, Berger ZD .
A qualitative exploration of favorite patients in primary care.
Patient Educ Couns 2016 Nov;99(11):1888-93. doi: 10.1016/j.pec.2016.06.023.
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Keywords: Patient Experience, Patient and Family Engagement, Primary Care, Clinician-Patient Communication
Tyler Ellis C, Charlton ME, Stitzenberg KB
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
The researchers identified patient roles, preferences, and expectations as they relate to treatment decision making for patients with stage I rectal cancer. They found that, in this study of 154 adults with newly-diagnosed and surgically treated stage 1 rectal cancer, the preferred decision-making role for patients did not match the actual decision-making process. They recommended that future efforts focus on bridging the gap between the decision-making process and patient preferences regarding various treatment approaches.
AHRQ-funded; HS000032.
Citation: Tyler Ellis C, Charlton ME, Stitzenberg KB .
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
Dis Colon Rectum 2016 Oct;59(10):907-15. doi: 10.1097/dcr.0000000000000662.
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Keywords: Cancer: Colorectal Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Patient Experience, Patient and Family Engagement
Denman DC, Baldwin AS, Marks EG
Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents.
The researchers investigated measures of motivation for HPV vaccination using confirmatory factor analysis to test a three-factor measurement model. Their findings support the use of three subscales to measure motivation in HPV vaccination and suggest possible cultural differences in motivation.
AHRQ-funded; HS022418.
Citation: Denman DC, Baldwin AS, Marks EG .
Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents.
Vaccine 2016 Sep 22;34(41):4985-90. doi: 10.1016/j.vaccine.2016.08.037.
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Keywords: Children/Adolescents, Education: Patient and Caregiver, Infectious Diseases, Patient and Family Engagement, Vaccination
Adler-Milstein J, Embi PJ, Middleton B
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
There is a chasm between the current health IT ecosystem and the health IT ecosystem. In this paper, the authors identify a set of focal goals and associated near-term achievable actions that are critical to pursue in order to enable the health IT ecosystem to meet the acute needs of modern health care delivery. These ideas emerged from discussions that occurred during the 2015 American Medical Informatics Association Policy Invitational Meeting.
AHRQ-funded; HS023969.
Citation: Adler-Milstein J, Embi PJ, Middleton B .
Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
J Am Med Inform Assoc 2017 Sep 1;24(5):1036-43. doi: 10.1093/jamia/ocx017.
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Keywords: Healthcare Delivery, Health Information Technology (HIT), Patient and Family Engagement, Policy, Health Information Technology (HIT)
Gulbrandsen P, Clayman ML, Beach MC
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
The researchers described the different ways in which illness represents an existential problem, and its implications for shared decision-making. They found that the fundamental uncertainty, state of vulnerability, and lack of power of the ill patient, imbue shared decision-making with a deeper existential significance and call for greater attention to the emotional and relational dimensions of care. They propose that the aim of shared decision-making should be restoration of the patient's autonomous capacity.
AHRQ-funded; HS022932.
Citation: Gulbrandsen P, Clayman ML, Beach MC .
Shared decision-making as an existential journey: aiming for restored autonomous capacity.
Patient Educ Couns 2016 Sep;99(9):1505-10. doi: 10.1016/j.pec.2016.07.014.
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Keywords: Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Balbale SN, Locatelli SM, LaVela SL
Through their eyes: lessons learned using participatory methods in health care quality improvement projects.
The authors examined participatory methods to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. They concluded that using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs.
AHRQ-funded; HS000084.
Citation: Balbale SN, Locatelli SM, LaVela SL .
Through their eyes: lessons learned using participatory methods in health care quality improvement projects.
Qual Health Res 2016 Aug;26(10):1382-92. doi: 10.1177/1049732315618386.
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Keywords: Healthcare Delivery, Quality of Care, Patient and Family Engagement, Quality Improvement
Asan O, Holden RJ, Flynn KE
Provider use of a novel EHR display in the pediatric intensive care unit. Large Customizable Interactive Monitor (LCIM).
The purpose of this study was to explore providers' perspectives on the use of a novel technology, "Large Customizable Interactive Monitor" (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit. The study revealed this next generation HIT might have great potential for family-centered rounds, team education during rounds, and family education/engagement in their child's health in the patient room.
AHRQ-funded; HS023626.
Citation: Asan O, Holden RJ, Flynn KE .
Provider use of a novel EHR display in the pediatric intensive care unit. Large Customizable Interactive Monitor (LCIM).
Appl Clin Inform 2016 Jul 20;7(3):682-92. doi: 10.4338/aci-2016-02-ra-0030.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Intensive Care Unit (ICU), Patient and Family Engagement, Children/Adolescents
Luff D, Allair B, Litterer K
Parent and teen engagement in pediatric health services research training.
The Harvard-wide Pediatric Health Services Research (HSR) Fellowship Program is a multidisciplinary program that has trained child health researchers for over 20 years. In 2013, it set out to engage patients and families in the redesign of its research training activities. The authors concluded that the benefits from including parents and teens in our program exceeded their expectations. Patients and parents of children with chronic illness came to understand how research informs the care they receive.
AHRQ-funded; HS000063.
Citation: Luff D, Allair B, Litterer K .
Parent and teen engagement in pediatric health services research training.
Acad Pediatr 2016 Jul;16(5):496-98. doi: 10.1016/j.acap.2016.02.004.
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Keywords: Children/Adolescents, Health Services Research (HSR), Health Services Research (HSR), Patient and Family Engagement, Children/Adolescents
Grob R, Schlesinger M, Parker AM
Breaking narrative ground: Innovative methods for rigorously eliciting and assessing patient narratives.
The researchers sought to design a methodology for rigorously eliciting narratives about patients' experiences with clinical care that is potentially useful for public reporting and quality improvement. They demonstrated that a five-question protocol that has been tested and refined yields three- to sixfold increases in completeness and four- to tenfold increases in meaningfulness, compared to a single open-ended question. It performs equally well for healthy and sick patients.
AHRQ-funded; HS021858; HS016980; HS016978.
Citation: Grob R, Schlesinger M, Parker AM .
Breaking narrative ground: Innovative methods for rigorously eliciting and assessing patient narratives.
Health Serv Res 2016 Jun;51 Suppl 2:1248-72. doi: 10.1111/1475-6773.12503.
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Keywords: Patient Experience, Patient and Family Engagement, Research Methodologies
Khan A, Rogers JE, Forster CS
Communication and shared understanding between parents and resident-physicians at night.
The researchers studied communication breakdowns evidenced by lack of shared understanding between parents and night-team residents about the reason for admission and care plan. After conducting a prospective cohort study of 286 parents and 37 night-team senior residents, they found that parents and residents reported that they shared an understanding with one another about care plans in 86.0percent and 73.1 percent of cases, respectively.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Forster CS .
Communication and shared understanding between parents and resident-physicians at night.
Hosp Pediatr 2016 Jun;6(6):319-29. doi: 10.1542/hpeds.2015-0224.
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Keywords: Care Coordination, Healthcare Delivery, Communication, Patient and Family Engagement, Clinician-Patient Communication
Kostick KM, Minard CG, Wilhelms LA
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
The authors presented a comprehensive and valid methodology for developing a clinically informed and patient-centered measure of knowledge about left ventricular assist device (LVAD) therapy to facilitate discussion and measure candidate understanding of treatment options. They concluded that the LVAD knowledge scale may be useful in clinical settings to identify gaps in knowledge among patient candidates considering LVAD treatment; to better tailor education and discussion with patients and their caregivers; and to enhance informed decision-making before treatment decisions are made.
AHRQ-funded; HS024849.
Citation: Kostick KM, Minard CG, Wilhelms LA .
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
J Heart Lung Transplant 2016 Jun;35(6):768-76. doi: 10.1016/j.healun.2016.01.015.
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Keywords: Shared Decision Making, Heart Disease and Health, Medical Devices, Patient and Family Engagement, Patient-Centered Outcomes Research
Gillespie SM, Shah MN, Wasserman EB
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
High-intensity telemedicine has been shown to reduce the need for emergency department (ED) care for older adult senior living community (SLC) residents with acute illnesses. In this study, the investigators evaluated the effect of SLC engagement in a telemedicine program on ED use rates. The investigators concluded that individuals residing in more engaged SLCs experienced a greater decrease in ED use compared with subjects residing in less engaged SLCs or those without access to high-intensity telemedicine for acute illnesses.
AHRQ-funded; HS018047.
Citation: Gillespie SM, Shah MN, Wasserman EB .
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
Telemed J E Health 2016 Jun;22(6):489-96. doi: 10.1089/tmj.2015.0152..
Keywords: Elderly, Emergency Department, Health Information Technology (HIT), Healthcare Utilization, Patient and Family Engagement, Telehealth
Rocque GB, Partridge EE, Pisu M
The Patient Care Connect Program: transforming health care through lay navigation.
In this article, the authors described the Patient Care Connect Program's development, infrastructure, selection and training of lay navigators, and program operations.
AHRQ-funded; HS023009; HS013852.
Citation: Rocque GB, Partridge EE, Pisu M .
The Patient Care Connect Program: transforming health care through lay navigation.
J Oncol Pract 2016 Jun;12(6):e633-42. doi: 10.1200/jop.2015.008896.
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Keywords: Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Roberts MC, Bryson A, Weinberger M
Patient-centered communication for discussing oncotype DX testing.
The researchers identified patient-centered communication strategies/gaps for discussing Oncotype DX testing (ODX) results. They applied a patient-centered communication framework to analyze qualitative interviews with oncologists about how they communicate about ODX with patients. Overall, providers discussed four patient-centered communication domains: exchanging information, assessing uncertainty, making decisions and cross-cutting themes.
AHRQ-funded; HS019468; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Patient-centered communication for discussing oncotype DX testing.
Cancer Invest 2016 May 27;34(5):205-12. doi: 10.3109/07357907.2016.1172637.
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Keywords: Cancer, Cancer: Breast Cancer, Communication, Clinician-Patient Communication, Shared Decision Making, Genetics, Patient and Family Engagement, Patient-Centered Healthcare, Women
Mishra SR, Haldar S, Pollack AH
"Not just a receiver": understanding patient behavior in the hospital environment.
Through interviews with hospitalized patients and their caregivers, the authors identified ways that patients and caregivers actively participate in their care. They described the different roles patients and caregivers assume in interacting with their hospital care team and then discuss how systems designed to support patient engagement in the hospital setting can promote active participation and help patients achieve better outcomes.
AHRQ-funded; HS022894.
Citation: Mishra SR, Haldar S, Pollack AH .
"Not just a receiver": understanding patient behavior in the hospital environment.
Proc SIGCHI Conf Hum Factor Comput Syst 2016 May 7;2016:3103-14. doi: 10.1145/2858036.2858167.
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Keywords: Health Information Technology (HIT), Hospitals, Patient and Family Engagement, Patient-Centered Outcomes Research
Hong MK, Wilcox L, Machado D
Care partnerships: toward technology to support teens' participation in their health care.
The authors conducted 38 in-depth interviews along with nine non-participant observations of clinical consultations to better understand common challenges and needs that could be supported through design. They drew their findings to propose design goals for sociotechnical systems to support teens in partnering in their care, highlighting the need for design to support gradually evolving partnerships in care.
AHRQ-funded; HS021393.
Citation: Hong MK, Wilcox L, Machado D .
Care partnerships: toward technology to support teens' participation in their health care.
Proc SIGCHI Conf Hum Factor Comput Syst 2016 May 7;2016:5337-49. doi: 10.1145/2858036.2858508.
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Keywords: Children/Adolescents, Chronic Conditions, Patient and Family Engagement, Patient Self-Management