National Healthcare Quality and Disparities Report
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Topics
- Access to Care (2)
- Asthma (2)
- Behavioral Health (2)
- Breast Feeding (2)
- Cancer (5)
- Cancer: Breast Cancer (1)
- Caregiving (1)
- Children/Adolescents (3)
- Chronic Conditions (4)
- Clinical Decision Support (CDS) (2)
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- Communication (1)
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- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (2)
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- Data (3)
- Dementia (1)
- Depression (2)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Disparities (6)
- Education: Patient and Caregiver (4)
- Elderly (3)
- Electronic Health Records (EHRs) (12)
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- Evidence-Based Practice (3)
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- Healthcare Cost and Utilization Project (HCUP) (1)
- (-) Health Information Technology (HIT) (38)
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- Health Services Research (HSR) (2)
- Health Status (1)
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- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
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- Neurological Disorders (1)
- Nursing Homes (1)
- Opioids (1)
- Outcomes (3)
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- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Experience (3)
- Patient Self-Management (2)
- Pregnancy (1)
- Prevention (1)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Quality Improvement (2)
- Quality of Care (2)
- Quality of Life (1)
- (-) Racial and Ethnic Minorities (38)
- Registries (1)
- Respiratory Conditions (1)
- Risk (1)
- Rural/Inner-City Residents (1)
- Rural Health (3)
- Screening (1)
- Sexual Health (1)
- Shared Decision Making (1)
- Social Determinants of Health (3)
- Substance Abuse (1)
- Telehealth (8)
- Urban Health (2)
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- Women (3)
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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 38 Research Studies DisplayedReed KG, Sun Z, Yabes JG
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
The purpose of this study was to evaluate variations among patients who do and do not visit Commission on Cancer (CoC) accredited facilities. The researchers utilized Pennsylvania Cancer Registry data linked to facility records for 87,472 patients diagnosed with cancer between 2018 and 2019. The study found that patients in the most advantaged Area Deprivation Index quartiles were more likely to visit CoC facilities compared with other quartiles. Urban patients were more likely than rural to be seen at a CoC facility as were Hispanic patients and non-Hispanic Black patients compared with White patients.
AHRQ-funded; HS027396.
Citation: Reed KG, Sun Z, Yabes JG .
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
JNCI Cancer Spectr 2023 Oct 31; 7(6). doi: 10.1093/jncics/pkad080..
Keywords: Cancer, Health Information Technology (HIT), Racial and Ethnic Minorities, Rural Health, Rural/Inner-City Residents
Hernandez-Boussard T, Siddique SM, Bierman AS
AHRQ Author: Bierman AS
Promoting equity in clinical decision making: dismantling race-based medicine.
The authors recommended a race-aware approach to clinical decision support to address concerns raised about racial and ethnic biases built into the algorithms that lead to persistent disparities in health and healthcare. The proposed approach will require sustained commitment and effort among stakeholders, research, and technology sectors. Important steps will include increasing diversity in clinical trial populations, broadening the focus of precision medicine, improving education about complex factors that shape health outcomes, and developing new guidelines and policies that enable culturally responsive care.
AHRQ-authored.
Citation: Hernandez-Boussard T, Siddique SM, Bierman AS .
Promoting equity in clinical decision making: dismantling race-based medicine.
Health Affairs 2023 Oct; 42(10):1369-73. doi: 10.1377/hlthaff.2023.00545..
Keywords: Racial and Ethnic Minorities, Clinical Decision Support (CDS), Health Information Technology (HIT)
Krishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Hua Y, Temkin-Greener H, Cai S
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
The purpose of this study was to explore primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD) who resided in Assisted Living Facilities (Als) during the early stage of the COVID-19 pandemic, with a focus on possible racial and socioeconomic differences. The study found that at the start of the pandemic in quarter 2 of 2020, Black residents were less likely to have telemedicine visits than their White counterparts. In the following two quarters, Black residents were more likely to receive primary care via telemedicine than White residents; a similar difference was observed between Hispanic and White residents, but with smaller effect sizes. Compared with nondual residents, dual residents were more likely to receive primary care via telemedicine in Q3. In addition, residents in AL communities with a higher proportion of dual residents, compared with those in low-dual ALs, were less likely to receive primary care via telemedicine throughout the study period. However, the difference in telemedicine use between higher vs lower dual ALs narrowed over time.
AHRQ-funded; HS026893.
Citation: Hua Y, Temkin-Greener H, Cai S .
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
J Am Med Dir Assoc 2023 Aug; 24(8):1157-58.e3. doi: 10.1016/j.jamda.2023.05.005..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Racial and Ethnic Minorities, Elderly
Khor S, Heagerty PJ, Basu A
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
This study examined whether the accuracy of a proxy for colorectal cancer (CRC) recurrence differed by race/ethnicity and the possible mechanisms that drove the differences. Using data from a large integrated health care system, the authors identified a stratified random sample of 282 Black/African American (AA), Hispanic, and non-Hispanic White (NHW) patients with CRC who received primary treatment. The recurrence proxy was found to have excellent overall accuracy (positive predictive value [PPV] 89.4%; negative predictive value 96.5%; mean difference in timing 1.96 months); however, accuracy varied by race/ethnicity. Compared with NHW patients, PPV was 14.9% lower among Hispanic patients and 4.3% lower among Black/AA patients. The proxy disproportionately inflated the 5-year recurrence incidence for Hispanic patients by 10.6%. Compared with NHW patients, proxy recurrences for Hispanic patients were almost three times as likely to have been misclassified as positive (adjusted risk ratio 2.91). The authors theorize that higher false positives among racial/ethnic minorities may be related to higher prevalence of noncancerous lung-related problems and substantial delays in primary treatment because of insufficient patient-provider communication and abnormal treatment patterns.
AHRQ-funded; HS013853.
Citation: Khor S, Heagerty PJ, Basu A .
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
JCO Clin Cancer Inform 2023 Jun; 7:e2300004. doi: 10.1200/cci.23.00004..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Disparities
Wirth AN, Cushman NA, Reilley BA
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
Researchers evaluated the extent to which Indian Country Extension for Community Healthcare Outcomes (ECHO) telehealth clinics increase access to hepatitis C virus (HCV) treatment and serve American Indians/Alaska Native (AI/AN) patients holistically. They conducted a retrospective descriptive analysis of Indian Country ECHO treatment recommendations from 2017 to 2021. Most patients received recommendations for HCV treatment by their primary care providers, along with recommendations beyond the scope of HCV. The researchers concluded that Indian Country ECHO telehealth clinic provided comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
AHRQ-funded; HS026370.
Citation: Wirth AN, Cushman NA, Reilley BA .
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
J Rural Health 2023 Mar;39(2):358-66. doi: 10.1111/jrh.12733.
Keywords: Hepatitis, Access to Care, Racial and Ethnic Minorities, Community-Based Practice, Telehealth, Health Information Technology (HIT), Chronic Conditions
Ferucci ED, Arnold RI, Holck P
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
The purpose of this study was to explore and describe factors associated with telemedicine use in the setting of usual care in the Alaskan Tribal Health System (ATHS) prior to the COVID-19 pandemic. The researchers collected electronic health records (EHR) data from 2015 through 2019 for 3,075 patients with chronic diseases requiring specialty care from 4 regions in the ATHS to identify ever users (799) and never users (2,276) of telemedicine. The study found that the factors of male gender, age, geographic region, rate of outpatient visits per year, and having had at least one cardiology clinic visit were all associated with telemedicine use.
AHRQ-funded; HS026208.
Citation: Ferucci ED, Arnold RI, Holck P .
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
Telemed J E Health 2022 May;28(5):682-89. doi: 10.1089/tmj.2021.0131..
Keywords: Telehealth, Chronic Conditions, Racial and Ethnic Minorities, Health Information Technology (HIT)
Kostick-Quenet KM, Cohen IG, Gerke S
Mitigating racial bias in machine learning.
This article discusses the challenges in applying existing guidelines for mitigating algorithmic bias in a machine learning (ML) and/or artificial intelligence (AI) tool for real-world clinical decisions making by physicians and patients. The authors then discuss the existing legal regulation of ML/AI racial bias and future directions. Their team developed a decision support framework for patients with severe heart failure that includes a prognostic ML algorithm to calculate personalized estimates for patients about their likely outcomes after receiving a left ventricular-assist device (LVAD). Their goal is to identify the potential for racial bias in the tool’s algorithm identified practical challenges regarding algorithmic bias that other developers may face. The algorithms’ training data base was examined to review data quality. The authors also examined other comorbidities and their role in predicting LVAD outcomes. Existing and proposed initiatives to address algorithmic bias through regulation is also discussed in detail. The authors, who are mostly bioethics experts recommend that developers seeking to mitigate bias in ML use their algorithms as leverage to call upon stakeholders who are responsible for generating relevant datasets to make a concerted effort to document race and associated variables to enable systematic inquiries into sources of potential racial bias.
AHRQ-funded; HS027784.
Citation: Kostick-Quenet KM, Cohen IG, Gerke S .
Mitigating racial bias in machine learning.
J Law Med Ethics 2022;50(1):92-100. doi: 10.1017/jme.2022.13..
Keywords: Racial and Ethnic Minorities, Health Information Technology (HIT)
Valdovinos C, Perez-Aguilar G, Huerta RG
Electronic health literacy among linguistically diverse patients in the Los Angeles County safety net health system.
Few studies have been conducted which evaluate levels of eHealth literacy in underserved populations, yet eHealth literacy may affect telehealth utilization. The objective of this study was to describe eHealth literacy levels as well as technology use and access patterns among English-speaking and Limited English Proficiency (LEP) patients from three Los Angeles clinics for uninsured, Medicaid, and other vulnerable patients (“safety-net” clinics). Between June and July of 2017, patients aged 18 or over with diabetes mellitus and/ or hypertension and their caregivers were recruited for the study. The researchers asked both English-speaking and LEP Spanish-speaking patients about their technology use and access, and assessed their levels of health literacy using the eHealth Literacy Scale (eHeals). A total of 62 patients and 9 caregivers, with a mean age of 56, completed the questionnaire. The study found that 67% of participants used a telephone that had internet access. For the 10 items on the eHEALS instrument, the mean score was in the moderate range at 26/50 points. There was no difference in the mean eHEALS score between the English-speaking and LEP Spanish speaking groups, however 68% of English-speaking participants “agreed/ strongly agreed” that they knew how to use the internet to answer their health questions, compared to 47% of the Spanish-speaking participants (P<.05). The study concluded that despite moderate levels of electronic health literacy, participant’s perceived confidence and skills in engaging with electronic health systems were low.
AHRQ-funded; HS026407.
Citation: Valdovinos C, Perez-Aguilar G, Huerta RG .
Electronic health literacy among linguistically diverse patients in the Los Angeles County safety net health system.
Ethn Dis 2022 Winter;32(1):21-30. doi: 10.18865/ed.32.1.21..
Keywords: Health Literacy, Health Information Technology (HIT), Racial and Ethnic Minorities
Thompson HM, Sharma B, Bhalla S
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
The objective of this study was to assess fairness and bias of a previously validated machine learning opioid misuse classifier. Two experiments were conducted with the classifier's original and external validation datasets from 2 health systems. Bias was assessed via testing for differences in type II error rates across racial/ethnic subgroups (Black, Hispanic/Latinx, White, Other) using bootstrapped 95% confidence intervals. The investigators concluded that standardized, transparent bias assessments were needed to improve trustworthiness in clinical machine learning models.
AHRQ-funded; HS026385.
Citation: Thompson HM, Sharma B, Bhalla S .
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
J Am Med Inform Assoc 2021 Oct 12;28(11):2393-403. doi: 10.1093/jamia/ocab148..
Keywords: Opioids, Substance Abuse, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities
Jackman KP, Hightow-Weidman L, Poteat T
Evaluating psychometric determinants of willingness to adopt sexual health patient portal services among black college students: a mixed-methods approach.
The authors used mixed methods to describe perceptions of access to sexually transmitted infection test results via electronic personal health record (PHR) and correlates of willingness to adopt its use. Three qualitative themes emerged on relative advantages, barriers, and functionality of PHRs. Reliable latent factors, centering on PHR convenience and functionality, were positively associated with adoption willingness. Adoption may be boosted with tailored designs responsive to expressed service needs.
AHRQ-funded; HS023057.
Citation: Jackman KP, Hightow-Weidman L, Poteat T .
Evaluating psychometric determinants of willingness to adopt sexual health patient portal services among black college students: a mixed-methods approach.
J Am Coll Health 2021 Feb-Mar;69(2):190-97. doi: 10.1080/07448481.2019.1660352..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Young Adults, Sexual Health, Disparities, Infectious Diseases
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
This hybrid type II implementation-effectiveness cohort study aimed at evaluating appropriateness, acceptability and feasibility implementation outcomes, while also systematically examining the clinical effectiveness of a preconception care (PCC) intervention, the Gabby System, for Black and African American women receiving health services in community-based sites. Contextual factors that influenced uptake and appropriate implementation strategies were identified to inform future scalability of the intervention.
AHRQ-funded; HS025131.
Citation: Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N .
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
BMC Health Serv Res 2020 Sep 21;20(1):889. doi: 10.1186/s12913-020-05726-0..
Keywords: Racial and Ethnic Minorities, Women, Health Information Technology (HIT), Evidence-Based Practice, Community-Based Practice, Implementation
Jackman KP, Murray S, Hightow-Weidman
Digital technology to address HIV and other sexually transmitted infection disparities: intentions to disclose online personal health records to sex partners among students at a historically Black college.
Among an online survey sample of co-ed students, the authors described latent constructs and other variables associated with perceived behavioral intentions to disclose sexually transmitted infection (STI) test history using patient portals. They found that latent constructs representing communication valuation beliefs and practices were not associated with intentions, while self-reporting prior STI diagnosis was associated with intentions to disclose. They concluded that point-of-care messages focused on improvements to validating test results, communication, and empowerment, may be an effective strategy to support the adoption of patient portals for STI prevention among populations of college-aged Black youth.
AHRQ-funded; HS023057.
Citation: Jackman KP, Murray S, Hightow-Weidman .
Digital technology to address HIV and other sexually transmitted infection disparities: intentions to disclose online personal health records to sex partners among students at a historically Black college.
PLoS One 2020 Aug 21;15(8):e0237648. doi: 10.1371/journal.pone.0237648..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Electronic Health Records (EHRs), Health Information Technology (HIT), Young Adults, Racial and Ethnic Minorities, Prevention
Aguilera A, Figueroa CA, Hernandez-Ramos R
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE study.
In this randomized controlled trial, the researchers’ goal is to examine the effect of a text-messaging smartphone application to encourage physical activity in low-income ethnic minority patients with comorbid diabetes and depression. They will compare passively collected daily step counts, self-reported PHQ-8 and most recent hemoglobin A1c from medical records at baseline and at intervention completion at 6-month follow-up. They plan to submit manuscripts describing their user-designed methods and testing of the adaptive learning algorithm and will submit the results of the trial for publication in peer-reviewed journals and presentations at scientific meetings.
AHRQ-funded; HS025429.
Citation: Aguilera A, Figueroa CA, Hernandez-Ramos R .
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE study.
BMJ Open 2020 Aug 20;10(8):e034723. doi: 10.1136/bmjopen-2019-034723..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Low-Income, Health Promotion
Heintzman J, Marino M, Clark K
Using electronic health record data to study Latino immigrant populations in health services research.
The purpose of this study was to validate an electronic health record (EHR)-based algorithm that could serve as a safe proxy for self-reported immigration status for health services researchers. Researchers developed an EHR algorithm to classify a population of patients as likely undocumented or recent Latino immigrants and validated this algorithm by conducting semi-structured interviews of staff. They concluded that the EHR has potential for studying immigration status in health services research, although more study is needed to determine the accuracy and utility of EHRs for this purpose.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Clark K .
Using electronic health record data to study Latino immigrant populations in health services research.
J Immigr Minor Health 2020 Aug;22(4):754-61. doi: 10.1007/s10903-019-00925-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Health Services Research (HSR)
Whitley MD, Payán DD, Flórez KR
Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
Church-based programs can act on multiple levels to improve dietary and physical activity behaviors among African Americans and Latinos. However, the effectiveness of these interventions may be limited due to challenges in reaching all congregants or influencing behavior outside of the church setting. This study examined the feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
AHRQ-funded; HS000046.
Citation: Whitley MD, Payán DD, Flórez KR .
Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
Health Informatics J 2020 Jun;26(2):880-96. doi: 10.1177/1460458219853408..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Health Information Technology (HIT), Health Promotion
Walker DM, Hefner JL, Fareed N
Exploring the digital divide: age and race disparities in use of an inpatient portal.
Age and race disparities in the use of new technologies-the digital divide-may be limiting the potential of patient-facing health information technology to improve health and health care. The objective of this study was to investigate whether disparities exist in the use of patient portals designed specifically for the inpatient environment. The investigators identified lower use of the inpatient portal among African American and older patients, relative to White and younger patients, respectively.
AHRQ-funded; HS024379; HS024091; HS024349.
Citation: Walker DM, Hefner JL, Fareed N .
Exploring the digital divide: age and race disparities in use of an inpatient portal.
Telemed J E Health 2020 May;26(5):603-13. doi: 10.1089/tmj.2019.0065..
Keywords: Racial and Ethnic Minorities, Disparities, Health Information Technology (HIT), Inpatient Care, Hospitalization
Senft N, Abrams J, Katz
eHealth activity among African American and white cancer survivors: a new application of theory.
eHealth is a promising resource for cancer survivors and may contribute to reducing racial disparities in cancer survivorship. This research applied the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine eHealth activity among African American (AfAm) and White cancer survivors.
AHRQ-funded; HS022955.
Citation: Senft N, Abrams J, Katz .
eHealth activity among African American and white cancer survivors: a new application of theory.
Health Commun 2020 Mar;35(3):350-55. doi: 10.1080/10410236.2018.1563031..
Keywords: Racial and Ethnic Minorities, Cancer, Disparities, Health Status, Telehealth, Health Information Technology (HIT)
Polubriaginof FCG, Ryan P, Salmasian H
Challenges with quality of race and ethnicity data in observational databases.
This study assessed the quality of race and ethnicity information in observational health databases as well as electronic health records (EHRs) and to propose patient self-recording as a way to improve accuracy. Data from the Healthcare Cost and Utilization Project (HCUP) and Optum Labs, and from a single New York City healthcare system’s EHR was compared. Among 160 million patients in the HCUP database, no race or ethnicity data was recorded for 25% of the records. Among the 2.4 million patients in the New York City HER, race or ethnicity was unknown for 57%. However, when patients were allowed to directly record their race and ethnicity, percentages rose to 86%.
AHRQ-funded; HS021816; HS023704; HS024713.
Citation: Polubriaginof FCG, Ryan P, Salmasian H .
Challenges with quality of race and ethnicity data in observational databases.
J Am Med Inform Assoc 2019 Aug;26(8-9):730-36. doi: 10.1093/jamia/ocz113..
Keywords: Healthcare Cost and Utilization Project (HCUP), Data, Racial and Ethnic Minorities, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
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
Sorkin DH, Rizzo S, Biegler K
AHRQ Author: Ngo-Metzger Q
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
This article describes a multicomponent health information technology screening tool designed to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder (PTSD) in the primary care setting, with an eye toward meeting the mental health needs of traumatized refugees in the US Cambodian community. In a randomized controlled trial, 18 primary care providers were randomized to receive access to the mental health screening intervention, or to a minimal intervention control group. Cambodian American patients empaneled to participating providers were assigned to the providers' randomized group. From the results, the authors conclude that this approach offers the potential for training providers to diagnose and treat traumatized patients seeking mental health care in primary care.
AHRQ-authored.
Citation: Sorkin DH, Rizzo S, Biegler K .
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S190-s96. doi: 10.1097/mlr.0000000000001036..
Keywords: Depression, Diagnostic Safety and Quality, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Racial and Ethnic Minorities, Screening
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
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities