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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 45 Research Studies DisplayedMcAlearney AS, Sieck CJ, Gregory ME
Examining patients' capacity to use patient portals: insights for telehealth.
The objective of this study was to examine factors related to patients' capacity to use a patient portal and test the impact of these factors on patients' portal use. Using data from a large-scale randomized controlled trial of patient portal use, over one thousand hospitalized patients responded to survey items that were then mapped onto the 4 dimensions of the Engagement Capacity Framework. Findings showed that patients with fewer resources, fewer capabilities, lower willingness, and lower overall capacity to use patient portals used the portal less; in contrast, those with lower perceived self-efficacy used the portal more. These differences in patients' capacity to use patient portals provide an initial understanding of factors that may influence the use of telehealth and offer important guidance in efforts to support patients' telehealth use.
AHRQ-funded; HS024379; HS024091; HS024349.
Citation: McAlearney AS, Sieck CJ, Gregory ME .
Examining patients' capacity to use patient portals: insights for telehealth.
Med Care 2021 Dec;59(12):1067-74. doi: 10.1097/mlr.0000000000001639..
Keywords: Telehealth, Health Information Technology (HIT), Patient and Family Engagement
Brown TT, Hurley VB, Rodriguez HP
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
This cross-sectional study assessed the association of physician practice-level adoption of patient engagement strategies (PES), such as shared decision-making and motivational interviewing, with utilization and spending. The cohort included primary and secondary patients in 2190 practices who receiving treatment for hip (39,336), knee (48,362), and lower-back (67,940) issues who were Medicare beneficiaries that were matched to the 2017-2018 National Survey of Healthcare Organizations and Systems. Outcome measures were total knee replacement (TKR), total hip replacement (THR), 1-2 level posterior lumbar fusion (LF), total annual spending, and components of total annual spending. Spending was significantly lower in some categories for practices with relatively higher PES adoption, but did not differ for other practices. The odds of receiving THR were higher in independent practices for patients attributed to practices with moderate PES compared to patients in practices with low PES.
AHRQ-funded; HS024075.
Citation: Brown TT, Hurley VB, Rodriguez HP .
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
BMJ Open 2021 Nov 26;11(11):e053121. doi: 10.1136/bmjopen-2021-053121..
Keywords: Patient and Family Engagement, Healthcare Utilization, Healthcare Costs, Arthritis, Orthopedics
Fuji KT, Abbott AA, Galt KA
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
The purpose of this study was to compare use of a standalone personal health records (PHRs) by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c). Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
Perspect Health Inf Manag 2021 Fall;18(4):1e..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Patient Self-Management, Chronic Conditions, Patient and Family Engagement
De Roo AC, Vitous CA, Rivard SJ
High-risk surgery among older adults: not-quite shared decision-making.
This study explored surgeons’ approaches to decision-making for surgery among adults ≥65 years at high-risk of postoperative complications or death. The authors conducted semistructured in-depth interviews with 46 practicing surgeons across Michigan. They found that although shared decision-making is strongly recommended, surgeons who perform high-risk operations among older adults predominantly focused on assessing risk and setting expectations with patients and families rather than inviting them to actively participate in the decision-making process. Surgeons were also influenced by quality metrics, referrals, and personal experiences.
AHRQ-funded; HS026772; HS000053.
Citation: De Roo AC, Vitous CA, Rivard SJ .
High-risk surgery among older adults: not-quite shared decision-making.
Surgery 2021 Sep;170(3):756-63. doi: 10.1016/j.surg.2021.02.005..
Keywords: Elderly, Surgery, Shared Decision Making, Patient and Family Engagement
Smith BM, Sharma R, Das A
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient and family engagement is important for family-centered care, particularly for children and adolescents with chronic disease. In this study the investigators aimed to 1) identify available evidence from systematic reviews on engagement strategies used to help children, adolescents, and their caregivers manage chronic conditions, and 2) identify gaps in the literature. They searched PubMed and CINAHL from January 2015 to January 2020 for systematic reviews on patient and family engagement strategies in the pediatrics population (<18 years).
AHRQ-funded; 290201500006I.
Citation: Smith BM, Sharma R, Das A .
Patient and family engagement strategies for children and adolescents with chronic diseases: a review of systematic reviews.
Patient Educ Couns 2021 Sep;104(9):2213-23. doi: 10.1016/j.pec.2021.02.026..
Keywords: Children/Adolescents, Patient and Family Engagement, Chronic Conditions, Patient-Centered Healthcare, Evidence-Based Practice, Patient Self-Management
Hershberger PJ, Pei Y, Bricker DA
Advancing motivational interviewing training with artificial intelligence: ReadMI.
The research team developed and tested a training tool, Real-time Assessment of Dialogue in Motivational Interviewing (ReadMI), that uses natural language processing to provide immediate motivational interviewing (MI) metrics and thereby address the need for more effective MI training. They found that the more time a physician spent talking, the less likely the physician was engaging in MI-consistent interview behaviors, including open-ended questions, reflective statements, or use of a change ruler. They concluded that ReadMI produced specific metrics that a trainer can share with a student, resident, or clinician for immediate feedback.
AHRQ-funded; HS026548.
Citation: Hershberger PJ, Pei Y, Bricker DA .
Advancing motivational interviewing training with artificial intelligence: ReadMI.
Adv Med Educ Pract 2021 Jun 4;12:613-18. doi: 10.2147/amep.S312373..
Keywords: Lifestyle Changes, Clinician-Patient Communication, Patient and Family Engagement
Willard-Grace R, Knox M, Huang B
Primary care clinician burnout and engagement association with clinical quality and patient experience.
Burnout and engagement are commonly conceptualized as opposite ends of a spectrum, and there is concern that high clinician burnout and lack of engagement may adversely impact patient care. In this study, the investigators matched self-reported data on burnout and engagement for 182 primary care clinicians with data on clinical quality (cancer screenings, hypertension and diabetes control) and patient experience (Clinician and Group Survey-Consumer Assessment of Healthcare Providers and Systems [CG-CAHPS] communication scores, overall rating, and likelihood to recommend the clinic).
AHRQ-funded; HS026067.
Citation: Willard-Grace R, Knox M, Huang B .
Primary care clinician burnout and engagement association with clinical quality and patient experience.
J Am Board Fam Med 2021 May-Jun;34(3):542-52. doi: 10.3122/jabfm.2021.03.200515..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Burnout, Patient Experience, Patient and Family Engagement, Provider: Clinician, Provider: Physician, Quality of Care, Provider: Nurse, Provider: Health Personnel
Dalal AK, Piniella N, Fuller TE
Evaluation of electronic health record-integrated digital health tools to engage hospitalized patients in discharge preparation.
Researchers sought to evaluate the effect of electronic health record (EHR)-integrated digital health tools comprised of a checklist and video on transitions-of-care outcomes for patients preparing for discharge. They found that EHR-integrated digital health tools to prepare patients for discharge did not significantly increase patient activation and was associated with a longer length of stay.
AHRQ-funded; HS024751.
Citation: Dalal AK, Piniella N, Fuller TE .
Evaluation of electronic health record-integrated digital health tools to engage hospitalized patients in discharge preparation.
J Am Med Inform Assoc 2021 Mar 18;28(4):704-12. doi: 10.1093/jamia/ocaa321..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Discharge, Patient and Family Engagement, Education: Patient and Caregiver
Feinberg E, Kuhn J, Eilenberg JS
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
This study looked at impacts of a modification to a pilot program called Family Navigation to help low-income, minority children needing autism-related diagnostic services receive those services. An advisory group recommended modifications to recruitment criteria and study conditions. 40 parent-child dyad participants were randomized between the two pilots to receive usual care (UC) or modified FN. Participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment were compared. Recruitment improved significantly with the modified protocol (4.8% vs. 19.5%) and no participants were excluded from study enrollment compared to the first pilot (43.6%). Families in the second pilot were more likely to complete diagnostic assessment and report greater satisfaction with clinical care.
AHRQ-funded; HS022155; HS022242.
Citation: Feinberg E, Kuhn J, Eilenberg JS .
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
Acad Pediatr 2021 Mar;21(2):265-71. doi: 10.1016/j.acap.2020.04.007..
Keywords: Children/Adolescents, Autism, Patient-Centered Healthcare, Care Coordination, Racial and Ethnic Minorities, Low-Income, Patient and Family Engagement, Chronic Conditions
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Shared Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)
Holden RJ, Abebe E
Medication transitions: vulnerable periods of change in need of human factors and ergonomics.
The authors present a novel view of transitions from the lens of patient ergonomics which posits that patients and other nonprofessionals experience many changes during patient work transitions toward health-related goals. Medication transitions are particularly vulnerable. Two cases of medication transitions; new and medication deprescribing are described in which the patient work lens reveals many accompanying changes, vulnerabilities, and opportunities for human factors and ergonomics.
AHRQ-funded; HS024384.
Citation: Holden RJ, Abebe E .
Medication transitions: vulnerable periods of change in need of human factors and ergonomics.
Appl Ergon 2021 Jan;90:103279. doi: 10.1016/j.apergo.2020.103279..
Keywords: Medication, Medication: Safety, Patient and Family Engagement, Transitions of Care, Patient Safety
Valentine KD, Mancini B, Vo H
Using standardized videos to examine the validity of the shared decision making process scale: results of a randomized online experiment.
The Shared Decision Making (SDM) Process scale is a brief, patient-reported measure of SDM with demonstrated validity in surgical decision-making studies. In this study, the investigators examined the validity of the scores in assessing SDM for cancer screening and medication decisions through standardized videos of good-quality and poor-quality SDM consultations. The investigators concluded that SDM process scores showed good evidence of validity in a hypothetical scenario but were lacking in ability to classify good-quality or poor-quality videos accurately.
AHRQ-funded; HSO25718.
Citation: Valentine KD, Mancini B, Vo H .
Using standardized videos to examine the validity of the shared decision making process scale: results of a randomized online experiment.
Med Decis Making 2022 Jan;42(1):105-13. doi: 10.1177/0272989x211029267..
Keywords: Shared Decision Making, Patient and Family Engagement
Slota C, Davis SA, Blalock SJ
Patient-physician communication on medication cost during glaucoma visits.
The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Most participants did not discuss medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51 percent), took one glaucoma medication (63 percent), and had Medicare (49 percent) as well as a form of prescription insurance (78 percent).
AHRQ-funded; HS023054.
Citation: Slota C, Davis SA, Blalock SJ .
Patient-physician communication on medication cost during glaucoma visits.
Optom Vis Sci 2017 Dec;94(12):1095-101. doi: 10.1097/opx.0000000000001139.
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Keywords: Eye Disease and Health, Healthcare Costs, Medication, Patient and Family Engagement, Clinician-Patient Communication
Gadepalli SK, Canvasser J, Eskenazi Y
Roles and experiences of parents in necrotizing enterocolitis: an international survey of parental perspectives of communication in the NICU.
The purpose of this study was to characterize parental perceptions of communication and support they were given about necrotizing enterocolitis (NEC). The authors suggest that areas for quality improvement include better communication and collaboration with parents through early engagement in NEC prevention using modalities beyond verbal instruction.
AHRQ-funded; HS022908.
Citation: Gadepalli SK, Canvasser J, Eskenazi Y .
Roles and experiences of parents in necrotizing enterocolitis: an international survey of parental perspectives of communication in the NICU.
Adv Neonatal Care 2017 Dec;17(6):489-98. doi: 10.1097/anc.0000000000000438..
Keywords: Communication, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Experience, Patient and Family Engagement
Ganapathy D, Acharya C, Lachar J
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
The researchers aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. In their proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight hepatic encephalopathy-related readmissions were potentially avoided after the use of the App.
AHRQ-funded; HS024004.
Citation: Ganapathy D, Acharya C, Lachar J .
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
Liver Int 2017 Dec;37(12):1843-51. doi: 10.1111/liv.13494.
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Keywords: Caregiving, Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Hospital Readmissions
Masterson Creber R, Chen T, Wei C
Brief report: patient activation among urban hospitalized patients with heart failure.
The purpose of this study was to identify whether patient activation is associated with patient-reported health outcomes in an urban and racially diverse inpatient sample of patients with heart failure. The study concluded that patient activation can be easily measured in hospitalized patients with heart failure and is associated with clinically meaningful patient-reported health outcomes.
AHRQ-funded; HS021816.
Citation: Masterson Creber R, Chen T, Wei C .
Brief report: patient activation among urban hospitalized patients with heart failure.
J Card Fail 2017 Nov;23(11):817-20. doi: 10.1016/j.cardfail.2017.08.452..
Keywords: Heart Disease and Health, Hospitalization, Patient and Family Engagement, Patient Self-Management, Urban Health
Walker DM, Sieck CJ, Menser T
Information technology to support patient engagement: where do we stand and where can we go?.
The authors evaluated the current capability of hospitals to offer health information technology that facilitates patient engagement (PE). They concluded that, while hospitals have reached modest levels of adoption of PE technologies, consistent monitoring of this capacity can identify opportunities to use technology to facilitate engagement.
AHRQ-funded; HS024091.
Citation: Walker DM, Sieck CJ, Menser T .
Information technology to support patient engagement: where do we stand and where can we go?.
J Am Med Inform Assoc 2017 Nov 1;24(6):1088-94. doi: 10.1093/jamia/ocx043.
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Keywords: Health Information Technology (HIT), Hospitals, Patient and Family Engagement
Wolinsky FD, Lou Y, Edmonds SW
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
This study examined whether a tailored patient-activation letter communicating bone mineral density (BMD) test results plus an educational brochure improved patient activation scores and levels at 12 and 52 wk post-baseline as the mechanism leading to enhanced bone healthcare.
AHRQ-funded; HS023009.
Citation: Wolinsky FD, Lou Y, Edmonds SW .
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
J Clin Densitom 2017 Oct/Dec;20(4):464-71. doi: 10.1016/j.jocd.2016.08.012..
Keywords: Education: Patient and Caregiver, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Walker J, Crotty BH, O'Brien J
Addressing the challenges of aging: how elders and their care partners seek information.
Elders in retirement communities face many challenges concerning information and communication. The purpose of this study was to gain insights into how these elders and their families manage health information and communication. The study suggests that elders in senior living communities, and their families, piece together information primarily from word of mouth communication. It asserts that electronic social and collaborative technologies may make information gathering easier.
AHRQ-funded; HS021495.
Citation: Walker J, Crotty BH, O'Brien J .
Addressing the challenges of aging: how elders and their care partners seek information.
Gerontologist 2017 Oct 1;57(5):955-62. doi: 10.1093/geront/gnw060..
Keywords: Elderly, Caregiving, Communication, Care Coordination, Patient and Family Engagement, Health Information Technology (HIT)
Yasui M, Pottick KJ, Chen Y
Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families.
The authors systematically reviewed 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. Its findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families.
AHRQ-funded; HS023007.
Citation: Yasui M, Pottick KJ, Chen Y .
Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families.
Clin Child Fam Psychol Rev 2017 Sep;20(3):250-332. doi: 10.1007/s10567-017-0229-2.
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Keywords: Children/Adolescents, Cultural Competence, Behavioral Health, Patient and Family Engagement, Patient-Centered Healthcare
Hartzler AL, Osterhage K, Demiris G
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
As a first step in formulating the role of personal health information management (PHIM) in healthy aging, researchers explored the perspectives of older adults on health and health information used in their everyday lives. Participants expressed wellness from a position of personal strength by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement.
AHRQ-funded; HS022106.
Citation: Hartzler AL, Osterhage K, Demiris G .
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
Inform Health Soc Care 2017 Sep;43(3):1-14. doi: 10.1080/17538157.2017.1297815.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Health Status
Brown SD, Grijalva CS, Ferrara A
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Electronic health records (EHRs) present healthcare delivery systems with scalable, cost-effective opportunities to promote lifestyle programs among patients at high risk for type 2 diabetes, yet little consensus exists on strategies to enhance patient engagement. In this study, the investigators explored patient perspectives on program outreach messages containing content tailored to EHR-derived diabetes risk factors--a theory-driven strategy to increase the persuasiveness of health communications.
AHRQ-funded; HS019367.
Citation: Brown SD, Grijalva CS, Ferrara A .
Leveraging EHRs for patient engagement: perspectives on tailored program outreach.
Am J of Manag Care 2017 Jul;23(7):e223-e30..
Keywords: Diabetes, Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Lifestyle Changes, Patient and Family Engagement
Shortell SM, Poon BY, Ramsay PP
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
For adult primary care practices seeing patients with diabetes and/or cardiovascular disease, researchers examined the relationship between selected practice characteristics, patient engagement, and patient-reported outcomes of care. They found that having a patient-centered culture was positively associated with fewer depression symptoms and better physical function scores. Patient activation was positively associated with fewer depression symptoms.
AHRQ-funded; HS024075.
Citation: Shortell SM, Poon BY, Ramsay PP .
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
J Gen Intern Med 2017 Jun;32(6):640-47. doi: 10.1007/s11606-016-3980-z.
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Keywords: Patient and Family Engagement, Patient-Centered Outcomes Research, Primary Care, Chronic Conditions, Diabetes, Cardiovascular Conditions
Berry ABL, Lim C, Hartzler AL
Creating conditions for patients' values to emerge in clinical conversations: perspectives of health care team members.
The researchers sought to inform the design of interventions to support conversations about patient values between patients with multiple chronic conditions and their health care providers. Their paper contributes a practice-based account of ways in which providers engage with patient values, and discusses how future work in interactive systems design might extend and enrich these engagements.
AHRQ-funded; HS022364.
Citation: Berry ABL, Lim C, Hartzler AL .
Creating conditions for patients' values to emerge in clinical conversations: perspectives of health care team members.
DIS (Des Interact Syst Conf) 2017 Jun;2017:1165-74. doi: 10.1145/3064663.3064669.
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Keywords: Chronic Conditions, Clinician-Patient Communication, Patient Self-Management, Patient and Family Engagement
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery