National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Arthritis (1)
- Cancer (5)
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- Children/Adolescents (2)
- Clinician-Patient Communication (1)
- Communication (3)
- COVID-19 (1)
- Dental and Oral Health (1)
- Diabetes (1)
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- Education: Patient and Caregiver (10)
- Elderly (2)
- Electronic Health Records (EHRs) (2)
- Eye Disease and Health (1)
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- Patient-Centered Outcomes Research (2)
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- Patient Safety (1)
- Patient Self-Management (2)
- Prevention (1)
- Public Health (2)
- Quality of Care (1)
- Quality of Life (1)
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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 25 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
Tieu L, Sarkar U, Schillinger D
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
The researchers explored patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital. Despite concerns about security, difficulty understanding medical information, and satisfaction with current communication processes, respondents generally expressed enthusiasm about portal use. Their findings suggest a strong need for training and support to assist vulnerable patients with portal registration and use, particularly those with limited health literacy.
AHRQ-funded; HS022561; HS022047; HS022408.
Citation: Tieu L, Sarkar U, Schillinger D .
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
J Med Internet Res 2015 Dec 03;17(12):e275. doi: 10.2196/jmir.4847.
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Keywords: Web-Based, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy
Petkovic J, Epstein J, Buchbinder R
Toward ensuring health equity: Readability and cultural equivalence of OMERACT patient-reported outcome measures.
The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM.
AHRQ-funded; HS021110.
Citation: Petkovic J, Epstein J, Buchbinder R .
Toward ensuring health equity: Readability and cultural equivalence of OMERACT patient-reported outcome measures.
J Rheumatol 2015 Dec;42(12):2448-59. doi: 10.3899/jrheum.141168.
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Keywords: Patient-Centered Outcomes Research, Outcomes, Health Literacy
Hahn EA, Burns JL, Jacobs EA
Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
The investigators examined associations between patient characteristics, health behaviors, and health outcomes and explored the role of health literacy as a potential mediator of outcomes. They found that health literacy was not associated with diabetes self-care, health status, or satisfaction with communication, and it did not mediate the effects of other factors on these outcomes. Diabetes self-efficacy was significantly associated with health behaviors and outcomes. The association between Spanish language preference and poorer health was not mediated by this group's lower health literacy.
AHRQ-funded; HS019335.
Citation: Hahn EA, Burns JL, Jacobs EA .
Health literacy and patient-reported outcomes: a cross-sectional study of underserved English- and Spanish-speaking patients with type 2 diabetes.
J Health Commun 2015;20 Suppl 2:4-15. doi: 10.1080/10810730.2015.1061071.
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Keywords: Communication, Diabetes, Health Literacy, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Brega AG, Freedman MA, LeBlanc WG
AHRQ Author: Brach C
Using the Health Literacy Universal Precautions Toolkit to improve the quality of patient materials.
The researchers conducted interviews to learn about practices’ implementation activities and assessed the readability, understandability, and actionability of patient education materials collected during pre- and postimplementation site visits. They found that many of the revised and newly developed documents had reading levels appropriate for most patients and better readability than the original materials.
AHRQ-authored.
Citation: Brega AG, Freedman MA, LeBlanc WG .
Using the Health Literacy Universal Precautions Toolkit to improve the quality of patient materials.
J Health Commun 2015 Oct;20 Suppl 2:69-76. doi: 10.1080/10810730.2015.1081997..
Keywords: Health Literacy, Education: Patient and Caregiver, Quality of Care
Goodman MS, Griffey RT, Carpenter CR
Do subjective measures improve the ability to identify limited health literacy in a clinical setting?
The researchers assessed whether the addition of Single-Item Literacy Screener (SILS) items or the Brief Health Literacy Screen (BHLS) to patient demographics readily available in ambulatory clinical settings reaching underserved patients improves the ability to identify limited health literacy. Their findings suggest that the BHLS and SILS items improve the ability to identify patients with limited health literacy compared with demographic predictors alone.
AHRQ-funded; HS020309.
Citation: Goodman MS, Griffey RT, Carpenter CR .
Do subjective measures improve the ability to identify limited health literacy in a clinical setting?
J Am Board Fam Med 2015 Sep-Oct;28(5):584-94. doi: 10.3122/jabfm.2015.05.150037..
Keywords: Health Literacy, Vulnerable Populations
Fink A, Beck JC
Developing and evaluating a website to guide older adults in their health information searches: a mixed-methods approach.
This mixed-methods study developed and evaluated an online program to improve older adults’ skills in identifying high-quality web-based health information. It found that experimental participants assigned significantly higher ratings of usability and learning to the new site than controls did to their tutorial although no differences were found in self-efficacy or knowledge.
AHRQ-funded; HS019745.
Citation: Fink A, Beck JC .
Developing and evaluating a website to guide older adults in their health information searches: a mixed-methods approach.
J Appl Gerontol 2015 Aug;34(5):633-51. doi: 10.1177/0733464813486961..
Keywords: Elderly, Web-Based, Health Information Technology (HIT), Health Literacy
Mueller SK, Giannelli K, Boxer R
Readability of patient discharge instructions with and without the use of electronically available disease-specific templates.
The investigators examined the impact of the use of electronic, patient-friendly, templated discharge instructions on the readability of discharge instructions provided to patients at discharge. They concluded that the use of electronically available templated discharge instructions may be a viable option to improve the readability of written material provided to patients at discharge, although the library of available templates requires expansion.
AHRQ-funded; HS023331.
Citation: Mueller SK, Giannelli K, Boxer R .
Readability of patient discharge instructions with and without the use of electronically available disease-specific templates.
J Am Med Inform Assoc 2015 Jul;22(4):857-63. doi: 10.1093/jamia/ocv005.
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Keywords: Education: Patient and Caregiver, Health Literacy, Hospital Discharge, Patient Safety
Slota C, Sayner R, Vitko M
Glaucoma patient expression of medication problems and nonadherence.
The purpose of this article was to evaluate what patient characteristics led patients to express (1) medication problems, including difficulty with side effects and eye drop administration, and (2) problems with nonadherence to glaucoma medications. It found that patients with lower health literacy are less likely to express medication-related problems and patients who express medication problems often express nonadherence.
AHRQ-funded; HS023054.
Citation: Slota C, Sayner R, Vitko M .
Glaucoma patient expression of medication problems and nonadherence.
Optom Vis Sci 2015 May;92(5):537-43. doi: 10.1097/opx.0000000000000574..
Keywords: Eye Disease and Health, Patient Adherence/Compliance, Medication, Health Literacy
Kestenbaum LA, Feemster KA
Identifying and addressing vaccine hesitancy.
Despite, and perhaps because of, their public health impact, an increasing number of parents and patients are choosing to delay or refuse vaccines. These individuals are described as “vaccine hesitant.” This review explores the history of vaccine hesitancy, its causes, and suggests approaches for reducing hesitancy and strengthening vaccine acceptance.
AHRQ-funded; HS020939.
Citation: Kestenbaum LA, Feemster KA .
Identifying and addressing vaccine hesitancy.
Pediatr Ann 2015 Apr;44(4):e71-5. doi: 10.3928/00904481-20150410-07..
Keywords: Vaccination, Health Literacy, Patient Adherence/Compliance
Heerman WJ, White RO, Barkin SL
Advancing informed consent for vulnerable populations.
The authors suggest an innovative approach that uses low health-literacy communication strategies and visual aids to augment and potentially replace the traditional approach to informed consent. This approach involves: (1) the use of effective health communication and low-literacy techniques, (2) the use of visual aids and graphics to promote understanding and guide the reader toward key study concepts, and (3) careful attention to child dissenting behaviors.
AHRQ-funded; HS022990.
Citation: Heerman WJ, White RO, Barkin SL .
Advancing informed consent for vulnerable populations.
Pediatrics 2015 Mar;135(3):e562-4. doi: 10.1542/peds.2014-3041..
Keywords: Children/Adolescents, Communication, Health Literacy, Obesity, Research Methodologies
Lyles CR, Sarkar U
Health literacy, vulnerable patients, and health information technology use: where do we go from here?
The authors comment on an article in the same issue that found only 32 percent of older adults used the Internet to get health information and only 10 percent of older adults with limited health literacy did so. They discuss its implications for the related issues of access, training, and perhaps most importantly, the usability of websites and other technology platforms.
AHRQ-funded; HS023558; HS022047.
Citation: Lyles CR, Sarkar U .
Health literacy, vulnerable patients, and health information technology use: where do we go from here?
J Gen Intern Med 2015 Mar;30(3):271-2. doi: 10.1007/s11606-014-3166-5..
Keywords: Health Literacy, Education: Patient and Caregiver, Elderly, Health Information Technology (HIT)
Smith W, Brach C, Horowitz AM
AHRQ Author: Brach C
Poor oral health literacy: why nobody understands you.
The authors examined the mistaken interpretation of the word “individuals” to be limited almost exclusively to citizens and patients. They identified gaps in knowledge, understanding, and practices regarding caries prevention among the public and all provider groups.
AHRQ-authored.
Citation: Smith W, Brach C, Horowitz AM .
Poor oral health literacy: why nobody understands you.
J Dent Hyg 2015 Feb;89 Suppl 1:36-8.
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Keywords: Dental and Oral Health, Health Literacy, Prevention
Dorn SD, Palsson OS, Woldeghebriel M
Development and pilot testing of an integrated, web-based self-management program for irritable bowel syndrome (IBS).
The researchers developed, assessed, and refined an integrated IBS self-management program (IBS Self-care) and then conducted a 12-week pilot test. They found that the IBS Self-Care program was well received by users who after 12 weeks reported improved knowledge about IBS, but no significant changes in self-efficacy or quality of life.
AHRQ-funded; HS019468.
Citation: Dorn SD, Palsson OS, Woldeghebriel M .
Development and pilot testing of an integrated, web-based self-management program for irritable bowel syndrome (IBS).
Neurogastroenterol Motil 2015 Jan;27(1):128-34. doi: 10.1111/nmo.12487..
Keywords: Patient Self-Management, Health Literacy, Education: Patient and Caregiver, Digestive Disease and Health
Halverson JL, Martinez-Donate AP, Palta M
Health literacy and health-related quality of life among a population-based sample of cancer patients.
The authors examined the relation between health literacy and health-related quality of life among cancer patients. Their cross-sectional survey found that health literacy is positively and independently associated with health-related quality of life among cancer patients. Their findings support adoption of health literacy best practices by cancer care systems.
AHRQ-funded; HS000083.
Citation: Halverson JL, Martinez-Donate AP, Palta M .
Health literacy and health-related quality of life among a population-based sample of cancer patients.
J Health Commun 2015;20(11):1320-9. doi: 10.1080/10810730.2015.1018638..
Keywords: Health Literacy, Quality of Life, Cancer