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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 17 of 17 Research Studies DisplayedSilverstein GD, Styke SC, Kaur S
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
This study’s objective was to evaluate the associations between health/eHealth literacy and depressive symptoms with app usage and clinical outcomes. The authors recruited adults with persistent asthma to utilize the ASTHMAXcel PRO mobile app. Participants completed the following questionnaires: Patient Health Questionnaire-9 (PHQ-9) to assess for depressive symptoms, Asthma Control Test (ACT), Mini Asthma Quality of Life (QOL) Questionnaire, and the Newest Vital Sign (NVS) tool to measure health literacy. Subsets of participant data were available on eHealth literacy (eHeals) (n = 24) and average number of app logins across 2 months (n = 40). The average participant age was 44.0 years, with 74% identifying as female. Increased depressive symptoms were associated with worse asthma control and asthma QOL, but not eHealth literacy. Higher eHealth literacy was associated with worse asthma QOL and more app logins. NVS scores weren’t associated with any measures.
AHRQ-funded; HS025645.
Citation: Silverstein GD, Styke SC, Kaur S .
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
Psychosom Med 2023 Sep 1; 85(7):605-11. doi: 10.1097/psy.0000000000001170..
Keywords: Health Literacy, Asthma, Telehealth, Health Information Technology (HIT), Education: Patient and Caregiver, Outcomes, Respiratory Conditions, Chronic Conditions
Lucy AT, Rakestraw SL, Stringer C
Readability of patient education materials for bariatric surgery.
This paper examined readability and reading level of online bariatric surgery and standardized perioperative electronic medical record (EMR) patient education materials (PEM). National organizations recommend that PEM not exceed a sixth grade reading level. One institution was used to assess readability of PEM. Text readability was assessed by seven validated instruments and mean readability scores calculated with standard deviations and compared using unpaired t-tests. A total of 32 webpages and seven EMR education documents were assessed. Web pages were overall assessed as "difficult to read" compared to "standard/average" readability EMR materials. All web pages were at or above high school reading levels, with the highest reading levels being pages with nutrition information and the lowest reading level patient testimonials. EMR materials were found to be at sixth to ninth grade reading level.
AHRQ-funded; HS023009.
Citation: Lucy AT, Rakestraw SL, Stringer C .
Readability of patient education materials for bariatric surgery.
Surg Endosc 2023 Aug; 37(8):6519-25. doi: 10.1007/s00464-023-10153-3..
Keywords: Surgery, Education: Patient and Caregiver, Obesity: Weight Management, Obesity, Health Literacy
Ahmed N, Brown J, Parau C
Bridging the digital health divide: characterizing patient portal users and nonusers in the U.S.
The purpose of this study was to 1) review variations in demographics between patient portal users and nonusers; and 2) review variations in health literacy, patient self-efficacy, and technology utilization and attitudes between patient portal users and nonusers. The researchers collected data from Amazon Mechanical Turk (MTurk) workers between December 2021 and January 2022. 489 Participants completed an online survey with questions on their attitudes about media and technology, attitudes about their health, their access to technology, health literacy, patient self-efficacy, and patient portal use. The study results indicated qualitative differences between users and nonusers of patient portals as related to type of neighborhood, income, education, disability status, comorbidity, type of insurance, and the presence or absence of primary care providers. Quantitative results supported the qualitative results, revealing that participants with insurance, a primary care provider, or a disability or comorbid condition had a greater likelihood of having a patient portal account.
AHRQ-funded; HS026298.
Citation: Ahmed N, Brown J, Parau C .
Bridging the digital health divide: characterizing patient portal users and nonusers in the U.S.
Med Care 2023 Jul; 61(7):448-55. doi: 10.1097/mlr.0000000000001869..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy
Stallings SC, Richmond SC, Canedo JR
Assessing patient-level knowledge of precision medicine in a community health center setting.
Researchers used a mixed-methods approach to identify patient-level factors that influenced understanding of cancer risk among federally qualified community health center (FQCHC) patients. Participants were English-speaking adults aged 40-79 years enrolled in focus groups; they completed surveys to assess patient-level understanding of precision medicine, numeracy, and health literacy. The findings suggested that patients may lack familiarity with precision medicine concepts relevant for understanding cancer treatment decisions. The researchers concluded that future educational efforts might help to bridge the gap in patient understanding and facilitate equitable opportunities for precision medicine for patients, including those seeking care from community health centers.
AHRQ-funded; HS026122.
Citation: Stallings SC, Richmond SC, Canedo JR .
Assessing patient-level knowledge of precision medicine in a community health center setting.
J Community Genet 2023 Apr; 14(2):197-210. doi: 10.1007/s12687-023-00632-4..
Keywords: Community-Based Practice, Health Literacy, Genetics
Arcia A, Pho AT, Lor M
Comparison of newest vital sign and brief health literacy screen scores in a large, urban Hispanic cohort.
The purpose of this study was to examine the relationship between Newest Vital Sign (NVS) and Brief Health Literacy Screen (BHLS) scores in a large cohort of English- and Spanish-speaking urban Hispanic adults. Scores on both measures showed good internal consistency but NVS items had high difficulty; greater than 50% of respondents scored 0. The correlation between measures was weak. The study concluded that health literacy scores were poor predictors of objective scores.
AHRQ-funded; HS019853; HS022961.
Citation: Arcia A, Pho AT, Lor M .
Comparison of newest vital sign and brief health literacy screen scores in a large, urban Hispanic cohort.
Patient Educ Couns 2023 Apr; 109:107628. doi: 10.1016/j.pec.2023.107628
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Keywords: Health Literacy, Racial and Ethnic Minorities, Urban Health
Lane S, Fitzsimmons E, Zelefsky A
Assessing electronic health literacy at an urban academic hospital.
The purpose of this study was to explore electronic health literacy (EHL) in patients at an urban, academic hospital in the Bronx, and evaluate for relationships between EHL levels and different demographic variables. The researchers designed a cross-sectional, observational study in adults 18 years or more who presented for services at the Montefiore Einstein Center for Cancer Care (MECCC) Department of Radiation Oncology or the Montefiore Department of Medicine in the Bronx. The study evaluated EHL using the existing, validated eHealth Literacy Scale (eHEALS) survey and the researchers’ newly developed eHealth Literacy Objective Scale-Scenario Based (eHeLiOS-SB) tool. The study found that there was a statistically significant relationship between age and EHL as evaluated by both eHEALS and eHeLiOS-SB, with lower EHL scores for older adults. A specific question designed to evaluate attitudes toward digital health technologies revealed that the majority of participants held a positive attitude toward those types of applications.
AHRQ-funded; HS025645.
Citation: Lane S, Fitzsimmons E, Zelefsky A .
Assessing electronic health literacy at an urban academic hospital.
Appl Clin Inform 2023 Mar; 14(2):365-73. doi: 10.1055/a-2041-4500..
Keywords: Health Literacy, Electronic Health Records (EHRs), Telehealth, Health Information Technology (HIT)
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.
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