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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
76 to 100 of 281 Research Studies DisplayedCanedo JR, Wilkins CH, Senft N
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
This study examined barriers to dissemination and adoption of precision medicine among the Hispanic/Latino population. Six focus groups and a demographic survey in English and Spanish was developed. Forty-one self-identified Hispanics/Latinos from diverse countries participated in the study. The participants had never heard of precision medicine and barriers to adoption and dissemination included lack of health insurance, distrust of government, immigration status, financial burden, limited English proficiency, low literacy levels, lack of information and lack of transportation. Facilitators included family support, information provided in Spanish, use of plain language and graphics and trust in healthcare providers and institutions. The authors recommend culturally- and linguistically-tailored, low-literacy educational material about precision medicine in English and Spanish.
AHRQ-funded; HS026122.
Citation: Canedo JR, Wilkins CH, Senft N .
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
BMC Public Health 2020 May 1;20(1):603. doi: 10.1186/s12889-020-08718-1..
Keywords: Racial and Ethnic Minorities, Cultural Competence, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Fisher KA, Gallagher TH, Smith KM
Communicating with patients about breakdowns in care: a national randomised vignette-based survey.
This study examined the impact of an apology when problems occur in patient care breakdowns occur at hospitals. Breakdowns included slow response to call bell, rude aide, and unanswered questions. A national online survey of 1188 adults aged 35 years or older were sampled from an online panel representative of the entire US population, created and maintained by GfK. Twice as many participants receiving an in-depth prompt about care breakdowns would recommend the hospital compared with those receiving no prompt (18.4% vs 8.8%). Almost three times as many participants who received a full apology would probably/definitely recommend the hospital compared with those receiving no apology (34.1% vs 13.6%). The survey also asked whether the respondent would speak up, with feeling upset being a strong determinant of greater intent to speak up.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Gallagher TH, Smith KM .
Communicating with patients about breakdowns in care: a national randomised vignette-based survey.
BMJ Qual Saf 2020 Apr;29(4):313-19. doi: 10.1136/bmjqs-2019-009712..
Keywords: Clinician-Patient Communication, Communication, Patient Experience, Patient and Family Engagement, Quality Improvement, Quality of Care, Hospitals
Fredericksen RJ, Fitzsimmons E, Gibbons LE
How do treatment priorities differ between patients in HIV care and their providers? A mixed-methods study.
The authors asked patients in HIV care and providers to prioritize topic areas to address during routine visits. They found that patients and providers showed high discordance in rank order priorities. Patients ranked social domains such as HIV stigma highly; a higher proportion of providers prioritized substance use domains. HIV stigma was a higher priority for patients in care fewer than 6 years, nonwhite patients, and younger patients. Patients' priorities differed between men and women, white race vs. other races, and Latinos vs. non-Latinos.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Fitzsimmons E, Gibbons LE .
How do treatment priorities differ between patients in HIV care and their providers? A mixed-methods study.
AIDS Behav 2020 Apr;24(4):1170-80. doi: 10.1007/s10461-019-02746-8.
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Keywords: Human Immunodeficiency Virus (HIV), Chronic Conditions, Social Stigma, Clinician-Patient Communication, Care Management
Banzett RBB, Sheridan AR, Baker KM
'Scared to death' dyspnoea from the hospitalised patient's perspective.
The authors collected patients' descriptions of dyspnea in their own words during a parent study in which 156 hospitalized patients completed a quantitative multidimensional dyspnea questionnaire. These volunteered comments provided insights not conveyed by structured rating scales. The researchers organized these comments into the most prominent themes, which included sensory experiences, emotional responses, self-blame, and precipitating events. Patients often mentioned air hunger, anxiety, and fear. Patients' own words can help to bridge the gap of understanding.
AHRQ-funded; HS024288.
Citation: Banzett RBB, Sheridan AR, Baker KM .
'Scared to death' dyspnoea from the hospitalised patient's perspective.
BMJ Open Respir Res 2020 Mar;7(1). doi: 10.1136/bmjresp-2019-000493..
Keywords: Respiratory Conditions, Clinician-Patient Communication, Communication
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
AHRQ-funded; HS026379.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA .
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
Keywords: Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
Feng JY, Toomey SL, Elliott MN
Factors associated with family experience in pediatric inpatient care.
Researchers assessed which aspects of pediatric inpatient experience have the strongest relationships with parents' willingness to recommend a hospital. Their cross-sectional study examined surveys completed by parents of children hospitalized at hospitals using the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey. They found that child comfort and nurse-parent communication showed the strongest relationships with willingness to recommend, followed by preparing to leave the hospital, doctor-parent communication, and keeping parents informed. They recommended improvement efforts focusing on creating an age-appropriate environment, improving the effectiveness of provider interactions, and engaging parents to share their values and concerns.
AHRQ-funded; HS020513; HS025299.
Citation: Feng JY, Toomey SL, Elliott MN .
Factors associated with family experience in pediatric inpatient care.
Pediatrics 2020 Mar;145(3): e20191264. doi: 10.1542/peds.2019-1264..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Quality Measures, Quality of Care, Inpatient Care, Patient Experience, Hospitals, Hospitalization, Patient and Family Engagement, Clinician-Patient Communication
McCarthy DM, Powell RE, Cameron KA
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
The purpose of this study was to evaluate the effectiveness of the Uncertainty Communication Education Module (UCEM) in improving physician communications. Patients' understanding of the care they received has implications for care quality, safety, and patient satisfaction, especially when they are discharged without a definitive diagnosis. Developing a patient-centered diagnostic uncertainty communication strategy will improve safety of acute care discharges. This trial has been designed to have a low-resource, scalable intervention that would allow for widespread dissemination and uptake.
AHRQ-funded; HS025651.
Citation: McCarthy DM, Powell RE, Cameron KA .
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
BMC Med Educ 2020 Feb 19;20(1):49. doi: 10.1186/s12909-020-1926-y..
Keywords: Education: Continuing Medical Education, Clinician-Patient Communication, Communication, Emergency Department, Simulation, Provider: Physician, Provider
Salzman DH, Rising KL, Cameron KA
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
Historically, medically trained experts have served as judges to establish a minimum passing standard (MPS) for mastery learning. As mastery learning expands from procedure-based skills to patient-centered domains, such as communication, there is an opportunity to incorporate patients as judges in setting the MPS. In this study, the investigators described their process of incorporating patients as judges to set the minimum passing standard (MPS) and compared the MPS set by patients and emergency medicine residency program directors (PDs).
AHRQ-funded; HS025651.
Citation: Salzman DH, Rising KL, Cameron KA .
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
J Grad Med Educ 2020 Feb;12(1):58-65. doi: 10.4300/jgme-d-19-00483.1..
Keywords: Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient Safety, Education: Continuing Medical Education, Training, Provider Performance
McGovern KM, Wells EE, Landstrom GL
Understanding interpersonal and organizational dynamics among providers responding to crisis.
Patient rescue occurs in phases: recognizing the problem, communicating the concern, and treating the complication. To help improve rescue, the investigators sought to understand facilitators and barriers to managing postoperative complications, using a criterion-based sample from a large academic medical center. The study identified significant variation in communication processes across providers caring for surgical patients.
AHRQ-funded; HS024403.
Citation: McGovern KM, Wells EE, Landstrom GL .
Understanding interpersonal and organizational dynamics among providers responding to crisis.
Qual Health Res 2020 Feb;30(3):331-40. doi: 10.1177/1049732319866818..
Keywords: Surgery, Patient Safety, Adverse Events, Clinician-Patient Communication, Communication
Hale KL, Wallace DD, Blanco-Duran D
Conversations between Latina mothers and their child's mental health provider: An observational study of shared decision-making regarding pediatric patient mental health needs.
The authors evaluated shared decision-making (SDM) and delineated SDM processes in audio-recorded conversations between language-congruent Spanish-/English-speaking clinicians and parents of pediatric mental health patients. They found that their present sample performed on par with other populations studied to date, and that it expanded the evaluation of observed SDM to include Latino patients and new clinician populations. The practical implications of their findings is that use of the Observer OPTION(5) instrument highlights that eliciting and integrating parent/patient preferences is a skill that requires attention when delivering culturally competent interventions.
AHRQ-funded; HS000032.
Citation: Hale KL, Wallace DD, Blanco-Duran D .
Conversations between Latina mothers and their child's mental health provider: An observational study of shared decision-making regarding pediatric patient mental health needs.
Patient Educ Couns 2020 Jan;103(1):96-102. doi: 10.1016/j.pec.2019.08.013..
Keywords: Children/Adolescents, Decision Making, Cultural Competence, Racial and Ethnic Minorities, Clinician-Patient Communication, Communication, Caregiving, Behavioral Health
White AEC
When and how do surgeons initiate noticings of additional concerns?
Physicians are trained on how to best solicit additional concerns from patients. What has not yet been studied is when and how physicians initiate additional concerns. This analysis focuses on when and how general surgeons share their noticings of medical problems unrelated to the upcoming (or recent) procedures that patients are being seen for.
AHRQ-funded; HS022236.
Citation: White AEC .
When and how do surgeons initiate noticings of additional concerns?
When and how do surgeons initiate noticings of additional concerns?.
Keywords: Clinician-Patient Communication, Surgery, Provider: Physician, Communication
Chan B, Lyles C, Kaplan C
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
In this study, the authors investigated differences in overall and patterns of portal use for patients with resident and attending primary care providers (PCPs). They concluded that given the lower patient-portal use among residents' patients, residency programs should develop curricula to bolster trainee competence in using the patient-portal for communication and to enhance the patient-physician relationship.
AHRQ-funded; HS022981; HS022408.
Citation: Chan B, Lyles C, Kaplan C .
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
J Gen Intern Med 2018 Dec;33(12):2085-91. doi: 10.1007/s11606-018-4637-x..
Keywords: Clinician-Patient Communication, Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider, Provider: Physician
McCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Schoenfeld EM, Probst MA, Quigley
Does shared decision making actually occur in the emergency department? Looking at it from the patients' perspective.
In this study the investigators sought to assess the frequency, content, and quality of shared decision making (SDM) in the emergency department (ED), from patients' perspectives. The investigators found that fewer than half of ED patients surveyed reported they were involved in SDM. The most common decision for which SDM was used was around ED disposition (admission vs. discharge). When SDM was employed, patients generally rated the discussion highly.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Probst MA, Quigley .
Does shared decision making actually occur in the emergency department? Looking at it from the patients' perspective.
Acad Emerg Med 2019 Dec;26(12):1369-78. doi: 10.1111/acem.13850..
Keywords: Decision Making, Emergency Department, Clinician-Patient Communication, Patient and Family Engagement
Ancker JS, Sharko M, Hong M
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
Parents routinely access young children's medical records, but medical societies strongly recommend confidential care during adolescence, and most medical centers restrict parental records access during the teen years. In this study, the investigators sought to assess public opinion about adolescent medical privacy. The investigators concluded that although medical societies recommend confidential care for adolescents, public opinion was largely in favor of parental access.
AHRQ-funded; HS021531.
Citation: Ancker JS, Sharko M, Hong M .
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
J Am Med Inform Assoc 2018 Dec;25(12):1593-99. doi: 10.1093/jamia/ocy120..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Gaufberg E, Olmsted MW, Bell SK
Third things as inspiration and artifact: a multi-stakeholder qualitative approach to understand patient and family emotions after harmful events.
The authors discuss an AHRQ conference held to establish a research agenda on patient and family emotional harm after medical errors. Topics include implications for quality and safety, educational innovation, and qualitative research.
AHRQ-funded; HS024463.
Citation: Gaufberg E, Olmsted MW, Bell SK .
Third things as inspiration and artifact: a multi-stakeholder qualitative approach to understand patient and family emotions after harmful events.
J Med Humanit 2019 Dec;40(4):489-504. doi: 10.1007/s10912-019-09563-z..
Keywords: Medical Errors, Adverse Events, Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient Safety
Meyer AND, Giardina TD, Khanna A
Pediatric clinician perspectives on communicating diagnostic uncertainty.
This study examined how pediatric clinicians discussed diagnostic uncertainty with their patients’ parents. A sample study was conducted at two large academic medical institutions in Texas. Twenty pediatric clinicians participated. Some clinicians felt more comfortable expressing diagnostic uncertainty to parents who were more educated. The strength of the parent-clinician relationship also changed how clinicians communicated with parents.
AHRQ-funded; HS022087; HS023602
Citation: Meyer AND, Giardina TD, Khanna A .
Pediatric clinician perspectives on communicating diagnostic uncertainty.
Int J Qual Health Care 2019 Nov 30;31(9):G107-G12. doi: 10.1093/intqhc/mzz061..
Keywords: Children/Adolescents, Caregiving, Clinician-Patient Communication, Communication
Khan A, Yin HS, Brach C
AHRQ Author: Brach C
Association between parent comfort with English and adverse events among hospitalized children.
The purpose of this study was to examine the association between parents’ limited comfort with English (LCE) and adverse events in a cohort of hospitalized children. Participants included Arabic-, Chinese-, English-, and Spanish-speaking parents of patients 17 years and younger in the pediatric units of seven North American hospitals. Findings showed that hospitalized children of parents expressing LCE were twice as likely to experience harms due to medical care. Targeted strategies are needed to improve communication and safety for this vulnerable group of children.
AHRQ-authored; AHRQ-funded; HS022986.
Citation: Khan A, Yin HS, Brach C .
Association between parent comfort with English and adverse events among hospitalized children.
JAMA Pediatr 2020 Dec;174(12):e203215. doi: 10.1001/jamapediatrics.2020.3215..
Keywords: Children/Adolescents, Caregiving, Cultural Competence, Clinician-Patient Communication, Communication, Adverse Events, Patient Safety, Inpatient Care, Hospitalization
Anderson AC, Akre E, Chen J
Exploring national trends of patient- and family-centered care among US children.
This study examined national trends in the receipt of high-quality patient-physician communication and patient empowerment through behavioral health counseling among children in the United States. They used Medical Expenditure Panel Survey (MEPS) data from 2010 to 2014. Two measures of patient- and family-centered care (PFCC) were analyzed: 1) a composite measure of high-quality patient-physician communication, and 2) patient empowerment through behavioral health counseling about healthy eating and exercise. There were high rates of receiving high-quality physician-patient communication (92-93%) as opposed to behavioral counseling about healthy eating (53-60%) and exercise (37-42%). There was a higher rate of high-quality physician-patient communication in 2014 than in 2010, but there was not a similar increase in receiving behavioral health counseling. Lower odds of receiving behavioral health counseling were found for parents with low income and low educational attainment as well as lack of insurance.
AHRQ-funded; HS022135.
Citation: Anderson AC, Akre E, Chen J .
Exploring national trends of patient- and family-centered care among US children.
J Child Health Care 2019 Jun;23(2):200-12. doi: 10.1177/1367493518786015..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient-Centered Outcomes Research, Family Health and History, Lifestyle Changes
Senft N, Butler E, Everson J
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
This study examined trends in eHealth disparities before and after the introduction of US federal financial incentives. The investigators compared rates of patient-provider messaging, which was directly incentivized, with rates of looking for health information on the Web, which was not directly incentivized. The investigators concluded that disparities in provider messaging widened over time, particularly following federal financial incentives.
AHRQ-funded; HS26395; HS26122.
Citation: Senft N, Butler E, Everson J .
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
J Med Internet Res 2019 Oct 7;21(10):e14976. doi: 10.2196/14976..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Disparities, Clinician-Patient Communication, Communication, Policy
Anandaiah AM, Stevens JP, Sullivan AM
Implementation of a bundled consent process in the ICU: a single-center experience.
This study examined perceptions of internal medicine residents in the ICU of an urban academic medical center about using a bundled consent process with patients and their families. The bundled consent provides consent for all commonly performed procedures on a single form. It has been advocated as an efficient method, but there is little published literature about its use. Out of 164 internal residents surveyed, 102 completed the survey. The majority (78%) felt it scared or stressed families, and only 26% felt confident that they would obtain valid informed consent.
AHRQ-funded; HS024288.
Citation: Anandaiah AM, Stevens JP, Sullivan AM .
Implementation of a bundled consent process in the ICU: a single-center experience.
Crit Care Med 2019 Oct;47(10):1332-36. doi: 10.1097/ccm.0000000000003905..
Keywords: Implementation, Intensive Care Unit (ICU), Hospitals, Clinician-Patient Communication, Communication
Choe AY, Unaka NI, Schondelmeyer AC
Inpatient communication barriers and drivers when caring for limited english proficiency children.
The authors identified barriers to and drivers of effective interpreter service use when caring for hospitalized limited English proficiency (LEP) children from the perspectives of pediatric medical providers and interpreters. Using Group Level Assessment, they found that participants identified unique barriers and drivers that impact communication with LEP patients and their families during hospitalization. They suggested that future directions include exploring the perspective of LEP families and utilizing team-based and family-centered communication strategies to standardize and improve communication practices.
AHRQ-funded; HS025138.
Citation: Choe AY, Unaka NI, Schondelmeyer AC .
Inpatient communication barriers and drivers when caring for limited english proficiency children.
J Hosp Med 2019 Oct;14(10):607-13. doi: 10.12788/jhm.3240..
Keywords: Clinician-Patient Communication, Communication, Cultural Competence, Children/Adolescents, Inpatient Care, Patient and Family Engagement, Caregiving
Ike B, Baldwin LM, Sutton S
Staff and clinician work-life perceptions after implementing systems-based improvements to opioid management.
The authors assessed the impact of implementing the Six Building Blocks on the work-life of primary care providers and staff. Six rural and rural-serving primary care organizations implemented the Six Building Blocks, with assistance from practice facilitators, clinical experts, and informatics specialists. The authors found that clinicians and staff reported improvement in their work-life after implementing the Six Building Blocks Program to improve opioid medication management and recommended further research on patient experiences specific to practice redesign programs.
AHRQ-funded; HS023750.
Citation: Ike B, Baldwin LM, Sutton S .
Staff and clinician work-life perceptions after implementing systems-based improvements to opioid management.
J Am Board Fam Med 2019 Sep-Oct;32(5):715-23. doi: 10.3122/jabfm.2019.05.190027.
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Keywords: Opioids, Pain, Chronic Conditions, Primary Care: Models of Care, Primary Care, Care Management, Ambulatory Care and Surgery, Quality Improvement, Medication, Provider, Clinician-Patient Communication
Berdahl TA, Kirby JB
AHRQ Author: Berdahl TA, Kirby JB
Patient-provider communication disparities by limited English proficiency (LEP): trends from the US Medical Expenditure Panel Survey, 2006-2015.
The purpose of this study was to describe trends in patient-provider communication by limited English proficiency (LEP) from 2006 to 2015. The investigators concluded that although patient-provider communication among LEP individuals improved since 2010, linguistic disparities persist and constitute a formidable challenge to achieving healthcare equity, a long-standing US policy goal.
AHRQ-authored.
Citation: Berdahl TA, Kirby JB .
Patient-provider communication disparities by limited English proficiency (LEP): trends from the US Medical Expenditure Panel Survey, 2006-2015.
J Gen Intern Med 2019 Aug;34(8). doi: 10.1007/s11606-018-4757-3..
Keywords: Clinician-Patient Communication, Communication, Cultural Competence, Disparities, Medical Expenditure Panel Survey (MEPS)