National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Arthritis (3)
- Asthma (1)
- Cancer (4)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Case Study (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (5)
- Communication (5)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Cultural Competence (2)
- Decision Making (6)
- Dental and Oral Health (1)
- Education: Patient and Caregiver (13)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Genetics (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (5)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (5)
- (-) Health Literacy (33)
- Health Promotion (2)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitalization (1)
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- Infectious Diseases (1)
- Inpatient Care (1)
- Medication (4)
- Patient-Centered Healthcare (4)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (7)
- Patient Self-Management (1)
- Practice Patterns (1)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Provider: Pharmacist (1)
- Public Health (2)
- Quality Improvement (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Screening (1)
- Stroke (1)
- Tools & Toolkits (4)
- Urinary Tract Infection (UTI) (1)
- Web-Based (1)
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 33 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
Bachmann JM, Goggins KM, Nwosu SK
Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.
The authors sought to evaluate the effect of perceived health competence on health behavior and health-related quality of life. They found that perceived health competence was highly associated with health behaviors and health-related quality of life, while low perceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90 days after discharge. They concluded that perceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Goggins KM, Nwosu SK .
Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.
Patient Educ Couns 2016 Dec;99(12):2071-79. doi: 10.1016/j.pec.2016.07.020.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Health Literacy, Patient Adherence/Compliance, Quality of Life
Mabachi NM, Cifuentes M, Barnard J
AHRQ Author: Brach C
Demonstration of the Health Literacy Universal Precautions Toolkit: lessons for quality improvement.
AHRQ’s Health Literacy Universal Precautions Toolkit was developed to help primary care practices assess and make changes to improve communication with and support for patients. Twelve diverse primary care practices implemented assigned tools over a 6-month period. Qualitative results revealed challenges practices experienced during implementation, including competing demands, bureaucratic hurdles, technological challenges, limited quality improvement experience, and limited leadership support.
AHRQ-authored.
Citation: Mabachi NM, Cifuentes M, Barnard J .
Demonstration of the Health Literacy Universal Precautions Toolkit: lessons for quality improvement.
J Ambul Care Manage 2016 Jul-Sep;39(3):199-208. doi: 10.1097/jac.0000000000000102..
Keywords: Health Literacy, Quality Improvement, Tools & Toolkits, Primary Care, Clinician-Patient Communication
Press VG, Arora VM, Trela KC
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
This study evaluated the relative effects of two different educational strategies (teach-to-goal instruction vs. brief verbal instruction) in adults hospitalized with asthma or chronic obstructive pulmonary disease. It concluded that, Acute care events were less common among teach-to-goal participants than brief intervention participants at 30 days (17 percent vs. 36 percent,), but not at 90 days.
AHRQ-funded; HS016967.
Citation: Press VG, Arora VM, Trela KC .
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
Ann Am Thorac Soc 2016 Jun;13(6):816-24. doi: 10.1513/AnnalsATS.201509-603OC.
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Keywords: Asthma, Respiratory Conditions, Comparative Effectiveness, Health Literacy, Medication
Yun K, Paul P, Subedi P
Help-seeking behavior and health care navigation by Bhutanese refugees.
The objective of this study was to document barriers to care, help-seeking behaviors, and the impact of a community-based patient navigation intervention on patient activation levels among Bhutanese refugees in the U.S. Following the intervention, only one-third reported the lowest level of patient activation and one-third were highly activated. Bhutanese refugees overcome healthcare access barriers by seeking help from a network of support that begins within the community.
AHRQ-funded; HS021706.
Citation: Yun K, Paul P, Subedi P .
Help-seeking behavior and health care navigation by Bhutanese refugees.
J Community Health 2016 Jun;41(3):526-34. doi: 10.1007/s10900-015-0126-x.
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Keywords: Access to Care, Cultural Competence, Education: Patient and Caregiver, Health Literacy, Racial and Ethnic Minorities
Bishop WP, Craddock Lee SJ, Skinner CS
Validity of single-item screening for limited health literacy in English and Spanish speakers.
The researchers evaluated 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. They found that for English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials."
AHRQ-funded; HS022418.
Citation: Bishop WP, Craddock Lee SJ, Skinner CS .
Validity of single-item screening for limited health literacy in English and Spanish speakers.
Am J Public Health 2016 May;106(5):889-92. doi: 10.2105/ajph.2016.303092.
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Keywords: Cultural Competence, Education: Patient and Caregiver, Health Literacy
Brach C
AHRQ Author: Brach C
Even in an emergency, doctors must make informed consent an informed choice.
When a stroke is suspected, a daughter is pressured to consent to her father's treatment without fully understanding the risks.
AHRQ-authored.
Citation: Brach C .
Even in an emergency, doctors must make informed consent an informed choice.
Health Aff 2016 Apr;35(4):739-43. doi: 10.1377/hlthaff.2015.1407.
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Keywords: Case Study, Decision Making, Emergency Department, Health Literacy, Patient and Family Engagement, Stroke
Burgette JM, Lee JY, Baker AD
Is dental utilization associated with oral health literacy?
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL.
AHRQ-funded; HS000032.
Citation: Burgette JM, Lee JY, Baker AD .
Is dental utilization associated with oral health literacy?
J Dent Res 2016 Feb;95(2):160-6. doi: 10.1177/0022034515617457..
Keywords: Dental and Oral Health, Healthcare Utilization, Health Literacy
Masnick M, Morgan DJ, Sorkin JD
Lack of patient understanding of hospital-acquired infection data published on the Centers for Medicare and Medicaid Services Hospital Compare Website.
This study assessed the interpretability of hospital-acquired infection (HAI) data as presented on the Centers for Medicare and Medicaid Services Hospital Compare website among patients who might benefit from access to these data. It concluded that current public HAI data presentation methods may be inadequate. When presented with numeric HAI data, study participants incorrectly compared hospitals on the basis of HAI data in more than 40% of the responses.
AHRQ-funded; HS018111.
Citation: Masnick M, Morgan DJ, Sorkin JD .
Lack of patient understanding of hospital-acquired infection data published on the Centers for Medicare and Medicaid Services Hospital Compare Website.
Infect Control Hosp Epidemiol 2016 Feb;37(2):182-7. doi: 10.1017/ice.2015.260.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Education: Patient and Caregiver, Health Literacy, Healthcare-Associated Infections (HAIs), Hospitals, Urinary Tract Infection (UTI)
Arcia A, Suero-Tejeda N, Bales ME
Sometimes more is more: iterative participatory design of infographics for engagement of community members with varying levels of health literacy.
The study objective was to collaborate with community members to develop tailored infographics that support comprehension of health information, engage the viewer, and may have the potential to motivate health-promoting behaviors. It concluded that carefully designed infographics can be useful tools to support comprehension and thus help patients engage with their own health data.
AHRQ-funded; HS019853; HS022961
Citation: Arcia A, Suero-Tejeda N, Bales ME .
Sometimes more is more: iterative participatory design of infographics for engagement of community members with varying levels of health literacy.
J Am Med Inform Assoc 2016 Jan;23(1):174-83. doi: 10.1093/jamia/ocv079.
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Keywords: Education: Patient and Caregiver, Health Literacy, Health Promotion, Patient and Family Engagement, Web-Based
Weiss BD, Brega AG, LeBlanc WG
AHRQ Author: Brach C
Improving the effectiveness of medication review: guidance from the Health Literacy Universal Precautions Toolkit.
The objective of this study was to determine whether the medication review tool in AHRQ’s Health Literacy Universal Precautions Toolkit can help to improve medication reviews in primary care practices. It found that eEvaluation before and after implementation revealed a 3-fold increase in the percentage of patients who brought all their prescription medications and a 6-fold increase in the number of prescription medications brought to office visits.
AHRQ-authored; AHRQ-funded; 290200710008.
Citation: Weiss BD, Brega AG, LeBlanc WG .
Improving the effectiveness of medication review: guidance from the Health Literacy Universal Precautions Toolkit.
J Am Board Fam Med 2016 Jan-Feb;29(1):18-23. doi: 10.3122/jabfm.2016.01.150163.
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Keywords: Health Literacy, Medication, Primary Care, Tools & Toolkits
Mirsky JB, Tieu L, Lyles C
Readability assessment of patient-provider electronic messages in a primary care setting.
The purpose of this study was to generate hypotheses about the readability of patient and provider electronic messages. It found that patients used more words in their initial e-mails compared to providers, but the Flesch-Kincaid Grade Levels (FKGLs) were similar, and 68 percent of provider messages were written below an FKGL = 8.
AHRQ-funded; HS023558; HS022408.
Citation: Mirsky JB, Tieu L, Lyles C .
Readability assessment of patient-provider electronic messages in a primary care setting.
J Am Med Inform Assoc 2016 Jan;23(1):202-6. doi: 10.1093/jamia/ocv087.
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Keywords: Communication, Health Information Technology (HIT), Health Literacy, Primary Care, Clinician-Patient Communication
Albrecht JS, Gruber-Baldini AL, Hirshon JM
Hospital discharge instructions: comprehension and compliance among older adults.
The purpose of this prospective cohort study was to quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. The investigators concluded that non-comprehension of discharge instructions among older adults was prevalent, multi-factorial, and varies by domain.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Gruber-Baldini AL, Hirshon JM .
Hospital discharge instructions: comprehension and compliance among older adults.
J Gen Intern Med 2014 Nov;29(11):1491-8. doi: 10.1007/s11606-014-2956-0..
Keywords: Elderly, Health Literacy, Hospital Discharge, Patient Adherence/Compliance
Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L
Is low health literacy associated with increased emergency department utilization and recidivism?
The study objective was to determine whether patients with low health literacy have higher emergency department (ED) use and higher ED recidivism than patients with adequate health literacy. It found that patients with inadequate health literacy had higher ED use compared to those with adequate health literacy.
AHRQ-funded; HS020309
Citation: Griffey RT, Kennedy SK, D'Agostino McGowan L, Good RT, Kennedy SK, D'Agostino McGowan L .
Is low health literacy associated with increased emergency department utilization and recidivism?
Acad Emerg Med. 2014 Oct;21(10):1109-15. doi: 10.1111/acem..
Keywords: Health Literacy, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization
Barton JL, Trupin L, Tonner C
English language proficiency, health literacy, and trust in physician are associated with shared decision making in rheumatoid arthritis.
The objective of this study was to examine patterns of perceived communication around decision making in 2 cohorts of adults with rheumatoid arthritis (RA). The investigators found that nearly one-third of subjects reported suboptimal shared decision making communication (SDM) with their clinicians, regardless of cohort. Lower trust in physician was independently associated with suboptimal SDM communication in both cohorts.
AHRQ-funded; HS019209.
Citation: Barton JL, Trupin L, Tonner C .
English language proficiency, health literacy, and trust in physician are associated with shared decision making in rheumatoid arthritis.
J Rheumatol 2014 Jul;41(7):1290-7. doi: 10.3899/jrheum.131350..
Keywords: Arthritis, Clinician-Patient Communication, Communication, Decision Making, Health Literacy, Patient and Family Engagement