National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Arthritis (2)
- Asthma (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Case Study (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (4)
- Communication (5)
- Comparative Effectiveness (1)
- Cultural Competence (2)
- Decision Making (5)
- Dental and Oral Health (2)
- Diabetes (1)
- Digestive Disease and Health (1)
- Education: Patient and Caregiver (8)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Eye Disease and Health (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (2)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (4)
- (-) Health Literacy (31)
- Health Promotion (1)
- Heart Disease and Health (1)
- Hospital Discharge (2)
- Hospitals (1)
- Medication (3)
- Obesity (1)
- Outcomes (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (4)
- Patient and Family Engagement (6)
- Patient Safety (1)
- Patient Self-Management (1)
- Prevention (1)
- Primary Care (3)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Stroke (1)
- Tools & Toolkits (2)
- Urinary Tract Infection (UTI) (1)
- Vaccination (1)
- Vulnerable Populations (1)
- Web-Based (3)
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 31 Research Studies DisplayedBachmann 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
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