National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Arthritis (2)
- Cancer (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (5)
- Communication (5)
- Decision Making (4)
- Dental and Oral Health (1)
- Diabetes (1)
- Digestive Disease and Health (1)
- Education: Patient and Caregiver (5)
- Elderly (4)
- Electronic Health Records (EHRs) (4)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Eye Disease and Health (1)
- Healthcare Delivery (3)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (6)
- (-) Health Literacy (29)
- Health Systems (1)
- Hospital Discharge (3)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (2)
- Obesity (1)
- Outcomes (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (3)
- Patient and Family Engagement (5)
- Patient Experience (1)
- Patient Safety (1)
- Patient Self-Management (2)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Risk (1)
- Telehealth (1)
- Vaccination (1)
- Vulnerable Populations (2)
- Web-Based (4)
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 29 Research Studies Displayedvan den Bogert CA, Miller MJ, Cobaugh DJ
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
The aim of this study was to evaluate screening questions for estimating nonsteroidal anti-inflammatory drug (NSAID) risk knowledge. It concluded that screening questions for subjective NSAID risk awareness and health literacy are predictive of objectively tested NSAID knowledge and can be used to triage patients as well as subsequently initiate and direct a conversation about NSAID risk.
AHRQ-funded; HS016956.
Citation: van den Bogert CA, Miller MJ, Cobaugh DJ .
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
J Patient Saf 2017 Dec;13(4):217-22. doi: 10.1097/pts.0000000000000143.
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Keywords: Adverse Drug Events (ADE), Health Literacy, Medication, Risk
Brach C
AHRQ Author: Brach C
The journey to become a health literate organization: a snapshot of health system improvement.
This chapter explores the journey that a growing number of organizations are taking to become health literate. A part of the chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. The chapter ends with lessons learned from the experiences of health literacy pioneers that may be useful to organizations embarking on the journey.
AHRQ-authored.
Citation: Brach C .
The journey to become a health literate organization: a snapshot of health system improvement.
Stud Health Technol Inform 2017;240:203-37.
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Keywords: Health Literacy, Health Systems, Quality Improvement
Wolinsky FD, Lou Y, Edmonds SW
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
This study examined whether a tailored patient-activation letter communicating bone mineral density (BMD) test results plus an educational brochure improved patient activation scores and levels at 12 and 52 wk post-baseline as the mechanism leading to enhanced bone healthcare.
AHRQ-funded; HS023009.
Citation: Wolinsky FD, Lou Y, Edmonds SW .
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
J Clin Densitom 2017 Oct/Dec;20(4):464-71. doi: 10.1016/j.jocd.2016.08.012..
Keywords: Education: Patient and Caregiver, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Liang L, Brach C
AHRQ Author: Liang L, Brach C
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. It found that the proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone.
AHRQ-authored.
Citation: Liang L, Brach C .
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
Health Lit Res Pract 2017 Oct;1(4):e216-e30. doi: 10.3928/24748307-20170929-01.
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Keywords: Healthcare Delivery, Health Literacy, Medical Expenditure Panel Survey (MEPS), Clinician-Patient Communication
Morrow D, Hasegawa-Johnson M, Huang T
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
The authors describe a project intended to improve the use of Electronic Medical Record (EMR) patient portal information by older adults with diverse numeracy and literacy abilities, so that portals can better support patient-centered care. Their approach combines quantitative measures, as well as experimental and individual difference methods in order to investigate which formats are more effective, and whether some formats benefit some types of patients more than others.
AHRQ-funded; HS022948.
Citation: Morrow D, Hasegawa-Johnson M, Huang T .
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
J Biomed Inform 2017 May;69:63-74. doi: 10.1016/j.jbi.2017.03.015.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Literacy, Patient Self-Management, Web-Based
Abujarad F, Alfano S, Bright TJ
AHRQ Author: Bright TJ
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
This paper describes how the authors designed, developed, and evaluated an mHealth tool for advancing the informed consent process. Their tool enables the informed consent process to be performed on tablets (e.g., iPads) utilizing virtual coaching with text-to-speech automated translation as well as an interactive multimedia elements (e.g., graphics, video clips, animations, presentations, etc.). They present the Used-Centered Design approach they adopted to develop the tool and the results of the different methods used during the development of the tool.
AHRQ-authored; AHRQ-funded; HS023987.
Citation: Abujarad F, Alfano S, Bright TJ .
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
AMIA Annu Symp Proc 2017 Apr 16;2017:374-83..
Keywords: Health Information Technology (HIT), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Telehealth
Tieu L, Schillinger D, Sarkar U
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
The objective of this study was to examine specific usability barriers to patient portal engagement among a diverse group of patients and caregivers. In navigating the portal, participants experienced basic computer barriers (eg, difficulty using a mouse), routine computer barriers (eg, mistyping, navigation issues), reading/writing barriers, and medical content barriers.
AHRQ-funded; HS022408; HS022561.
Citation: Tieu L, Schillinger D, Sarkar U .
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e47-e54. doi: 10.1093/jamia/ocw098.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy, Vulnerable Populations, Web-Based
Unaka NI, Statile A, Haney J
Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.
A cross-sectional study was conducted at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. The investigators found that overall, the readability, understandability, and completeness of discharge instructions were subpar. Efforts to improve the content of discharge instructions may promote safe and effective transitions home.
AHRQ-funded; HS023827.
Citation: Unaka NI, Statile A, Haney J .
Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.
J Hosp Med 2017 Feb;12(2):98-101. doi: 10.12788/jhm.2688..
Keywords: Children/Adolescents, Health Literacy, Hospital Discharge, Children/Adolescents
Ratanawongsa N, Barton JL, Lyles CR
Computer use, language, and literacy in safety net clinic communication.
The researchers investigated the associations between safety net clinician computer use and patient-provider communication for patients with limited health literacy (LHL) and limited English proficiency (LEP). They found that higher clinician computer use was associated with more biomedical focus with LEP/LHL patients, and clinician verbal dominance and lower ratings with patients with adequate English proficiency and health literacy.
AHRQ-funded; HS022561.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Computer use, language, and literacy in safety net clinic communication.
J Am Med Inform Assoc 2017 Jan;24(1):106-12. doi: 10.1093/jamia/ocw062.
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Keywords: Communication, Electronic Health Records (EHRs), Health Literacy, Clinician-Patient Communication, Health Information Technology (HIT)
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
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