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- Access to Care (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 Research Studies DisplayedLoo S, Brady KJS, Ragavan MI
Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings.
This study examined the validity of the Clinicians’ Cultural Sensitivity Survey (CCCS) for use in pediatric primary care, which was developed as a patient-reported survey assessing clinicians' recognition of cultural factors affecting care quality for older Latino patients. The authors adapted the survey for use with parents of pediatric patients. A convenience sampling approach was used to identify eligible parents during well-child visits at urban pediatric primary care clinic, and parents were administered the survey via electronic tablet. They first conducted exploratory factor analyses (EFAs) to explore the dimensionality of survey responses in the adapted CCSS, and then conducted a series of confirmatory factor analyses (CFAs) using maximum likelihood estimation based on the results of the EFAs. Exploratory and confirmatory factor analyses (N = 212 parent surveys) supported a three-factor structure assessing racial discrimination, culturally-affirming practices, and causal attribution of health problems. The 3-factor model also outperformed other potential factors in terms of fit statistics and demonstrated adequate fit.
AHRQ-funded; HS022242; HS026395.
Citation: Loo S, Brady KJS, Ragavan MI .
Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings.
J Immigr Minor Health 2023 Aug; 25(4):790-802. doi: 10.1007/s10903-023-01469-2..
Keywords: Children/Adolescents, Primary Care, Cultural Competence, Healthcare Delivery
Choe AY, Schondelmeyer AC, Thomson J
Improving discharge instructions for hospitalized children with limited english proficiency.
Research was conducted on an intervention for patients with limited English proficiency (LEP) who are discharged from the hospital without instructions in their preferred language. The objective was to increase the percentage of patients with LEP on the hospital medicine service who received translated discharge instructions from 12% to 80%. During the 18-month study period 540 patients with LEP were discharged. Spanish was the preferred language of 66% of these patients. The percentage of patients who received translated discharge instructions increased from 12% to 50% in 3 months, and to 77% in 18 months. For Spanish-language patients, the percentage increased to 96% by 18 months.
AHRQ-funded; HS026763; HS025138.
Citation: Choe AY, Schondelmeyer AC, Thomson J .
Improving discharge instructions for hospitalized children with limited english proficiency.
Hosp Pediatr 2021 Nov;11(11):1213-22. doi: 10.1542/hpeds.2021-005981.
AHRQ-funded; HS026763; HS025138..
AHRQ-funded; HS026763; HS025138..
Keywords: Children/Adolescents, Hospital Discharge, Clinician-Patient Communication, Cultural Competence, Communication
Tremblay ES, Ruiz J, Dykeman B
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
It is widely recognized that Type 1 Diabetes (T1D) outcomes are worse among Hispanic children; however, little is published about the perspectives of these patients and their caregivers. The intent of this study was to characterize the lived experience of Hispanic caregivers of children with T1D, focusing on the role of language and culture and their perspectives on current medical care and alternative care models.
AHRQ-funded; HS000063.
Citation: Tremblay ES, Ruiz J, Dykeman B .
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
Pediatr Diabetes 2021 Jul 7;22(7):1040-50. doi: 10.1111/pedi.13247..
Keywords: Children/Adolescents, Diabetes, Caregiving, Chronic Conditions, Racial and Ethnic Minorities, Cultural Competence
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
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
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
Schnierle J, Christian-Brathwaite N, Louisias M
Implicit bias: what every pediatrician should know about the effect of bias on health and future directions.
This article discusses the role in implicit bias and its effect on health outcomes. The most highly regarded tool to measure implicit bias is the Implicit Association Test (IAT). While there is limited evidence showing an association between implicit bias and health outcomes, existing publications do show clear associations. The authors discuss the need for future research that relies on pre- and post-IAT measurements to examine the effect of bias training among healthcare providers.
AHRQ-funded; HS022986.
Citation: Schnierle J, Christian-Brathwaite N, Louisias M .
Implicit bias: what every pediatrician should know about the effect of bias on health and future directions.
Curr Probl Pediatr Adolesc Health Care 2019 Feb;49(2):34-44. doi: 10.1016/j.cppeds.2019.01.003..
Keywords: Children/Adolescents, Provider: Physician, Racial and Ethnic Minorities, Cultural Competence
Ragavan MI, Fikre T, Millner U
The impact of domestic violence exposure on South Asian children in the United States: perspectives of domestic violence agency staff.
The goal of this study was to examine the needs of South Asian children subjected to domestic violence, from the perspective of staff in domestic violence agencies across the U.S. in order to determine if the children required culture-specific resources. Thirty interviews were conducted; participants described factors important to understanding the impact of domestic violence on South Asian children and discussed the development of culturally tailored resources. The findings suggests that framing South Asian children's experiences within the context of interweaving South Asian and American cultural values, with attention focused on how potential culture clashes may impact the way children that process trauma, is important. The authors recommend that further work triangulate these themes between children, parents, and extended family and in collaboration with domestic violence agencies.
AHRQ-funded; HS022242.
Citation: Ragavan MI, Fikre T, Millner U .
The impact of domestic violence exposure on South Asian children in the United States: perspectives of domestic violence agency staff.
Child Abuse Negl 2018 Feb;76:250-60. doi: 10.1016/j.chiabu.2017.11.006..
Keywords: Access to Care, Children/Adolescents, Cultural Competence, Domestic Violence, Family Health and History, Racial and Ethnic Minorities, Vulnerable Populations
Yasui M, Pottick KJ, Chen Y
Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families.
The authors systematically reviewed 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. Its findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families.
AHRQ-funded; HS023007.
Citation: Yasui M, Pottick KJ, Chen Y .
Conceptualizing culturally infused engagement and its measurement for ethnic minority and immigrant children and families.
Clin Child Fam Psychol Rev 2017 Sep;20(3):250-332. doi: 10.1007/s10567-017-0229-2.
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Keywords: Children/Adolescents, Cultural Competence, Behavioral Health, Patient and Family Engagement, Patient-Centered Healthcare