National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- (-) Cancer (22)
- Cancer: Breast Cancer (8)
- Caregiving (3)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Clinician-Patient Communication (14)
- (-) Communication (22)
- Community-Based Practice (1)
- Cultural Competence (1)
- Decision Making (5)
- Diagnostic Safety and Quality (3)
- Education: Patient and Caregiver (2)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Genetics (1)
- Healthcare Costs (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (3)
- Health Literacy (1)
- Health Promotion (1)
- Nursing (1)
- Outcomes (1)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (4)
- Patient Experience (1)
- Patient Safety (1)
- Prevention (2)
- Primary Care (1)
- Provider (2)
- Provider: Clinician (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Risk (2)
- Screening (3)
- Surgery (1)
- Telehealth (2)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Web-Based (1)
- Women (7)
- Young Adults (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 22 of 22 Research Studies DisplayedCho Y, Yang R, Gong Y
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
This study’s objective was to describe cancer survivors' use of electronic communication (e-communication) with clinicians and identify factors associated with their use, including the COVID-19 pandemic. The authors conducted a secondary analysis of cancer survivors (N = 1,482) from the combined Health Information National Trends Survey HINTS 5 Cycle 3 and Cycle 4. Survivors' use of e-communication was defined by at least one of four e-communication use behaviors in the previous 12 months. Cancer survivors had a 64% prevalence of e-communication use, with older adults (≥65 years old) were less likely to use e-communication. Survivors who were white, living in a metro area, diagnosed with breast cancer, seeking cancer-related information previously, or having a regular health care provider were more likely to use e-communication. The start of the COVID-19 pandemic was marginally associated with the increased e-communication use when other variables were controlled.
AHRQ-funded; HS027846.
Citation: Cho Y, Yang R, Gong Y .
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
Telemed J E Health 2023 Jun; 29(6):866-74. doi: 10.1089/tmj.2022.0203..
Keywords: Clinician-Patient Communication, Communication, Cancer, Telehealth, Health Information Technology (HIT)
Rosenberg SM, Gierisch JM, Revette AC
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
This study investigated the impact of a ductal carcinoma in situ (DCIS) diagnosis by engaging self-identified patients regarding their experience. Findings showed that, in a large, national sample, participants with a history of DCIS reported confusion and concern about the diagnosis and treatment, which caused worry and significant uncertainty.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Gierisch JM, Revette AC .
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
Cancer 2022 Apr 15;128(8):1676-83. doi: 10.1002/cncr.34126..
Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Women, Patient-Centered Healthcare, Clinician-Patient Communication, Patient and Family Engagement, Communication
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Decision Making, Clinician-Patient Communication, Communication
Bowles EJA, O'Neill SC, Li T
Effect of a randomized trial of a web-based intervention on patient-provider communication about breast density.
This study evaluated a personalized web-based intervention between women and their providers designed to improve breast cancer risk communication. This randomized trial included women aged 40-69 years with 504 women in the control group and 492 women who used the intervention website. The website included information about breast density, personalized breast cancer risk, chemoprevention, and magnetic resonance imaging. Participants self-reported their communication about density with providers at 6 weeks and 12 months. Women in the intervention arm were 2.39 times more likely to report density communication at 6 weeks than the control arm. This effect persisted at 12 months. At 6 weeks the effect was only significant among women who reported versus those who did not report any previous density discussions. A quarter of women in each arm did not have a density conversation at any point during the study.
AHRQ-funded; HS022982.
Citation: Bowles EJA, O'Neill SC, Li T .
Effect of a randomized trial of a web-based intervention on patient-provider communication about breast density.
J Womens Health 2021 Nov;30(11):1529-37. doi: 10.1089/jwh.2021.0053.
AHRQ-funded; HS022982..
AHRQ-funded; HS022982..
Keywords: Communication, Women, Cancer: Breast Cancer, Cancer, Health Information Technology (HIT)
Kranz AM, Ryan J, Mahmud A, AM, Ryan J, Mahmud A
Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics.
Lack of cancer screenings are more common in community health centers (CHCs) which provide primary care to disadvantaged populations due to difficulty accessing specialty care for their patients. This study’s objective was to describe CHCs use to integrate care with specialists and examine whether strongly integrated CHCs have higher rates of screening colorectal and cervical cancers. A 2017 survey of CHCs in 12 states and the District of Columbia was used to estimate the association between a composite measure of CHC/specialist integration and cancer screening rates and 4 measures of CHC/specialist communication using multivariate regression models. More integrated CHCs had higher screening rates of colorectal and cervical cancer and had significantly higher rates of knowing that specialist visits happened, knowing visit outcomes, receiving information after visits, and timely receipt of information.
AHRQ-funded; HS024067.
Citation: Kranz AM, Ryan J, Mahmud A, AM, Ryan J, Mahmud A .
Association of primary and specialty care integration on physician communication and cancer screening in safety-net clinics.
Prev Chronic Dis 2020 Oct 29;17:E134. doi: 10.5888/pcd17.200025..
Keywords: Cancer, Screening, Communication, Prevention, Patient-Centered Healthcare, Healthcare Delivery
Payán DD, Maggard-Gibbons M, Flórez KR
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. In this study, the investigators formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years) and conducted a randomized controlled trial of a health communication intervention for Latinas.
AHRQ-funded; HS019264.
Citation: Payán DD, Maggard-Gibbons M, Flórez KR .
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Cultural Competence, Health Promotion, Communication, Women, Community-Based Practice
Greenzang KA, Fasciano KM, Block SD
Early information needs of adolescents and young adults about late effects of cancer treatment.
This study evaluated the importance, quality, and implications of information about late effects in adolescents and young adults (AYA) recently diagnosed with cancer. Surveying AYAs with cancer who were 15 to 29 years old and were treated at the Dana-Farber Cancer Institute, researchers found that most AYAs with cancer value early information about the risks of late effects and infertility, yet many patients felt that they had not received high-quality information about these topics. They recommended the development of age-appropriate late-effect communication strategies that recognize high AYA distress to address the gap between desired information and perceived information quality.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Fasciano KM, Block SD .
Early information needs of adolescents and young adults about late effects of cancer treatment.
Cancer 2020 Jul 15;126(14):3281-88. doi: 10.1002/cncr.32932..
Keywords: Children/Adolescents, Young Adults, Cancer, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Risk
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
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
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
Hoover DS, Pappadis MR, Housten AJ
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
The purpose of this study was to examine preferences for communicating about screening mammography among racially/ethnically diverse older women. Through in-depth interviews, findings revealed that older women desire information about the benefits and harms of screening mammography and would prefer to learn this information through discussions with healthcare providers and multiple other formats. Results were consistent regardless of participants' age, race/ethnicity, or education.
AHRQ-funded; HS022134.
Citation: Hoover DS, Pappadis MR, Housten AJ .
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
Health Commun 2019 Jun;34(7):702-06. doi: 10.1080/10410236.2018.1431026..
Keywords: Cancer, Cancer: Breast Cancer, Clinician-Patient Communication, Communication, Elderly, Women, Prevention, Racial and Ethnic Minorities, Screening
Pisu M, Schoenberger YM, Herbey I
Perspectives on conversations about costs of cancer care of breast cancer survivors and cancer center staff: a qualitative study.
Despite recommendations to discuss the cost of care (CoC) with patients with cancer, little formal guidance is available on how to conduct these sensitive conversations in ways that are acceptable to both patients and providers. The objective of this study was to explore the perspectives of patients and medical and nonmedical cancer center staff on CoC conversations.
ARHQ-funded; HS023009.
Citation: Pisu M, Schoenberger YM, Herbey I .
Perspectives on conversations about costs of cancer care of breast cancer survivors and cancer center staff: a qualitative study.
Ann Intern Med 2019 May 7;170(9_Supplement):S54-s61. doi: 10.7326/m18-2117..
Keywords: Cancer: Breast Cancer, Cancer, Healthcare Costs, Clinician-Patient Communication, Communication
Greenzang KA, Cronin AM, Kang TI
Parental distress and desire for information regarding long-term implications of pediatric cancer treatment.
In this study, the authors evaluated parental distress associated with information regarding future limitations, and the extent to which distress is associated with information preferences. The investigators concluded that although information regarding future limitations caused by cancer treatment is upsetting to many parents, the majority of them desire this information, and those who are distressed are more likely to value this information.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Cronin AM, Kang TI .
Parental distress and desire for information regarding long-term implications of pediatric cancer treatment.
Cancer 2018 Dec 1;124(23):4529-37. doi: 10.1002/cncr.31772..
Keywords: Cancer, Caregiving, Children/Adolescents, Communication, Children/Adolescents
Davies L, Petitti DB, Martin L
Defining, estimating, and communicating overdiagnosis in cancer screening.
Overdiagnosis represents one harm of too much medicine, but the concept can be confusing. Because the U.S. Preventive Services Task Force (USPSTF) issues screening recommendations aimed largely at healthy persons, it has a particular interest in understanding harms related to screening, especially but not limited to overdiagnosis. In support of the USPSTF, the authors summarize the knowledge and provide guidance on defining, estimating, and communicating overdiagnosis in cancer screening.
AHRQ-funded; 290201200015I; 290201600006C.
Citation: Davies L, Petitti DB, Martin L .
Defining, estimating, and communicating overdiagnosis in cancer screening.
Ann Intern Med 2018 Jul 3;169(1):36-43. doi: 10.7326/m18-0694..
Keywords: Cancer, Communication, Diagnostic Safety and Quality, Screening, U.S. Preventive Services Task Force (USPSTF)
Bardach NS, Burkhart Q, Richardson LP
Hospital-based quality measures for pediatric mental health care.
The objective of this study was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. The investigators drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings and used them to identify sex and race disparities and substantial hospital variation.
AHRQ-funded; HS020506.
Citation: Bardach NS, Burkhart Q, Richardson LP .
Hospital-based quality measures for pediatric mental health care.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-3554..
Keywords: Cancer, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Diagnostic Safety and Quality, Patient Experience, Patient and Family Engagement
Gustafson DH, DuBenske LL, Atwood AK
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver. It found that when severe caregiver-reported symptoms were shared with clinicians, the symptoms were more likely to be subsequently reported as improved than when the symptoms were not shared with clinicians.
AHRQ-funded; HS019917.
Citation: Gustafson DH, DuBenske LL, Atwood AK .
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
J Med Internet Res 2017 Nov 14;19(11):e354. doi: 10.2196/jmir.7466.
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Keywords: Cancer, Caregiving, Communication, Telehealth, Web-Based
Shih YT, Chien CR
A review of cost communication in oncology: patient attitude, provider acceptance, and outcome assessment.
This review identified 15 articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality.
AHRQ-funded; HS020263.
Citation: Shih YT, Chien CR .
A review of cost communication in oncology: patient attitude, provider acceptance, and outcome assessment.
Cancer 2017 May 15;123(6):928-39. doi: 10.1002/cncr.30423.
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Keywords: Cancer, Communication, Healthcare Costs, Outcomes, Clinician-Patient Communication
Brand SR, Fasciano K, Mack JW
Communication preferences of pediatric cancer patients: talking about prognosis and their future life.
The aim of this study was to explore how young cancer patients experienced communication around their illness, especially communication about possible outcomes from disease or treatment. Overall, participants wanted medical information to be provided to them by their healthcare providers and wanted to be direct participants in medical conversations. However, many participants displayed some ambivalence or conveyed conflicting wishes for prognostic information.
AHRQ-funded; HS000063.
Citation: Brand SR, Fasciano K, Mack JW .
Communication preferences of pediatric cancer patients: talking about prognosis and their future life.
Support Care Cancer 2017 Mar;25(3):769-74. doi: 10.1007/s00520-016-3458-x.
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Keywords: Cancer, Children/Adolescents, Communication, Clinician-Patient Communication
Meyer AN, Murphy DR, Singh H
Communicating findings of delayed diagnostic evaluation to primary care providers.
In this study, researchers examined the effectiveness of various communication strategies to inform primary care practitioners (PCPs) about the delayed follow-up of cancer-related abnormal or "red-flag" findings. They found that strategies (emails, phone calls, contacting clinic directors) to communicate to PCPs information on delayed follow-up of findings suspicious for cancer were useful, but not fail-safe.
AHRQ-funded; HS022901.
Citation: Meyer AN, Murphy DR, Singh H .
Communicating findings of delayed diagnostic evaluation to primary care providers.
J Am Board Fam Med 2016 Jul-Aug;29(4):469-73. doi: 10.3122/jabfm.2016.04.150363.
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Keywords: Cancer, Communication, Diagnostic Safety and Quality, Primary Care
Roberts MC, Bryson A, Weinberger M
Patient-centered communication for discussing oncotype DX testing.
The researchers identified patient-centered communication strategies/gaps for discussing Oncotype DX testing (ODX) results. They applied a patient-centered communication framework to analyze qualitative interviews with oncologists about how they communicate about ODX with patients. Overall, providers discussed four patient-centered communication domains: exchanging information, assessing uncertainty, making decisions and cross-cutting themes.
AHRQ-funded; HS019468; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Patient-centered communication for discussing oncotype DX testing.
Cancer Invest 2016 May 27;34(5):205-12. doi: 10.3109/07357907.2016.1172637.
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Keywords: Cancer, Cancer: Breast Cancer, Communication, Clinician-Patient Communication, Decision Making, Genetics, Patient and Family Engagement, Patient-Centered Healthcare, Women
Morgans AK, Schapira L
Confronting therapeutic failure: a conversation guide.
The authors review the classic six-step SPIKES (setting, perception, invitation for information, knowledge, empathy, summarize and strategize) protocol for giving bad news that has been widely adopted since it was first published in this journal in 2005. They also offer practical tips derived from a thorough review of the evidence and our clinical experience.
AHRQ-funded; HS022990.
Citation: Morgans AK, Schapira L .
Confronting therapeutic failure: a conversation guide.
Oncologist 2015 Aug;20(8):946-51. doi: 10.1634/theoncologist.2015-0050..
Keywords: Cancer, Clinician-Patient Communication, Communication, Patient-Centered Healthcare, Patient-Centered Outcomes Research