National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (1)
- Breast Feeding (1)
- Cancer (1)
- (-) Caregiving (19)
- Care Management (1)
- Children/Adolescents (10)
- Chronic Conditions (1)
- Clinician-Patient Communication (2)
- Communication (3)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- (-) Education: Patient and Caregiver (19)
- Elderly (2)
- Emergency Department (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (3)
- Health Literacy (4)
- Health Promotion (3)
- Home Healthcare (2)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospitals (1)
- Infectious Diseases (1)
- Inpatient Care (1)
- Maternal Care (2)
- Medication (4)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Pain (1)
- Palliative Care (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (2)
- Patient Safety (1)
- Pregnancy (3)
- Prevention (2)
- Primary Care (2)
- Provider (1)
- Provider: Physician (1)
- Provider Performance (1)
- Public Reporting (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (2)
- Quality of Life (1)
- Sexual Health (1)
- Shared Decision Making (3)
- Sickle Cell Disease (1)
- Social Media (1)
- Training (2)
- Vaccination (1)
- Web-Based (1)
- Women (2)
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 19 of 19 Research Studies DisplayedCarroll AR, Schlundt D, Bonnet K
Caregiver and clinician perspectives on discharge medication counseling: a qualitative study.
This study’s objective was to explore the perspectives of multidisciplinary clinicians and caregivers regarding discharge medication counseling for children and to develop a conceptual model to inform intervention efforts to reduce discharge medication dosing errors. The authors conducted a qualitative analysis using results from focus groups and individual interviews with 17 caregivers and 16 clinicians. Domains and subthemes included: (1) infrastructure of healthcare delivery, including supplies for counseling, content and organization of discharge instructions, clinician training and education, roles and responsibilities of team members, and hospital pharmacy delivery and counseling program; (2) processes of healthcare delivery, including medication reconciliation, counseling content, counseling techniques, and language barriers and health literacy; and (3) measurable outcomes, including medication dosing accuracy and caregiver understanding and adherence to discharge instructions. The conceptual model that resulted from this analysis can be applied to the development and evaluation of interventions to reduce discharge medication dosing errors following a hospitalization.
AHRQ-funded; HS026122.
Citation: Carroll AR, Schlundt D, Bonnet K .
Caregiver and clinician perspectives on discharge medication counseling: a qualitative study.
Hosp Pediatr 2023 Apr; 13(4):325-42. doi: 10.1542/hpeds.2022-006937..
Keywords: Children/Adolescents, Medication, Hospital Discharge, Education: Patient and Caregiver, Caregiving
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
Breitenstein SM, Fehrenbacher C, Holod AF
A randomized trial of digitally delivered, self-administered parent training in primary care: effects on parenting and child behavior.
Researchers sought to evaluate the effects of a self-administered, digital behavioral parent training program (ezParent) on parent and child behavior for parents of young children. Their results suggested that ezParent as a self-administered behavioral parent training program may not be intense enough for child and parent behavioral change as a universal prevention model. Parents may require different levels of support for completion based on their level of service seeking, family characteristics, risk profile, and motivation for change.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Fehrenbacher C, Holod AF .
A randomized trial of digitally delivered, self-administered parent training in primary care: effects on parenting and child behavior.
J Pediatr 2021 Apr;231:207-14.e4. doi: 10.1016/j.jpeds.2020.12.016..
Keywords: Children/Adolescents, Caregiving, Primary Care, Education: Patient and Caregiver
Burgdorf JG, Arbaje AI, Wolff JL
Training needs among family caregivers assisting during home health, as identified by home health clinicians.
This study’s objective was to estimate the proportion of family caregivers assisting older adults during Medicare home health who have an identified need for activity-specific training and identify characteristics associated with caregiver training needs. This nationally representative retrospective cohort study included 1758 Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) and received Medicare-funded home health care between 2011 and 2016. More than 1 in 3 family caregivers assisting older adults during Medicare home health had an identified training need with at least 1 caregiving activity. Training needs varied widely, from 8.6% among caregiving helping with advocacy to 48.2% among caregivers helping with medical procedures. Weighted analyses adjusted for older adults’ health and function showed family caregivers were less likely to have identified training needs when assisting older adults with ongoing disability or who received caregiver assistance before home health admission.
AHRQ-funded; HS000029.
Citation: Burgdorf JG, Arbaje AI, Wolff JL .
Training needs among family caregivers assisting during home health, as identified by home health clinicians.
J Am Med Dir Assoc 2020 Dec;21(12):1914-19. doi: 10.1016/j.jamda.2020.05.032..
Keywords: Caregiving, Home Healthcare, Education: Patient and Caregiver, Training
Keller SC, Cosgrove SE, Arbaje AI
It's complicated: patient and informal caregiver performance of outpatient parenteral antimicrobial therapy-related tasks.
This study’s objective was to perform a patient-centered goal-directed task analysis to identify what is required for successful completion of outpatient parenteral antimicrobial therapy (OPAT) by patients and caregivers. The authors conducted 40 semi-structured patient interviews and also 20 observations of patients and caregivers performing OPAT. Six goals were identified. The authors concluded that patients and caregivers should use teach-back, take formal classes, and other forms of instruction to ensure safety and good outcomes for the patients.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Arbaje AI .
It's complicated: patient and informal caregiver performance of outpatient parenteral antimicrobial therapy-related tasks.
Am J Med Qual 2020 Mar/Apr;35(2):133-46. doi: 10.1177/1062860619853345..
Keywords: Caregiving, Patient-Centered Healthcare, Antimicrobial Stewardship, Medication, Education: Patient and Caregiver, Patient Safety
Jefferson UT, Zachary I, Majee W
Employing a user-centered design to engage mothers in the development of a mHealth breastfeeding application.
The Mother's Milk Connection mHealth application was designed to improve breastfeeding duration and access to support. This article describes a user-centered design process to engage mothers in the development of the Mother's Milk Connection application. Stakeholder and user engagement indicated the integration of four distinct features acceptable for use as a comprehensive mHealth intervention to improve access to breastfeeding support. Further, mHealth has the potential to be a useful strategy for providing breastfeeding support, and a clinical trial regarding the efficacy of the Mother's Milk Connection application is needed.
AHRQ-funded; HS022140.
Citation: Jefferson UT, Zachary I, Majee W .
Employing a user-centered design to engage mothers in the development of a mHealth breastfeeding application.
Comput Inform Nurs 2019 Oct;37(10):522-31. doi: 10.1097/cin.0000000000000549..
Keywords: Breast Feeding, Maternal Care, Pregnancy, Women, Health Information Technology (HIT), Patient and Family Engagement, Patient Adherence/Compliance, Health Promotion, Education: Patient and Caregiver, Caregiving
Burgdorf J, Roth DL, Riffin C
Factors associated with receipt of training among caregivers of older adults.
Emerging evidence suggests that support of family caregivers, including education and training, can improve health outcomes for caregivers and care recipients. In this paper, the authors examine whether caregiver characteristics are associated with receipt of training. The investigators found that 93% of older adults’ family caregivers did not report receiving role-related training.
AHRQ-funded; HS000029.
Citation: Burgdorf J, Roth DL, Riffin C .
Factors associated with receipt of training among caregivers of older adults.
JAMA Intern Med 2019 Jun;179(6):833-35. doi: 10.1001/jamainternmed.2018.8694.
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Keywords: Caregiving, Training, Education: Patient and Caregiver, Home Healthcare, Quality of Life, Elderly
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Shared Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
Armstrong MJ, Rastgardani T, Gagliardi AR
Barriers and facilitators of communication about off periods in Parkinson's disease: qualitative analysis of patient, carepartner, and physician Interviews.
This article discusses barriers and facilitators of communication with Parkinson’s disease patients, care partners, and their physicians specifically during off periods. Twenty persons with Parkinson’s and their care partners, and 20 physicians participated in interviews using a semi-structured questionnaire. Communication barrier levels were identified as patient-level, caregiver-level, and physician-level. For patients cognitive impairment and reluctance to discuss symptoms was the largest barrier. Caregiver absence was also a barrier. For physicians barriers were distraction by technology and lack of appreciation of off period burdens. Various tools such as home diaries, questionnaires and mobile phone videos can be used to aid communication regarding off periods. Patients and their caregivers stressed the need for more formal educational materials and improved educational tools.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Rastgardani T, Gagliardi AR .
Barriers and facilitators of communication about off periods in Parkinson's disease: qualitative analysis of patient, carepartner, and physician Interviews.
PLoS One 2019 Apr 18;14(4):e0215384. doi: 10.1371/journal.pone.0215384..
Keywords: Communication, Clinician-Patient Communication, Neurological Disorders, Caregiving, Education: Patient and Caregiver, Health Literacy, Patient and Family Engagement
Egan M, Yin HS, Greenhawt M
Low caregiver health literacy among pediatric food-allergic patients is associated with poorer food allergy management knowledge.
In this paper, the authors discuss how lower health literacy in caregivers of children with food allergies is associated with deficiencies in demonstrating correct use of an epinephrine autoinjector, increased reactions to foods in the past 12 months, and knowledge gaps on treatment of allergic reactions.
AHRQ-funded; HS024599.
Citation: Egan M, Yin HS, Greenhawt M .
Low caregiver health literacy among pediatric food-allergic patients is associated with poorer food allergy management knowledge.
J Allergy Clin Immunol Pract 2019 Feb;7(2):655-58. doi: 10.1016/j.jaip.2018.05.021..
Keywords: Caregiving, Health Literacy, Children/Adolescents, Education: Patient and Caregiver
Margolis MA, Brewer NT, Shah PD
Stories about HPV vaccine in social media, traditional media, and conversations.
To understand how stories from media and social interactions shape parents' HPV vaccination decisions, the authors sought to characterize parents' exposure to these stories, as well as associations between story exposure and vaccination behavior. They found that stories of HPV vaccine harms may be associated more strongly with vaccination behavior than stories of HPV vaccine preventable diseases. They recommended that communication campaigns consider strategies to elevate stories of preventable diseases in social and traditional media.
AHRQ-funded; HS000032.
Citation: Margolis MA, Brewer NT, Shah PD .
Stories about HPV vaccine in social media, traditional media, and conversations.
Prev Med 2019 Jan;118:251-56. doi: 10.1016/j.ypmed.2018.11.005..
Keywords: Caregiving, Children/Adolescents, Communication, Education: Patient and Caregiver, Health Promotion, Infectious Diseases, Prevention, Sexual Health, Social Media, Vaccination
Crosby LE, Walton A, Shook LM
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
This study developed a decision aid for use of hydroxyurea for parents of children with sickle cell anemia. There are national evidence-based guidelines, but they do not offer strategies for implementation. A multicomponent decision aid was developed via a needs assessment, clinic observations and iterative feedback. The decision aid was considered useful by the 75 parents and 28 clinicians who participated in all phases of the study.
AHRQ-funded; HS021114.
Citation: Crosby LE, Walton A, Shook LM .
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
J Pediatr Hematol Oncol 2019 Jan;41(1):56-63. doi: 10.1097/mph.0000000000001257..
Keywords: Caregiving, Children/Adolescents, Chronic Conditions, Shared Decision Making, Education: Patient and Caregiver, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Sickle Cell Disease
Turner AM, Osterhage KP, Taylor JO, et al.
A closer look at health information seeking by older adults and involved family and friends: design considerations for health information technologies.
Older adults are the largest consumers of healthcare. As part of a broader study of personal health information management (PHIM), the investigators interviewed older adults in King County, Washington, and their involved family and friends (FF), regarding health information (HI) sources they seek and utilize. The authors indicated that design considerations include: facilitating access to quality provider-vetted HI, incorporating older adults and FF in the design process, and creating shared spaces for communication of HI among older adults, FF, and providers.
AHRQ-funded; HS022106.
Citation: Turner AM, Osterhage KP, Taylor JO, et al..
A closer look at health information seeking by older adults and involved family and friends: design considerations for health information technologies.
AMIA Annu Symp Proc 2018 Dec 5;2018:1036-45..
Keywords: Elderly, Health Information Technology (HIT), Caregiving, Education: Patient and Caregiver, Health Literacy
Connor KA, Duran G, Faiz-Nassar M
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
The aim of this qualitative study was to assess stakeholder perspectives on the feasibility of implementing Centering Parenting (CP) in federally qualified health centers (FQHCs) in Baltimore. The investigators concluded that perceptions regarding facilitators and barriers to CP implementation in FQHCs were similar to existing group well-child care literature; however the benefit of emphasis on maternal wellness was a unique finding. The investigators suggested that a maternal wellness integration might make CP a particularly desirable model for implementation at FQHCs, but potential systems barriers must be addressed.
AHRQ-funded; HS017596.
Citation: Connor KA, Duran G, Faiz-Nassar M .
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
Acad Pediatr 2018 Jul;18(5):510-15. doi: 10.1016/j.acap.2017.09.011..
Keywords: Caregiving, Children/Adolescents, Education: Patient and Caregiver, Health Promotion, Healthcare Delivery, Maternal Care, Newborns/Infants, Pregnancy, Women
Parast L, Bardach NS, Burkhart Q
Development of new quality measures for hospital-based care of suicidal youth.
This study researched the value of 4 new quality measures developed to assess hospital-based care for suicidal youth. The four quality measures focused on counseling caregivers about restricting access to lethal means of self-harm, and the benefits and risks of antidepressant medications. They were divided into measures for the emergency department (ED) and inpatient measures. Survey field tests were conducted with caregivers of youth who were admitted to the ED or inpatient care for suicidality at 1 of 2 children’s hospitals between July 2013 and June 2014. Most caregivers did receive counseling about restricting their child’s access to lethal means of self-harm and also reported higher rates of counseling of benefits on antidepressants both in the ED and in the inpatient setting than the risks.
AHRQ-funded; HS020506.
Citation: Parast L, Bardach NS, Burkhart Q .
Development of new quality measures for hospital-based care of suicidal youth.
Acad Pediatr 2018 Apr;18(3):248-55. doi: 10.1016/j.acap.2017.09.017..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Patient and Caregiver, Emergency Department, Hospitalization, Hospitals, Inpatient Care, Behavioral Health, Prevention, Quality of Care, Quality Measures
Holroyd LE, Anders S, Robinson JR
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
AHRQ-funded; HS021496.
Citation: Holroyd LE, Anders S, Robinson JR .
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
AMIA Annu Symp Proc 2017 Apr 16;2017:902-11..
Keywords: Caregiving, Education: Patient and Caregiver, Health Information Technology (HIT), Pregnancy, Web-Based
Breitenstein SM, Schoeny M, Risser H
A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care.
The purpose of this paper is to describe the study protocol evaluating the implementation, efficacy, and cost-effectiveness of implementing the tablet-based ezParent program in pediatric primary care settings. Data on parenting and child behavior outcomes will be obtained at baseline, and at 3, 6, and 12 months post baseline. The authors suggest that the implementation of the ezParent is an innovative opportunity to promote positive parenting with potential for universal access to the preschool population and for low cost by building on existing infrastructure in pediatric primary care settings.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Schoeny M, Risser H .
A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care.
Contemp Clin Trials 2016 Sep;50:229-37. doi: 10.1016/j.cct.2016.08.017.
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Keywords: Children/Adolescents, Healthcare Costs, Primary Care, Education: Patient and Caregiver, Caregiving
Smith B, McDuff J, Naierman N
What consumers want to know about quality when choosing a hospice provider.
This study drew on focus group and survey data collected in 5 metropolitan areas to learn more about hospice quality data. The researchers found that participants placed top priority on measures related to pain and symptom management. The National Quality Forum-approved measures resonate well with consumers, who also appear to be ready for access to data on the quality of hospice providers.
AHRQ-funded; HS021870.
Citation: Smith B, McDuff J, Naierman N .
What consumers want to know about quality when choosing a hospice provider.
Am J Hosp Palliat Care 2015 Jun;32(4):393-400. doi: 10.1177/1049909114524475.
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Keywords: Caregiving, Education: Patient and Caregiver, Shared Decision Making, Palliative Care, Provider Performance, Public Reporting, Quality of Care, Quality Indicators (QIs)
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care