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- Access to Care (1)
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- Sleep Problems (1)
- Stroke (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 23 of 23 Research Studies DisplayedChoe 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
Chen DW, Reyes-Gastelum D, Hawley ST
Unmet information needs among Hispanic women with thyroid cancer.
The authors sought to determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer. They assessed acculturation with the Short Acculturation Scale for Hispanics. They found that low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Hawley ST .
Unmet information needs among Hispanic women with thyroid cancer.
J Clin Endocrinol Metab 2021 Jun 16;106(7):e2680-e87. doi: 10.1210/clinem/dgab128..
Keywords: Cancer, Women, Racial and Ethnic Minorities, Education: Patient and Caregiver, Cultural Competence
Alcántara C, Giorgio Cosenzo L, McCullough E
Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: a systematic review of randomized controlled trials in the United States.
This systematic review examined behavioral randomized controlled trials (RCTs) on prevalent sleep-wake disorders and sleep disturbances to determine if these studies targeted underserved populations or addressed contextual and cultural factors. The authors examined sociodemographic characteristics of behavioral RCTs that targeted underserved adults, identified types of cultural adaptations (surface-level or deep-level), and described intervention effectiveness on primary sleep outcomes. Overall out of 56 studies, 6.97% targeted underserved groups (veterans, women, racial/ethnic minorities, low socioeconomic status, disability status); and 64.9% made surface-level or deep-level cultural adaptations. Most cultural adaptions were made to behavioral therapies, and cognitive behavioral therapy for insomnia (CBT-I). Surface-level cultural adaptions made were mostly to the delivery modality and setting. Deep-level cultural adaptations to the content and core intervention components were the most typical. Intervention effectiveness varied by type of adapted intervention and the participant population. RCTs including adapted CBT-I interventions among participants showed consistent significant reductions in adverse sleep outcomes versus control.
AHRQ-funded; HS024274.
Citation: Alcántara C, Giorgio Cosenzo L, McCullough E .
Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: a systematic review of randomized controlled trials in the United States.
Sleep Med Rev 2021 Apr;56:101455. doi: 10.1016/j.smrv.2021.101455..
Keywords: Sleep Problems, Cultural Competence, Behavioral Health, Racial and Ethnic Minorities, Vulnerable Populations
Kirby JB, Berdahl TA, Stone RA
AHRQ Author: Kirby JB, Berdahl TA
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
Investigators sought to estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups. Using MEPS data, they found that negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. They recommended that researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care avoid categorizing all Asians into a single group.
AHRQ-authored.
Citation: Kirby JB, Berdahl TA, Stone RA .
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
J Gen Intern Med 2021 Apr;36(4):888-93. doi: 10.1007/s11606-020-06391-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Patient Experience, Racial and Ethnic Minorities, Cultural Competence
Gerchow L, Burka LR, Miner S
Language barriers between nurses and patients: a scoping review.
This systematic review explored how research has examined the nursing workforce with respect to language barriers and identifies gaps for further research. Four databases were used to identify 48 studies representing 16 countries. Most studies were qualitative, with the inpatient setting most commonly studied. Studies were coded for data analysis. Coding produced four themes: interpreter use/misuse, barriers to and facilitators of quality care, cultural competence, and interventions. Regardless of setting, country, or language, nurses noted like experiences and applied similar strategies.
AHRQ-funded; HS023593.
Citation: Gerchow L, Burka LR, Miner S .
Language barriers between nurses and patients: a scoping review.
Patient Educ Couns 2021 Mar;104(3):534-53. doi: 10.1016/j.pec.2020.09.017..
Keywords: Cultural Competence, Communication, Provider: Nurse, Provider
Rodriguez JA, Fossa A, Mishuris R
Bridging the language gap in patient portals: an evaluation of Google Translate.
Due to communication barriers, limited English-proficient (LEP) patients face challenges in the healthcare system. Given the language divide, the investigators sought to assess the use of Google Translate (GT) in the clinical setting and compare its efficacy to traditional human translation of patient messages. The investigators translated the messages to English using a professional translator and GT and created a series of clinical comprehension questions based on the message content.
AHRQ-funded; HS021495.
Citation: Rodriguez JA, Fossa A, Mishuris R .
Bridging the language gap in patient portals: an evaluation of Google Translate.
J Gen Intern Med 2021 Feb;36(2):567-69. doi: 10.1007/s11606-020-05719-z..
Keywords: Cultural Competence, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT)
Zachrison KS, Natsui S, Luan Erfe BM
Language preference does not influence stroke patients' symptom recognition or emergency care time metrics.
The objective of this study was to determine whether acute ischemic stroke (AIS) patients' language preference was associated with differences in time from symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DTI), and door-to-needle (DTN) time. The investigators concluded that consistent with prior reports examining disparities in care, a systems-based approach to acute stroke prevents differences in hospital-based metrics.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Natsui S, Luan Erfe BM .
Language preference does not influence stroke patients' symptom recognition or emergency care time metrics.
Am J Emerg Med 2021 Feb;40:177-80. doi: 10.1016/j.ajem.2020.10.064..
Keywords: Stroke, Cardiovascular Conditions, Emergency Department, Cultural Competence, Diagnostic Safety and Quality
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
Squires A, Miner S, Liang E
How language barriers influence provider workload for home health care professionals: A secondary analysis of interview data.
Increasingly, patients with limited English proficiency are accessing home health care services in the United States. Few studies have examined how language barriers influence provider role implementation or workload in the home health care setting. The objective of this study was to explore home health care professionals' perspectives about how workload changes from managing language barriers influence quality and safety in home health care.
AHRQ-funded; HS023593.
Citation: Squires A, Miner S, Liang E .
How language barriers influence provider workload for home health care professionals: A secondary analysis of interview data.
Int J Nurs Stud 2019 Nov;99:103394. doi: 10.1016/j.ijnurstu.2019.103394..
Keywords: Home Healthcare, Cultural Competence, Communication, Provider, Healthcare Delivery
Howard SD, Lee KL, Nathan AG
Healthcare experiences of transgender people of color.
Researchers investigated how transgender people of color (TPOC) healthcare experiences are shaped by both race/ethnicity and gender identity. Using interviews and focus groups with participants in the Chicago area, they found that all participants described healthcare experiences where providers responded negatively to their race/ethnicity and/or gender identity. A majority of participants sought out healthcare locations designated as lesbian, gay, bisexual, and transgender-friendly in an effort to avoid discrimination, but feared experiencing racism there. When describing positive healthcare experiences, participants were most likely to highlight providers' respect for their gender identity. The researchers concluded that TPOC have different experiences compared with white transgender or cisgender racial/ethnic minorities and recommended that providers improve understanding of intersectional experiences of TPOC to improve quality of care.
AHRQ-funded; HS023050.
Citation: Howard SD, Lee KL, Nathan AG .
Healthcare experiences of transgender people of color.
J Gen Intern Med 2019 Oct;34(10):2068-74. doi: 10.1007/s11606-019-05179-0..
Keywords: Patient Experience, Vulnerable Populations, Cultural Competence, Racial and Ethnic Minorities, Primary Care, Ambulatory Care and Surgery
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
Berdahl TA, Kirby JB
AHRQ Author: Berdahl TA, Kirby JB
Patient-provider communication disparities by limited English proficiency (LEP): trends from the US Medical Expenditure Panel Survey, 2006-2015.
The purpose of this study was to describe trends in patient-provider communication by limited English proficiency (LEP) from 2006 to 2015. The investigators concluded that although patient-provider communication among LEP individuals improved since 2010, linguistic disparities persist and constitute a formidable challenge to achieving healthcare equity, a long-standing US policy goal.
AHRQ-authored.
Citation: Berdahl TA, Kirby JB .
Patient-provider communication disparities by limited English proficiency (LEP): trends from the US Medical Expenditure Panel Survey, 2006-2015.
J Gen Intern Med 2019 Aug;34(8). doi: 10.1007/s11606-018-4757-3..
Keywords: Clinician-Patient Communication, Communication, Cultural Competence, Disparities, Medical Expenditure Panel Survey (MEPS)
Rodriguez JA, Davis RB, Percac-Lima S
Non-English language availability of community health center websites.
This study examined the availability of the Health Resources and Services Administration (HRSA)-supported community health center (CHC) websites that provide translated home page content. Out of 1400 CHC homepages, 34.3% provided translated information with half using Google Translate. Odds of the homepage being translated increased as the limited English-proficient (LEP) population by county increased, Internet subscription at the state level increased, or if the CHC was in a metropolitan area. Most of the homepages were translated into Spanish in counties with higher Spanish LEP populations, but this was not true for other non-Spanish language LEP populations.
AHRQ-funded; HS021495.
Citation: Rodriguez JA, Davis RB, Percac-Lima S .
Non-English language availability of community health center websites.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S121-s26. doi: 10.1097/mlr.0000000000001027..
Keywords: Communication, Cultural Competence, Education: Patient and Caregiver, Health Information Technology (HIT)
Chan B, Goldman LE, Sarkar U
High perceived social support and hospital readmissions in an older multi-ethnic, limited English proficiency, safety-net population.
This study examined the association between perceived social support and 30-day hospital readmission or death in older adults. The study used the cohort from the Support From Hospital to Home for Elders (SHHE) trial. Participants were English, Chinese and Spanish-speaking adults living in the community who were admitted to wards at an urban safety-net hospital in San Francisco. Overall readmission or death rate was 15%. Participants had a mean age of 66.2 with the majority being Asian (31.9%), then Black (24.8%), Latino (19.3%) and White (18.8%). Researchers found that those with high social support had half the odds of admission or death than those with low social support. The protection however seemed true only among minorities, and seemed to have the opposite effect among whites.
AHRQ-funded; HS022981.
Citation: Chan B, Goldman LE, Sarkar U .
High perceived social support and hospital readmissions in an older multi-ethnic, limited English proficiency, safety-net population.
BMC Health Serv Res 2019 May 24;19(1):334. doi: 10.1186/s12913-019-4162-6..
Keywords: Communication, Cultural Competence, Elderly, Hospital Readmissions, Racial and Ethnic Minorities
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Milla C, Guo M, Chang A
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Childbirth is a national priority area for healthcare quality improvement. Patient perspectives are increasingly valued in healthcare, yet Asian American and Pacific Islander (AAPI) perspectives of healthcare quality are often understudied, particularly from individuals with limited English proficiency (LEP). In this study, the goal was to understand factors that consumers in Hawai'i, including AAPI and those with LEP, used to compare patient care in hospitals, especially for childbirth.
AHRQ-funded; HS021903.
Citation: Milla C, Guo M, Chang A .
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Hawaii J Med Public Health 2019 Mar;78(3):89-97..
Keywords: Labor and Delivery, Pregnancy, Hospitals, Quality Improvement, Quality of Care, Cultural Competence, Women
Johnston FM, Neiman JH, Parmley LE
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
This study focused on the issue of lack of palliative care for African-Americans with cancer. Stakeholder interviews and focus groups were conducted with cancer patients, caregivers, health care administrators, oncologists, and community health workers (CHWs). Participants felt that CHWs could play a central role in bridging patients with their providers, information and resources. They also felt that CHWs should either come from the community, or be familiar with the history, culture, and norms of the communities from which they operate.
AHRQ-funded; HS024736.
Citation: Johnston FM, Neiman JH, Parmley LE .
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
J Palliat Med 2019 Mar;22(3):302-06. doi: 10.1089/jpm.2018.0366..
Keywords: Access to Care, Cancer, Healthcare Delivery, Healthcare Utilization, Cultural Competence, Disparities, Palliative Care, Racial and Ethnic Minorities
Lion KC, Kieran K, Desai A
Audio-recorded discharge instructions for limited English proficient parents: a pilot study.
Parents with limited English proficiency (LEP) demonstrate lower comprehension of discharge instructions. This study was conducted to (1) determine the feasibility of providing a greeting card with language-specific, audio-recorded discharge instructions to LEP parents; (2) describe use of and satisfaction with the cards; and (3) evaluate card effect on instruction comfort with home care and comprehension. The authors concluded that providing language-concordant, audio-recorded discharge instructions was feasible, and parents reported high satisfaction with and frequent use of the cards with multiple caregivers.
AHRQ-funded; HS024299.
Citation: Lion KC, Kieran K, Desai A .
Audio-recorded discharge instructions for limited English proficient parents: a pilot study.
Jt Comm J Qual Patient Saf 2019 Feb;45(2):98-107. doi: 10.1016/j.jcjq.2018.06.001..
Keywords: Hospital Discharge, Cultural Competence, Clinician-Patient Communication, Communication, Education: Patient and Caregiver
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
Brenner AT, Ko LK, Janz N
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to colorectal cancer (CRC) screening differ by race/ethnicity and primary language. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations.
AHRQ-funded; HS013853.
Citation: Brenner AT, Ko LK, Janz N .
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
J Health Care Poor Underserved 2015 Aug;26(3):824-38. doi: 10.1353/hpu.2015.0075.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Low-Income, Racial and Ethnic Minorities, Screening
Percac-Lima S, Ashburner JM, Bond B
Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
The goal of this research was to evaluate whether a patient navigator (PN) program for refugee women decreases disparities in breast cancer screening. Results showed that linguistically and culturally tailored PN decreased disparities over time in breast cancer screening among female refugees from Somalia, the Middle East, and Bosnia.
AHRQ-funded; HS018161.
Citation: Percac-Lima S, Ashburner JM, Bond B .
Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
J Gen Intern Med 2013 Nov;28(11):1463-8. doi: 10.1007/s11606-013-2491-4.
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Keywords: Cancer: Breast Cancer, Cultural Competence, Disparities, Racial and Ethnic Minorities, Screening
Percac-Lima S, Benner CS, Lui R
The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women.
The authors evaluated the impact of patient navigation on cervical cancer prevention in Latinas. They found that patient navigation can prevent cervical cancer in Latina women by increasing colposcopy clinic attendance, shortening time to colposcopy, and decreasing severity of cervical abnormalities over time.
AHRQ-funded; HS019161.
Citation: Percac-Lima S, Benner CS, Lui R .
The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women.
J Womens Health 2013 May;22(5):426-31. doi: 10.1089/jwh.2012.3900.
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Keywords: Cancer: Cervical Cancer, Cultural Competence, Prevention, Racial and Ethnic Minorities, Screening