National Healthcare Quality and Disparities Report
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- Arthritis (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 15 of 15 Research Studies DisplayedJensen JL, Sweeney A, Gill C
Evaluation of patient access to Spanish-language-concordant care on a postpartum unit.
This study evaluated patient access to Spanish-language-concordant care on a postpartum unit and to identify facilitators and barriers to the use of interpretation services. This mixed-methods study included a chart review of 50 randomly selected birthing parent-newborn couplets and interviews with 14 inpatient health care team members, and semistructured interviews at a tertiary academic medical center in the southeastern United States. The chart review included examination of patient characteristics, health care team composition including Spanish language proficiency, length of stay, number of interpreter requests, and time between clinician interpreter requests and interpreter arrival on the unit. Access to an interpreter or clinician certified in medical Spanish was offered to 12 of 50 (24%) couplets upon admission to the unit and to 7 of 50 (14%) of couplets for daily maternal and newborn medical rounds. Clinicians reported on long and unpredictable wait times to access interpreters. Temporary solutions included relying on hand gestures, broken Spanish, and smartphone apps to "get by" when communicating with patients without certified interpretation services. These deviations from national standards may put postpartum families at risk for harm.
AHRQ-funded; HS027260.
Citation: Jensen JL, Sweeney A, Gill C .
Evaluation of patient access to Spanish-language-concordant care on a postpartum unit.
Nurs Womens Health 2022 Dec;26(6):429-38. doi: 10.1016/j.nwh.2022.09.002.
Keywords: Maternal Care, Cultural Competence, Clinician-Patient Communication, Communication
Canedo JR, Villalta-Gil V, Grijalva CG CG
How do Hispanics/Latinos perceive and value the return of research results?
This study’s objective was to examine differences among Hispanics/Latinos by education and income in the experience and expectations about the return of research results, perceived value of specific types of information, and the least and most valuable specific information. This retrospective observational design study used a cross-sectional national survey sample of Hispanics/Latinos (n = 327). Higher educational attainment and income were both positively associated with the perceived value of getting results. Higher education respondents specifically perceived greater value in information about how lifestyle and genetics affect their risk of disease, how genetics affect how they respond to medications, their ancestry, available clinical trials near them, and how to connect with other study participants.
AHRQ-funded; HS026122.
Citation: Canedo JR, Villalta-Gil V, Grijalva CG CG .
How do Hispanics/Latinos perceive and value the return of research results?
Hisp Health Care Int 2022 Dec;20(4):238-47. doi: 10.1177/15404153211070821..
Keywords: Racial and Ethnic Minorities, Cultural Competence, Education: Patient and Caregiver
Fowler FJ, Brenner PS, Cosenza C
How responding in Spanish affects CAHPS results.
The purpose of this study was to examine the associations of language and ethnicity with responses to CAHPS surveys and assess the effect of responding to CAHPS surveys in Spanish. The researchers surveyed patients who had received care at a Connecticut community health center within 6 or 12 months of being sent a CAHPS survey that asks about care experiences. Three hypotheses were tested: 1. Spanish speakers are more likely to choose extreme response options. 2. The meaning of the Spanish translation is different than the English version of the questions, with Spanish speakers providing different answers because of meaning differences. 3. Spanish speakers have different expectations regarding their health care than those who answer in English. Researchers evaluated any differences by ethnicity and language. The study found that those answering in Spanish gave significantly more positive reports than the other two groups on three of the five measures, and higher than the non-Hispanic respondents on a fourth. The study concluded that subjects answering in Spanish gave more positive reports of their medical experiences than Hispanics and non-Hispanics answering in English.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Cosenza C .
How responding in Spanish affects CAHPS results.
BMC Health Serv Res 2022 Jul 8;22(1):884. doi: 10.1186/s12913-022-08262-1..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cultural Competence, Patient Experience, Quality of Care, Racial and Ethnic Minorities
Hunte R, Klawetter S, Paul S
"Black nurses in the home is working": advocacy, naming, and processing racism to improve Black maternal and infant health.
The purpose of this qualitative study was to examine how Black women’s health, pregnancy and parenting are impacted by racism, and how the relationship between Black women’s health, pregnancy and parenting and racism-related stress are affected by a culturally-specific perinatal care program. The researchers conducted focus groups and utilized a Black Feminist approach to center the perspectives and lived experiences of Black women. Four themes surfaced in the analysis, including: 1) The widespread reach of structural racism, 2) Trust and healing facilitated through shared identities, 3) Racism directly impacts mental health, and 4) Advocacy at all levels is a vital service. The researchers concluded that structural racism has chronic and toxic effects on Black women’s physical and mental health, and Black perinatal care should include: culturally-specific approaches, advocacy, mental health support with specific attention to racism-related stress, and examination of implicit biases.
AHRQ-funded; HS026370.
Citation: Hunte R, Klawetter S, Paul S .
"Black nurses in the home is working": advocacy, naming, and processing racism to improve Black maternal and infant health.
Matern Child Health J 2022 Apr;26(4):933-40. doi: 10.1007/s10995-021-03283-4..
Keywords: Racial and Ethnic Minorities, Women, Maternal Care, Pregnancy, Newborns/Infants, Cultural Competence
Gutman CK, Lion KC, Fisher CL
Breaking through barriers: the need for effective research to promote language-concordant communication as a facilitator of equitable emergency care.
The authors discuss the issue of individuals with limited English proficiency (LEP) and the high risk for adverse outcomes in the US health care system, especially in the emergency department. They point out that, although professional language interpretation improves the quality of care for these patients, it remains underused. They find few examples in the literature of rigorous interventions to improve quality of care and outcomes for patients with LEP and urge further high-quality research to improve communication with patients with LEP along the continuum of emergency care in order to achieve equity in outcomes.
AHRQ-funded; HS026006.
Citation: Gutman CK, Lion KC, Fisher CL .
Breaking through barriers: the need for effective research to promote language-concordant communication as a facilitator of equitable emergency care.
J Am Coll Emerg Physicians Open 2022 Feb;3(1):e12639. doi: .
Keywords: Communication, Emergency Department, Cultural Competence, Clinician-Patient Communication
Squires A, Ma C, Miner S
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
In home health care, language barriers are understudied. Language barriers between patients and providers are known to affect a variety of patient outcomes. How a patient's language preference influences hospital readmission risk from home health care has yet to be determined. The objective of this retrospective cross-sectional study was to determine if home care patients' language preference is associated with their risk for hospital readmission from home health care within 30 days of hospital discharge.
AHRQ-funded; HS023593.
Citation: Squires A, Ma C, Miner S .
Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: a retrospective analysis.
Int J Nurs Stud 2022 Jan;125:104093. doi: 10.1016/j.ijnurstu.2021.104093..
Keywords: Cultural Competence, Home Healthcare, Hospital Readmissions, Risk, Communication
Rosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
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
Cunningham-Erves J, Barajas C, Mayo-Gamble TL
Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities.
This study’s goal was to address knowledge deficiencies about cancer clinical trials and biospecimen donation that can potentially improve participation among racial and ethnic minorities. The researchers included community-based organization (CBO) leaders as research team members, conducted focus groups and cognitive interviews with community members as reviewers/consultants, and interacted with two community advisory groups. Five focus group themes were identified. A final program consisted of two versions (English and Spanish) of a culturally-appropriate slide presentation with speaker notes and videos that represent community member and researcher testimonials. It is hoped these findings will help promote cancer clinical trial participation among African Americans and Latinos.
AHRQ-funded; HS026122.
Citation: Cunningham-Erves J, Barajas C, Mayo-Gamble TL .
Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities.
BMC Public Health 2020 Jun 3;20(1):840. doi: 10.1186/s12889-020-08939-4..
Keywords: Cancer, Racial and Ethnic Minorities, Cultural Competence, Research Methodologies, Disparities
Kulhawy-Wibe SC, Zell J, Michaud K
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Researchers conducted a systematic review and appraisal of the cross-cultural adaptation and cross-cultural validity of the Health Assessment Questionnaire and its derivatives, and of the more recent Patient-Reported Outcomes Measurement Information System (PROMIS) functional status assessment measures (FSAMs) in rheumatoid arthritis. They concluded that their review highlighted a paucity of data on the cross-cultural validity of FSAMs and the mostly poor- or fair-quality methods by which they were translated and adapted.
AHRQ-funded; HS025638.
Citation: Kulhawy-Wibe SC, Zell J, Michaud K .
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2020 Jun;72(6):798-805. doi: 10.1002/acr.23904..
Keywords: Arthritis, Cultural Competence, Health Status
Canedo JR, Wilkins CH, Senft N
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
This study examined barriers to dissemination and adoption of precision medicine among the Hispanic/Latino population. Six focus groups and a demographic survey in English and Spanish was developed. Forty-one self-identified Hispanics/Latinos from diverse countries participated in the study. The participants had never heard of precision medicine and barriers to adoption and dissemination included lack of health insurance, distrust of government, immigration status, financial burden, limited English proficiency, low literacy levels, lack of information and lack of transportation. Facilitators included family support, information provided in Spanish, use of plain language and graphics and trust in healthcare providers and institutions. The authors recommend culturally- and linguistically-tailored, low-literacy educational material about precision medicine in English and Spanish.
AHRQ-funded; HS026122.
Citation: Canedo JR, Wilkins CH, Senft N .
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
BMC Public Health 2020 May 1;20(1):603. doi: 10.1186/s12889-020-08718-1..
Keywords: Racial and Ethnic Minorities, Cultural Competence, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication
Squires A, Sadarangani T, Jones S
Strategies for overcoming language barriers in research.
This study synthesized methodological recommendations for cross-language research studies with the goal to improve the quality of future research and expand the evidence-base for clinical practice. Clear methodological recommendations were generated that can improve research rigor and quality of cross-language qualitative and quantitative studies. The authors suggest that the recommendations generated in their paper have the potential to have an impact on the health and well-being of migrants around the world.
AHRQ-funded; HS023593.
Citation: Squires A, Sadarangani T, Jones S .
Strategies for overcoming language barriers in research.
J Adv Nurs 2020 Feb;76(2):706-14. doi: 10.1111/jan.14007..
Keywords: Health Services Research (HSR), Research Methodologies, Communication, 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
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