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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results1 to 15 of 15 Research Studies Displayed
Jensen 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.
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.
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.
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.
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.
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.
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
Choe AY, Schondelmeyer AC, Thomson J
Improving discharge instructions for hospitalized children with limited english proficiency.
Research was conducted on an intervention for patients with limited English proficiency (LEP) who are discharged from the hospital without instructions in their preferred language. The objective was to increase the percentage of patients with LEP on the hospital medicine service who received translated discharge instructions from 12% to 80%. During the 18-month study period 540 patients with LEP were discharged. Spanish was the preferred language of 66% of these patients. The percentage of patients who received translated discharge instructions increased from 12% to 50% in 3 months, and to 77% in 18 months. For Spanish-language patients, the percentage increased to 96% by 18 months.
AHRQ-funded; HS026763; HS025138.
Citation: Choe AY, Schondelmeyer AC, Thomson J . Improving discharge instructions for hospitalized children with limited english proficiency. Hosp Pediatr 2021 Nov;11(11):1213-22. doi: 10.1542/hpeds.2021-005981.
AHRQ-funded; HS026763; HS025138..
AHRQ-funded; HS026763; HS025138..
Keywords: Children/Adolescents, Hospital Discharge, Clinician-Patient Communication, Cultural Competence, Communication
Tremblay ES, Ruiz J, Dykeman B
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
It is widely recognized that Type 1 Diabetes (T1D) outcomes are worse among Hispanic children; however, little is published about the perspectives of these patients and their caregivers. The intent of this study was to characterize the lived experience of Hispanic caregivers of children with T1D, focusing on the role of language and culture and their perspectives on current medical care and alternative care models.
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.
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.
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.
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.
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.
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.
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
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.
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.
Keywords: Cancer: Colorectal Cancer, Cultural Competence, Low-Income, Racial and Ethnic Minorities, Screening