National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Arthritis (1)
- Asthma (1)
- Cardiovascular Conditions (2)
- Caregiving (3)
- Case Study (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (5)
- Chronic Conditions (2)
- Clinician-Patient Communication (7)
- Communication (3)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Cultural Competence (2)
- Decision Making (6)
- Dental and Oral Health (2)
- Digestive Disease and Health (1)
- Disabilities (1)
- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (11)
- Elderly (2)
- Electronic Health Records (EHRs) (3)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (8)
- (-) Health Literacy (36)
- Health Promotion (1)
- Health Systems (1)
- Heart Disease and Health (2)
- Hospital Discharge (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (2)
- Low-Income (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (4)
- Neurological Disorders (1)
- Nursing (1)
- Osteoporosis (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (5)
- Patient Experience (1)
- Patient Self-Management (1)
- Pregnancy (2)
- Primary Care (3)
- Quality Improvement (3)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (1)
- Risk (2)
- Stroke (1)
- Surgery (1)
- Telehealth (2)
- Tools & Toolkits (2)
- Training (1)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (2)
- Web-Based (4)
- 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 25 of 36 Research Studies DisplayedDe Oliveira GS, Errea M, Bialek J
The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis.
The primary aim of this study was to evaluate a possible association between health literacy and decision conflict in surgical patients. Patients undergoing a diverse number of elective surgeries were enrolled in the study. Health literacy was measured using the Newest Vital Sign instrument and decision conflict using the low literacy version of the Decision Conflict Scale. The investigators found that poor health literacy is associated with greater decision conflict in patients undergoing elective surgical procedures.
AHRQ-funded; HS024158.
Citation: De Oliveira GS, Errea M, Bialek J .
The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis.
BMC Health Serv Res 2018 Dec 12;18(1):958. doi: 10.1186/s12913-018-3755-9..
Keywords: Decision Making, Education: Patient and Caregiver, Health Literacy, Surgery
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
Fisher KA, Tan ASL, Matlock DD
Keeping the patient in the center: common challenges in the practice of shared decision making.
This study examines the practice of shared-decision making (SDM) to achieve patient-centered decisions. It was determined that not all circumstances make it possible for that to happen and there have to be some basic elements present. Those elements include the patients’ health literacy, their emotional state, their relationship with the clinician and the nature of the decision.
AHRQ-funded; HS024596.
Citation: Fisher KA, Tan ASL, Matlock DD .
Keeping the patient in the center: common challenges in the practice of shared decision making.
Patient Educ Couns 2018 Dec;101(12):2195-201. doi: 10.1016/j.pec.2018.08.007..
Keywords: Clinician-Patient Communication, Decision Making, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement
Zuckerman KE, Chavez AE, Regalado Murillo C
Disparities in familiarity with developmental disabilities among low-income parents.
Parent knowledge about developmental disabilities (DDs) may facilitate access to DD care; however, parents may vary in their knowledge and familiarity with common DDs. The objective of this study was to assess racial/ethnic and language differences in low-income families' familiarity, knowledge, and personal experience with DDs. The investigators concluded that low-income Latino-LEP and other race parents have less familiarity or personal experience with DDs and are less aware of early signs of DDs compared to low-income white parents.
AHRQ-funded; HS000063.
Citation: Zuckerman KE, Chavez AE, Regalado Murillo C .
Disparities in familiarity with developmental disabilities among low-income parents.
Acad Pediatr 2018 Nov - Dec;18(8):944-51. doi: 10.1016/j.acap.2018.06.011..
Keywords: Disabilities, Children/Adolescents, Caregiving, Health Literacy, Low-Income, Vulnerable Populations, Racial and Ethnic Minorities
Guo M, Quensell M, Chang A
Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: implications for patient engagement and health equity.
In this study, women in Oahu, Hawai'i with a recent delivery were interviewed about their understanding of ten common obstetric terms. Health literacy was assessed by the rapid estimate of adult literacy in medicine (REALM). Multivariable models predicted total terms comprehended by demographic factors. The investigators found that participants were unfamiliar with common obstetrics terminology. Comprehension struggles were more common among populations with maternal health disparities, including Asian and Pacific Islander subgroups, and those with low health literacy.
AHRQ-funded; HS021903.
Citation: Guo M, Quensell M, Chang A .
Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: implications for patient engagement and health equity.
Matern Child Health J 2018 Nov;22(11):1543-49. doi: 10.1007/s10995-018-2597-8..
Keywords: Health Literacy, Patient and Family Engagement, Pregnancy, Women
Abutaleb A, Buchwald A, Chudy-Onwugaje K
Inflammatory bowel disease telemedicine clinical trial: impact of educational text messages on disease-specific knowledge over 1 year.
The authors aimed to determine if delivery of educational messages through a telemedicine system improves inflammatory bowel disease (IBD) knowledge. They found that, although telemedicine improves IBD-specific knowledge through text messaging, telemedicine is not superior to education given through standard visits at referral centers.
AHRQ-funded; HS018975.
Citation: Abutaleb A, Buchwald A, Chudy-Onwugaje K .
Inflammatory bowel disease telemedicine clinical trial: impact of educational text messages on disease-specific knowledge over 1 year.
Inflamm Bowel Dis 2018 Sep 15;24(10):2191-97. doi: 10.1093/ibd/izy149..
Keywords: Telehealth, Health Information Technology (HIT), Digestive Disease and Health, Education: Patient and Caregiver, Health Literacy, Quality of Life
Phillippi JC, Doersam JK, Neal JL
Electronic informed consent to facilitate recruitment of pregnant women into research.
This study examined the use of electronic informed consent to increase the participation of racially and geographically diverse pregnant women in prospective research. They evaluated the feasibility and utility of e-consent in the first year of a multiyear clinical trial involving pregnant women. Out of 86 women screened, 71 were eligible, 65 agreed to review the e-consent form, and 61 completed the process. Even those women who reported low health literacy were able to complete the form and may expedite enrollment of a representative sample.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Doersam JK, Neal JL .
Electronic informed consent to facilitate recruitment of pregnant women into research.
J Obstet Gynecol Neonatal Nurs 2018 Jul;47(4):529-34. doi: 10.1016/j.jogn.2018.04.134.
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Keywords: Women, Pregnancy, Health Literacy
Burgette JM, Preisser JS, Weinberger M
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.
The purpose of the study was to examine the moderating effect of parents' health literacy (HL) on the effectiveness of North Carolina Early Head Start (EHS) in improving children's dental use. The investigators found that parents in EHS had a higher prevalence of low HL compared to non-EHS parents. Parents' HL did not moderate the relationship between EHS and child dental use, suggesting that EHS results in similar improvements in dental use regardless of parent's HL levels.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use.
J Public Health Dent 2018 Jun;78(3):257-65. doi: 10.1111/jphd.12269..
Keywords: Caregiving, Children/Adolescents, Dental and Oral Health, Health Literacy
Fredericksen RJ, Gibbons L, Brown S
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
The purpose of this study was to assess knowledge of names and purposes of prescribed medications among patients with multiple chronic conditions. The investigators found that many patients demonstrated difficulty identifying the name and purpose of prescribed medications; this did not differ by demographic group or medication storage type. They suggest that patients may benefit from routine review of medications with their provider in order to improve health literacy, outcomes, and patient-reported adherence measurement.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Gibbons L, Brown S .
Medication understanding among patients living with multiple chronic conditions: implications for patient-reported measures of adherence.
Res Social Adm Pharm 2018 Jun;14(6):540-44. doi: 10.1016/j.sapharm.2017.06.009..
Keywords: Chronic Conditions, Health Literacy, Medication, Patient Adherence/Compliance
Shoemaker SJ, Brach C, Edwards A
AHRQ Author: Brach C
Opportunities to improve informed consent with AHRQ training modules.
Patients often do not understand the risks, benefits, and alternatives of undergoing specific interventions, even after signing a consent form. This paper describes a mixed-methods pilot test of two Agency for Healthcare Research and Quality (AHRQ) informed consent training modules that was implemented in four hospitals. The study concluded that many opportunities exist for hospitals to improve their informed consent practices.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Shoemaker SJ, Brach C, Edwards A .
Opportunities to improve informed consent with AHRQ training modules.
Jt Comm J Qual Patient Saf 2018 Jun;44(6):343-52. doi: 10.1016/j.jcjq.2017.11.010..
Keywords: Decision Making, Education: Continuing Medical Education, Health Literacy, Hospitals, Clinician-Patient Communication, Training
Sepucha KR, Abhyankar P, Hoffman AS
Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist.
This study sought to develop and reach consensus on reporting guidelines to improve the quality of publications evaluating patient decision aids (PDAs). The study concluded that the SUNDAE (Standards for UNiversal reporting of patient Decision Aid Evaluations) Checklist will help ensure that reports of PDA evaluation studies are understandable, transparent and of high quality.
AHRQ-funded; HS024250.
Citation: Sepucha KR, Abhyankar P, Hoffman AS .
Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist.
BMJ Qual Saf 2018 May;27(5):380-88. doi: 10.1136/bmjqs-2017-006986..
Keywords: Communication, Decision Making, Education: Patient and Caregiver, Evidence-Based Practice, Guidelines, Health Literacy, Patient-Centered Healthcare
Sterling MR, Safford MM, Goggins K
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the post hospitalization period. The purpose of this study was to examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF).
AHRQ-funded; HS000066.
Citation: Sterling MR, Safford MM, Goggins K .
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
J Hosp Med 2018 Mar;13(3):145-51. doi: 10.12788/jhm.2932..
Keywords: Health Literacy, Hospital Readmissions, Hospitalization, Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Risk
Shaikh U, Yin HS, Mistry KB
AHRQ Author: Mistry KB
Leveraging medical conferences and webinars for hands-on clinical quality improvement: an intervention to improve health literacy-informed communication in pediatrics.
In this article, the authors describe the process and results with integrating a hands-on quality improvement learning session at the 2016 American Academy of Pediatrics meeting supplemented with virtual peer and expert support through webinars. Their results indicate that this process provided participants with the opportunity to improve clinical care through the use of health literacy–informed communication strategies.
AHRQ-authored.
Citation: Shaikh U, Yin HS, Mistry KB .
Leveraging medical conferences and webinars for hands-on clinical quality improvement: an intervention to improve health literacy-informed communication in pediatrics.
Am J Med Qual 2018 Mar/Apr;33(2):213-15. doi: 10.1177/1062860617719129.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Health Literacy, Children/Adolescents, Quality Improvement
Harris VC, Links AR, Hong P
Consulting Dr. Google: quality of online resources about tympanostomy tube placement.
The authors of this study evaluate the quality of leading Internet resources describing tympanostomy tube (TT) placement. They concluded that Internet resources about TT placement varied in quality pertaining to health literacy, principles of shared decision making, and consistency with practice guidelines.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Hong P .
Consulting Dr. Google: quality of online resources about tympanostomy tube placement.
Laryngoscope 2018 Feb;128(2):496-501. doi: 10.1002/lary.26824..
Keywords: Children/Adolescents, Education: Patient and Caregiver, Health Information Technology (HIT), Health Literacy, Web-Based
Lopez-Olivo MA, Ingleshwar A, Volk RJ
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Researched developed multimedia educational tools that incorporated videos to help patients understand their chronic diseases including osteoporosis, osteoarthritis, and rheumatoid arthritis. Tools were developed in English and Spanish. A total of 60 patients (20 per disease) were recruited to see the videos and were interviewed after all. All participants gave them a favorable rating and felt it helped them understand the disease, the importance of taking their medications, and seeing their doctor regularly. They found the videos and accompanying materials easy to use and easy to understand.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, Ingleshwar A, Volk RJ .
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Arthritis Care Res 2018 Feb;70(2):213-20. doi: 10.1002/acr.23271..
Keywords: Arthritis, Chronic Conditions, Education: Patient and Caregiver, Osteoporosis, Health Literacy
Dowding D, Merrill JA, Onorato N
The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design.
This study explored home care nurses' numeracy and graph literacy and their relationship to comprehension of visualized data. Results suggest that nurses' comprehension of visualized information is influenced by their numeracy, graph literacy, and the display format of the data. Individual differences in numeracy and graph literacy skills need to be taken into account when designing dashboard technology.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Onorato N .
The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design.
J Am Med Inform Assoc 2018 Feb;25(2):175-82. doi: 10.1093/jamia/ocx042.
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Keywords: Decision Making, Health Information Technology (HIT), Health Literacy, Health Information Technology (HIT), Nursing
van den Bogert CA, Miller MJ, Cobaugh DJ
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
The aim of this study was to evaluate screening questions for estimating nonsteroidal anti-inflammatory drug (NSAID) risk knowledge. It concluded that screening questions for subjective NSAID risk awareness and health literacy are predictive of objectively tested NSAID knowledge and can be used to triage patients as well as subsequently initiate and direct a conversation about NSAID risk.
AHRQ-funded; HS016956.
Citation: van den Bogert CA, Miller MJ, Cobaugh DJ .
Screening questions for nonsteroidal anti-inflammatory drug risk knowledge.
J Patient Saf 2017 Dec;13(4):217-22. doi: 10.1097/pts.0000000000000143.
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Keywords: Adverse Drug Events (ADE), Health Literacy, Medication, Risk
Brach C
AHRQ Author: Brach C
The journey to become a health literate organization: a snapshot of health system improvement.
This chapter explores the journey that a growing number of organizations are taking to become health literate. A part of the chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. The chapter ends with lessons learned from the experiences of health literacy pioneers that may be useful to organizations embarking on the journey.
AHRQ-authored.
Citation: Brach C .
The journey to become a health literate organization: a snapshot of health system improvement.
Stud Health Technol Inform 2017;240:203-37.
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Keywords: Health Literacy, Health Systems, Quality Improvement
Wolinsky FD, Lou Y, Edmonds SW
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
This study examined whether a tailored patient-activation letter communicating bone mineral density (BMD) test results plus an educational brochure improved patient activation scores and levels at 12 and 52 wk post-baseline as the mechanism leading to enhanced bone healthcare.
AHRQ-funded; HS023009.
Citation: Wolinsky FD, Lou Y, Edmonds SW .
Activating patients with a tailored bone density test results letter and educational brochure: the PAADRN Randomized Controlled Trial.
J Clin Densitom 2017 Oct/Dec;20(4):464-71. doi: 10.1016/j.jocd.2016.08.012..
Keywords: Education: Patient and Caregiver, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement, Clinician-Patient Communication
Liang L, Brach C
AHRQ Author: Liang L, Brach C
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. It found that the proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone.
AHRQ-authored.
Citation: Liang L, Brach C .
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
Health Lit Res Pract 2017 Oct;1(4):e216-e30. doi: 10.3928/24748307-20170929-01.
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Keywords: Healthcare Delivery, Health Literacy, Medical Expenditure Panel Survey (MEPS), Clinician-Patient Communication
Morrow D, Hasegawa-Johnson M, Huang T
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
The authors describe a project intended to improve the use of Electronic Medical Record (EMR) patient portal information by older adults with diverse numeracy and literacy abilities, so that portals can better support patient-centered care. Their approach combines quantitative measures, as well as experimental and individual difference methods in order to investigate which formats are more effective, and whether some formats benefit some types of patients more than others.
AHRQ-funded; HS022948.
Citation: Morrow D, Hasegawa-Johnson M, Huang T .
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
J Biomed Inform 2017 May;69:63-74. doi: 10.1016/j.jbi.2017.03.015.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Literacy, Patient Self-Management, Web-Based
Abujarad F, Alfano S, Bright TJ
AHRQ Author: Bright TJ
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
This paper describes how the authors designed, developed, and evaluated an mHealth tool for advancing the informed consent process. Their tool enables the informed consent process to be performed on tablets (e.g., iPads) utilizing virtual coaching with text-to-speech automated translation as well as an interactive multimedia elements (e.g., graphics, video clips, animations, presentations, etc.). They present the Used-Centered Design approach they adopted to develop the tool and the results of the different methods used during the development of the tool.
AHRQ-authored; AHRQ-funded; HS023987.
Citation: Abujarad F, Alfano S, Bright TJ .
Building an informed consent tool starting with the patient: the patient-centered Virtual Multimedia Interactive Informed Consent (VIC).
AMIA Annu Symp Proc 2017 Apr 16;2017:374-83..
Keywords: Health Information Technology (HIT), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Telehealth
Tieu L, Schillinger D, Sarkar U
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
The objective of this study was to examine specific usability barriers to patient portal engagement among a diverse group of patients and caregivers. In navigating the portal, participants experienced basic computer barriers (eg, difficulty using a mouse), routine computer barriers (eg, mistyping, navigation issues), reading/writing barriers, and medical content barriers.
AHRQ-funded; HS022408; HS022561.
Citation: Tieu L, Schillinger D, Sarkar U .
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e47-e54. doi: 10.1093/jamia/ocw098.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy, Vulnerable Populations, Web-Based
Unaka NI, Statile A, Haney J
Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.
A cross-sectional study was conducted at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. The investigators found that overall, the readability, understandability, and completeness of discharge instructions were subpar. Efforts to improve the content of discharge instructions may promote safe and effective transitions home.
AHRQ-funded; HS023827.
Citation: Unaka NI, Statile A, Haney J .
Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.
J Hosp Med 2017 Feb;12(2):98-101. doi: 10.12788/jhm.2688..
Keywords: Children/Adolescents, Health Literacy, Hospital Discharge, Children/Adolescents
Ratanawongsa N, Barton JL, Lyles CR
Computer use, language, and literacy in safety net clinic communication.
The researchers investigated the associations between safety net clinician computer use and patient-provider communication for patients with limited health literacy (LHL) and limited English proficiency (LEP). They found that higher clinician computer use was associated with more biomedical focus with LEP/LHL patients, and clinician verbal dominance and lower ratings with patients with adequate English proficiency and health literacy.
AHRQ-funded; HS022561.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Computer use, language, and literacy in safety net clinic communication.
J Am Med Inform Assoc 2017 Jan;24(1):106-12. doi: 10.1093/jamia/ocw062.
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Keywords: Communication, Electronic Health Records (EHRs), Health Literacy, Clinician-Patient Communication, Health Information Technology (HIT)