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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 16 of 16 Research Studies Displayed
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 / 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 / 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 / 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 / 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
Castaneda-Guarderas A, Glassbereg J, Grudzen CR
Shared decision making with vulnerable populations in the emergency department.
The authors introduce a research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses to address questions of shared decision making (SDM) among vulnerable groups at a disadvantage in the healthcare system, as well as changes that are needed, and how to cultivate and teach these competencies.
Citation: Castaneda-Guarderas A, Glassbereg J, Grudzen CR . Shared decision making with vulnerable populations in the emergency department. Acad Emerg Med 2016 Dec;23(12):1410-16. doi: 10.1111/acem.13134.
Keywords: Cultural Competence, Decision Making, Emergency Department, Patient and Family Engagement, Vulnerable Populations
Martens CE, Crutchfield TM, Laping JL
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
The objectives for this paper were: (1) to improve understanding of preferences regarding potential colorectal cancer (CRC) screening program characteristics, and (2) to improve understanding of the barriers and facilitators around CRC screening with the Hispanic, immigrant community in North Carolina. They found that Hispanics may have a general awareness of and interest in CRC screening, but multiple barriers prevent them from getting screened, and recommended that special attention be given to designing culturally and linguistically appropriate programs to improve access to healthcare resources, insurance, and associated costs among Hispanics.
Citation: Martens CE, Crutchfield TM, Laping JL . Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina. J Cancer Educ 2016 Dec;31(4):652-59. doi: 10.1007/s13187-015-0890-4.
Keywords: Cancer: Colorectal Cancer, Cultural Competence, Racial / Ethnic Minorities, Racial / Ethnic Minorities, Screening
Yun K, Paul P, Subedi P
Help-seeking behavior and health care navigation by Bhutanese refugees.
The objective of this study was to document barriers to care, help-seeking behaviors, and the impact of a community-based patient navigation intervention on patient activation levels among Bhutanese refugees in the U.S. Following the intervention, only one-third reported the lowest level of patient activation and one-third were highly activated. Bhutanese refugees overcome healthcare access barriers by seeking help from a network of support that begins within the community.
Citation: Yun K, Paul P, Subedi P . Help-seeking behavior and health care navigation by Bhutanese refugees. J Community Health 2016 Jun;41(3):526-34. doi: 10.1007/s10900-015-0126-x.
Keywords: Access to Care, Cultural Competence, Education: Patient and Caregiver, Health Literacy, Racial / Ethnic Minorities
Rosas LG, Lv N, Xiao L
Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.
The authors discussed the 5-year Vida Sana study, which tests a culturally adapted and technology-enhanced group-based Diabetes Prevention Program intervention in a randomized controlled trial with overweight/obese Latino adults who have metabolic syndrome and/or pre-diabetes. The main goal was to determine the effectiveness of the intervention. The authors hypothesized that the intervention will lead to a greater mean reduction in weight at 24 months vs. usual care.
Citation: Rosas LG, Lv N, Xiao L . Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial. Contemp Clin Trials 2016 May;48:30-40. doi: 10.1016/j.cct.2016.03.003.
Keywords: Cultural Competence, Lifestyle Changes, Racial / Ethnic Minorities, Primary Care, Racial / Ethnic Minorities
Bishop WP, Craddock Lee SJ, Skinner CS
Validity of single-item screening for limited health literacy in English and Spanish speakers.
The researchers evaluated 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. They found that for English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials."
Citation: Bishop WP, Craddock Lee SJ, Skinner CS . Validity of single-item screening for limited health literacy in English and Spanish speakers. Am J Public Health 2016 May;106(5):889-92. doi: 10.2105/ajph.2016.303092.
Keywords: Cultural Competence, Education: Patient and Caregiver, Health Literacy
Tucker CM, Wall WA, Wippold G
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
The researchers sought to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF). They found that this inventory has 2 factors with high internal consistency reliability. They concluded that the T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity and that it can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff.
AHRQ-funded; HS013151; HS010726.
Citation: Tucker CM, Wall WA, Wippold G . Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity. Health Serv Res Manag Epidemiol 2016 Apr 27;3. doi: 10.1177/2333392816629600.
Keywords: Healthcare Delivery, Cultural Competence, Patient-Centered Healthcare, Primary Care, Provider
Li J, Maxwell AE, Glenn BA
Healthcare access and utilization among Korean Americans: The mediating role of English use and proficiency.
This study examines whether English language use and proficiency plays a mediating role in the relationships between length of hospital stay in the US and health insurance coverage, access to, and use of care. Results show that health care utilization was primarily driven by having health insurance and a usual source of care. Recommendations include a focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans to mitigate health disparities associated with reduced access to health services in this population.
Citation: Li J, Maxwell AE, Glenn BA . Healthcare access and utilization among Korean Americans: The mediating role of English use and proficiency. Int J Soc Sci Res 2016 Mar;4(1):83-97. doi: 10.5296/ijssr.v4i1.8678.
Keywords: Access to Care, Cultural Competence, Disparities, Healthcare Utilization, Racial / Ethnic Minorities
Howard J, Etz RS, Crocker JB
Maximizing the patient-centered medical home (PCMH) by choosing words wisely.
The authors described new terminology that some innovative primary care practices are using to support the transformational culture of the PCMH. Using data from the AHRQ-funded Working Conference for PCMH Innovation 2013, they found that language innovations were used by 5 of the 10 convened practices and that participants felt that the language used was important for reinforcing substantive changes. They concluded that new terminology must represent values to which practices genuinely aspire.
Citation: Howard J, Etz RS, Crocker JB . Maximizing the patient-centered medical home (PCMH) by choosing words wisely. J Am Board Fam Med 2016 Mar-Apr;29(2):248-53. doi: 10.3122/jabfm.2016.02.150199.
Keywords: Cultural Competence, Innovations and Emerging Issues, Patient-Centered Healthcare, Primary Care