National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Arthritis (2)
- Behavioral Health (2)
- Blood Thinners (1)
- Cancer (5)
- Cancer: Breast Cancer (3)
- Cardiovascular Conditions (1)
- Caregiving (7)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (5)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (29)
- (-) Communication (41)
- COVID-19 (1)
- Critical Care (1)
- Cultural Competence (1)
- Data (1)
- (-) Decision Making (41)
- Diagnostic Safety and Quality (2)
- Dialysis (1)
- Education: Patient and Caregiver (7)
- Elderly (2)
- Electronic Health Records (EHRs) (4)
- Emergency Department (2)
- Evidence-Based Practice (1)
- Genetics (1)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (6)
- Health Literacy (3)
- Heart Disease and Health (1)
- Imaging (1)
- Infectious Diseases (2)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (3)
- Medication (1)
- Newborns/Infants (2)
- Nursing (2)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Healthcare (10)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (12)
- Patient Experience (2)
- Patient Safety (2)
- Prevention (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Provider (2)
- Provider: Health Personnel (1)
- Provider: Physician (3)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Stroke (1)
- Surgery (3)
- Training (1)
- Transplantation (3)
- Vaccination (2)
- Web-Based (1)
- Women (3)
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 41 Research Studies DisplayedRao BR, Jung EH, Dickert NW
Getting cost discussions right: nudging patients to avoid cognitive pitfalls.
The purpose of this article was to discuss the challenges of high out-of-pocket medication costs and their negative impact on healthcare, patient behavior, and access to quality care. The authors report that integrating cost information into medical decisions can be a useful tool for improving patient outcomes, but there are several cognitive biases that can skew patients' decisions in different directions. The article emphasizes the need for using nudge strategies as a focused counterweight to address out-of-pocket costs and other complex medical decisions. The authors explain that nudges involving manipulations in framing and choice architecture can be harnessed to impact decisions in a predictable way without restricting options or changing economic incentives. The article suggests several nudge strategies that clinicians can employ to help patients make better decisions and avoid cognitive pitfalls in shared decision-making discussions related to out-of-pocket costs.
AHRQ-funded; HS028558.
Citation: Rao BR, Jung EH, Dickert NW .
Getting cost discussions right: nudging patients to avoid cognitive pitfalls.
Circ Cardiovasc Qual Outcomes 2023 Jan; 16(1):e009447. doi: 10.1161/circoutcomes.122.009447..
Keywords: Healthcare Costs, Decision Making, Clinician-Patient Communication, Communication
Rosenberg SM, Gierisch JM, Revette AC
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
This study investigated the impact of a ductal carcinoma in situ (DCIS) diagnosis by engaging self-identified patients regarding their experience. Findings showed that, in a large, national sample, participants with a history of DCIS reported confusion and concern about the diagnosis and treatment, which caused worry and significant uncertainty.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Gierisch JM, Revette AC .
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
Cancer 2022 Apr 15;128(8):1676-83. doi: 10.1002/cncr.34126..
Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Women, Patient-Centered Healthcare, Clinician-Patient Communication, Patient and Family Engagement, Communication
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Decision Making, Clinician-Patient Communication, Communication
Aronson PL, Schaeffer P, Niccolai LM
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
This study examined parents’ perceptions of receiving and understanding information in the emergency department (ED) and their perspectives on shared decision making (SDM) in the management of febrile infants 60 days of age or less. The authors conducted semistructured interviews with 23 parents of febrile infants ≤60 days old evaluated in the pediatric ED at an urban, academic medical center. Themes for parents’ perspectives on SDM included: 1) giving parents the opportunity to express their opinions and concerns builds confidence in the decision making process, 2) parents’ preferences for participation in decision making vary considerably, and 3) different perceptions about risk influence parents’ preferences about having their infant undergo a lumbar puncture (LP). Parents valued risk and benefits of having their infant undergo an LP differently, which influences their preferences.
AHRQ-funded; HS026006.
Citation: Aronson PL, Schaeffer P, Niccolai LM .
Parents' perspectives on communication and shared decision making for febrile infants ≤60 days old.
Pediatr Emerg Care 2021 Dec;37(12):e1213-e19. doi: 10.1097/pec.0000000000001977..
Keywords: Newborns/Infants, Clinician-Patient Communication, Communication, Decision Making, Emergency Department
Links AR, Callon W, Wasserman C
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
A deeper understanding of the dialogue clinicians use to relay treatment recommendations is needed to fully understand their influence on patient decisions about surgery. In this study, the authors characterize how otolaryngologists provide treatment recommendations and suggest a classification framework. The investigators concluded that clinicians provide treatment recommendations in a variety of ways that may introduce more or less certainty and choice to parental treatment decisions.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
Patient Educ Couns 2021 Jun;104(6):1371-79. doi: 10.1016/j.pec.2020.11.015..
Keywords: Children/Adolescents, Surgery, Caregiving, Decision Making, Clinician-Patient Communication, Communication, Provider: Physician, Provider
Kostick KM, Blumenthal-Barby JS
Avoiding "toxic knowledge": the importance of framing personalized risk information in clinical decision-making.
In this article, the authors discuss personalized risk information in clinical decision making, concluding that the framing of this information’s intended purpose at the patient level should be tailored to the decision-making context as a patient perceives it, which may vary from patient to patient.
AHRQ-funded; HS027784.
Citation: Kostick KM, Blumenthal-Barby JS .
Avoiding "toxic knowledge": the importance of framing personalized risk information in clinical decision-making.
Per Med 2021 Mar;18(2):91-95. doi: 10.2217/pme-2020-0174..
Keywords: Clinical Decision Support (CDS), Decision Making, Risk, Clinician-Patient Communication, Communication
Nair D, Malhotra S, Lupu D
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
This paper uses case vignettes to highlight challenges in communication, prognostication, and medical decision-making that have been exacerbated by the COVD-19 pandemic for patients with kidney disease. The authors include best practice recommendations to mitigate those issues and conclude with implications for interdisciplinary models of care in crisis settings. Concerns about certain biomarkers, demographics, and medical comorbidities that can predict an increased risk for mortality among patients with COVID-19 and kidney disease are discussed, because there may be communication barriers related to physical exposure and conservation of personal protective equipment with those at-risk patients.
AHRQ-funded; HS026395.
Citation: Nair D, Malhotra S, Lupu D .
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
Curr Opin Nephrol Hypertens 2021 Mar 1;30(2):190-97. doi: 10.1097/mnh.0000000000000689..
Keywords: COVID-19, Dialysis, Kidney Disease and Health, Decision Making, Clinician-Patient Communication, Communication, Chronic Conditions
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)
Thate JA, Couture B, Schnock KO
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
It is clear that interdisciplinary communication and collaboration have the potential to mitigate healthcare-associated harm, yet there is limited research on how communication through documentation in the patient record can support collaborative decision making. Understanding what information is needed to support collaborative decision making is necessary to design electronic health information systems that facilitate effective communication and, ultimately, safe care. To explore this issue, the investigators focused on information needs related to central venous catheter management and the prevention of central line-associated blood stream infections.
AHRQ-funded; HS0235335.
Citation: Thate JA, Couture B, Schnock KO .
Information needs and the use of documentation to support collaborative decision-making: implications for the reduction of central line-associated blood stream infections.
Comput Inform Nurs 2020 Nov 2;39(4):208-14. doi: 10.1097/cin.0000000000000683..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Decision Making, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Rogith D, Satterly T, Singh H
Application of human factors methods to understand missed follow-up of abnormal test results.
This study demonstrated application of human factors methods for understanding causes for lack of timely follow-up of abnormal test results ("missed results") in outpatient settings. The investigators identified 30 cases of missed test results by querying electronic health record data, developed a critical decision method based interview guide to understand decision-making processes, and interviewed physicians who ordered these tests. They analyzed transcribed responses, developed a CI-based flow model, and conducted a fault tree analysis to identify hierarchical relationships between factors that delayed action.
AHRQ-funded; HS022087; HS022901.
Citation: Rogith D, Satterly T, Singh H .
Application of human factors methods to understand missed follow-up of abnormal test results.
Appl Clin Inform 2020 Oct;11(5):692-98. doi: 10.1055/s-0040-1716537..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Decision Making, Diagnostic Safety and Quality, Communication, Clinician-Patient Communication
Brand-McCarthy SR, Delaney RK, Noseworthy PA
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
This paper discusses the need for shared decision making (SDM) in atrial fibrillation (AF) patients not just at the beginning of treatment but throughout during ongoing care. Use of SDM can help with patient adherence to recommended anticoagulation treatment regimens and lifestyle changes. It can help build a strong partnership between clinician and patient.
AHRQ-funded; HS026379.
Citation: Brand-McCarthy SR, Delaney RK, Noseworthy PA .
Can shared decision making improve stroke prevention in atrial fibrillation?: Implications of the updated guidelines.
Circ Cardiovasc Qual Outcomes 2020 Mar;13(3):e006080. doi: 10.1161/circoutcomes.119.006080..
Keywords: Decision Making, Stroke, Heart Disease and Health, Cardiovascular Conditions, Prevention, Guidelines, Blood Thinners, Medication, Clinician-Patient Communication, Communication
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
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Pavlo AJ, O'Connell M, Olsen S
Missing ingredients in shared decision-making?
This article discusses the practice of shared decision making (SDM) for clinicians when making decisions in health care. This widespread practice is considered the best approach for person-centered care, but for individuals diagnosed with serious mental illness there are still many barriers to effective collaboration. The authors suggest that more emphasis needs to be placed on the doctor-patient relationship itself conducting SDM.
AHRQ-funded; HS023000.
Citation: Pavlo AJ, O'Connell M, Olsen S .
Missing ingredients in shared decision-making?
Psychiatr Q 2019 Jun;90(2):333-38. doi: 10.1007/s11126-019-9624-9..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Decision Making, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Links AR, Callon W, Wasserman C
Surgeon use of medical jargon with parents in the outpatient setting.
This study analyzed the use of unexplained medical jargon with parents whose children have sleep-disordered breathing and their consultations with otolaryngologists in a pediatric surgical setting. Participants (64 parents and 8 otolaryngologists) completed questionnaires that evaluated demographics, clinical features and parental role in decision-making. Unexplained medical jargon was commonly used by physicians (mean total utterances per visit = 28.9) while parents used jargon a mean of 4.3 times. Clinicians used more jargon when they felt that parents had greater involvement in decision-making or when parents used more jargon themselves. These results will be incorporated into communication training for clinicians.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Surgeon use of medical jargon with parents in the outpatient setting.
Patient Educ Couns 2019 Jun;102(6):1111-18. doi: 10.1016/j.pec.2019.02.002..
Keywords: Ambulatory Care and Surgery, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Education: Patient and Caregiver, Provider, Provider: Physician
Novogrodsky E, Yaghoubian A, Connor SE
The role of media in non-directed (altruistic) living kidney donation.
This study sought to characterize how non-directed living kidney donors use media and informational resources over the course of their kidney donation journey. The investigators conducted semi-structured interviews with non-directed donors (NDDs) who initiated kidney transplant chains. The investigators concluded that media and informational resources play an important role in the process of donation for NDDs, including inspiring interest in donation through personal narratives.
AHRQ-funded; HS000029.
Citation: Novogrodsky E, Yaghoubian A, Connor SE .
The role of media in non-directed (altruistic) living kidney donation.
Health Commun 2019 Feb;34(2):259-67. doi: 10.1080/10410236.2017.1405480..
Keywords: Kidney Disease and Health, Transplantation, Decision Making, Communication, Education: Patient and Caregiver
Shah PD, Calo WA, Gikey MB
Questions and concerns about HPV vaccine: a communication experiment.
The purpose of this study was to identify effective responses to parents' questions and concerns about human papillomavirus (HPV) vaccine, using a surveyed national sample of 1196 parents of children aged 9 - 17. Brief videos of a pediatrician providing messages that addressed seven HPV vaccination topics were recorded and parents viewed four videos on one randomly assigned topic, in random order, and evaluated the messages. The authors conclude that the most important principles for increasing message effectiveness are to include information on the benefits of vaccination, including cancer prevention, and to avoid expressing urgency to vaccinate when addressing parents' questions or concerns. The authors also recommend that providers need to be prepared to have longer conversations with parents who express concerns about the HPV vaccine.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Gikey MB .
Questions and concerns about HPV vaccine: a communication experiment.
Pediatrics 2019 Feb;143(2):pii: e20181872. doi: 10.1542/peds.2018-1872..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Infectious Diseases, Vaccination
Kim K, Heinze K, Xu J
Theories of health care decision making at the end of life: a meta-ethnography.
The aim of this meta-ethnography was to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decisionmaking among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS), and their caregivers or providers. A conceptual framework was developed using themes including context of decision making, communication and negotiation of decisionmaking, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes.
AHRQ-funded; HS022140.
Citation: Kim K, Heinze K, Xu J .
Theories of health care decision making at the end of life: a meta-ethnography.
West J Nurs Res 2018 Dec;40(12):1861-84. doi: 10.1177/0193945917723010..
Keywords: Caregiving, Communication, Decision Making, Palliative Care
Quintana Y, Crotty B, Fahy D
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
This open prospective cohort study aimed to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. It used a mixed methods approach, utilizing qualitative survey data along with website usage analytic data.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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Keywords: Caregiving, Communication, Decision Making, Elderly, Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication, Web-Based
Callon W, Beach MC, Links AR
An expanded framework to define and measure shared decision-making in dialogue: a 'top-down' and 'bottom-up' approach.
In this study, the investigators aimed to develop a comprehensive, descriptive framework to measure shared decision making (SDM) in clinical encounters. They listened to audio-recorded dialogue to identify all communication processes related to decision making and coded 55 pediatric otolaryngology visits using the framework and report interrater reliability. They identified 14 clinician behaviors and 5 patient behaviors that had not been previously described, and developed a new descriptive (what does happen), rather than normative (what should happen), SDM framework.
AHRQ-funded; HS022932.
Citation: Callon W, Beach MC, Links AR .
An expanded framework to define and measure shared decision-making in dialogue: a 'top-down' and 'bottom-up' approach.
Patient Educ Couns 2018 Aug;101(8):1368-77. doi: 10.1016/j.pec.2018.03.014..
Keywords: Clinician-Patient Communication, Communication, Decision Making
Bardach NS, Burkhart Q, Richardson LP
Hospital-based quality measures for pediatric mental health care.
The objective of this study was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. The investigators drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings and used them to identify sex and race disparities and substantial hospital variation.
AHRQ-funded; HS020506.
Citation: Bardach NS, Burkhart Q, Richardson LP .
Hospital-based quality measures for pediatric mental health care.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-3554..
Keywords: Cancer, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Diagnostic Safety and Quality, Patient Experience, Patient and Family Engagement
Shay LA, Baldwin AS, Betts AC
Parent-provider communication of HPV vaccine hesitancy.
The authors of this study developed a typology characterizing parent-provider communication around the human papillomavirus (HPV) vaccine in order to assist providers in communicating more effectively with parents around HPV vaccine hesitancy. Visits with unvaccinated adolescents at six pediatric clinics in Dallas, Texas, in which parents were undecided about HPV vaccination, were audio-recorded. The parents’ verbal expression of hesitancy and whether the providers responded with acquiescence and/or persistence were qualitatively coded, and the frequency of parent and provider communication codes and same-day vaccination described. The results indicate that providers who engage hesitant parents and address their concerns can lead to same-day HPV vaccination, and that even parents who make assertive statements are amenable to influence by providers.
AHRQ-funded; HS022418.
Citation: Shay LA, Baldwin AS, Betts AC .
Parent-provider communication of HPV vaccine hesitancy.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-2312..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Infectious Diseases, Vaccination
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
Shaffer VA, Focella ES, Hathaway A
On the usefulness of narratives: an interdisciplinary review and theoretical model.
This article addresses the questions: How can stories from other people be used to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, persuading listeners to change their attitudes or altering behaviors? Should narratives be used in health education, promotion, or behavior change interventions? Researchers conducted a review of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their roles in communication, engagement, recall, persuasion, and health behavior change. Broad theories about information processing and persuasion from psychology and models about narrative messaging found in the health communication and marketing literature were also reviewed to provide insight into the processes by which narratives have their effect on health behavior. The researchers conclude there are important communication gaps in areas of behavioral medicine that could be addressed with narratives, but more work is needed to employ narrative messaging systematically.
AHRQ-funded; HS021681; HS023328.
Citation: Shaffer VA, Focella ES, Hathaway A .
On the usefulness of narratives: an interdisciplinary review and theoretical model.
Ann Behav Med 2018 Apr 19;52(5):429-42. doi: 10.1093/abm/kax008..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Patient Experience, Patient and Family Engagement