National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
201 to 225 of 383 Research Studies DisplayedShay 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
Jones CD, Burke RE
Web exclusive. Annals for Hospitalists Inpatient Notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
In this article, the authors outline 3 key problems in postacute care (PAC) transitions and offer potential solutions. They assert that improving hospitalists' knowledge of PAC, improving communication after hospital discharge, and creating mechanisms for feedback to hospitalists are all possible ways of getting past the PAC “black box.”
AHRQ-funded; HS024569.
Citation: Jones CD, Burke RE .
Web exclusive. Annals for Hospitalists Inpatient Notes - getting past the "black box"-opportunities for hospitalists to improve postacute care transitions.
Ann Intern Med 2018 May 15;168(10):H02 - H03. doi: 10.7326/m18-0940..
Keywords: Communication, Hospital Discharge, Inpatient Care, Transitions of Care
Klara K, Kim J, Ross JS
Direct-to-consumer broadcast advertisements for pharmaceuticals: off-label promotion and adherence to FDA guidelines.
Direct-to-consumer (DTC) advertisements for prescription drugs in the United States are regulated by the Food and Drug Administration (FDA). Off-label promotion, or the advertisement of a drug for an indication not approved by the FDA, is prohibited. The objective of this study was to examine the presence of off-label promotion in broadcast DTC ads and to assess their adherence to FDA guidelines mandating fair balance in presentation of risks and benefits and prohibiting misleading advertisement claims.
AHRQ-funded; HS022882.
Citation: Klara K, Kim J, Ross JS .
Direct-to-consumer broadcast advertisements for pharmaceuticals: off-label promotion and adherence to FDA guidelines.
J Gen Intern Med 2018 May;33(5):651-58. doi: 10.1007/s11606-017-4274-9..
Keywords: Medication, Guidelines, Policy, Communication
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
Holtrop JS, Ruland S, Diaz S
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
The investigators examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. They sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Using surveys, they found that social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. They concluded that structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.
AHRQ-funded; HS022690.
Citation: Holtrop JS, Ruland S, Diaz S .
Using social network analysis to examine the effect of care management structure on chronic disease management communication within primary care.
J Gen Intern Med 2018 May;33(5):612-20. doi: 10.1007/s11606-017-4247-z.
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Keywords: Care Management, Chronic Conditions, Communication, Primary Care, Teams
Patterson ES
Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature.
This narrative review sought to integrate and synthesize insights from recent studies of workarounds to the intended use of health information technology (HIT) by health care professionals. It concluded that workarounds were employed to avoid changes to workflow, enable interdisciplinary communication, coordinate activities, and have real-time portable access to summarized and synthesized information.
AHRQ-funded; HS024379.
Citation: Patterson ES .
Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature.
Hum Factors 2018 May;60(3):281-92. doi: 10.1177/0018720818762546.
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Keywords: Communication, Health Information Technology (HIT), Nursing, Patient Safety
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
Barbieri AL, Fadare O, Fan L
Challenges in communication from referring clinicians to pathologists in the electronic health record era.
This study reports on the role played by electronic health record inbox messages (EHRmsg) in a safety event involving pathology. Clinicians assumed that pathologists used EHRmsg as clinical care team members, however, pathologists rarely did. Communication gaps exist between primary clinicians and pathologists in the EHR era and they have potential to result in patient harm.
AHRQ-funded; HS022087.
Citation: Barbieri AL, Fadare O, Fan L .
Challenges in communication from referring clinicians to pathologists in the electronic health record era.
J Pathol Inform. 2018 Apr 2;9:8. doi: 10.4103/jpi.jpi_70_17..
Keywords: Adverse Events, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Mogul DB, Henderson ML, Bridges JFP
Expanding the Facebook platform to engage and educate online communities.
This article discusses the development and use of a mobile application (app) called Liver Space that was developed through Facebook’s platform. This app is for the pediatric liver community including patients and caregivers. Unlike most Facebook health groups, this one is vetted by healthcare providers who are specialists. The app provides up-to-date information and includes emerging news, summaries from important scholarly journals and human interest stories. There is an “ask an expert” function incorporated into Liver Space. Also included in the app is the ability for users to track their labs and weight and to graph the data.
AHRQ-funded; HS023876.
Citation: Mogul DB, Henderson ML, Bridges JFP .
Expanding the Facebook platform to engage and educate online communities.
Am J Gastroenterol 2018 Apr;113(4):457-58. doi: 10.1038/ajg.2017.450..
Keywords: Social Media, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT), Patient and Family Engagement, Patient Self-Management
Meyers D, Miller T, Genevro J
AHRQ Author: Meyers D, Miller T, Genevro J, Zhan C, De La Mare J, Fournier A, Bennett H, McNellis RJ
EvidenceNOW: Balancing primary care implementation and implementation research.
In 2015, AHRQ invested in the largest primary care research project in its history. EvidenceNOW is a $112 million effort to disseminate and implement patient-centered outcomes research evidence in more than 1,500 primary care practices and to study how quality-improvement support can build the capacity of primary care practices to understand and apply evidence. EvidenceNOW comprises 7 implementation research grants, each funded to provide external quality-improvement support to primary care practices to implement evidence-based cardiovascular care and to conduct rigorous internal evaluations of their work.
AHRQ-authored.
Citation: Meyers D, Miller T, Genevro J .
EvidenceNOW: Balancing primary care implementation and implementation research.
Ann Fam Med 2018 Apr;16(Suppl 1):S5-s11. doi: 10.1370/afm.2196.
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Keywords: Cardiovascular Conditions, Communication, Evidence-Based Practice, Heart Disease and Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Quality of Care, Quality Improvement, Implementation
Knierim SD, Newcomer S, Castillo A
Latino parents' perceptions of pediatric weight counseling terms.
This study analyzed what would the least offensive terms to use with Latino parents when clinicians talk to them about their childrens’ weight, particularly for counseling obese youth. Latino parents across demographic groups were surveyed in English or Spanish and rated the most and least offensive terms to describe excess weight using a 5-point scale. The least offensive term was “demasiado peso para su salud”, or “too much weight for his/her health” in English. The most offensive was “gordo” or “muy gordo” meaning chubby or fat. Terminology makes a difference in how the parents will respond to weight counseling and follow-up.
AHRQ-funded; HS022143.
Citation: Knierim SD, Newcomer S, Castillo A .
Latino parents' perceptions of pediatric weight counseling terms.
Acad Pediatr 2018 Apr;18(3):342-53. doi: 10.1016/j.acap.2017.09.006..
Keywords: Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management, Racial and Ethnic Minorities
Everson J, Funk RJ, Kaufman SR
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
This study sought to determine whether observed patterns of physician interaction around shared patients are associated with higher levels of teamwork as perceived by physicians. It found that in hospitals where physicians repeatedly cared for patients with the same colleagues, physicians perceived better teamwork. When physicians who worked together also had other colleagues in common, the reported teamwork was stronger.
AHRQ-funded; HS024525; HS024728.
Citation: Everson J, Funk RJ, Kaufman SR .
Repeated, close physician coronary artery bypass grafting teams associated with greater teamwork.
Health Serv Res 2018 Apr;53(2):1025-41. doi: 10.1111/1475-6773.12703.
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Keywords: Cardiovascular Conditions, Care Coordination, Communication, Surgery, Teams
Swetz KM, Kamal AH
Palliative Care
This article reviews the basics of effective communication, symptom management, and end-of-life care and provides an overview of current evidence to support patient-centered palliative care.
AHRQ-funded; HS023681.
Citation: Swetz KM, Kamal AH .
Palliative Care
Ann Intern Med 2018 Mar 6;168(5):Itc33-itc48. doi: 10.7326/aitc201803060..
Keywords: Clinician-Patient Communication, Communication, Palliative Care, Patient-Centered Healthcare
Wisk LE, Gray SH, Gooding HC
I thought you said this was confidential?-Challenges to protecting privacy for teens and young adults.
In this opinion paper, the authors discuss challenges to protecting privacy for teens and young adults. They specifically examine the implications of the dependent coverage expansion provision of the Affordable Care Act.
AHRQ-funded; HS022986.
Citation: Wisk LE, Gray SH, Gooding HC .
I thought you said this was confidential?-Challenges to protecting privacy for teens and young adults.
JAMA Pediatr 2018 Mar;172(3):209-10. doi: 10.1001/jamapediatrics.2017.3927..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Policy, Young Adults
McArdle J, Sorensen A, Fowler CI
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
The purpose of this study using TeamSTEPPS was to assess the implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Results suggested that successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The Safety Program for Perinatal Care strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances.
AHRQ-funded; 2902010000241.
Citation: McArdle J, Sorensen A, Fowler CI .
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
J Obstet Gynecol Neonatal Nurs 2018 Mar;47(2):191-201. doi: 10.1016/j.jogn.2017.11.014.
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Keywords: Labor and Delivery, Newborns/Infants, Pregnancy, Adverse Events, TeamSTEPPS, Injuries and Wounds, Care Management, Education: Continuing Medical Education, Training, Tools & Toolkits, Patient Safety, Nursing, Communication, Quality of Care
Feder SL, Britton MC, Chaudhry SI
"They need to have an understanding of why they're coming here and what the outcomes might be." Clinician perspectives on goals of care for patients discharged from hospitals to skilled nursing facilities.
This study examined how clinicians view goals of care (GoC) for hospitalized patients discharged to skilled nursing facilities (SNFs). A variety of clinicians were interviewed: 22% were nurses, 20% physicians, 15% from care management, and 15% from social services. Many respondents felt that patients and their families had unrealistic GoCs. However, conversations on GoCs were infrequent during hospitalizations which contribute to unrealistic expectations for SNF care and poor patient outcomes. The researchers recommend interventions to ensure that GoC conversations and are held regularly and in a timely manner before transfer occurs.
AHRQ-funded; HS023554.
Citation: Feder SL, Britton MC, Chaudhry SI .
"They need to have an understanding of why they're coming here and what the outcomes might be." Clinician perspectives on goals of care for patients discharged from hospitals to skilled nursing facilities.
J Pain Symptom Manage 2018 Mar;55(3):930-37. doi: 10.1016/j.jpainsymman.2017.10.013..
Keywords: Care Coordination, Clinician-Patient Communication, Communication, Hospital Discharge, Nursing Homes, Patient and Family Engagement, Provider: Clinician, Provider: Nurse, Provider: Physician
Alexander GL, Olden HA, Troy T
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
This mixed-methods study assessed teens' awareness of the link between weight and asthma management, and perspectives on how medical providers might open a discussion about managing weight. The investigators found that most teens responded favorably to initiating weight loss if it impacted asthma management, valued their provider addressing weight and family participation in weight management efforts.
AHRQ-funded; HS022417.
Citation: Alexander GL, Olden HA, Troy T .
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
J Asthma 2018 Mar;55(3):266-74. doi: 10.1080/02770903.2017.1323921..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management
Bhise V, Meyer AND, Menon S
Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study.
This study evaluated the effects of three different strategies for communicating diagnostic uncertainty on patient perceptions of physician competence and visit satisfaction. It concluded that parents may react less negatively in terms of perceived competence, physician confidence and trust, and intention to adhere when diagnostic uncertainty is communicated using implicit strategies, such as using broad differential diagnoses or most likely diagnoses.
AHRQ-funded; HS022087; HS023602.
Citation: Bhise V, Meyer AND, Menon S .
Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study.
Int J Qual Health Care 2018 Feb;30(1):2-8. doi: 10.1093/intqhc/mzx170.
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Keywords: Communication, Patient Experience, Patient Experience, Clinician-Patient Communication
Kim SY, Flory J, Relton C
Rejoinder.
In this letter, the author responds to Weijer et al. and Wendler, who commented on the author’s article, Ethics and Practice of Trials within Cohorts: an Emerging Pragmatic Trial Design, published in 2018 in Clinical Trials volume 15.
AHRQ-funded; HS023898.
Citation: Kim SY, Flory J, Relton C .
Rejoinder.
Clin Trials 2018 Feb;15(1):27-28. doi: 10.1177/1740774517746629..
Keywords: Communication, Research Methodologies
Arcia A, Woollen J, Bakken S
A systematic method for exploring data attributes in preparation for designing tailored infographics of patient reported outcomes.
Tailored visualizations of patient reported outcomes (PROs) are valuable health communication tools to support shared decision making, health self-management, and engagement with research participants, such as cohorts in the NIH Precision Medicine Initiative. The authors of the study present a systematic method to exploring data attributes, with a specific focus on application to self-reported health data. They present two case studies to illustrate how this method affected design decisions particularly with respect to outlier and non-missing zero values.
AHRQ-funded; HS019853; HS022961.
Citation: Arcia A, Woollen J, Bakken S .
A systematic method for exploring data attributes in preparation for designing tailored infographics of patient reported outcomes.
eGEMS 2018 Jan 24;6(1):2. doi: 10.5334/egems.190..
Keywords: Communication, Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Data
Kurth AE, Krist AH, Borsky AE
AHRQ Author: Borsky AE, Fan T, Weinstein R
U.S. Preventive Services Task Force methods to communicate and disseminate clinical preventive services recommendations.
The U.S. Preventive Services Task Force (USPSTF) issues evidence-based screening and prevention recommendations, and key to this task is dissemination and implementation of these recommendations. This paper outlines the approaches used by the USPSTF to both solicit input (e.g., public comment periods), as well as to facilitate dissemination of its recommendations to help improve the health of all Americans (e.g., web-based and mobile application tools, journal publications, and annual reports to Congress).
AHRQ-authored.
Citation: Kurth AE, Krist AH, Borsky AE .
U.S. Preventive Services Task Force methods to communicate and disseminate clinical preventive services recommendations.
Am J Prev Med 2018 Jan;54(1s1):S81-s87. doi: 10.1016/j.amepre.2017.07.004.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Benda N, Hettinger A, Bisantz A
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
This study described the patterns and content of nurse to physician verbal conversations in three emergency departments (EDs) with electronic health records. It found that physician participants experienced significantly more communication events than nurse participants, while nurses initiated significantly more communication events than physicians. Most of the communication events occurred at the physician workstation followed by patient treatment areas.
AHRQ-funded; HS022542.
Citation: Benda N, Hettinger A, Bisantz A .
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
Journal of Healthcare Informatics Research 2017 Dec;1(2):218-30.
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Keywords: Communication, Electronic Health Records (EHRs), Provider: Health Personnel, Emergency Department, Nursing
Gadepalli SK, Canvasser J, Eskenazi Y
Roles and experiences of parents in necrotizing enterocolitis: an international survey of parental perspectives of communication in the NICU.
The purpose of this study was to characterize parental perceptions of communication and support they were given about necrotizing enterocolitis (NEC). The authors suggest that areas for quality improvement include better communication and collaboration with parents through early engagement in NEC prevention using modalities beyond verbal instruction.
AHRQ-funded; HS022908.
Citation: Gadepalli SK, Canvasser J, Eskenazi Y .
Roles and experiences of parents in necrotizing enterocolitis: an international survey of parental perspectives of communication in the NICU.
Adv Neonatal Care 2017 Dec;17(6):489-98. doi: 10.1097/anc.0000000000000438..
Keywords: Communication, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Experience, Patient and Family Engagement
Gustafson DH, DuBenske LL, Atwood AK
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver. It found that when severe caregiver-reported symptoms were shared with clinicians, the symptoms were more likely to be subsequently reported as improved than when the symptoms were not shared with clinicians.
AHRQ-funded; HS019917.
Citation: Gustafson DH, DuBenske LL, Atwood AK .
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
J Med Internet Res 2017 Nov 14;19(11):e354. doi: 10.2196/jmir.7466.
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Keywords: Cancer, Caregiving, Communication, Telehealth, Web-Based
Ganiats TG, Bierman AS
AHRQ Author: Ganiats TG, Bierman AS
AHRQ's tools for better practice: helping family physicians manage today's challenges.
AHRQ is engaged in the dissemination and widespread implementation of what works in primary care. The agency’s main point of contact with the primary care community is the National Center for Excellence in Primary Care Research (NCEPCR). The authors discuss the variety of tools and resources made available by the NCEPCR.
AHRQ-authored.
Citation: Ganiats TG, Bierman AS .
AHRQ's tools for better practice: helping family physicians manage today's challenges.
Am Fam Physician 2017 Nov 1;96(9):569-70.
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Keywords: Communication, Evidence-Based Practice, Provider: Physician, Primary Care, Tools & Toolkits