IDEAS for a Healthy Baby: Reducing Disparities in Consumer Use of Quality Data

健康宝宝的想法：减少消费者使用质量数据的差异

• 批准号: 8449907
• 负责人: Sarah L Goff
• 金额: $ 30.92万
• 依托单位: BAYSTATE MEDICAL CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8449907
• 关键词: IDEAS; Healthy; Baby; Reducing; Disparities

DESCRIPTION (provided by applicant): Efforts to increase transparency regarding health care quality are partially guided by the belief that this information will enable consumers to make more informed choices. Although the amount of information reported on websites has increased dramatically, use by consumers remains limited and largely restricted to white, college-educated and middle-aged consumers. There are many barriers that prevent patients from making effective use of current public reporting websites, including failure to recognize that quality may vary between providers, lack of awareness of publicly reported data, limited internet access, and low health literacy and numeracy. Innovative approaches are therefore needed to overcome barriers to using these data, particularly in vulnerable populations, to ensure a health care system in which every consumer can benefit from public reporting. Patient navigator's help patients 'navigate' through the complex health care delivery environment, and use of patient navigators may be an effective approach to engage consumers and to help them interpret the information presented in public reports. The scientific aims of the study are: 1) to test the efficacy of an office-based patient navigator to assist low-income pregnant women in using publicly reported data to select a pediatric care provider; 2) to assess the efficacy of the intervention in subgroups defined by parity, race/ethnicity, and health literacy; 3) to evaluate th importance of publicly reported information about quality compared to other factors when selecting a pediatric provider; and 4) to assess the intervention's impact on self-management of health care. Women attending the prenatal clinic at a large urban medical center will be enrolled, and randomized to the navigator intervention or an informational pamphlet control. Women randomized to the intervention arm will receive two 20 minute sessions with a trained patient navigator who will guide them in navigating and interpreting information about the quality of care provided at local pediatric practices as presented on the Massachusetts Health Quality Partners website. Women randomized to the control arm will receive a pamphlet detailing how to use the Massachusetts Health Quality Partners website, but will not have trained patient navigators. A survey designed for the purpose of this study will be administered at baseline and post-intervention. Health literacy, numeracy and level of activation for self-management of health care will also be assessed as potential mediators of intervention effectiveness. The primary study outcomes will be the average performance on clinical quality and patient experience measures for the practices selected in the intervention and control groups. Secondary outcomes will include analyses of efficacy among groups of women defined by parity and an assessment of the relative importance of factors considered when choosing a pediatric care provider. Successful completion of the study aims will yield important new knowledge about the value of guided web site navigation as a strategy to reduce disparities in the use of publicly reported information. PUBLIC HEALTH RELEVANCE: Numerous factors prevent consumers from making effective use of publicly reported information about the quality of health care, including limited recognitio that quality of care varies between physicians, lack of awareness of existing websites, limited internet access, low health literacy and numeracy. In the proposed randomized controlled trial we will evaluate the impact of providing assistance in the use and interpretation of information about the quality of pediatric care on the Massachusetts Health Quality Partners Quality Insights website among a population of low-income pregnant women. Results of the study will advance our understanding of effective strategies for overcoming barriers to using publicly reported information among vulnerable populations.

描述（由申请人提供）：提高医疗保健质量透明度的努力部分是基于这样的信念：这些信息将使消费者能够做出 更明智的选择。尽管网站上报告的信息量急剧增加，但消费者的使用仍然有限，并且主要限于白人、受过大学教育的消费者和中年消费者。有许多障碍阻碍患者有效利用当前的公共报告网站，包括未能认识到质量可能会影响患者的健康。 提供者之间存在差异、缺乏对公开报告数据的认识、互联网接入有限以及健康素养和计算能力较低。因此，需要采取创新方法来克服使用这些数据的障碍，特别是在弱势群体中，以确保每个消费者都能从公共报告中受益的医疗保健系统。患者导航器帮助患者在复杂的医疗保健提供环境中“导航”，并且使用患者导航器可能是吸引消费者并帮助他们解释公共报告中提供的信息的有效方法。 该研究的科学目的是：1）测试办公室患者导航器帮助低收入孕妇使用公开报告的数据选择儿科护理提供者的功效； 2) 评估干预措施在按均等性、种族/族裔和健康素养定义的亚组中的有效性； 3) 在选择儿科服务提供者时，与其他因素相比，评估公开报告的质量信息的重要性； 4) 评估干预措施对医疗保健自我管理的影响。参加大型城市医疗中心产前诊所的妇女将被登记，并随机接受导航干预或信息小册子对照。随机分配到干预组的女性将接受两次 20 分钟的课程，由训练有素的患者导航员主持，患者导航员将指导她们导航和解释马萨诸塞州健康质量合作伙伴网站上提供的有关当地儿科诊所提供的护理质量的信息。随机分配到对照组的女性将收到一本小册子，详细说明如何使用马萨诸塞州健康质量合作伙伴网站，但不会有经过培训的患者导航员。为本研究目的而设计的调查将在基线和干预后进行。健康素养、计算能力和医疗保健自我管理的激活水平也将被评估为干预效果的潜在中介因素。主要研究结果将是干预组和对照组中所选实践的临床质量和患者体验测量的平均表现。次要结果将包括对按胎次定义的女性群体的疗效进行分析，以及对选择儿科护理提供者时考虑的因素的相对重要性进行评估。成功完成研究目标将产生关于引导网站导航作为减少公开报告信息使用差异的策略的价值的重要新知识。 公共卫生相关性：许多因素阻碍消费者有效利用公开报道的有关医疗保健质量的信息，包括对医生之间的医疗质量差异认识有限、对现有网站缺乏认识、互联网访问有限、健康素养和计算能力低。在拟议的随机对照试验中，我们将评估在马萨诸塞州健康质量合作伙伴质量洞察网站上为低收入孕妇群体提供有关儿科护理质量信息的使用和解释方面的帮助的影响。该研究的结果将增进我们对克服弱势群体使用公开报告信息的障碍的有效策略的理解。