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）：提高有关医疗保健质量透明度的努力的部分指导是信念，即该信息将使消费者能够制造 更明智的选择。尽管网站上报告的信息量显着增加，但消费者的使用仍然有限，并且在很大程度上仅限于白人，受过大学教育和中年消费者。有许多障碍可以防止患者有效利用当前的公开报告网站，包括未能认识到质量可能 提供者之间有所不同，缺乏对公开报告的数据的认识，Internet访问有限以及健康素养和计算能力的不同。因此，需要创新的方法来克服使用这些数据，尤其是在弱势群体中，以确保每个消费者都可以从公开报告中受益的医疗保健系统。患者导航员的帮助患者通过复杂的医疗保健提供环境“导航”，使用患者导航器可能是吸引消费者并帮助他们解释公开报告中提供的信息的有效方法。 该研究的科学目的是：1）测试基于办公室的患者导航员的功效，以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； 2）评估干预措施在均衡，种族/民族和健康素养定义的亚组中的疗效； 3）评估与选择儿科提供者相比，与其他因素相比，公开报告的有关质量的信息的重要性； 4）评估干预对医疗保健自我管理的影响。将招募在大型城市医学中心参加产前诊所的妇女，并随机分配导航员干预或信息小册子控制。随机分配干预部门的妇女将与训练有素的患者导航员进行两次20分钟的课程，这些导航员将指导她们在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实践中提供的护理质量的信息。妇女将随机分配到控制臂将收到一名小册子，详细说明如何使用马萨诸塞州健康质量合作伙伴网站，但不会训练有培训的患者导航员。为这项研究而设计的调查将在基线和干预后进行。健康素养，算术和自我管理的激活水平也将被评估为干预效率的潜在介体。主要的研究结果将是干预和对照组中选择的实践的临床质量和患者经验指标的平均表现。次要结果将包括通过平等定义的妇女群体之间的疗效分析，并评估选择儿科护理提供者所考虑的因素的相对重要性。成功完成研究目标将产生有关指导网站导航价值的重要新知识，以减少使用公开报告信息的差异的策略。 公共卫生相关性：许多因素阻止消费者有效利用有关医疗保健质量的公开报告的信息，包括有限认识到医生之间的护理质量有所不同，缺乏对现有网站的认识，有限的互联网访问，低健康素养和计算能力。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见解网站上提供和解释有关儿科护理质量的信息的影响的影响。该研究的结果将提高我们对有效策略的理解，以克服弱势群体中使用公开报告的信息的障碍。