Engaging Parents with Low Health Literacy in Designing Hospital Public Reports

描述（由申请人提供）：我们提出的研究旨在探讨消费者对当地医院质量和绩效报告的信息需求和偏好。我们将探索性研究的重点放在了解一个特别高风险的弱势群体——有特殊医疗保健需求的儿童的低收入父母——如何选择、处理、理解和利用健康信息，为他们的孩子做出适当的健康决定。有特殊卫生保健需求儿童的低收入父母是卫生保健服务的频繁消费者，因此最需要可操作的、相关的基于医院的卫生保健指标，以告知他们为子女寻求护理的选择。然而，目前报告健康指标的模式并不能适应健康素养低的风险增加的人群的需求。为此，我们提出了两个具体目标：具体目标1：利用社区参与的方法，建立与医院护理相关的消费者信息需求和偏好。使用有目的的样本，我们将应用定性数据收集技术来确定低收入父母的信息需求，因为它们与医院护理的质量有关，并进行“信息差距分析”，以确定父母希望获得的相对于现有数据的数据。具体目标2：使用混合方法方法，为有特殊医疗保健需求的儿童的低收入父母创建和评估消费者驱动的医院指标。使用AHRQ MONAHRQ软件作为基础，我们将在儿童国家医院开发医院指标；将它们发布在DC-HCN门户网站上，并测试家长的解释和使用这些指标的意图。最终，所有消费者都应该能够随时获得相关的、可操作的医院绩效报告，使他们能够根据可靠的质量、成本和价值衡量标准，对自己的护理做出明智的决定。我们的研究将填补有关公共报告的知识空白，并建立一个证据基础，为公共报告的内容、设计、传播和使用提供信息，并为特别弱势群体（有特殊卫生保健需求的儿童的低收入父母）加强报告实践提供指导。

DESCRIPTION (provided by applicant): Our proposed research explores the information needs and preferences of consumers regarding reports of local hospital quality and performance. We focus our exploratory research on understanding how one particularly high-risk, vulnerable population- low-income parents of children with special health care needs - prefer, process, understand, and utilize health information to make appropriate health decisions for their children. Low-income parents of children with special health care needs are frequent consumers of health care services and are thus most in need of actionable, relevant hospital-based healthcare metrics to inform their choices in seeking care for their children. However, current models of reporting health metrics are not tailored to the needs of populations with increased risk of low-health literacy. To this end, we propose two specific aims: Specific Aim 1: To establish consumer information needs and preferences as they pertain to hospital-based care using a community-engaged approach. Using purposive samples, we will apply qualitative data collection techniques to identify information needs of low-income parents as they relate to the quality of hospital-based care and produce an "information gap analysis" to identify the data that parents desire relative to currently available data. Specific Aim 2: To create and assess consumer-driven hospital metrics for low- income parents of children with special health care needs using a mixed- methods approach. Using AHRQ MONAHRQ software as the foundation, we will develop hospital metrics at Children's National; post them on the DC-HCN portal, and test parent interpretation and intent to use those metrics. Ultimately, all consumers should have ready access to relevant, actionable reports of hospital performance that allow them to make informed decisions about their care based on reliable measures of the quality, cost, and value. Our study will fill knowledge gaps around public reporting and establish an evidence base to inform the content, design, dissemination and use of public reports, and guide the way forward for enhanced reporting practices for a particularly vulnerable population: low-income parents of children with special health care needs. PUBLIC HEALTH RELEVANCE: Our proposed research has strong public health relevance as it focuses on empowering a particular vulnerable population - low-income parents of children with special health care needs - to navigate our complex health delivery system and tests novel ways of communicating complex health information to this vulnerable population. We focus on understanding the information needs of this specific population of parents given the heightened health care needs of their children combined with the high risk of parental poor health literacy. Our work advances public health by engaging consumers in developing useful, actionable information about hospital care that can help guide their health care decisions and, ultimately, increase health equity.