Papers by Beverly Weidmer
Health Services and Outcomes Research Methodology, 2001
Hospital tumor registries may permit efficient identification of relatively large numbers of pati... more Hospital tumor registries may permit efficient identification of relatively large numbers of patients for clinical and health services research. This study investigates the feasibility and cost of using hospital tumor registry data for identifying cancer patients with particular clinical characteristics, corresponding to the protocol entry criteria of four randomly sampled Phase III clinical treatment trials for cancer. We screened tumor registry data on 717 patients diagnosed with cancer in 1997 and 1998 who had been identified and abstracted by the registry of a large academic medical center by April, 1999; and we abstracted the medical records of the 122 patients who passed the registry screen. For each clinical profile, the registry screen eliminated a substantial fraction of patients who did not meet the relevant criteria. Of the patients identified from the tumor registry as potential matches, 41% matched the relevant clinical profile based on detailed medical records review. The cost and effort of the registry-based method were substantially lower than would have been necessary if we had reviewed medical records without the registry screen, suggesting that tumor registry data can be a relatively efficient tool for identifying research subjects.
Journal of Adolescent Health, 2010
To examine the perspectives of publicly insured adolescents and their parents on ways to encourag... more To examine the perspectives of publicly insured adolescents and their parents on ways to encourage adolescent utilization of preventive health services.We conducted eight focus groups with 77 adolescents enrolled in a large Medicaid managed care plan in Los Angeles County, California, and two focus groups with 21 of their parents. Discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis.Adolescents and parents reported that the most effective way to encourage preventive care utilization among teens was to directly address provider-level barriers related to the timeliness, privacy, confidentiality, comprehensiveness, and continuity of their preventive care. They reported that incentives (e.g., cash, movie tickets, gift cards) might also be an effective way to increase preventive care utilization. To improve adolescent receipt of surveillance and guidance on sensitive health-related topics, most adolescents suggested that the best way to encourage clinician–adolescent discussion was to increase private face-to-face discussions with a clinician with whom they had a continuous and confidential relationship. Adolescents reported that the use of text messaging, e-mail, and Internet for providing information and counseling on various sensitive health-related topics would also encourage adolescent utilization of preventive health services. Parents, however, more often preferred that their teen receive these services through in-office discussions and clinician-provided brochures.State agencies, health plans, clinics, and individual providers may consider focusing their efforts to improve adolescents' utilization of preventive services on basic structural and quality of care issues related to the clinician–patient relationship, access to services, and confidentiality.
Journal of Health Care for The Poor and Underserved, 2009
Objective. Develop a culturally appropriate, reliable, and valid survey that can be used by the C... more Objective. Develop a culturally appropriate, reliable, and valid survey that can be used by the Choctaw Nation Health Services (CNHS) to compare patients' health care experiences across CNHS clinics, and to support quality improvement efforts. Methods. We worked with CNHS staff to adapt the CAHPS Clinician and Group Survey for this purpose. We conducted cognitive interviews and a field-test to evaluate the survey. results. Cognitive testing yielded a survey that covered issues relevant to CNHS patients. Field testing yielded 696 surveys, (58% response rate). Analyses provided support for internal consistency of multi-item scales. Correlations among scales indicate the scales were related to one another but not redundant. Discussion. The CAHPS American Indian Survey is useful for assessing perceptions of care at the clinic level and across different clinics. The close partnership with CNHS helped yield a survey that is scientifically sound, reflects how services are organized and delivered locally, and meets CNHS information needs.
Journal of Health Care for The Poor and Underserved, 2009
Objective. Develop a culturally appropriate, reliable, and valid survey that can be used by the C... more Objective. Develop a culturally appropriate, reliable, and valid survey that can be used by the Choctaw Nation Health Services (CNHS) to compare patients' health care experiences across CNHS clinics, and to support quality improvement efforts. Methods. We worked with CNHS staff to adapt the CAHPS Clinician and Group Survey for this purpose. We conducted cognitive interviews and a field-test to evaluate the survey. results. Cognitive testing yielded a survey that covered issues relevant to CNHS patients. Field testing yielded 696 surveys, (58% response rate). Analyses provided support for internal consistency of multi-item scales. Correlations among scales indicate the scales were related to one another but not redundant. Discussion. The CAHPS American Indian Survey is useful for assessing perceptions of care at the clinic level and across different clinics. The close partnership with CNHS helped yield a survey that is scientifically sound, reflects how services are organized and delivered locally, and meets CNHS information needs.
Violence Against Women, 2007
This product is part of the RAND Corporation reprint series. RAND reprints present previously pub... more This product is part of the RAND Corporation reprint series. RAND reprints present previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints have been formally reviewed in accordance with the publisher's editorial policy, and are compliant with RAND's rigorous quality assurance standards for quality and objectivity.
American Journal of Evaluation, 2006
This product is part of the RAND Corporation reprint series. RAND reprints present previously pub... more This product is part of the RAND Corporation reprint series. RAND reprints present previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints have been formally reviewed in accordance with the publisher's editorial policy, and are compliant with RAND's rigorous quality assurance standards for quality and objectivity.
Journal of Health Care for The Poor and Underserved, 2009
Objective. Develop a culturally appropriate, reliable, and valid survey that can be used by the C... more Objective. Develop a culturally appropriate, reliable, and valid survey that can be used by the Choctaw Nation Health Services (CNHS) to compare patients' health care experiences across CNHS clinics, and to support quality improvement efforts. Methods. We worked with CNHS staff to adapt the CAHPS Clinician and Group Survey for this purpose. We conducted cognitive interviews and a field-test to evaluate the survey. results. Cognitive testing yielded a survey that covered issues relevant to CNHS patients. Field testing yielded 696 surveys, (58% response rate). Analyses provided support for internal consistency of multi-item scales. Correlations among scales indicate the scales were related to one another but not redundant. Discussion. The CAHPS American Indian Survey is useful for assessing perceptions of care at the clinic level and across different clinics. The close partnership with CNHS helped yield a survey that is scientifically sound, reflects how services are organized and delivered locally, and meets CNHS information needs.
International Journal of Std & Aids, 2002
Antiretroviral medications for HIV infection can be combined into dozens of recommended regimens.... more Antiretroviral medications for HIV infection can be combined into dozens of recommended regimens. However, little is known about patient preferences regarding antiretroviral therapy. We assessed the impact of clinicianmutable adherence barriers by conducting four patient focus groups (two English and two Spanish) consisting of 30 patients that focused discussion on antiretroviral treatment preferences. We also surveyed antiretroviral treatment preference from 31 subjects using the method of paired comparisons in which subjects indicated their preferences of regimen potency, pill burden, inconvenience, and side-effects using a 10-point rating scale. We found that most patients would tolerate severe side-effects, inconvenience, and large pill burden to have a potent antiretroviral regimen. In our population, patients generally preferred regimens with fewer side-effects to those with less inconvenience. Pill burden was of least importance among the domains studied. These preferences should be considered when selecting a regimen and developing interventions to improve antiretroviral adherence and patient outcomes.
Provision of "culturally competent" medical care is one of the strategies advocated for reducing ... more Provision of "culturally competent" medical care is one of the strategies advocated for reducing or eliminating racial and ethnic health disparities. This report identifies five domains of culturally competent care that can best be assessed through patients' perspectives: 1) patient-provider communication; 2) respect for patient preferences and shared decision-making; 3) experiences leading to trust or distrust; 4) experiences of discrimination; and 5) linguistic competency. The authors review the literature focusing on these domains, summarize the salient issues and current knowledge, and discuss the policy and research implications. Incorporating patients' perspectives on culturally and linguistically appropriate services into current measures of quality will provide important data and create opportunities for providers and health plans to make improvements.
Hispanic Journal of Behavioral Sciences, 2003
This study describes the psychometric properties of the Consumer Assessments of Health Plans Surv... more This study describes the psychometric properties of the Consumer Assessments of Health Plans Survey (CAHPS) in 279 persons who completed it in Spanish and 439 persons who completed it in English. We found negatively skewed distributions of responses and sig-nificant ...
Provision of "culturally competent" medical care is one of the strategies advocated for reducing ... more Provision of "culturally competent" medical care is one of the strategies advocated for reducing or eliminating racial and ethnic health disparities. This report identifies five domains of culturally competent care that can best be assessed through patients' perspectives: 1) patient-provider communication; 2) respect for patient preferences and shared decision-making; 3) experiences leading to trust or distrust; 4) experiences of discrimination; and 5) linguistic competency. The authors review the literature focusing on these domains, summarize the salient issues and current knowledge, and discuss the policy and research implications. Incorporating patients' perspectives on culturally and linguistically appropriate services into current measures of quality will provide important data and create opportunities for providers and health plans to make improvements.
Hispanic Journal of Behavioral Sciences, 2003
This study describes the psychometric properties of the Consumer Assessments of Health Plans Surv... more This study describes the psychometric properties of the Consumer Assessments of Health Plans Survey (CAHPS) in 279 persons who completed it in Spanish and 439 persons who completed it in English. We found negatively skewed distributions of responses and sig-nificant ...
Journal of The American Academy of Child and Adolescent Psychiatry, 2003
The complexity of health information often exceeds patients' skills to understand and use it.
The complexity of health information frequently exceeds patients' skills to understand and use it... more The complexity of health information frequently exceeds patients' skills to understand and use it. Improvement in hospital communication has the potential to improve the quality of care.
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Papers by Beverly Weidmer