Notice2022-26930
Supplemental Evidence and Data Request on Patient and Provider Level Strategies To Address Racial/Ethnic Disparities in Health and Healthcare
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
December 12, 2022
Issuing agencies
Health and Human Services DepartmentAgency for Healthcare Research and Quality
Abstract
The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from the public. Scientific information is being solicited to inform our review on Patient and Provider Level Strategies to Address Racial/ Ethnic Disparities in Health and Healthcare, which is currently being conducted by the AHRQ's Evidence-based Practice Centers (EPC) Program. Access to published and unpublished pertinent scientific information will improve the quality of this review.
Full Text
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<title>Federal Register, Volume 87 Issue 237 (Monday, December 12, 2022)</title>
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[Federal Register Volume 87, Number 237 (Monday, December 12, 2022)]
[Notices]
[Pages 76042-76044]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-26930]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Supplemental Evidence and Data Request on Patient and Provider
Level Strategies To Address Racial/Ethnic Disparities in Health and
Healthcare
AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.
ACTION: Request for supplemental evidence and data submissions.
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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is
seeking scientific information submissions from
[[Page 76043]]
the public. Scientific information is being solicited to inform our
review on Patient and Provider Level Strategies to Address Racial/
Ethnic Disparities in Health and Healthcare, which is currently being
conducted by the AHRQ's Evidence-based Practice Centers (EPC) Program.
Access to published and unpublished pertinent scientific information
will improve the quality of this review.
DATES: Submission Deadline on or before January 11, 2023.
ADDRESSES:
Email submissions: <a href="/cdn-cgi/l/email-protection#b3d6c3d0f3d2dbc1c29ddbdbc09dd4dcc5"><span class="__cf_email__" data-cfemail="3653465576575e4447185e5e4518515940">[email protected]</span></a>.
Print submissions:
Mailing Address: Center for Evidence and Practice Improvement,
Agency for Healthcare Research and Quality, ATTN: EPC SEADs
Coordinator, 5600 Fishers Lane, Mail Stop 06E53A, Rockville, MD 20857.
Shipping Address (FedEx, UPS, etc.): Center for Evidence and
Practice Improvement, Agency for Healthcare Research and Quality, ATTN:
EPC SEADs Coordinator, 5600 Fishers Lane, Mail Stop 06E77D, Rockville,
MD 20857.
FOR FURTHER INFORMATION CONTACT: Jenae Benns, Telephone: 301-427-1496
or Email: <a href="/cdn-cgi/l/email-protection#afcadfccefcec7ddde81c7c7dc81c8c0d9"><span class="__cf_email__" data-cfemail="3a5f4a597a5b52484b14525249145d554c">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: The Agency for Healthcare Research and
Quality has commissioned the Evidence-based Practice Center (EPC)
Program to complete a review of the evidence for Patient and Provider
Level Strategies to Address Racial/Ethnic Disparities in Health and
Healthcare. AHRQ is conducting this systematic review pursuant to
Section 902 of the Public Health Service Act, 42 U.S.C. 299a.
The EPC Program is dedicated to identifying as many studies as
possible that are relevant to the questions for each of its reviews. In
order to do so, we are supplementing the usual manual and electronic
database searches of the literature by requesting information from the
public (e.g., details of studies conducted). We are looking for studies
that report on Patient and Provider Level Strategies to Address Racial/
Ethnic Disparities in Health and Healthcare, including those that
describe adverse events. The entire research protocol is available
online at: <a href="https://effectivehealthcare.ahrq.gov/">https://effectivehealthcare.ahrq.gov/</a>.
This is to notify the public that the EPC Program would find the
following information on Patient and Provider Level Strategies to
Address Racial/Ethnic Disparities in Health and Healthcare helpful:
[ssquf] A list of completed studies that your organization has
sponsored for this indication. In the list, please indicate whether
results are available on <a href="http://ClinicalTrials.gov">ClinicalTrials.gov</a> along with the
<a href="http://ClinicalTrials.gov">ClinicalTrials.gov</a> trial number.
[ssquf] For completed studies that do not have results on
<a href="http://ClinicalTrials.gov">ClinicalTrials.gov</a>, a summary, including the following elements: study
number, study period, design, methodology, indication and diagnosis,
proper use instructions, inclusion and exclusion criteria, primary and
secondary outcomes, baseline characteristics, number of patients
screened/eligible/enrolled/lost to follow-up/withdrawn/analyzed,
effectiveness/efficacy, and safety results.
[ssquf] A list of ongoing studies that your organization has
sponsored for this indication. In the list, please provide the
<a href="http://ClinicalTrials.gov">ClinicalTrials.gov</a> trial number or, if the trial is not registered, the
protocol for the study including a study number, the study period,
design, methodology, indication and diagnosis, proper use instructions,
inclusion and exclusion criteria, and primary and secondary outcomes.
[ssquf] Description of whether the above studies constitute ALL
Phase II and above clinical trials sponsored by your organization for
this indication and an index outlining the relevant information in each
submitted file.
Your contribution is very beneficial to the Program. Materials
submitted must be publicly available or able to be made public.
Materials that are considered confidential, marketing materials, study
types not included in the review, or information on indications not
included in the review cannot be used by the EPC Program. This is a
voluntary request for information, and all costs for complying with
this request must be borne by the submitter.
The draft of this review will be posted on AHRQ's EPC Program
website and available for public comment for a period of 4 weeks. If
you would like to be notified when the draft is posted, please sign up
for the email list at: <a href="https://www.effectivehealthcare.ahrq.gov/email-updates">https://www.effectivehealthcare.ahrq.gov/email-updates</a>.
The technical brief will answer the following questions. This
information is provided as background. AHRQ is not requesting that the
public provide answers to these questions.
Guiding Questions
What is the current evidence for strategies targeted at patients
and provider/health professionals and designed to reduce racial and
ethnic disparities and improve health outcomes in the treatment of
common chronic conditions in adults?
a. What interventions have been studied?
b. What racial and ethnic populations have been studied?
c. What common (multiple and single) chronic conditions have been
studied?
d. What primary outcomes have been studied?
e. What are the reported effects of the strategies used in studies
of interventions to reduce disparities?
f. What are the reported unintended consequences, harms, or adverse
events of the strategies used in studies of interventions to reduce
disparities?
g. Within race/ethnic groups, what other intersectional influences
(e.g., disability status, income status, sexual identity and
orientation, income, geographic location, language etc) have been
targeted in studies of interventions to reduce disparities?
h. What study designs have been used?
i. What information is available on the applicability and
sustainability of interventions?
j. What gaps exist in the current research?
Questions for Experts/Researchers/Advocacy Organizations/Provider
Organizations/Practicing Clinicians
a. What patient-level and health professional-level efforts has
your organization, institution or practice employed to reduce racial
and ethnic disparities in chronic conditions healthcare and health
outcomes?
i. Can you describe the rationale for this effort, for instance
what problem was driving the decision to implement the solution/
intervention? Was the intervention successful or not? What were the
challenges? How are you measuring disparities and evaluating
interventions and outcomes as a result of them?
b. Do you engage community partnerships in your approach? If so,
how?
i. Are there similar approaches you are aware of? Which other
practice or provider is trying similar approaches?
c. Are there concepts, or conceptual frameworks, that are important
in understanding the patient-level and health professional-level
interventions to reduce racial/ethnic disparities in health and
healthcare?
d. How do you identify special groups that are not being served,
and how do you prioritize which groups for designing interventions for?
What are the challenges?
e. How does your organization tailor the patient-level and health
professional-level approach to reach racial and ethnic minorities that
may be
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marginalized due to other factors (such as disability status, income
status, sexual identity and orientation, income, geographic location,
language etc)? Which of these factors have been most challenging to
address and why? Which factors are relatively easy to address and
implement?
f. What concerns do you have about the sustainability of patient-
level and health professional-level strategies/interventions intended
to address racial and ethnic disparities in health and healthcare?
g. Gray literature: What are prominent sources where you obtain
information on patient-level and health professional-level strategies/
interventions? Who has conducted such interventions?
h. What information and resource does your organization or
institution need to be more effective in incorporating patient-level
and health professional-level interventions in reducing racial and
ethnic disparities in health and healthcare?
i. What are current gaps in the research and what future research
is needed most?
Questions for Patient Advocates, Families, Caregivers
a. Data clearly shows that racial and ethnic minority groups often
have worse health and care for chronic diseases. Why do you think this
is the case?
b. Have you or your loved ones experienced differences in care
received, are you aware of any health provider (that is doctor and
nurse) efforts to rectify these differences? What are the efforts/
programs?
c. Have you or your loved ones participated in (or are you aware
of) such program(s)? Was there any effort to consider your race and
other social factors (such as your disability status, income status,
sexual identity and orientation, income, geographic location, language
etc) in the program(s)?
d. Are you aware of community collaboration efforts of such
programs to rectify the differences in your health and care? Should
community organizations be involved in these efforts? How? What are
some barriers that community organizations face in collaborating with
healthcare organizations?
e. What types of efforts do you think your health provider (that is
doctor or nurse) could do that might reduce these differences in the
care received by racial and ethnic minority groups? What would be
needed for them to work? Are there things you could do as well? Give
example(s).
f. Are there sources where you obtain information about these
efforts?
PICOTS (Populations, Interventions, Comparators, Outcomes, and Settings)
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Element Included Excluded
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Population............. <bullet> Racial and <bullet> Pediatric
ethnic minority adults populations.
with common chronic <bullet> Non-U.S
conditions. populations.
<bullet> Health
Professionals
providing healthcare
for racial and ethnic
minority adults with
common chronic
conditions.
Interventions.......... <bullet> Strategies <bullet> Exploratory
specifically targeted sub-group analysis
to reduce racial and where the aims of the
ethnic minority health studies are not
and healthcare relevant to racial/
disparities at patient- ethnic health
level and health disparities.
professional-level, <bullet> Public health/
with relevant links to policy-based
healthcare system. interventions without
<bullet> Strategies relevant links to
with community healthcare system.
involvement with <bullet> Interventions
relevant links to aimed at medical
healthcare system. school students,
pharmacy students,
and other allied
health students.
Comparators............ <bullet> Standard care.
<bullet> Alternative
strategy/intervention..
Outcomes............... <bullet> Health-related
outcome measures
(e.g., disease
specific morbidity and
mortality, BP control,
Hba1c levels).
<bullet> Process of
care measures (e.g.,
referrals to mental
healthcare, cultural
relevance).
<bullet> Care
utilization outcome
measures (e.g., rates
of readmission for
long-term
complications of
diabetes).
<bullet> Financial/re-
imbursement measures..
<bullet> Harms (e.g.,
unintended negative
consequences,
including
misallocation of
effort, decreased
patient satisfaction,
etc.).
<bullet> Stigma other
related experience of
discrimination..
Timing................. Any.
Settings............... Any.
Study design........... Randomized controlled Stand-alone
trial, non-randomized qualitative studies,
controlled trial, systematic reviews,
nonrandomized study narrative reviews,
designs, mixed methods. case reports, case
series protocols,
conference abstracts.
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Dated: December 7, 2022.
Marquita Cullom,
Associate Director.
[FR Doc. 2022-26930 Filed 12-9-22; 8:45 am]
BILLING CODE 4160-90-P
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