Evaluation of ARRA Comparative Effectiveness Research Dissemination Contract Efforts - Section 3

3.1 Demographics of Consumer Respondents

The survey asked consumer respondents to provide basic demographic information (refer to Appendix B: Consumer Survey, questions 47-55). Interviewers asked respondents to report the following demographic variables: age, sex, race, ethnicity and enrollment in Medicare and/or Medicaid. Respondents also indicated if they are currently seeking medical care, provide care for another person with a medical condition, or are a member of a patient group.

The age distribution of respondents was as follows: 43 percent were aged 18 to 44 years of age, 36 percent were 45 to 64 years of age, and 20 percent were 65 years of age or older. Approximately 55 percent of the respondents were male, 76 percent of the respondents identified as "White," 31 percent reported themselves to be Medicare beneficiaries, and 15 percent reported that they were covered by Medicaid. Exhibit 9 summarizes the remaining demographic characteristics of the consumer survey respondents and includes national percentages of each population to provide a frame of reference.

Exhibit 9. Demographic Characteristics of the Consumer Survey Respondents

Return to Contents

3.2 Consumer Level of Awareness

3.2.1 Unaided Awareness of the Concept of Comparing Treatment Options among Consumers

The first set of questions on the consumer survey elicited information on consumers' unaided awareness of the concept of comparing treatment options. No definition or description of CER was provided prior to asking the initial or "unaided" awareness questions. Exhibit 10 shows the unaided awareness level of the consumer survey respondents. Approximately two-thirds of respondents (65 percent) reported that they had "heard of the concept of comparing health care treatments with your clinician to decide what options will work best for you." A smaller group, 45 percent, reported awareness of "research that can help compare treatment choices;" 52 percent were unaware of such research.

Exhibit 10. Consumer Respondents' Unaided Awareness of the Concept of Comparing Treatment Options⁹

Of the respondents who reported awareness of research comparing treatment options, 11 percent (n=34) indicated that they had heard of the research referred to "by a specific name." Of those who had heard of the research referred to by a specific name, only two respondents knew it as "comparative effectiveness research" and two identified this research as "patient-centered outcomes research," "PCOR," or "shared decisionmaking."

The IMPAQ team used a Chi-Square test to determine whether there were significant differences among different demographic groups and their unaided awareness of CER. Respondents who were between 18 and 44 years old (compared to aged 45 and older respondents), White (compared to Black and other races), and female (compared to male) were statistically more likely to be aware of CER. Medicare beneficiaries, who comprised 31 percent of the consumer respondents, were statistically less likely than their non-enrollee counterparts to be aware of CER. Medicaid beneficiaries, who constituted 15 percent of consumer respondents, were also statistically less likely than non-enrollees to indicate unaided awareness of CER. Go to Appendix M (Exhibits M-1 – M-2) for the cross-tabulations.

3.2.2 Aided Awareness of CER among Consumers

To assess aided awareness of CER, the interviewers provided a definition of CER to respondents and then asked them if they had "ever heard of the existence of research that helps you compare treatment options." Approximately 21 percent of respondents said they had, while 77 percent indicated that they were either unaware of CER. Exhibit 11 shows the aided awareness level of the consumer survey respondents.

Exhibit 11. Consumer Respondents' Aided Awareness of CER¹⁰

Of the 174 respondents indicating aided awareness of such research, 58 percent reported that they heard about it within the last nine months. Fifty-two percent indicated that the "information was related to a specific medical condition," while 86 percent indicated that they are "aware that there is research on the evaluation of treatment options for specific medical conditions."

As shown in Exhibit 12, when asked how they heard about this research, 21 percent of respondents who reported aided awareness cited print media as their primary source of information. Respondents indicated Web sites (19 percent) as the second most common source, followed by television/radio (19 percent) and their health care provider (18 percent).

Exhibit 12. Where Consumer Respondents Reporting Aided Awareness Learned of CER¹¹

*Wherever applicable, responses in the "Other" category were recoded into one of the existing categories.

The IMPAQ team used a Chi-Square test to determine whether there were significant differences among demographic groups and their aided awareness of CER. Similar to statistical findings for unaided awareness, respondents who are between 45 to 64 years old (compared to aged 18 to 44 and 65 and older respondents), Black (compared to White and other races), and female (compared to male) were statistically more likely to report aided awareness of CER. Medicare beneficiaries were statistically less likely than their non-enrollee counterparts to be aware of CER. Medicaid beneficiaries were also statistically less likely than non-enrollees to indicate awareness of CER. Go to Appendix M (Exhibits M-3) for the cross-tabulations.

3.2.3 Awareness of the Effective Health Care Program among Consumers

Of the 948 survey respondents, 11 percent reported having heard of AHRQ prior to the survey; seven percent of respondents reported that they had heard of the EHC Program, and three respondents had visited its Web site.

Return to Contents

3.3 Consumer Level of Knowledge and Understanding

Those indicating that they had become aware of CER through their health care provider (n=40) were asked if their provider started the discussion. Of these, 21 respondents, or 51 percent, indicated that their provider had initiated the conversation about CER. Of respondents who learned about CER from a source other than a health care provider (n=134), 97 percent reported that they "understand how this research can be useful."

Interviewers asked respondents who reported awareness (unaided or aided) of CER and/or the EHC Program (n=598) if they could describe the idea of evaluating treatment options to a family member or friend; 68 percent indicated that they could.

Return to Contents

3.4 Consumer Attitudes and Perceived Benefits of CER

3.4.1 Perceived Benefits of CER among Consumers

A majority of the 598 respondents who indicated awareness (unaided or aided) of CER and/or the EHC Program reported positive perceived benefits of CER (Exhibit 13). Eighty-eight percent of respondents who indicated unaided or aided awareness reported that evaluating treatment options provides information to help "make good medical health care choices;" similarly, 88 percent reported that evaluating treatment options "allows patients and doctors to make choices based on the needs of individual patients." In addition, 81 percent indicated that decisions reached after evaluating treatment options "lead to better health outcomes for patients," and 44 percent indicated that decisions reached after evaluating treatment options "lowers medical expenses/costs."

Exhibit 13. Perceived Benefits of CER among "Aware"¹² Consumer Respondents¹³

3.4.2 Interest in Learning about CER among Consumers

As shown in Exhibit 14, the majority of the 948 respondents were interested in evaluating treatment options before making medical decisions (74 percent), while fewer were interested in learning more about evaluating treatment options for specific conditions (51 percent). More than half of the respondents (58 percent) expressed interest in learning about the EHC Program.

Exhibit 14. Interest in Learning More about CER among Consumer Respondents¹⁴

Return to Contents

3.5 Consumer Level of Behavior Change and Use of CER

3.5.1 Use of CER among Consumers

Of the 598 respondents who indicated awareness (unaided or aided) of CER and/or the EHC Program, 52 percent currently use research to help make medical decisions (Exhibit 15). If they were not currently using CER, interviewers asked if respondents had ever used it to help make a medical decision and 21 percent (n=308) reported that they had used it in the past. Of that group, 51 respondents indicated that they used it more than twelve months ago while 32 respondents reported that they used it within the last twelve months.

Using a Chi-Square test to determine whether there were significant differences among different demographic groups and their current use of CER, the team found that 18 to 44 year olds (compared to respondents aged 45 and older), Blacks (compared to Whites and other races), and females (compared to males) were statistically significantly more likely to use CER. Medicare beneficiaries were statistically more likely than their non-Medicare enrollee counterparts to use CER; however, Medicaid beneficiaries were statistically less likely than non-enrollees to report use of CER. Go to Appendix M (Exhibit M-4) for the cross-tabulations.

Exhibit 15. "Aware"¹⁵ Consumer Respondents' Current or Previous Use of Research Comparing Treatment Options¹⁶

Additionally, the IMPAQ team found that 11 percent of the 598 respondents reporting awareness (unaided or aided) of CER and/or the EHC Program indicated that they were also aware of AHRQ's consumer summaries, which are available from AHRQ's EHC Program Web site. Of the 70 respondents who were aware of the consumer summaries, 26 individuals reported actually using them when making health care decisions.

The IMPAQ team used a Chi-Square test to determine whether there were significant differences among different demographic groups and their awareness of consumer summaries. The team found that respondents who were 65 years and older (compared to 18 to 64 year olds), Black (compared to Whites and other races), and female (compared to males) were statistically more likely to be aware of consumer summaries. Medicare beneficiaries were statistically more likely than non-enrollees to be aware of consumer summaries. Similarly, Medicaid beneficiaries were statistically more likely than non-enrollees to indicate awareness of consumer summaries. Go to Appendix M (Exhibit M-5) for the cross-tabulations.

We asked all 598 respondents who reported awareness (unaided or aided) of CER and/or the EHC Program where they prefer to obtain medical information. As shown in Exhibit 16, most identified a health care provider (73 percent) and the Internet (58 percent).

Exhibit 16. Where "Aware"¹⁷ Consumer Respondents Prefer to Get Medical Information¹⁸

3.5.2 Intention to use CER among Consumers

As shown in Exhibit 17, 45 percent of all 948 respondents indicated that they intend to use either AHRQ's consumer summaries or other studies that evaluate treatment options within the next year to prepare for a medical visit or make medical decisions for themselves, a family member, or a close friend.

The IMPAQ team used a Chi-Square test to determine whether there were significant differences among different demographic groups and their intention to use consumer summaries. The team found that 18 to 44 year olds (compared to aged 45 and older respondents), Black respondents (compared to Whites and other races), and females (compared to males) were more likely to report an intention to use consumer summaries. Medicare beneficiaries were statistically less likely than their non-enrollee counterparts to report intention to use consumer summaries. However, Medicaid beneficiaries were statistically more likely than non-enrollees to indicate intention to use consumer summaries. Go to Appendix M (Exhibit M-6) for the cross-tabulations.

Exhibit 17. Intention to Use CER among Consumer Respondents¹⁹

Return to Contents

3.6 Consumer Exposure to Dissemination Strategies

Of the 559 respondents who reported unaided and/or aided awareness of CER, 11 percent indicated that, in the past six months, they had seen links to the EHC Program Web site or information comparing treatment options on a Web site. Of the 413 respondents who reported that they were a member of an organization that provides information about health care, 17 percent said the organization informed them about the EHC Program or about CER.

⁹ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹⁰ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹¹ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹² "Aware" refers to those respondents who indicated unaided or aided awareness of CER and/or awareness of the EHC Program.

¹³ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹⁴ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹⁵ "Aware" refers to those respondents who indicated unaided or aided awareness of CER and/or awareness of the EHC Program.

¹⁶ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹⁷ "Aware" refers to those respondents who indicated unaided or aided awareness of CER and/or awareness of the EHC Program.

¹⁸ Note: Frequencies reflect raw numbers; percentages shown are weighted.

¹⁹ Note: Frequencies reflect raw numbers; percentages shown are weighted.

Return to Contents

Proceed to Next Section