Discovering the Full Spectrum of Cardiovascular Disease

Yancey, Antronette K.; Robinson, Robert G.; Ross, Robert K.; Washington, Reginald L.; Goodell, Heather R.; Goodwin, Norma J.; Benjamin, Elisabeth; Langie, Rosa G.; Galloway, James M.; Carroll, Lewis; Kong, B. Waine; Leggett, Christopher J.W.B.; Williams, Richard; Wong, Michael

doi:10.1161/01.cir.0000157744.30181.ff

Cited by 22 publications

(11 citation statements)

References 47 publications

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“…110 Qualitative approaches can also inform the development of tailored intervention strategies for areas of high disease risk and burden for ethnic/racial minority groups. 111 Finally, ensuring patient safety, including reduction of misuse of medical therapies and oversights in the course of clinical care, has been identified as a priority. Patient and provider views on sensitive healthcare quality issues such as adverse events and medical errors are topics well suited for qualitative investigation.…”

Section: Future Directions For Outcomes Research On Cardiovascular DImentioning

confidence: 99%

Qualitative and Mixed Methods Provide Unique Contributions to Outcomes Research

2009

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O utcomes research examines the effects of medical care interventions and policies on the health outcomes of individuals and society. 1 Investigators conducting outcomes research seek to inform the development of clinical practice guidelines, to evaluate the quality of medical care, and to foster effective interventions to improve the quality of care. 2 Outcomes research has traditionally used quantitative sciences to examine the utilization, cost, and clinical effectiveness of medical care through randomized and nonrandomized experimental designs. Quantitative methods are not as well suited to measure other complex aspects of the healthcare delivery system, such as organizational change, clinical leadership in implementing evidence-based guidelines, and patient perceptions of quality of care, which are also critical issues in outcomes research. [3][4][5][6][7] These more nuanced aspects of healthcare delivery may be most appropriately examined with qualitative research methods. 8 -10 Qualitative approaches are becoming more common in clinical medicine and health services research. 5,[11][12][13][14][15] Federal encouragement of qualitative research is regularly reflected in funding program announcements issued by the National Institutes of Health. 16 For more than a decade, federal agencies and foundations such as the National Science Foundation have demonstrated a commitment to supporting qualitative research through funding scientific conferences, workshops, and monographs on this field of inquiry. [17][18][19][20] Despite this steady growth in qualitative research, outcomes investigators in cardiology have relatively little guidance on when and how best to implement these methods in their investigations.The purpose of the present report is to introduce qualitative methods as providing unique and critical contributions to outcomes research. This report will describe the situations in which qualitative approaches are most helpful; summarize the primary principles and practices in study design, sampling, data collection, and data analysis for qualitative studies; present representative examples of cardiovascular outcomes research that uses qualitative methods; and synthesize current standards for ensuring rigor and enhancing credibility of qualitative research. Defining Qualitative ResearchQualitative research is a form of scientific inquiry that spans different disciplines, fields, and subject matter and comprises many varied approaches. 21 Qualitative methods can be used to understand complex social processes, to capture essential aspects of a phenomenon from the perspective of study participants, 5 and to uncover beliefs, values, and motivations that underlie individual health behaviors. [22][23][24] Such research can also illuminate aspects of organizational context and healthcare delivery that influence organizational performance and quality of care. 10,25 Qualitative studies are often exploratory in nature and seek to generate novel insights 9,23,26,27 using inductive (starting with observations and dev...

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Section: Future Directions For Outcomes Research On Cardiovascular DImentioning

confidence: 99%

Qualitative and Mixed Methods Provide Unique Contributions to Outcomes Research

2009

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“…The issues are complex, in large part because the genesis of disparities in health care is multifactorial, involving differences in access to care, health behaviors across populations, cultural and environmental factors, socioeconomics, genetics, and, perhaps, bias. 39,40 For example, an AHA-commissioned analysis of the National Health Interview Survey found that nonwhites and Hispanics with cardiovascular diseases and stroke are more likely to be uninsured than their Caucasian counterparts. 17 As a result, healthcare reform initiatives should incorporate a multifaceted approach to addressing these issues.…”

Section: Discussionmentioning

confidence: 99%

The American Heart Association’s 2008 Statement of Principles for Healthcare Reform

Gibbons¹,

Jones²,

Gardner

et al. 2008

Circulation

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“…(Koplan and Dietz 1999;French, Story et al 2001;Kumanyika 2001;Kersh and Morone 2002;Yancey, Kumanyika et al 2004;Yancey, Robinson et al 2005) Table 1 Descriptive statistics for fully enrolled study participants at baseline …”

Section: Discussionmentioning

confidence: 99%

“…(Colditz and Mariani 2000;French, Story et al 2001;Kersh and Morone 2002;Sturm 2002;Chou, Grossman et al 2004;Swinburn, Gill et al 2005) Addressing the acceleration of this epidemic is particularly important to efforts to eliminate health disparities, as obesity is a primary driver of chronic disease disparities such as cardiovascular diseases, Type 2 diabetes mellitus, and certain cancers. (Kumanyika 1987;Pi-Sunyer 1991;McGinnis and Foege 1993;Myers, Kagawa-Singer et al 1995;Koplan and Dietz 1999;Mokdad, Serdula et al 1999;Smith, Clark et al 2005;Yancey, Robinson et al 2005) African-American women have higher rates of obesity and more severe levels of obesity compared with other major ethnic-gender groups (Kuczmarski, Flegal et al 1994;National Institutes of Health NHLBI 1998) and are at greater risk of death from obesity-related cancers such as breast cancer and colon cancer. (Jemal, Clegg et al 2004) Both dietary and physical activity patterns contribute to this disparity, (United States.…”

Section: Introductionmentioning

confidence: 99%

Fighting cancer with fitness: Dietary outcomes of a randomized, controlled lifestyle change intervention in healthy African–American women

McCarthy¹,

Yancey

Harrison

et al. 2007

Preventive Medicine

Self Cite

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Objectives-This study tested the efficacy of an eight-week, culturally targeted community-based nutrition and physical activity promotion intervention, Fight Cancer with Fitness! (FCF).Methods-A randomized, controlled trial was conducted in a black-owned commercial gym in a sample of 366 predominantly overweight or obese, healthy African-American women.Results-Dietary quality as indexed by fruit and vegetable intake improved significantly in the intervention group compared to the control group at 12 months follow-up, and proportion of calories consumed as fat decreased in both groups.Conclusions-This individually-targeted cancer prevention intervention produced beneficial effects on dietary quality that were sustained for at least 12 months.

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Discovering the Full Spectrum of Cardiovascular Disease

Cited by 22 publications

References 47 publications

Qualitative and Mixed Methods Provide Unique Contributions to Outcomes Research

Qualitative and Mixed Methods Provide Unique Contributions to Outcomes Research

The American Heart Association’s 2008 Statement of Principles for Healthcare Reform

Fighting cancer with fitness: Dietary outcomes of a randomized, controlled lifestyle change intervention in healthy African–American women

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