[Federal Register Volume 71, Number 199 (Monday, October 16, 2006)]
[Notices]
[Pages 60711-60712]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-8674]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


Request for Measures of Consumers' Assessment of Cultural 
Competency

AGENCY: Agency for Healthcare Research and Quality (AHRQ), DHHS.

ACTION:  Notice of request for measures.

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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is 
soliciting the submission of instruments or items that measure patient 
perspectives on the cultural awareness of the healthcare professionals 
providing care to those patients. This initiative is in response to the 
need to develop a new CAHPS[supreg] cultural competency survey. AHRQ is 
interested in incorporating this survey into an integrated set of 
carefully tested, standardized survey questionnaires and accompanying 
reports. The addition of the CAHPS[supreg] cultural competency 
component to the set is intended to empower consumers with quality of 
care information while also encouraging healthcare professionals to 
provide culturally competent care. The survey will be designed to 
assess the quality of care and services provided by healthcare 
professional in the context of cultural competency.
    Based on prior work, there are several functional areas that the 
planned instrument could assess such as: (1) Patient-provider 
communication (e.g., providers give clear explanations, patients feel 
that they get all the information they need,), (2) respect for patient 
preferences/shared decision-making (e.g., providers discuss pros and 
cons of treatment options, providers understand and takes into account 
patient's environment, family members are appropriately included in 
decisions), (3) experiences leading to trust or distrust (e.g., 
providers treat patients in a culturally sensitive or insensitive 
manner that led to trust or distrust), (4) experiences of 
discrimination (e.g., providers or staff treat patients with disrespect 
because of a patients' racial/ethnic backgrounds, insurance type/
status, lack of proficiency in English), (5) language access (e.g., 
availability of interpreter services and translated materials), and (6) 
alternative treatment (e.g., providers are open to discussion about 
traditional healers and remedies).

DATES: Please submit instruments or individual items and supporting 
information on or before November 15, 2006. AHRQ will not respond 
individually to submitters, but will consider all submitted instruments 
and publicly report the results of the review of the submissions in 
aggregate.

ADDRESSES: Submissions should include a brief cover letter, copy of the 
instrument or items for consideration and supporting information as 
specified under the Submission Criteria below. Submissions may be in 
the form of a letter or e-mail, preferably with an electronic file as 
an e-mail attachment. Responses to this request should be submitted to: 
Anna Caponiti, Center for Quality Improvement and Patient Safety, 
Agency for Healthcare Research and Quality, 540 Gaither Road, 
Rockville, MD 20850, Phone: (301) 427-1402, Fax: (301) 427-1341, E-
mail: <a href="/cdn-cgi/l/email-protection#37565959561954564758595e435e77565f4546195f5f4419505841"><span class="__cf_email__" data-cfemail="50313e3e317e3331203f3e39243910313822217e3838237e373f26">[email protected]</span></a>.
    To facilitate handling of submissions, please include full 
information about the instrument developer or contact: (a) Name, (b) 
title, (c) organization, (d) mailing address, (e) telephone number, (f) 
fax number, and (g) e-mail address. Also please submit a copy of the 
instrument or items for consideration along with evidence that they 
meet the criteria below. It would be appreciated if each citation of a 
peer-reviewed journal article pertaining to the instrument includes the 
title of the article, author(s), publication year, journal name, 
volume, issue, and page numbers where article appears, but all of these 
details are not required. Submitters must also provide a statement of 
willingness to grant to AHRQ the right to use and authorize others to 
use submitted measures and their documentation as part of a 
CCAHPS[supreg]-trademarked instrument. This CAHPS[supreg] instrument 
for patients' perspectives on cultural competency of healthcare 
professionals provision of care will be made publicly available, free 
of charge. Electronic submissions are encouraged.

FOR FURTHER INFORMATION CONTACT: Anna Caponiti, at the address above.

SUPPLEMENTARY INFORMATION: 

Background Information

    The CAHPS[supreg] program was initiated in 1995 to develop a survey 
and report on consumers' perspectives on the quality of their health 
plans. Since that time, the CAHPS[supreg] program, in partnership with 
the Centers for Medicare and Medicaid Services (CMS) and others, has 
expanded its scope and developed

[[Page 60712]]

consumer surveys and reports regarding consumer perspectives on 
individual clinicians, group practices, in-center hemodialysis 
services, nursing homes and hospitals. AHRQ determined that the 
CAHPS[supreg] team should develop a survey to obtain consumer 
perspectives on cultural awareness of healthcare professionals.
    The vision of the Agency for Healthcare Research and Quality is to 
foster health care research that helps the American health care system 
provide access to high-quality, cost-effective services; be accountable 
and responsive to consumers and purchasers; and improve health status 
and quality of life. The CAHPS[supreg] program was developed as a 
result of AHRQ's vision. One of the components missing from the current 
measurement set is an assessment of patients' perspective on cultural 
awareness of healthcare professionals.

Submission Criteria

    Instruments submitted should focus on patient perspectives on the 
quality of care and services provided by healthcare professionals in 
the context of cultural awareness demonstrated by those healthcare 
professionals.
    AHRQ is interested in measures that: (a) Capture patients' 
experiences of quality of received health care in the context of 
healthcare professionals' cultural awareness and (b) demonstrate a high 
degree of reliability and validity. Accordingly, each submission should 
include, in addition to the name of the pertinent instrument, domains 
included, and the language(s) the instrument is available in, the 
following information: Evidence of cultural/cross group comparability, 
if any; instrument reliability (internal consistency, test-retest, 
etc.); validity (content, construct, criterion-related); response 
rates; methods and results of cognitive testing and field-testing as 
well as descriptions of sampling strategies (including payer type) and 
data collection protocols, including such elements as mode of 
administration, use of advance letters, timing and frequencies of 
contacts. Evidence addressing these criteria should be demonstrated 
through submission of peer-reviewed journal article(s) or through the 
best evidence available at the time of submission.
    In addition, a list of where the instrument has been fielded should 
also be included in the submission. Submission of copies of existing 
report formats developed to disclose findings to consumers and 
providers is desirable, but not required. Additionally, information 
about existing database(s) for the instrument(s) submitted is helpful, 
but not required for submission.
    Submitters' willingness to grant to AHRQ the right to use and 
authorize others to use their instrument or item and accompanying 
explanatory material means that the CAHPS[supreg] trademark will be 
applied to a new instrument which will combine the best features of the 
submissions as well as any ideas that may develop from reviewing them. 
It also ensures free access to this instrument and the instrument's 
supportive/administrative information. AHRQ, in collaboration with 
CAHPS grantees, will evaluate all submitted instruments or items. As 
the CAHPS instrument is constructed, one or more items may be selected 
for use, either in whole or in part, or modified, prior to testing 
them. AHRQ will assume responsibility for the final instruments as well 
as any future modifications.
    The final instrument will bear the CAHPS[supreg] trademark and it 
will be made available without charge for use by all interested 
parties. Submitters will have relinquished ownership of any items that 
appear in the final instrument. However, item ownership will be 
protected during testing of the survey. As a matter of quality control, 
there will be warnings that the CAHPS[supreg] trademark or 
identification may not be used if any changes are made to the 
instrument or final measure set without review and permission of the 
Agency.

    Dated: October 5, 2006.
Carolyn M. Clancy,
Director.
[FR Doc. 06-8674 Filed 10-13-06; 8:45 am]
BILLING CODE 4160-90-M


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