Publications

The Right Question Institute is an emerging thought leader for addressing the key challenges of improving education, increasing patient activation in healthcare, and making democracy work better. To complement our initiatives in these areas, we publish books, articles, blog posts, research papers, and make media appearances.

Books

Make Just One Change: Teach Students to Ask Their Own Questions
Dan Rothstein and Luz Santana, Foreword by Wendy D. Puriefoy
[http://www.hepg.org/hep/book/144]

Microdemocracy: A New Starting Point for Democratic Action (in progress)

Education Articles

Teaching Students to Ask Their Own Questions: One small change can yield big results
Dan Rothstein and Luz Santana
Harvard Education Letter: Volume 27, Number 5
 Sept/Oct 2011
[http://www.hepg.org/hel/article/507]

Setting Off and Sustaining Sparks of Curiosity and Creativity
Dan Rothstein
Voices in Education: The Blog of Harvard Education Publishing. January 13, 2012
[http://www.hepg.org/blog/69]

Sharing the Power of the Question
Dan Rothstein and Luz Santana
ASCD Express: What Does a Whole Child Approach to Education Look Like? March 29, 2012. Volume 7, Issue 13.
[http://www.ascd.org/ascd-express/vol7/713-rothstein.aspx]

Radio Interviews & Podcasts

Here & Now: Educators Want Students To Ask The Questions
Interview with Dan Rothstein and Luz Santana by Robin Young

August 23, 2012
[http://hereandnow.wbur.org/2012/08/23/educators-students-ask]

TEDx Talk by Dan Rothstein
March 4, 2012
[https://dev.rightquestion.org/blog/giving-tedx-talk/]

Harvard EdCast: Make Just One Change
Interview with Co-Authors Dan Rothstein and Luz Santana

By Matt Weber
[http://www.gse.harvard.edu/news-impact/2011/11/harvard-edcast-make-just-one-change/]

CBS News Interview: Dan Raviv
October 2011

Healthcare Publications

Alegría, M., Polo, A., Gao, S., Santana, L., Rothstein, D., Jimenez,
A., Hunter, M.L., Mendieta, F., Oddo, V., Normand, S.L. (2008).
Evaluation of a patient activation and empowerment intervention in
mental health care. Med Care, 46(3), 247-56.
Read article summary:

The Cambridge Health Alliance Center for Multicultural Health Research delivered the Right Question Project – Mental Health (RQP-MH) intervention, with minority patients receiving mental health services. This intervention included a Question Formulation Technique (QFT)™ and a Framework for Accountable Decision-Making (FADM)™, two techniques developed by the Right Question Institute. The RQP-MH intervention aimed to improve patient-provider interactions and to increase patient involvement and decision making, by building patients’ skills to obtain information from providers, clarify expectations of treatment, and become active participants in care. This study implemented RQP-MH in a three-pronged approach:

  • RQP-MH Coaching to Care Managers
  • RQP-MH Trainings for Patients
  • Treatment Adherence and Fidelity Checks

After adjusting for age, sex, race/ethnicity, and education, intervention subjects were over three times more likely to be retained in treatment than comparison patients. In terms of engagement, intervention patients were over four times more likely to be engaged in care than comparison patients.  When assessing the intensity of visits for   having at least one visit, intervention subjects were 28% more likely to be engaged in treatment than comparison patients.

RQP-MH Intervention Model
Click here to read the full article in published in Medical Care

Cortes, D.E., Mulvaney-Day, N., Fortuna, L., Reinfeld, S., Alegría,
M. (2009). Patient—provider communication: understanding the role
of patient activation for Latinos in mental health treatment. Health
Education & Behavior, 36(1), 138-54.

Deen, D., Lu, W.H., Rothstein, D., Santana, L., Gold, M.R.(2011).
Asking questions: the effect of a brief intervention in community
health centers on patient activation. Patient Education and
Counseling, 84(2), 257-60.

Lu, W.H., Deen, D., Rothstein, D., Santana, L., Gold, M.R. (2011).
Activating community health center patients in developing question-
formulation skills: a qualitative study. Health Education & Behavior,
38(6), 637-45.
Read article summary:

First-year medical students delivered a 10-minute patient activation intervention (PAI), developed by the Right Question Institute, to low-income, racial/ethnic minority patients of several community health centers in New York City. The PAI aimed to improve these patients’ communication with their physicians and to increase patient activation on the Patient Activation Measure®. The intervention was performed while patients waited to be seen by a physician and can be delivered by people with limited medical training. It included the following five steps:

  1. Understanding decisions
  2. Choosing a focus for the health care visit
  3. Brainstorming questions
  4. Identifying closed-ended and open-ended questions
  5. Prioritizing questions

Overall, patients valued the PAI as a useful tool for engaging them in the physician-patient relationship. In addition, patients who received the PAI reported increased satisfaction with the healthcare that they received. The study also revealed several factors that influence the question-asking behavior of minority patients including patient attitudes, social factors, and patient’s self-efficacy in question formulation.

Quotes from participants:

I liked the fact that you pulled me to the side to reassure me that I was in charge as much as the doctor was or even more so.

The talk (PAI) gave me an extra push to ask what I need. I don’t feel nervous and intimidated.

I used to just be satisfied with a simple answer or whatever she (the physician) answered but this time I was able to get more information.

Preparing questions helped improve the visit.

Framework for patient question-asking behavior
Click here to read the full article in Patient Education and Counseling.
Click here to read another article on RQI’s work with CCNY.

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