Our objective is to build the scientific base for effective public reporting of healthcare quality by examining the nature, type and dissemination of public reports by engaging consumers in focus groups to identify their needs in healthcare decision-making. Consistent with the Patient Protection and Affordable Care Act of 2010, that aims to improve dissemination of measures of healthcare quality and resource use and as identified in the Agency for Healthcare Research and Quality's (AHRQ) request for applications, we intend to fill two of the major gaps in the public reporting evidence base identified by AHRQ through the engagement of subgroups of AHRQ's priority populations and Medicare beneficiaries. We will address the major gaps identified by AHRQ: 1) improve the design and presentation of public reports to meet the needs to consumers, and 2) increase consumer's use and the dissemination of public reports. Our application aims to help fill the gaps identified above through a qualitative developmental study that engages consumers in the Commonwealth of Virginia, most specifically vulnerable Medicare beneficiaries with type II diabetes: African Americans and Latinos compared with a White population. We will engage these target populations in focus groups to ask them about the role public reports of quality data may play in meeting their personal health care needs. Specifically we aim to determine: (1) How public reports can be designed to address the varying information needs of vulnerable populations as they make decisions for their personal health care including selection of health care providers - both physicians and hospitals. (2) How the content, design and dissemination of public reports can best reflect meaningful information that consumers would actually use in their personal decision-making. Our qualitative study design proposes two rounds of focus groups. The first round will focus on Aim 1 and the results will be used by project staff together with Virginia Health Information (VHI) developer of Virginia consumer reports, to develop public report templates and to identify themes, both of which will be relevant in the design of the round two focus groups, which will focus on Aim 2. Final study results will be used by VHI to develop a final public report to Virginia Medicare beneficiaries on type II diabetes; further we will disseminate project findings with the assistance of our national advisory committee to ensure wide scale dissemination beyond Virginia. PUBLIC HEALTH RELEVANCE: This study is critically important to building the science of public reporting of quality of care and empowering consumers with information that allows rating or comparison of providers according to performance standards of quality. Further it addresses the information needs of vulnerable priority populations identified by the Agency for Healthcare Research and Quality by focusing on Medicare beneficiaries with type 2 diabetes who are African American, Latino and White. This approach is critical because each of these populations likely have different needs and concerns related to the design, content and dissemination of public reports; previous research clearly indicates that one size does not fit all and must be taken into account with regard to the needs of various ethnic and racial populations.