National Healthcare Quality and Disparities Report
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- Caregiving (1)
- Children/Adolescents (8)
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- Communication (1)
- Comparative Effectiveness (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedHsieh N
Unpacking intersectional inequities in flu vaccination by sexuality, gender, and race-ethnicity in the United States.
This study examined influenza vaccination inequities at the intersection of sexuality, gender, and race-ethnicity using data from the 2013 to 2018 National Health Interview Survey (N = 166,908). It found that White gay men had the highest vaccination rate (56%), while Black bisexual women had the lowest rate (23%). Sexual minority women (Black or Hispanic) had lower vaccination rates than heterosexual women, but sexual minority men had higher or similar vaccination rates than heterosexual men. While economic enabling, noneconomic enabling, and need-based factors all help to explain a substantial portion of these gaps, they cannot explain all the disadvantages faced by Black lesbian, bisexual, heterosexual women, and Black heterosexual men.
AHRQ-funded; HS029329.
Citation: Hsieh N .
Unpacking intersectional inequities in flu vaccination by sexuality, gender, and race-ethnicity in the United States.
J Health Soc Behav 2024 Mar; 65(1):38-59. doi: 10.1177/00221465231199276.
Keywords: Influenza, Vaccination, Disparities
Khorasani S, Zubiago J, Carreiro J
Influenza vaccination in Massachusetts jails: a mixed-methods analysis.
The objectives of this study were to survey health administrators in Massachusetts county jails about institutional influenza vaccine policies and practices and estimate influenza vaccination rates in Massachusetts jails from 2013 to 2020. Findings showed that influenza vaccination rates in Massachusetts jails were low, and delivery practices in jails varied. The authors noted that lack of influenza vaccinations in jails is a gap in health care that needs to be prioritized, especially considering the current COVID-19 pandemic. They suggested that further investigations for effective and equitable vaccination in this population should involve people who are incarcerated and people who make influenza vaccine policies in jails.
AHRQ-funded; HS026008.
Citation: Khorasani S, Zubiago J, Carreiro J .
Influenza vaccination in Massachusetts jails: a mixed-methods analysis.
Public Health Rep 2022 Sep-Oct;137(5):936-43. doi: 10.1177/00333549211041659..
Keywords: Influenza, Vaccination, Respiratory Conditions
Hofstetter AM, Opel DJ, Stockwell MS
Associations between health care professional communication practices and influenza vaccination of hospitalized children.
The objective of this study was to describe the communication of health care professionals (HCPs) with parents of hospitalized children concerning the influenza vaccine. A survey was conducted online or via telephone with English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a pediatric hospital after discharge. Findings showed that a parent-reported HCP conversation and recommendation were associated with influenza vaccination during hospitalization.
AHRQ-funded; HS025470.
Citation: Hofstetter AM, Opel DJ, Stockwell MS .
Associations between health care professional communication practices and influenza vaccination of hospitalized children.
Acad Pediatr 2021 Sep-Oct;21(7):1142-50. doi: 10.1016/j.acap.2021.06.014..
Keywords: Children/Adolescents, Influenza, Vaccination, Communication, Health Promotion, Clinician-Patient Communication
Hofstetter AM, Opel DJ, Stockwell MS
Influenza-related knowledge, beliefs, and experiences among caregivers of hospitalized children.
Caregivers frequently decline influenza vaccine for their hospitalized child. In this study, the investigators aimed to examine factors impacting their influenza vaccine decision-making. The investigators conducted a cross-sectional survey study of English- and Spanish-speaking caregivers of children hospitalized at a tertiary care pediatric hospital between November 2017 and April 2018.They identified key factors impacting influenza vaccine decision-making among caregivers of hospitalized children, a critical step to improving uptake in this population.
AHRQ-funded; HS025470.
Citation: Hofstetter AM, Opel DJ, Stockwell MS .
Influenza-related knowledge, beliefs, and experiences among caregivers of hospitalized children.
Hosp Pediatr 2021 Aug;11(8):815-32. doi: 10.1542/hpeds.2020-003459..
Keywords: Children/Adolescents, Caregiving, Influenza, Vaccination
Orenstein EW, ElSayed-Ali O, Kandaswamy S
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
The authors’ goal was to design and evaluate a clinical decision support (CDS) strategy to increase the proportion of eligible hospitalized children who receive a seasonal influenza vaccine prior to inpatient discharge. They found that a user-centered CDS may be associated with significantly improved influenza vaccination rates among hospitalized children.
AHRQ-funded; HS027689.
Citation: Orenstein EW, ElSayed-Ali O, Kandaswamy S .
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
JAMA Netw Open 2021 Jul;4(7):e2117809. doi: 10.1001/jamanetworkopen.2021.17809..
Keywords: Children/Adolescents, Influenza, Vaccination, Clinical Decision Support (CDS), Health Information Technology (HIT), Hospital Discharge
Bartsch SM, Mitgang EA, Geller G
What if the influenza vaccine did not offer such variable protection?
This study looked at the impact of reducing the variability in responses to the influenza vaccine across the population. Protection from the vaccine can vary significantly from person to person due to differences in immune systems, body types, and other factors. The authors compared the projected cases, direct medical costs, and productivity losses at the 30%, 50%, and 70% efficacy rates.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Mitgang EA, Geller G .
What if the influenza vaccine did not offer such variable protection?
J Infect Dis 2020 Sep 1;222(7):1138-44. doi: 10.1093/infdis/jiaa240..
Keywords: Influenza, Vaccination, Respiratory Conditions, Public Health
Butler AM, Layton JB, Dharnidharka VR
Comparative effectiveness of high-dose versus standard-dose influenza vaccine among patients receiving maintenance hemodialysis.
This study compared outcomes of routine dialysis patients who received either the standard dose vaccine (SDV) for influenza or a high-dose vaccine (HDV). Out of 22,215 influenza patient-seasons among adults 65 years and older, 97.4% received SDV and 2.6% received HDV. There did not seem to be any additional protection provided by the HDV for all-cause mortality or influenza-related outcomes.
AHRQ-funded; HS019455.
Citation: Butler AM, Layton JB, Dharnidharka VR .
Comparative effectiveness of high-dose versus standard-dose influenza vaccine among patients receiving maintenance hemodialysis.
Am J Kidney Dis 2020 Jan;75(1):72-83. doi: 10.1053/j.ajkd.2019.05.018..
Keywords: Vaccination, Influenza, Comparative Effectiveness, Dialysis, Kidney Disease and Health, Hospitalization, Outcomes
Frentzel E, Jump RLP, Archbald-Pannone L
Recommendations for mandatory influenza vaccinations for health care personnel from AMDA's Infection Advisory Subcommittee.
Preventing influenza infections is a national health priority, particularly among geriatric and adults with frailty who reside in post-acute and long-term care (PALTC) settings. Older adults account for more than 70% of deaths from influenza, a reflection of decreased vaccine effectiveness in that age group. Annually vaccinating health care personnel (HCP) working with these patients against influenza is critical to reducing influenza morbidity and mortality among patients. In this paper, the authors discuss the recommendations for mandatory influenza vaccinations for health care personnel.
AHRQ-funded; HS023779.
Citation: Frentzel E, Jump RLP, Archbald-Pannone L .
Recommendations for mandatory influenza vaccinations for health care personnel from AMDA's Infection Advisory Subcommittee.
J Am Med Dir Assoc 2020 Jan;21(1):25-28.e2. doi: 10.1016/j.jamda.2019.11.008..
Keywords: Influenza, Vaccination, Provider, Policy
O'Leary ST, Narwaney KJ, Wagner NM
Efficacy of a web-based intervention to increase uptake of maternal vaccines: an RCT.
Tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines are recommended for pregnant women in each pregnancy, yet uptake is suboptimal. This study tested the efficacy of an online vaccine resource in increasing uptake of Tdap and influenza vaccines among pregnant women. The investigators concluded that Web-based vaccination information sent to pregnant women can positively influence maternal influenza vaccine uptake.
AHRQ-funded; HS021492.
Citation: O'Leary ST, Narwaney KJ, Wagner NM .
Efficacy of a web-based intervention to increase uptake of maternal vaccines: an RCT.
Am J Prev Med 2019 Oct;57(4):e125-e33. doi: 10.1016/j.amepre.2019.05.018..
Keywords: Vaccination, Pregnancy, Women, Health Information Technology (HIT), Social Media, Influenza
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination
Schaffer SJ, Rand CM, Humiston SG
Practical considerations in developing a successful school-located influenza vaccination (SLIV) program.
This paper discussed strategies in developing a successful school-located influenza vaccination (SLIV) program. The authors indicate that adequate planning is crucial for SLIV success. In addition, they delineate several components that are important for a SLIV program to be successful: 1. Buy-in from school districts and school nurses, 2. Timing of SLIV clinics, 3. Publicizing SLIV to parents, 4. Obtaining vaccination consent, 5. Adequacy of resources, 6. Billing, and 7. Sustainability
AHRQ-funded; HS021163.
Citation: Schaffer SJ, Rand CM, Humiston SG .
Practical considerations in developing a successful school-located influenza vaccination (SLIV) program.
Vaccine 2019 Apr 10;37(16):2171-73. doi: 10.1016/j.vaccine.2019.01.088..
Keywords: Vaccination, Influenza, Infectious Diseases, Children/Adolescents
Szilagyi PG, Schaffer S, Rand CM
Text message reminders for child influenza vaccination in the setting of school-located influenza vaccination: a randomized clinical trial.
This study assessed whether text message reminders to parents could raise rates for children receiving school-located influenza vaccination (SLIV). Researchers randomized families with children in urban elementary schools to receive either text message plus SLIV (intervention) or SLIV alone (comparison). All parents were also sent two ‘backpack’ notifications and two autodialer phone reminders about SLIV at a single SLIV clinic. The text message reminders did not raise influenza vaccination rates above those observed with SLIV alone, and the authors conclude that more intensive interventions are needed to raise influenza vaccination rates.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
Text message reminders for child influenza vaccination in the setting of school-located influenza vaccination: a randomized clinical trial.
Clin Pediatr 2019 Apr;58(4):428-36. doi: 10.1177/0009922818821878..
Keywords: Children/Adolescents, Influenza, Health Information Technology (HIT), Vaccination
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
Szilagyi PG, Schaffer S, Rand CM
School-located influenza vaccinations for adolescents: a randomized controlled trial.
In this study, the investigators aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. In 2015-2016, they performed a cluster-randomized trial of adolescent SLIV in middle/high schools. They concluded that SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
School-located influenza vaccinations for adolescents: a randomized controlled trial.
J Adolesc Health 2018 Feb;62(2):157-63. doi: 10.1016/j.jadohealth.2017.09.021..
Keywords: Children/Adolescents, Education, Influenza, Prevention, Public Health, Vaccination
Anderson LJ, Shekelle P, Keeler E
The cost of interventions to increase influenza vaccination: a systematic review.
This study sought to systematically review economic evaluations of healthcare-based quality improvement interventions for improving influenza vaccination uptake among general populations and healthcare workers. The investigators concluded that quality improvement interventions for influenza vaccination involved per-enrollee costs that were similar to the cost of the vaccine itself ($11.78-$36.08/dose). They suggested that based on limited available evidence in general populations, quality improvement interventions may be cost saving to cost effective for the health system.
AHRQ-funded; HS022644.
Citation: Anderson LJ, Shekelle P, Keeler E .
The cost of interventions to increase influenza vaccination: a systematic review.
Am J Prev Med 2018 Feb;54(2):299-315. doi: 10.1016/j.amepre.2017.11.010..
Keywords: Healthcare Costs, Influenza, Quality Improvement, Vaccination
Albright K, Hurley LP, Lockhart S
Attitudes about adult vaccines and reminder/recall in a safety net population.
The objective of this study was to determine patient perspectives on adult vaccines generally; attitudes about Tdap, pneumococcal polysaccharide (PPSV-23), and seasonal influenza vaccines specifically; and preferences for adult reminder/recall delivery.
AHRQ-funded; HS022648.
Citation: Albright K, Hurley LP, Lockhart S .
Attitudes about adult vaccines and reminder/recall in a safety net population.
Vaccine 2017 Dec 19;35(52):7292-96. doi: 10.1016/j.vaccine.2017.11.001..
Keywords: Influenza, Pneumonia, Vaccination, Prevention, Respiratory Conditions
Lee BY, Bartsch SM, Mvundura M
An economic model assessing the value of microneedle patch delivery of the seasonal influenza vaccine.
The researchers utilized a susceptible-exposed-infectious-recovered transmission model linked to an economic influenza outcomes model to assess the economic value of introducing the microneedle patch (MNP) into the U.S. influenza vaccine market from the third-party payer and societal perspectives. They concluded that if healthcare providers administered the MNP, its introduction would be less costly and more effective in the majority of scenarios assessed.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Mvundura M .
An economic model assessing the value of microneedle patch delivery of the seasonal influenza vaccine.
Vaccine 2015 Sep 08;33(37):4727-36. doi: 10.1016/j.vaccine.2015.02.076.
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Keywords: Healthcare Delivery, Healthcare Costs, Influenza, Vaccination
Pop-Vicas A, Rahman M, Gozalo PL
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
This study estimated the effect of influenza vaccination on hospitalization and mortality in nursing home (NH) residents. It found that the association between vaccine match and reduction in overall mortality and pneumonia and influenza hospitalizations was strongest for A/H3N2, the influenza strain typically responsible for the most-severe influenza cases.
AHRQ-funded; HS018462.
Citation: Pop-Vicas A, Rahman M, Gozalo PL .
Estimating the effect of influenza vaccination on nursing home residents' morbidity and mortality.
J Am Geriatr Soc 2015 Sep;63(9):1798-804. doi: 10.1111/jgs.13617..
Keywords: Influenza, Nursing Homes, Vaccination, Hospitalization
Nace DA, Lin CJ, Ross TM
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
The researchers compared high-dose to standard-dose inactivated influenza vaccine in residents of long-term-care facilities (LTCFs) during the 2011-2012 and 2012-2013 influenza seasons. They found that, among frail, elderly residents of LTCFs, high-dose influenza vaccine produced superior responses for all strains except influenza A(H1N1) in 2012-2013.
AHRQ-funded; HS023779.
Citation: Nace DA, Lin CJ, Ross TM .
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
J Infect Dis 2015 Jun 15;211(12):1915-24. doi: 10.1093/infdis/jiu622.
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Keywords: Elderly, Influenza, Long-Term Care, Prevention, Vaccination
Lee BY, Bartsch SM, Brown ST
Quantifying the economic value and quality of life impact of earlier influenza vaccination.
This study quantifies the potential benefits and cost-savings of vaccinating against influenza earlier than current practice. It found that, depending on the timing of the influenza season peak, influenza transmissibility, and preexisting immunity, vaccinating those who typically receive the vaccine later by the end of September could avert up to $3.7 million in direct costs, and $10.7 million in productivity losses.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Brown ST .
Quantifying the economic value and quality of life impact of earlier influenza vaccination.
Med Care 2015 Mar;53(3):218-29. doi: 10.1097/mlr.0000000000000302..
Keywords: Vaccination, Influenza, Healthcare Costs
Stockwell MS, Catallozzi M, Camargo S
Registry-linked electronic influenza vaccine provider reminders: a cluster-crossover trial.
The objective of the study was to determine the impact on vaccine administration of EHR influenza vaccination reminders that are linked to a city immunization information system. It found that a noninterruptive, immunization information system–linked influenza vaccination reminder can increase vaccination late in the winter when fewer vaccine doses are usually administered. Tailoring the reminder to clinicians’ needs can increase its use.
AHRQ-funded; HS018158.
Citation: Stockwell MS, Catallozzi M, Camargo S .
Registry-linked electronic influenza vaccine provider reminders: a cluster-crossover trial.
Pediatrics 2015 Jan;135(1):e75-82. doi: 10.1542/peds.2014-2616..
Keywords: Health Information Technology (HIT), Influenza, Vaccination, Registries
Fiscella K
Tackling disparities in influenza vaccination in primary care: it takes a team.
This article discusses a study in the same issue by Maurer. Fiscella describes reasons involving influenza vaccination disparities and points out that the emergence of accountable care organizations creates opportunities for better integration of primary care and public health.
AHRQ-funded; HS022440.
Citation: Fiscella K .
Tackling disparities in influenza vaccination in primary care: it takes a team.
J Gen Intern Med 2014 Dec;29(12):1579-81. doi: 10.1007/s11606-014-2999-2.
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Keywords: Disparities, Influenza, Primary Care, Teams, Vaccination
Ahrens KA, Louik C, Kerr S
Seasonal influenza vaccination during pregnancy and the risks of preterm delivery and small for gestational age birth.
The researchers examined the associations between seasonal influenza vaccination during pregnancy and the risks of PTD and SGA among a multiyear retrospective cohort of pregnancies. With the exception of pre-term delivery (PTD) associated with the 2009–10 seasonal vaccine, they found no meaningful increases in PTD or small for gestational age risks associated with seasonal trivalent influenza vaccination during pregnancy.
AHRQ-funded; HS018463.
Citation: Ahrens KA, Louik C, Kerr S .
Seasonal influenza vaccination during pregnancy and the risks of preterm delivery and small for gestational age birth.
Paediatr Perinat Epidemiol 2014 Nov;28(6):498-509. doi: 10.1111/ppe.12152..
Keywords: Influenza, Vaccination, Pregnancy, Labor and Delivery
Campbell LJ, Li Q, Li Y
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
The authors identified nursing home (NH) characteristics that may be associated with employee influenza vaccination rates (EVRs). They concluded that, as NHs generally have low EVRs, it may be necessary to target low-performing facilities to achieve substantial improvements.
AHRQ-funded; HS000044.
Citation: Campbell LJ, Li Q, Li Y .
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
J Am Med Dir Assoc 2014 Oct;15(10):768-72. doi: 10.1016/j.jamda.2014.06.005.
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Keywords: Provider: Health Personnel, Influenza, Nursing Homes, Prevention, Vaccination
Khazeni N, Hutton DW, Collins CI
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
In order to determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a severe influenza pandemic in a large metropolitan area, researchers used a dynamic transmission model. They found that vaccination in an influenza-A (H7N9) pandemic would need to be completed much faster than in the 2009 pandemic to substantially reduce morbidity, mortality, and health care costs.
AHRQ-funded; HS019816
Citation: Khazeni N, Hutton DW, Collins CI .
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
Ann Intern Med. 2014 May 20;160(10):684-94. doi: 10.7326/M13-2071..
Keywords: Vaccination, Influenza, Mortality, Healthcare Costs, Public Health