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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 21 of 21 Research Studies DisplayedIsbell LM, Graber ML, Rovenpor DR
Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.
The purpose of this randomized experiment study was to investigate the influence of comorbid depression on diagnostic accuracy. The researchers utilized an interactive vignette that described a patient with a complex presentation of pernicious anemia. Fifty-nine physician participants were randomized to diagnose either a patient with or without (control) comorbid depression and related behaviors. All other clinical information was identical. Physicians recorded a differential diagnosis, ordered tests, and rated patient likeability. The study found that the patient with comorbid depression was less likeable than the control patient. Accuracy of diagnosis was lower in the depression condition compared to the control condition, but this difference was not statistically significant. Accuracy was lower in the depression condition (vs. control) when physicians ordered less tests, but there was no variation for physicians who ordered more tests.
AHRQ-funded; HS025752.
Citation: Isbell LM, Graber ML, Rovenpor DR .
Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.
Diagnosis 2023 Aug; 10(3):257-66. doi: 10.1515/dx-2020-0106..
Keywords: Depression, Behavioral Health
Bui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Kalofonos I, Zito M, Fletcher E
A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States.
This paper described the effects of participation of a pilot trial of Veterans Voices and Visions (VVV) groups, which is an adaptation of the Hearing Voices (HV) groups which were created to assist patients undergoing psychosis. The trial was conducted at the VA and were co-led by clinicians and Veteran peer support specialists. Over a 16-week period, quantitative analysis showed a statistically significant reduction in distress, due to auditory hallucinations, as measured by the Psychotic Symptom Rating Scales (PSYRATS). A reduction in malevolence and omnipotence and an increase in benevolence related to auditory hallucinations was shown with the Beliefs about Voices Questionnaire- Revised (BAVQ-R), but there was no change in resistance. Qualitative data from Week 8 and the endpoint (Week 16) interviews revealed several perceived benefits from groups: 1) normalization and camaraderie, 2) increased hope and confidence, 3) self-understanding and reframing of experiences, and 4) building relationships outside of groups.
AHRQ-funded.
Citation: Kalofonos I, Zito M, Fletcher E .
A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States.
Int J Soc Psychiatry 2024 Feb; 70(1):122-31. doi: 10.1177/00207640231196747.
Keywords: Community-Based Practice, Behavioral Health
Wnorowska JH, Naik V, Ramgopal S
Characteristics of pediatric behavioral health emergencies in the prehospital setting.
This retrospective cross-sectional study aimed to characterize pediatric behavioral health encounters in the United States and assess factors associated with sedative medication administration and physical restraint use. Analyzing data from 2019 to 2020, among 2,740,271 pediatric EMS encounters, 11.3% were for behavioral health. Sedatives were used in 2.2% and restraints in 3.0% of these encounters. Factors influencing medication and restraint use included age, disabilities, geographic region, and EMS system type.
AHRQ-funded; HS026385.
Citation: Wnorowska JH, Naik V, Ramgopal S .
Characteristics of pediatric behavioral health emergencies in the prehospital setting.
Acad Emerg Med 2024 Feb; 31(2):129-39. doi: 10.1111/acem.14833.
Keywords: Children/Adolescents, Behavioral Health, Emergency Medical Services (EMS)
Kovacevic M, Montes M, Tirone V
Treating a common comorbidity: pain outcomes following a 3-week cognitive processing therapy-based intensive treatment for posttraumatic stress disorder address.
This study examined changes in pain, posttraumatic stress disorder (PTSD), and depressive symptoms among 125 veterans completing a 3-week cognitive processing therapy (CPT)-based intensive treatment program (ITP) for PTSD. The authors explored whether pretreatment pain interference predicted changes in PTSD and depressive symptom severity and whether larger changes in pain interference over the course of treatment were associated with larger changes in PTSD and depressive symptom severity. Higher levels of pretreatment pain interference were associated with higher PTSD, and depressive symptom severity, over time. Larger reductions in pain interference corresponded to more improvement in PTSD symptoms, but not depressive symptoms.
AHRQ-funded; HS028511.
Citation: Kovacevic M, Montes M, Tirone V .
Treating a common comorbidity: pain outcomes following a 3-week cognitive processing therapy-based intensive treatment for posttraumatic stress disorder address.
J Trauma Stress 2024 Feb; 37(1):47-56. doi: 10.1002/jts.22979.
Keywords: Pain, Behavioral Health, Outcomes, Chronic Conditions
Kaplan J, Somohano VC, Zaccari B
Randomized controlled trials of mind-body interventions for posttraumatic stress disorder: a systematic review.
This systematic review examined strength of evidence for use of mind-body interventions (MBIs), including mindfulness-based interventions (MiBIs), meditation- and mantra-based interventions (MMIs), and movement-based interventions (MoBIs) for treatment of post-traumatic stress disorder (PTSD). The authors used the AHRQ-funded evidence tables for the PTSD-Repository to identify relevant studies and assess the risk of bias. The search was conducted between June 2018 and June 2022 using a number of relevant databases. They found 26 randomized controlled trials that met their inclusion criteria. Strength of evidence was rated as low for MiBIs and MMIs, largely due to contradicting results, inconsistent use of active versus passive comparators, and high risk of bias. It was rated as moderate for MoBIs due to individual studies consistently favoring the intervention and a relatively large number of studies and participants. Only two of the included studies had objective outcome measures.
AHRQ-funded; HS026370.
Citation: Kaplan J, Somohano VC, Zaccari B .
Randomized controlled trials of mind-body interventions for posttraumatic stress disorder: a systematic review.
Front Psychol 2024 Jan 24; 14:1219296. doi: 10.3389/fpsyg.2023.1219296.
Keywords: Complementary and Alternative Medicine, Behavioral Health
Foot C, Korthuis PT, Tsui JI
Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.
The objective of this secondary analysis of data from two clinical trials comparing buprenorphine and extended-release naltrexone was to estimate the effect of ongoing stimulant use on return to illicit opioid use after initiation of medication for opioid use disorder (MOUD). The findings indicated that people on medication for opioid use disorder who subsequently used stimulants appeared more likely to return to non-prescribed opioids use compared with those without stimulant use; this association appeared stronger among patients who initiated buprenorphine compared with those who initiated extended-release naltrexone.
AHRQ-funded; HS026370.
Citation: Foot C, Korthuis PT, Tsui JI .
Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.
Addiction 2024 Jan; 119(1):149-57. doi: 10.1111/add.16334..
Keywords: Opioids, Substance Abuse, Medication, Behavioral Health
Adams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR .
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health
Wolf RM, Hall M, Williams DJ
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
This retrospective cohort study examined associations between pharmacologic restraint use and race and ethnicity among children (aged 5-≤18 years) admitted for mental health conditions to acute care nonpsychiatric children's hospitals. Study period was 2018 to 2022 and was conducted at 41 US children’s hospitals and included a cohort of 61,503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81), Asian (aOR, 0.82), or other race and ethnicity (aOR, 0.68) were less likely to receive pharmacologic restraint, with no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males, except for Hispanic males, and not found in females. Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ .
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
Pediatrics 2024 Jan; 153(1). doi: 10.1542/peds.2023-061353..
Keywords: Disparities, Children/Adolescents, Behavioral Health, Inpatient Care, Hospitals, Medication
Goyal NK, Sood E, Gannon MA
Priorities for well child care of families affected by parental opioid use disorder.
This study’s objective was to explore priorities for well childcare (WCC) visit content for women in treatment with opioid use disorder to inform primary care recommendations for this population. Eligible participants had children 2 years or younger and were English speaking. Among the 30 parent participants, they were overwhelmingly White (83%) and unmarried (90%). Thirteen clinicians participated, of whom 9 were attending physicians. Interviews were conducted with parents and clinicians which led to five emerging themes: (1) improving knowledge and confidence related to child development, behavior, and nutrition; (2) mitigating safety concerns; (3) addressing complex health and subspecialty needs through care coordination; (4) acknowledging parental health and wellbeing in the pediatric encounter; and (5) supporting health education and care related to neonatal opioid withdrawal syndrome. These issues were expressed as hard to address by parents and clinicians due to time constraints, social determinants of health, and significant informational needs.
AHRQ-funded; HS027399.
Citation: Goyal NK, Sood E, Gannon MA .
Priorities for well child care of families affected by parental opioid use disorder.
J Addict Med 2024 Jan-Feb; 18(1):48-54. doi: 10.1097/adm.0000000000001243..
Keywords: Opioids, Substance Abuse, Behavioral Health, Caregiving, Children/Adolescents
Martwick J, Kaufmann J, Bailey S
Impact of healthcare location concordance on receipt of preventive care among children whose parents have a substance use and/or mental health diagnosis.
This study examined the association of children with parents with >1 substance use and/or other mental health (SU/MH) diagnoses and parent-child clinic concordance with rates of well-child checks (WCCs) and childhood vaccinations. This retrospective cohort study used electronic health record data from the OCHIN network of community health organizations (CHOs) from 2010 to 2018. This included 280 CHOs across 17 states and 41,413 parents with >1 SU/MH diagnosis linked to 65,417 children ages 0 to 17 years, each with >1 visit to an OCHIN clinic during the study period. The authors found that among children utilizing the same clinic as their parent versus children using a different clinic (reference group), there were greater WCC rates in the first 15 months of life; no difference in WCC rates in ages 3 to 17; higher odds for vaccine completion before age 2; and lower odds for vaccine completion before age 18.
AHRQ-funded; HS025962.
Citation: Martwick J, Kaufmann J, Bailey S .
Impact of healthcare location concordance on receipt of preventive care among children whose parents have a substance use and/or mental health diagnosis.
J Prim Care Community Health 2024 Jan-Dec; 15. doi: 10.1177/21501319241229925.
Keywords: Children/Adolescents, Prevention, Substance Abuse, Behavioral Health, Vaccination, Healthcare Utilization
Graaf G, Hughes PM, deJong NA
Family support services and reported parent coping among caregivers of children with emotional, behavioral, or developmental disorders.
Researchers examined the association of family support services with caregiver mental health and well-being, as well as caregiver coping, among families of children with special health care needs (CSHCN). Data was taken from the National Survey of Children's Health. Results showed that adequate care coordination was associated with higher rates of caregiver-reported positive coping for CSHCN caregivers who had no source of emotional support. Emotional support services were also associated with increased reports of positive coping. The researchers concluded that mobilization of resources that can aid caregivers in coordinating care and provide emotional support may play a key role in positive caregiver coping for families of CSHCN.
AHRQ-funded; HS000032.
Citation: Graaf G, Hughes PM, deJong NA .
Family support services and reported parent coping among caregivers of children with emotional, behavioral, or developmental disorders.
J Dev Behav Pediatr 2024 Jan; 45(1):e54-e62. doi: 10.1097/dbp.0000000000001230.
Keywords: Children/Adolescents, Caregiving, Disabilities, Behavioral Health
Minden SL, Ding L, Cleary PD
Improving the quality of mental health care in multiple sclerosis.
The researchers surveyed multiple sclerosis (MS) patients across the U.S. to determine how many experienced mental health problems and received treatment over the preceding year. Also studied were patient experiences with and ratings of care, type of treatment provider, and the location of care. The researchers found a high unmet need for mental health treatment among persons with MS.
AHRQ-funded; HS016978
Citation: Minden SL, Ding L, Cleary PD .
Improving the quality of mental health care in multiple sclerosis.
J Neurol Sci. 2013 Dec 15;335(1-2):42-7. doi: 10.1016/j.jns.2013.08.021..
Keywords: Behavioral Health, Quality of Care, Chronic Conditions
Gilbert AL, Bauer NS, Carroll AE
Child exposure to parental violence and psychological distress associated with delayed milestones.
The researchers examined the association between parental report of intimate partner violence (IPV) and parental psychological distress (PPD) with child attainment of developmental milestones. They found that parental report of both IPV and PPD during the first 72 months of a child’s life is significantly associated with developmental milestone failure across all 4 developmental domains and within the domains of language, personal-social, and gross motor development.
AHRQ-funded; HS017939; HS018453.
Citation: Gilbert AL, Bauer NS, Carroll AE .
Child exposure to parental violence and psychological distress associated with delayed milestones.
Pediatrics 2013 Dec;132(6):e1577-83. doi: 10.1542/peds.2013-1020..
Keywords: Children/Adolescents, Domestic Violence, Family Health and History, Depression, Anxiety, Behavioral Health
Schumacher JR, Palta M, Loconte NK
Characterizing the psychological distress response before and after a cancer diagnosis.
The purpose of this study was to estimate the magnitude and long-term temporal course of the cancer psychological distress response, incorporating negative (depression and anxiety) and positive (psychological well-being). Cancer survivors were more likely to experience clinically significant increases in depression and anxiety, with no significant results being found for well-being.
AHRQ-funded; HS00083
Citation: Schumacher JR, Palta M, Loconte NK .
Characterizing the psychological distress response before and after a cancer diagnosis.
J Behav Med. 2013 Dec;36(6):591-600. doi: 10.1007/s10865-012-9453-x..
Keywords: Cancer, Behavioral Health, Quality of Life
Chambers C, Katic M, Chiu S
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
This study identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
AHRQ-funded; HS014129.
Citation: Chambers C, Katic M, Chiu S .
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S380-8. doi: 10.2105/ajph.2013.301646..
Keywords: Hospitalization, Social Determinants of Health, Behavioral Health, Health Status
Hartung DM, Middleton L, McFarland BH
Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population.
The researchers sought to determine the accuracy of administrative claims for identifying off-label use of second-generation antipsychotics (SGAs) in a Medicaid population. They found that Medicaid claims data had high predictive ability for identifying users of SGAs who did not have documentation of schizophrenia or bipolar disorder in the medical record.
AHRQ-funded; HS019456
Citation: Hartung DM, Middleton L, McFarland BH .
Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population.
Psychiatr Serv. 2013 Dec;64(12):1236-42. doi: 10.1176/appi.ps.005482012..
Keywords: Medicaid, Behavioral Health, Medication
Sentell T, Unick GJ, Ahn HJ
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
This study of mental illness severity and psychiatric hospitalization among Asian Americans and Pacific Islanders (AA/PIs) in Hawaii found that AA/PI subgroups (Chinese, Japanese, Filipino, and Native Hawaiians) had lower psychiatric hospitalization rates than whites, but rates varied across AA/PI subgroups.
AHRQ-funded; HS019990
Citation: Sentell T, Unick GJ, Ahn HJ .
Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.
Psychiatr Serv. 2013 Nov;64(11):1095-102. doi: 10.1176/appi.ps.201200408..
Keywords: Behavioral Health, Hospitalization, Racial and Ethnic Minorities, Disparities
Bobo WV, Cooper WO, Stein CM
Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
This study found that in a group of 25, 834 Medicaid-enrolled children and youth who had recently initiated use of either an antipsychotic or a control psychotropic drug, antipsychotic users had a risk of a newly diagnosed type 2 diabetes 3 times greater than the propensity-score matched controls. This group was confined to those who had not been diagnosed with conditions for which antipsychotics were the only recognized pharmacotherapy.
AHRQ-funded; HS0116974
Citation: Bobo WV, Cooper WO, Stein CM .
Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
JAMA Psychiatry. 2013 Oct;70(10):1067-75. doi: 10.1001/jamapsychiatry.2013.2053..
Keywords: Children/Adolescents, Behavioral Health, Diabetes, Medication, Medicaid
Chambers DA, Haim A, Mullican CA
AHRQ Author: Mullican CA
Health information technology and mental health services research: a path forward.
This article reports on the AHRQ- and NIMH-organized November 2010 workshop, “Health Information Technology and Mental Health: The Way Forward.” The primary workshop goal was to bring together experts in mental health services and interventions research, practitioners, consumers, and technologists to discuss emerging opportunities in uniting all aspects of health IT and mental health research. The workshop resulted in a four-paper series, envisioning a future mental health system in which health IT is fully integrated within mental health service systems, for patient, clinician, and system levels.
AHRQ-authored.
Citation: Chambers DA, Haim A, Mullican CA .
Health information technology and mental health services research: a path forward.
Gen Hosp Psychiatry 2013 Jul-Aug;35(4):329-31. doi: 10.1016/j.genhosppsych.2013.03.006.
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Keywords: Access to Care, Health Information Technology (HIT), Health Services Research (HSR), Health Information Technology (HIT), Behavioral Health
Baron KG, Lattie E, Ho J
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
This study investigating interest in mental health and specialty behavioral medicine counseling and predictors of utilization over 1 year among primary care patients found high interest but low utilization. Interest in receiving services at the baseline initial survey was the strongest predictor of utilization.
AHRQ-funded; HS00078
Citation: Baron KG, Lattie E, Ho J .
Interest and use of mental health and specialty behavioral medicine counseling in US primary care patients.
Int J Behav Med. 2013 Mar;20(1):69-76. doi: 10.1007/s12529-011-9211-4..
Keywords: Behavioral Health, Healthcare Utilization, Primary Care