National Healthcare Quality and Disparities Report
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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
26 to 50 of 83 Research Studies DisplayedTurer CB, Barlow SE, Sarwer DB
Association of clinician behaviors and weight change in school-aged children.
This study used clinical practice data to determine whether recommended weight management clinician behaviors were associated with weight status improvement in children aged 6-12 years who are overweight or obese. Electronic health record data (2009-2014) from 52 clinics were used. Weight status was examined from 1 visit to the next as dichotomous improvement (versus worsening or no change) and change in percentage overweight (over sex/age-specific BMI95).
AHRQ-funded; HS022418.
Citation: Turer CB, Barlow SE, Sarwer DB .
Association of clinician behaviors and weight change in school-aged children.
Am J Prev Med 2019 Sep;57(3):384-93. doi: 10.1016/j.amepre.2019.04.029..
Keywords: Children/Adolescents, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research
Drouin O, Sharifi M, Gerber M
Parents' willingness to pay for pediatric weight management programs.
This study examined parents’ interested in continuing and willingness to pay (WTP) for 2 pediatric weight management programs after their childrens’ participation. Participants were parents of 2- to 12-year-old children with a body mass index equal to or greater than the 85th percentile who participated in the Connect for Health trial. One group received enhanced primary care (EPC) and the other group EPC plus individualized coaching (EPC+C). After 1 year, they assessed parents’ self-reported WTP for a similar program and the maximum amount they would pay. Of 638 parents polled, 85% were interested in continuing and 38% of them were willing to pay. The median amount they were willing to pay was $25/month. Parents of Hispanic/Latino children versus white ethnicity and those reporting a higher satisfaction with the program more most likely to endorse WTP. Parents of children getting EPC+C were also more willing to pay.
AHRQ-funded; HS024332; HS022986.
Citation: Drouin O, Sharifi M, Gerber M .
Parents' willingness to pay for pediatric weight management programs.
Acad Pediatr 2019 Sep - Oct;19(7):764-72. doi: 10.1016/j.acap.2019.05.124..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Healthcare Costs, Caregiving, Primary Care, Primary Care: Models of Care
Baskind MJ, Taveras EM, Gerber MW
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. In this study, the investigators studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. The investigators found that among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity.
AHRQ-funded; HS024332; HS022986.
Citation: Baskind MJ, Taveras EM, Gerber MW .
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Prev Chronic Dis 2019 Mar 28;16:E39. doi: 10.5888/pcd16.180368..
Keywords: Children/Adolescents, Family Health and History, Lifestyle Changes, Obesity, Obesity: Weight Management, Risk, Stress
Whooten R, Kerem L, Stanley T
Physical activity in adolescents and children and relationship to metabolic health.
The purpose of this review was to summarize recent developments relating to the role of physical activity in insulin resistance and increased metabolic health in children and adolescents. Recent findings confirm the role of physical activity in decreasing insulin resistance and metabolic syndrome, but the authors note that the current literature is limited by unstandardized research methods and definitions. Future research that addresses these issues in order to offer targeted physical activity interventions is recommended.
AHRQ-funded; HS000063.
Citation: Whooten R, Kerem L, Stanley T .
Physical activity in adolescents and children and relationship to metabolic health.
Curr Opin Endocrinol Diabetes Obes 2019 Feb;26(1):25-31. doi: 10.1097/med.0000000000000455..
Keywords: Children/Adolescents, Diabetes, Lifestyle Changes, Obesity, Obesity: Weight Management
Knierim SD, Moore SL, Raghunath SG
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. The investigators concluded that a home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns.
AHRQ-funded; HS021138; HS022143.
Citation: Knierim SD, Moore SL, Raghunath SG .
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
Matern Child Health J 2018 Nov;22(11):1589-97. doi: 10.1007/s10995-018-2553-7..
Keywords: Children/Adolescents, Home Healthcare, Low-Income, Obesity, Children/Adolescents, Racial and Ethnic Minorities
Bramante CT, Thornton RLJ, Bennett WL
Systematic review of natural experiments for childhood obesity prevention and control.
This article reviews the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. A search of PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 sought studies about policies evaluated by natural experiments reporting childhood BMI outcomes. Interventions were classified by environmental focus and stratified by setting; risk of bias was evaluated for each study. Most of the studies evaluated took place in a school setting. The most common environmental focus in any setting was food/beverage. All four of the studies that focused on food/beverage and physical activity in schools showed decreased prevalence of overweight/obesity in the subjects. BMI decreased in all four studies in both school and community settings. The authors note that while school-based policies focusing on both food/beverage and physical activity environments showed consistent improvement in BMI, most of these studies had high risk of bias. Improved methods for the evaluation of natural experiments for childhood obesity prevention are needed.
AHRQ-funded; 290201200007I.
Citation: Bramante CT, Thornton RLJ, Bennett WL .
Systematic review of natural experiments for childhood obesity prevention and control.
Am J Prev Med 2019 Jan;56(1):147-58. doi: 10.1016/j.amepre.2018.08.023..
Keywords: Children/Adolescents, Evidence-Based Practice, Obesity, Obesity: Weight Management, Prevention
Danilack VA, Brousseau EC, Phipps MG
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
Weight retention after pregnancy is a concern for adolescents who may be entering adulthood at unhealthy weights. In this article, the investigators studied associations between each of three measures: pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and post-pregnancy BMI in a longitudinal follow-up of an adolescent pregnancy study cohort. They concluded that teens experienced an increase in BMI from pre-pregnancy to within 4 years after their first delivery, and this increase was related to GWG.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Phipps MG .
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
J Womens Health 2018 Dec;27(12):1456-58. doi: 10.1089/jwh.2017.6635..
Keywords: Children/Adolescents, Pregnancy, Obesity: Weight Management, Obesity, Women
Grout RW, Thompson-Fleming R, Carroll AE
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
The objective of this study was to determine the rate of positive pain screenings in pediatric primary care and evaluate the relationship between reported pain and obesity, demographics, and exam findings during routine pediatric encounters. The investigators concluded that pain is common in general pediatric encounters, and occurs more frequently in obese children and those who previously reported pain. Pain reporting may be influenced by seasonal variation and clinic factors.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Grout RW, Thompson-Fleming R, Carroll AE .
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
BMC Pediatr 2018 Nov 21;18(1):363. doi: 10.1186/s12887-018-1335-0..
Keywords: Children/Adolescents, Obesity, Pain, Children/Adolescents, Primary Care
Fiechtner L, Fonte ML, Castro I
Determinants of binge eating symptoms in children with overweight/obesity.
In this study, the investigators examined the prevalence and multilevel determinants of three binge eating symptoms: (1) sneaking, hiding, or hoarding food; (2) eating in the absence of hunger, and (3) inhibition or embarrassment when eating in front of others among 817 children aged 5-12 years old with overweight/obesity receiving primary care in eastern Massachusetts. They examined the associations of child and parent/household characteristics with the prevalence ratios (PRs) of these three binge eating symptoms.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Fonte ML, Castro I .
Determinants of binge eating symptoms in children with overweight/obesity.
Child Obes 2018 Nov/Dec;14(8):510-17. doi: 10.1089/chi.2017.0311..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Nutrition, Family Health and History, Patient-Centered Healthcare
Gorski Findling MT, Wolfson JA, Rimm EB
Differences in the neighborhood retail food environment and obesity among US children and adolescents by SNAP participation.
The authors sought to understand the association between children's neighborhood food access and overweight/obesity in a national sample of US households, and whether this association differs by Supplemental Nutrition Assistance Program (SNAP) participation or household purchases. Using data from the National Household Food Acquisition and Purchase Survey, 2012-2013, they found that the odds of childhood overweight/obesity were higher with greater access to combination grocery/other stores overall and for children in SNAP. Eligible non-SNAP children had higher odds of overweight/obesity with greater access to convenience stores. The average child lived in a household with 6.3% of total spending at food outlets on sugary beverages. They concluded that greater neighborhood access to combination grocery/other stores is associated with higher obesity prevalence for children overall and those in SNAP.
AHRQ-funded; HS000055.
Citation: Gorski Findling MT, Wolfson JA, Rimm EB .
Differences in the neighborhood retail food environment and obesity among US children and adolescents by SNAP participation.
Obesity 2018 Jun;26(6):1063-71. doi: 10.1002/oby.22184.
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Keywords: Children/Adolescents, Low-Income, Nutrition, Obesity, Social Determinants of Health
Fiechtner L, Perkins M, Biggs V
Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Recent studies have demonstrated the effectiveness of family-centered, pediatric weight management programs in reducing childhood obesity. Yet, programs to optimize the care of low-income children with obesity are needed. The investigators sought to examine the comparative effectiveness of two, potentially scalable pediatric weight management programs delivered to low-income children in a clinical or community setting.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Perkins M, Biggs V .
Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Contemp Clin Trials 2018 Apr;67:16-22. doi: 10.1016/j.cct.2018.01.002..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Low-Income, Vulnerable Populations, Nutrition, Patient-Centered Healthcare, Family Health and History, Evidence-Based Practice, Comparative Effectiveness
Foster BA, Fu E, Bendiks N
Capacity-oriented approaches to developing childhood obesity interventions: a systematic review.
Capacity-oriented approaches to health interventions seek to empower the target population or community to manage the health issue themselves using resources they can control. Positive deviance, resilience and asset-based approaches are three such methods of developing and implementing health interventions. This study aimed to review the efficacy of interventions explicitly applying these methods in addressing childhood obesity using adiposity as the primary outcome, measured by standardized body mass index.
AHRQ-funded; HS024332.
Citation: Foster BA, Fu E, Bendiks N .
Capacity-oriented approaches to developing childhood obesity interventions: a systematic review.
Clin Obes 2018 Apr;8(2):95-104. doi: 10.1111/cob.12234..
Keywords: Children/Adolescents, Obesity, Patient-Centered Outcomes Research
Knierim SD, Newcomer S, Castillo A
Latino parents' perceptions of pediatric weight counseling terms.
This study analyzed what would the least offensive terms to use with Latino parents when clinicians talk to them about their childrens’ weight, particularly for counseling obese youth. Latino parents across demographic groups were surveyed in English or Spanish and rated the most and least offensive terms to describe excess weight using a 5-point scale. The least offensive term was “demasiado peso para su salud”, or “too much weight for his/her health” in English. The most offensive was “gordo” or “muy gordo” meaning chubby or fat. Terminology makes a difference in how the parents will respond to weight counseling and follow-up.
AHRQ-funded; HS022143.
Citation: Knierim SD, Newcomer S, Castillo A .
Latino parents' perceptions of pediatric weight counseling terms.
Acad Pediatr 2018 Apr;18(3):342-53. doi: 10.1016/j.acap.2017.09.006..
Keywords: Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management, Racial and Ethnic Minorities
Alexander GL, Olden HA, Troy T
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
This mixed-methods study assessed teens' awareness of the link between weight and asthma management, and perspectives on how medical providers might open a discussion about managing weight. The investigators found that most teens responded favorably to initiating weight loss if it impacted asthma management, valued their provider addressing weight and family participation in weight management efforts.
AHRQ-funded; HS022417.
Citation: Alexander GL, Olden HA, Troy T .
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
J Asthma 2018 Mar;55(3):266-74. doi: 10.1080/02770903.2017.1323921..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management
Gowey MA, Chandler-Laney PC
Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.
The objective of this study was to examine the association between children's post-prandial glucose responses and maternal report of their eating behaviours. The study’s results suggested that earlier and smaller post-prandial glucose excursions may be related to children's response to food cues.
AHRQ-funded; HS023009.
Citation: Gowey MA, Chandler-Laney PC .
Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.
Clin Obes 2018 Feb;8(1):39-42. doi: 10.1111/cob.12210..
Keywords: Children/Adolescents, Nutrition, Obesity
Gowey MA, Chandler-Laney PC
Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.
The objective of this study was to examine the association between children's post-prandial glucose responses and maternal report of their eating behaviours. The study’s results suggested that earlier and smaller post-prandial glucose excursions may be related to children's response to food cues.
AHRQ-funded; HS023009.
Citation: Gowey MA, Chandler-Laney PC .
Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.
Clin Obes 2018 Feb;8(1):39-42. doi: 10.1111/cob.12210..
Keywords: Children/Adolescents, Nutrition, Obesity
Wong MS, Jones-Smith JC, Colantuoni E
The longitudinal association between early childhood obesity and fathers' involvement in caregiving and decision-making.
This study assessed the longitudinal association between changes in obesity among children aged 2 to 4 years and changes in fathers' involvement with raising children. Children whose fathers increased their frequency of taking children outside and involvement with physical childcare experienced a decrease in their odds of obesity from age 2 to age 4.
AHRQ-funded; HS000029.
Citation: Wong MS, Jones-Smith JC, Colantuoni E .
The longitudinal association between early childhood obesity and fathers' involvement in caregiving and decision-making.
Obesity 2017 Oct;25(10):1754-61. doi: 10.1002/oby.21902.
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Keywords: Caregiving, Children/Adolescents, Family Health and History, Obesity, Patient-Centered Healthcare
Wong MS, Showell NN, Bleich SN
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
This study examined the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. It found that parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian.
AHRQ-funded; HS000029.
Citation: Wong MS, Showell NN, Bleich SN .
The association between parent-reported provider communication quality and child obesity status: variation by parent obesity and child race/ethnicity.
Patient Educ Couns 2017 Aug;100(8):1588-97. doi: 10.1016/j.pec.2017.03.015.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Obesity, Clinician-Patient Communication, Racial and Ethnic Minorities
Quattrin Wilfley, DE
The promise and opportunities for screening and treating childhood obesity: USPSTF recommendation statement.
This editorial discusses the updated recommendation statement and evidence review released by the United States Preventive Services Task Force (USPSTF) on screening for obesity in children. The Task Force recommendations are called ‘a call to arms’ against a condition that has immediate as well as long-term consequences for the health of the children affected. The authors note that the evaluation techniques for screening for obesity carry very few risks. Family-based behavioral treatment and the effectiveness of behavioral interventions, as well as pharmacotherapies, are also discussed.
AHRQ-funded; HS022816.
Citation: Quattrin Wilfley, DE .
The promise and opportunities for screening and treating childhood obesity: USPSTF recommendation statement.
JAMA Pediatr 2017 Aug;171(8):733-35. doi: 10.1001/jamapediatrics.2017.1604..
Keywords: Children/Adolescents, Guidelines, Obesity, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF)
Fiechtner L, Puente GC, Sharifi M
A community resource map to support clinical-community linkages in a randomized controlled trial of childhood obesity, eastern Massachusetts, 2014-2016.
The researchers describe the process by which they created an online interactive community resources map for use in the Connect for Health randomized controlled trial. The trial was conducted in the 6 pediatric practices that cared for the highest percentage of children with overweight or obesity. Parents and community partners identified several community resources that could help support behavior change.
AHRQ-funded; HS024332.
Citation: Fiechtner L, Puente GC, Sharifi M .
A community resource map to support clinical-community linkages in a randomized controlled trial of childhood obesity, eastern Massachusetts, 2014-2016.
Prev Chronic Dis 2017 Jul 6;14:E53. doi: 10.5888/pcd14.160577.
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Keywords: Children/Adolescents, Obesity, Community Partnerships
Kass AE, Theim Hurst K, Kolko RP
Psychometric evaluation of the youth eating disorder examination questionnaire in children with overweight or obesity.
This study evaluated the psychometric properties of the Youth Eating Disorder Examination Questionnaire (YEDE-Q) and its utility for detecting loss of control (LOC) eating . It concluded that the YEDE-Q may not have utility as a screener for identifying true cases of LOC eating among school-age children with overweight or obesity.
AHRQ-funded; HS000078.
Citation: Kass AE, Theim Hurst K, Kolko RP .
Psychometric evaluation of the youth eating disorder examination questionnaire in children with overweight or obesity.
Int J Eat Disord 2017 Jul;50(7):776-80. doi: 10.1002/eat.22693.
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Keywords: Behavioral Health, Children/Adolescents, Nutrition, Obesity, Screening
Kass AE, Wilfley DE, Eddy KT
Secretive eating among youth with overweight or obesity.
This study evaluated the prevalence and correlates of secretive eating in youth with overweight or obesity. It found that youth who endorsed secretive eating had higher eating-related psychopathology and were more likely to endorse loss of control eating and purging than their counterparts who did not endorse secretive eating. Groups did not differ in excessive exercise or behavioral problems.
AHRQ-funded; HS000078.
Citation: Kass AE, Wilfley DE, Eddy KT .
Secretive eating among youth with overweight or obesity.
Appetite 2017 Jul 1;114:275-81. doi: 10.1016/j.appet.2017.03.042.
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Keywords: Behavioral Health, Children/Adolescents, Obesity
O'Connor EA, Evans CV, Burda BU
Screening for obesity and intervention for weight management in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The researchers conducted a systematic review of the benefits and harms of screening and treatment for obesity and overweight in children and adolescents to inform the US Preventive Services Task Force. They concluded that lifestyle-based weight loss interventions with 26 or more hours of intervention contact are likely to help reduce excess weight in children and adolescents. The clinical significance of the small benefit of medication use is unclear.
AHRQ-funded; 290201200015IEPC4.
Citation: O'Connor EA, Evans CV, Burda BU .
Screening for obesity and intervention for weight management in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Jun 20;317(23):2427-44. doi: 10.1001/jama.2017.0332.
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Keywords: Children/Adolescents, Obesity, Screening, U.S. Preventive Services Task Force (USPSTF)
Bello JK, Mohanty N, Bauer V
Pediatric hypertension: provider perspectives.
The researchers aimed to gain insights into reasons for low rates of diagnosis and treatment from primary care providers. In interviews, providers reflected on numerous barriers to diagnosis, management, and follow-up; recommendations for educational content; and how community health center systems can be improved. Findings informed development of a multifaceted intervention.
AHRQ-funded; HS024100.
Citation: Bello JK, Mohanty N, Bauer V .
Pediatric hypertension: provider perspectives.
Glob Pediatr Health 2017 Jun 6;4:2333794x17712637. doi: 10.1177/2333794x17712637.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Healthcare Delivery, Blood Pressure, Obesity, Primary Care
Bossick AS, Barone C, Alexander GL
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
This study examined family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Providers recognize several challenges and barriers to discussing weight management in the well-child visit.
AHRQ-funded; HS022417.
Citation: Bossick AS, Barone C, Alexander GL .
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
J Patient Cent Res Rev 2017 Summer;4(3):114-24. doi: 10.17294/2330-0698.1444.
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Keywords: Children/Adolescents, Clinician-Patient Communication, Obesity, Obesity: Weight Management, Patient-Centered Healthcare