National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (5)
- Ambulatory Care and Surgery (1)
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- (-) Community-Based Practice (13)
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- Quality of Care (1)
- Racial and Ethnic Minorities (2)
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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 13 of 13 Research Studies DisplayedKaufman A, Dickinson WP, Fagnan LJ
The role of health extension in practice transformation and community health improvement: lessons from 5 case studies.
The states of New Mexico, Oklahoma, Oregon, Colorado, and Washington stand out in stretching the boundaries of health extension; their stories reveal lessons learned regarding the successes and challenges. All states saw the need for long-term, sustained fundraising beyond grants in an environment expecting a short-term return on investment, and they were challenged operating in a shifting health system landscape where the creativity and personal relationships built with small primary care practices was hindered when these practices were purchased by larger health delivery systems.
AHRQ-funded; HS020890; HS020972; HS23904; HS023908.
Citation: Kaufman A, Dickinson WP, Fagnan LJ .
The role of health extension in practice transformation and community health improvement: lessons from 5 case studies.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S67-s72. doi: 10.1370/afm.2409..
Keywords: Community-Based Practice, Health Services Research (HSR), Healthcare Delivery, Organizational Change, Primary Care, Social Determinants of Health, Practice Improvement
Burnett-Zeigler I, Satyshur MD, Hong S
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
The authors examined the acceptability and feasibility of a mindfulness-based group intervention for socio-economically disadvantaged women in an urban community health center. Participants reported benefits to the intervention as well as barriers to session attendance. The authors concluded that the mindfulness-based intervention for depression was acceptable, reduced stress, and improved coping and functioning among women in a community health center.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Satyshur MD, Hong S .
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
Complement Ther Med 2019 Aug;45:19-24. doi: 10.1016/j.ctim.2019.05.012..
Keywords: Community-Based Practice, Depression, Behavioral Health, Racial and Ethnic Minorities, Women
Huguet N, Valenzuela S, Marino M
Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.
The authors assessed ambulatory care use and diagnosed health conditions among a cohort of community health center (CHC) patients uninsured before enactment of the Affordable Care Act (ACA) and followed them after enactment. They found that, post-ACA, 20.9% of patients remained uninsured, 15.0% gained Medicaid, 12.4% gained other insurance, and 51.7% did not have a visit. The authors concluded that a significant percentage of CHC patients remained uninsured; that many who remained uninsured had diagnosed health conditions; and that one-half continued to have three or more visits to CHCs, which continue to be essential providers for uninsured patients.
AHRQ-funded; HS024270.
Citation: Huguet N, Valenzuela S, Marino M .
Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.
Ann Fam Med 2019 Jul;17(4):336-44. doi: 10.1370/afm.2385..
Keywords: Access to Care, Ambulatory Care and Surgery, Community-Based Practice, Health Insurance, Healthcare Delivery, Medicaid, Policy, Uninsured
Trinacty CM, LaWall E, Ashton M
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Given its distinctive history, culture, and location, Hawai'i has unique social factors impacting population health. Local health systems are striving to address these issues to meet their patients' health needs. Yet the evidence on precisely how health care systems and communities may work together to achieve these goals are limited both generally and specifically in the Hawai'i context. This article described real-world efforts by 3 local health care delivery systems that integrated the identification of social needs into clinical care using the electronic health record (EHR).
AHRQ-funded; HS023185.
Citation: Trinacty CM, LaWall E, Ashton M .
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Hawaii J Med Public Health 2019 Jun;78(6 Suppl 1):46-51..
Keywords: Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Healthcare Delivery, Vulnerable Populations
Lyles CR, Handley MA, Ackerman SL
Innovative implementation studies conducted in US safety net health care settings: a systematic review.
This systematic review examined innovation/implementation studies conducted in US safety net health care settings, including community clinics or integrated safety net systems. Most of the innovations were internally developed which created more acceptability among staff/providers, higher leadership involvement, and greater amounts of customization.
AHRQ-funded; HS022047.
Citation: Lyles CR, Handley MA, Ackerman SL .
Innovative implementation studies conducted in US safety net health care settings: a systematic review.
Am J Med Qual 2019 May/Jun;34(3):293-306. doi: 10.1177/1062860618798469..
Keywords: Community-Based Practice, Healthcare Delivery
Hurley VB, Rodriguez HP, Shortell SM
The role of accountable care organization affiliation and ownership in promoting physician practice participation in quality improvement collaboratives.
The goal of this study was to examine organizational influences on physician practices' propensity to participate in quality improvement collaboratives (QICs). Using data from the third wave of the National Study of Physician Organizations, findings showed that 13.6% of practices surveyed participated in a QIC. ACO affiliation, CHC ownership, larger practice size, and health information technology functionality were positively associated with QIC participation. Practice use of QI methods partially mediated the association of ACO affiliation with QIC participation.
AHRQ-funded; HS022241.
Citation: Hurley VB, Rodriguez HP, Shortell SM .
The role of accountable care organization affiliation and ownership in promoting physician practice participation in quality improvement collaboratives.
Health Care Manage Rev 2019 Apr/Jun;44(2):174-82. doi: 10.1097/hmr.0000000000000148.
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Keywords: Quality Improvement, Quality of Care, Provider: Physician, Provider, Community-Based Practice
Lindau ST
CommunityRx, an e-prescribing system connecting people to community resources.
CommunityRx is an e-prescribing system that make it easier for patients in communities to connect with health resources. NowPow, LLC is an information technology enterprise that is part of CommunityRx. NowPow participated in AHRQ’s EvidenceNow grants program and worked with hundreds of small Midwestern primary care practices in the Healthy Hearts in the Heartland study. By 2018, over 1600 youths had been employed (many for the first-time) and generated annual asset census for Chicago, New York, and two rural areas of North Carolina. CommunityRx has been successful in providing health resource information to lower-income communities such as Chicago’s South Side. They also found that half of people who received a HealtheRx e-prescription use the information to help others.
AHRQ-funded; HS023921.
Citation: Lindau ST .
CommunityRx, an e-prescribing system connecting people to community resources.
Am J Public Health 2019 Apr;109(4):546-47. doi: 10.2105/ajph.2019.304986..
Keywords: Access to Care, Community-Based Practice, Electronic Prescribing (E-Prescribing), Evidence-Based Practice, Health Information Technology (HIT), Medication, Vulnerable Populations
Aggarwal R, Pham M, Dillingham R
Expanded HIV clinic-based mental health care services: association with viral suppression.
This study compared two cohorts of people living with HIV (PLWH) who were receiving clinic-based mental health services. Cohort A received the services before or during 2012, and Cohort B from 2013-2014. Cohort A had three times as many participants with a CD4 count <200. Cohort B were more likely to also have a substance abuse diagnosis. The researchers concluded that the later cohort may not have as much benefit from increased access to co-located mental health services and substance use services.
AHRQ-funded; HS024196.
Citation: Aggarwal R, Pham M, Dillingham R .
Expanded HIV clinic-based mental health care services: association with viral suppression.
Open Forum Infect Dis 2019 Apr;6(4):ofz146. doi: 10.1093/ofid/ofz146..
Keywords: Access to Care, Behavioral Health, Community-Based Practice, Human Immunodeficiency Virus (HIV), Substance Abuse
Reid R, Rising E, Kaufman A
The influence of a place-based foundation and a public university in growing a rural health workforce.
This article describes a partnership between a private, place-based foundation and the University of New Mexico's Office for Community Health. The university’s resources and the JF Maddox Foundation’s entrepreneurial nature, discretionary grant-making, and local convening capabilities combined to an innovative approach for addressing an acute shortage in the local health care delivery workforce in an isolated, rural setting in New Mexico. Results included a significant increase in recruitment of key health care professionals, a more cohesive medical community, a school-based clinic, and support for other community challenges such as the prevention of teen pregnancy.
AHRQ-funded; HS023904.
Citation: Reid R, Rising E, Kaufman A .
The influence of a place-based foundation and a public university in growing a rural health workforce.
J Community Health 2019 Apr;44(2):292-96. doi: 10.1007/s10900-018-0585-y..
Keywords: Access to Care, Community-Based Practice, Community Partnerships, Rural Health, Workforce
Timbie JW, Kranz AM, Mahmud A
Specialty care access for Medicaid enrollees in expansion states.
The goal of this study was to assess current levels of difficulty accessing specialty care for patients at community health centers (CHCs) by insurance type, in order to identify specific barriers and the strategies that CHCs use to overcome these barriers. A cross-sectional survey was administered to medical directors at CHCs in nine states as well as the District of Columbia, all of which had expanded Medicaid. Among the barriers reported by CHCs were few specialists in Medicaid managed care organization (MCO) networks accepting new patients and MCO administrative requirements for obtaining specialist consults. Strategies to enhance access to specialists included entering into referral agreements, developing appointment reminder systems, and participation in data exchange and other community-based initiatives. The authors conclude that payment policies and network adequacy rules may need to be reexamined to address these challenges.
AHRQ-funded; HS024067.
Citation: Timbie JW, Kranz AM, Mahmud A .
Specialty care access for Medicaid enrollees in expansion states.
Am J Manag Care 2019 Mar;25(3):e83-e87..
Keywords: Access to Care, Community-Based Practice, Healthcare Delivery, Medicaid
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Herrera CN, Brochier A, Pellicer M
Implementing social determinants of health screening at community health centers: clinician and staff perspectives.
Screening for social determinants of health (SDOH) during primary care office visits is recommended by pediatric and internal medicine professional guidelines. Less is known about how SDOH screening and service referral can be successfully integrated into clinical practice. SDOH screening and referral care models can help support the mission of community health centers by identifying unmet material needs. Additional support for SDOH models might include piloting the SDOH screening model workflow and formalizing the workflow before implementation, including the specific roles for clinicians, staff, and patient navigators.
AHRQ-funded; HS022242.
Citation: Herrera CN, Brochier A, Pellicer M .
Implementing social determinants of health screening at community health centers: clinician and staff perspectives.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719887260. doi: 10.1177/2150132719887260..
Keywords: Social Determinants of Health, Screening, Community-Based Practice, Primary Care, Provider: Clinician, Provider
Sun CJ, Nall JL, Rhodes SD
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice.
AHRQ-funded; HS022981.
Citation: Sun CJ, Nall JL, Rhodes SD .
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Am J Mens Health 2019 Jan-Feb;13(1):1557988318804901. doi: 10.1177/1557988318804901..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Men's Health, Community-Based Practice, Patient Adherence/Compliance