National Healthcare Quality and Disparities Report
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- Access to Care (1)
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- Cancer (8)
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- Cancer: Colorectal Cancer (8)
- Cancer: Lung Cancer (1)
- Cancer: Ovarian Cancer (1)
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- Human Immunodeficiency Virus (HIV) (4)
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- (-) Screening (45)
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- Urban Health (1)
- Women (7)
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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 45 Research Studies DisplayedBouchelle Z, Menko SG, Yazdani M
Parent perspectives on documentation and sharing of health-related social needs data.
This survey aimed to examine parents of pediatric patients’ preferences regarding how health-related social needs (HRSN) screening program data are documented and shared. The authors conducted semi-structured interviews with parents of hospitalized children participating in an HRSN screening program at a quaternary care children's hospital. Interviews were then coded to identify emergent themes. A total of 20 parents were interviewed with all being female, 55% identifying as Black or African American and 20% identifying as Hispanic or Latino. Parents expressed comfort with electronic health record documentation of HRSN data and the use of ICD-10 Revision Z codes as long as this information was used to provide families with meaningful support. Most parents viewed social workers and medical teams as being the most appropriate recipients of the data, with few parents feeling comfortable with HRSN data being shared with payors. Parents wanted transparency around HRSN data sharing, with many expressing concerns that documentation and sharing of HRSN data could lead to unwanted or unsafe disclosures or result in child welfare referrals.
AHRQ-funded; HS028555.
Citation: Bouchelle Z, Menko SG, Yazdani M .
Parent perspectives on documentation and sharing of health-related social needs data.
Hosp Pediatr 2024 Apr; 14(4):308-16. doi: 10.1542/hpeds.2023-007478..
Keywords: Children/Adolescents, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bradford W, Akselrod H, Bassler J
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
This multisite, retrospective cohort study of hospitalized patients with opioid use disorder with infectious complications of injection drug use looked at rates of HIV screening, pre-exposure prophylaxis, and treatment among these patients. The authors included 322 patients, with most (300) now known to have HIV. Of those, only 2 had a documented discussion of PrEP, while only 1 was prescribed PrEP on discharge. Among the 22 people with HIV (PWH), only 13 had a viral load collected during admission of whom all were viremic and 10 were successfully linked to care post-discharge. Both groups had high rates of readmission, Medicaid or uninsured status, and unstable housing.
AHRQ-funded; HS013852.
Citation: Bradford W, Akselrod H, Bassler J .
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
Addict Sci Clin Pract 2024 Mar 26; 19(1):22. doi: 10.1186/s13722-024-00451-z..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Prevention, Inpatient Care
Liu PH, Singal AG, Murphy CC
Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
This study examined receipt of past-year colorectal cancer (CRC screening) according to predicted 10-year mortality risk among 25,888 community-dwelling adults aged 65-84 years who were not up-to-date with screening in the nationwide National Health Interview Survey. Ten-year mortality risk was estimated using a validated index with the lowest to highest quintiles of the index ranging from 12%-79%. The authors also examined the proportion of screening performed among adults with life expectancy <10 years. They found that the prevalence of past-year CRC screening was 39.5%, 40.6%, 38.7%, 36.4%, and 35.4%, from the lowest to highest quintile of 10-year mortality risk, demonstrating that the odds of CRC screening did not differ in the lowest vs highest quintile. One-quarter of past-year CRC screening occurred in adults with life expectancy <10 years, and more than half (50.7%) of adults aged 75-84 years had 10-year mortality risk ≥50% at the time of screening. Invasive but not noninvasive screening increased as 10-year mortality risk increased among adults aged 70-79 years.
AHRQ-funded; HS022418.
Citation: Liu PH, Singal AG, Murphy CC .
Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
Am J Gastroenterol 2024 Feb; 119(2):353-63. doi: 10.14309/ajg.0000000000002536.
Keywords: Elderly, Cancer: Colorectal Cancer, Mortality, Screening, Colonoscopy
Miller AC, Koeneman SH, Suneja M
Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study.
This study’s objective was to describe individual variation in diurnal temperature patterns during episodes of febrile activity using millions of recorded temperatures and evaluate the probability of recording a fever by sex and for different age groups. The authors used timestamped deidentified temperature readings from thermometers across the US to construct illness episodes where continuous periods of activity in a single user included a febrile reading. They modeled the mean temperature recorded and probability of registering a fever across the course of a day using sinusoidal regression models while accounting for user age and sex. They then estimated the probability of recording a fever by time of day for children, working-age adults, and older adults. They found wide variation in body temperatures over the course of a day and across individual characteristics, with temperature patterns differing between men and women, and average temperatures declining for older age groups. There was a wide variation of the likelihood of fever detection by the time of day and by an individual’s age or sex.
AHRQ-authored; HS027375.
Citation: Miller AC, Koeneman SH, Suneja M .
Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study.
Diagnosis 2024 Feb 1; 11(1):54-62. doi: 10.1515/dx-2023-0074.
Keywords: Infectious Diseases, Screening
Feltner C, Wallace IF, Nowell SW
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review reviewed the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force. This literature review looked at English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions. Main outcomes and measures were screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms. A total of 38 studies in 41 articles were included (N = 9006). There were 21 studies (n = 7489) that assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (e.g., expressive language). Three studies assessing parent-reported tools for expressive language skills had consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). Other screening tools had widely varying accuracy. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders. There were no RCTs included on the harms of interventions.
AHRQ-funded; 75Q80120D00006.
Citation: Feltner C, Wallace IF, Nowell SW .
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2024 Jan 23; 331(4):335-51. doi: 10.1001/jama.2023.24647..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Prevention, Evidence-Based Practice
Peaker B, Dooley C B, Peaker B, Dooley C C
AHRQ Author: Peaker B
Screening for syphilis in nonpregnant adolescents and adults.
This case study described a 42-year-old male presenting at the clinic with low back pain that had been radiating down his right leg for one week. Case study questions related to the USPSTF recommendation on Screening for Syphilis in Nonpregnant Adolescents and Adults addressed why this patient was at increased risk, whether screening should take place, and why the USPSTF does not recommend screening for all people.
AHRQ-authored.
Citation: Peaker B, Dooley C B, Peaker B, Dooley C C .
Screening for syphilis in nonpregnant adolescents and adults.
Am Fam Physician 2024 Jan; 109(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Sexual Health, Children/Adolescents
Balbin CA, Kawamoto K
The SIMPLE architectural pattern for integrating patient-facing apps into clinical workflows: desiderata and application for lung cancer screening.
To address the need for electronic health record (EHR) systems to accept the connection of any patient-facing digital health app using the SMART on FHIR standard, the authors proposed the Standards-based Implementation Maximizing Portability Leveraging the EHR (SIMPLE). SIMPLE’s architectural pattern was designed to meet several key requirements, such as not requiring patients to install new software; not retaining patient data outside of the EHR; leveraging existing personal health record (PHR) capabilities to optimize user experience; and maximizing portability.
AHRQ-funded; HS028791.
Citation: Balbin CA, Kawamoto K .
The SIMPLE architectural pattern for integrating patient-facing apps into clinical workflows: desiderata and application for lung cancer screening.
AMIA Annu Symp Proc 2024 Jan 11; 2023:844-53..
Keywords: Workflow, Health Information Technology (HIT), Cancer: Lung Cancer, Cancer, Screening
Crawford J, Beaton D, Almad F
AHRQ Author: Bierman AS
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
The objective of this work was to develop a survey that considered cultural relevance and diversity of South Asian populations, with the aim of describing or predicting factors that influence colorectal cancer screening intention and adherence. The initial development of the Colon Cancer Screening Behaviours Survey for South Asian populations was completed using a number of steps. This initial survey was later cross-culturally translated and adapted into the Urdu language.
AHRQ-authored.
Citation: Crawford J, Beaton D, Almad F .
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
BMC Res Notes 2017 Dec 28;10(1):770. doi: 10.1186/s13104-017-3098-3.
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Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Patient Adherence/Compliance, Racial and Ethnic Minorities, Screening
Kistler CE, Golin C, Morris C
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
This paper reports on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. The study aims to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Morris C .
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
Clin Trials 2017 Dec;14(6):648-58. doi: 10.1177/1740774517725289..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Elderly, Prevention, Screening
Childers CP, Childers KK, Maggard-Gibbons M
National estimates of genetic testing in women with a history of breast or ovarian cancer.
In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15 percent of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. This study found that fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing.
AHRQ-funded; HS025079.
Citation: Childers CP, Childers KK, Maggard-Gibbons M .
National estimates of genetic testing in women with a history of breast or ovarian cancer.
J Clin Oncol 2017 Dec 1;35(34):3800-06. doi: 10.1200/jco.2017.73.6314.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Family Health and History, Genetics, Quality of Care, Screening, Women
Gao TY, Howe CJ, Zullo AR
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. The study’s findings suggested that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians.
AHRQ-funded; HS022998.
Citation: Gao TY, Howe CJ, Zullo AR .
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
Vulnerable Child Youth Stud 2017;12(4):277-91. doi: 10.1080/17450128.2016.1268741..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Lifestyle Changes, Screening, Urban Health
Fan T, Rogers A
AHRQ Author: Fan T
Screening for latent tuberculosis infection in adults.
G.R. is a 21-year-old nonpregnant woman who is new to the area and your office. She is applying to graduate school and wants to make sure her vaccinations are up to date. She reports she is doing well and has no concerns. This case study on tuberculosis screening poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Fan T, Rogers A .
Screening for latent tuberculosis infection in adults.
Am Fam Physician 2017 Nov 15;96(10):675-76.
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Keywords: Case Study, Infectious Diseases, Screening, U.S. Preventive Services Task Force (USPSTF)
Mabry-Hernandez I, Gottfredson R
AHRQ Author: Mabry-Hernandez I
Screening for lipid disorders in children and adolescents.
This case study concerns a healthy 12-year-old boy presenting for a school physical and well visit. His family history reveals that his maternal grandfather had a heart attack and that his father has started taking a medication for elevated cholesterol levels. His mother is concerned about his genetic risk of a cholesterol disorder and asks if he should be screened. The article poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Mabry-Hernandez I, Gottfredson R .
Screening for lipid disorders in children and adolescents.
Am Fam Physician 2017 Oct 15;96(8):529-30.
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Keywords: Children/Adolescents, Family Health and History, Screening, U.S. Preventive Services Task Force (USPSTF)
Rauscher GH, Dabbous F, Dolecek TA
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
The researchers sought to estimate the extent of an anticipated racial disparity in interval breast cancer (IBC) within a single, large health care organization. Contrary to expectation, in patient-adjusted models, there was no IBC racial disparity. The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated disparity in IBC.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Dabbous F, Dolecek TA .
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
Ann Epidemiol 2017 Oct;27(10):654-58. doi: 10.1016/j.annepidem.2017.09.002.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Racial and Ethnic Minorities, Women, Screening, Screening, Imaging
Adams LB, Richmond J, Corbie-Smith G
Medical mistrust and colorectal cancer screening among African Americans.
The goal of this systematic review was to summarize evidence investigating associations between medical mistrust and CRC screening among African Americans, and variations in these associations by gender, CRC screening type, and level of mistrust. The study found that quantitative differences in mistrust and CRC screening by gender were mixed, but qualitative studies highlighted fear of experimentation and intrusiveness of screening methods as unique themes among African American men.
AHRQ-funded; HS000032.
Citation: Adams LB, Richmond J, Corbie-Smith G .
Medical mistrust and colorectal cancer screening among African Americans.
J Community Health 2017 Oct;42(5):1044-61. doi: 10.1007/s10900-017-0339-2..
Keywords: Cancer: Colorectal Cancer, Prevention, Racial and Ethnic Minorities, Screening
Offorjebe OA, Wynn A, Moshashane N
Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana.
This paper describes a prospective cohort study which was conducted among 300 pregnant women presenting to the antenatal clinic at Princess Marina Hospital in Gaborone, Botswana who enrolled in an STI screening study. The authors specifically examine partner notification and treatment. They conclude that their findings suggest that pregnant women are willing to utilize patient-based partner notification, but actual partner treatment might be lower than intended.
AHRQ-funded; HS000046.
Citation: Offorjebe OA, Wynn A, Moshashane N .
Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana.
Int J STD AIDS 2017 Oct;28(12):1184-89. doi: 10.1177/0956462417692455..
Keywords: Infectious Diseases, Pregnancy, Screening, Women
Fan T, Rogers A
AHRQ Author: Fan T
Screening for syphilis infection in nonpregnant adults and adolescents.
R.J. is a 27-year-old man who presents for a well-patient visit. He always keeps his appointments and likes to make sure he is healthy. R.J. has started a new relationship and asks if he should be screened for syphilis. The case study asks a series of three questions based on the USPSTF recommendation statement. Answers are provided.
AHRQ-authored.
Citation: Fan T, Rogers A .
Screening for syphilis infection in nonpregnant adults and adolescents.
Am Fam Physician 2017 Sep 15;96(6):393-94.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Shared Decision Making, Infectious Diseases, Case Study
Jonas DE, Amick HR, Wallace IF
Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the US Preventive Services Task Force.
The researchers reviewed the evidence on screening for and treatment of amblyopia, its risk factors, and refractive error in children aged 6 months to 5 years to inform the US Preventive Services Task Force. They concluded that studies directly evaluating the effectiveness of screening were limited and do not establish whether vision screening in preschool children is better than no screening.
AHRQ-funded; 290201200015I.
Citation: Jonas DE, Amick HR, Wallace IF .
Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Sep 5;318(9):845-58. doi: 10.1001/jama.2017.9900.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Eye Disease and Health, Children/Adolescents, Screening, Newborns/Infants
Pham R, Cross S, Fernandez B
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
This community-led study was conducted to assess patient preferences for fecal immunochemical tests (FIT) characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection. The authors concluded that FIT characteristics influenced patient's perceptions of test acceptability and feasibility and indicated that health system leaders, payers, and clinicians should select FITs that are both clinically effective and incorporate patient preferred test characteristics.
AHRQ-funded; HS022981.
Citation: Pham R, Cross S, Fernandez B .
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
J Am Board Fam Med 2017 Sep-Oct;30(5):632-44. doi: 10.3122/jabfm.2017.05.170151..
Keywords: Cancer: Colorectal Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Rural Health, Screening
Kronish IM, Kent S, Moise N
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
The goal of the study was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. The study found that top-ranked barriers to home BP monitoring were concerns about compliance with the correct test protocol, accuracy of tests results, out-of-pocket costs of home BP devices, and time needed to instruct patients on home BP monitoring protocol.
AHRQ-funded; HS024262.
Citation: Kronish IM, Kent S, Moise N .
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
J Am Soc Hypertens 2017 Sep;11(9):573-80. doi: 10.1016/j.jash.2017.06.012..
Keywords: Blood Pressure, Primary Care, Diagnostic Safety and Quality, Screening
Fan T, Amobi A
AHRQ Author: Fan T
Screening for gynecologic conditions with pelvic examination.
A 37-year-old woman presents to your office for her annual wellness visit. She is not due for a Papanicolaou (Pap) smear this year. She is not pregnant, reports no problems, and has no risk factors for sexually transmitted infections. She asks if she should have a pelvic examination today. The case study asks a series of three questions based on the USPSTF recommendation statement. Answers are provided.
AHRQ-authored.
Citation: Fan T, Amobi A .
Screening for gynecologic conditions with pelvic examination.
Am Fam Physician 2017 Aug 15;96(4):253-54.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Women, Case Study, Shared Decision Making, Screening
Rowell-Cunsolo TL, Cortes YI, Long Y
Acceptability of rapid HIV testing among Latinos in Washington Heights, New York City, New York, USA.
In the United States, human immunodeficiency virus (HIV) has a disproportionately large impact on Latino Americans. Seventy-five percent of those surveyed accepted rapid HIV testing when offered. More religious participants were less likely than less religious participants to undergo testing. Participants tested for HIV within the past year were less likely than those who had not been tested within the past year to agree to undergo testing.
AHRQ-funded; HS022961.
Citation: Rowell-Cunsolo TL, Cortes YI, Long Y .
Acceptability of rapid HIV testing among Latinos in Washington Heights, New York City, New York, USA.
J Immigr Minor Health 2017 Aug;19(4):861-67. doi: 10.1007/s10903-016-0525-9.
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Keywords: Health Services Research (HSR), Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Racial and Ethnic Minorities, Screening
Misra-Hebert AD, Hu B, Klein EA
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
The researchers assessed prostate cancer screening practices in primary care since the initial United States Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA) testing for older men. Prostate cancer screening declined from 2007 to 2014 even in higher-risk groups and follow-up screening rates were not related to previous PSA level.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Klein EA .
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
BJU Int 2017 Aug;120(2):257-64. doi: 10.1111/bju.13793.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Primary Care, Practice Patterns
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)
Zieve GG, Richardson LP, Katzman K
Adolescents' perspectives on personalized e-feedback in the context of health risk behavior screening for primary care: Qualitative study.
The aim of this study was to explore youth perceptions of and preferences for receiving personalized feedback for multiple health risk behaviors and reinforcement for health promoting behaviors from an electronic health screening tool for primary care settings, using qualitative methodology. Overall, the tool was well-received by participants who perceived it as a way to enhance-but not replace-their interactions with providers.
AHRQ-funded; HS023383.
Citation: Zieve GG, Richardson LP, Katzman K .
Adolescents' perspectives on personalized e-feedback in the context of health risk behavior screening for primary care: Qualitative study.
J Med Internet Res 2017 Jul 20;19(7):e261. doi: 10.2196/jmir.7474.
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Keywords: Children/Adolescents, Health Information Technology (HIT), Health Promotion, Primary Care, Screening