National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (67)
- Adverse Drug Events (ADE) (35)
- Adverse Events (89)
- Alcohol Use (5)
- Ambulatory Care and Surgery (29)
- Antibiotics (41)
- Antimicrobial Stewardship (18)
- Anxiety (23)
- Arthritis (7)
- Asthma (75)
- Autism (23)
- Back Health and Pain (1)
- Behavioral Health (175)
- Blood Clots (2)
- Blood Pressure (12)
- Brain Injury (15)
- Breast Feeding (1)
- Burnout (2)
- Cancer (36)
- Cancer: Breast Cancer (3)
- Cardiovascular Conditions (27)
- Care Coordination (20)
- Caregiving (95)
- Care Management (27)
- Case Study (19)
- Catheter-Associated Urinary Tract Infection (CAUTI) (3)
- Central Line-Associated Bloodstream Infections (CLABSI) (10)
- Children's Health Insurance Program (CHIP) (34)
- (-) Children/Adolescents (1566)
- Chronic Conditions (109)
- Clinical Decision Support (CDS) (24)
- Clinician-Patient Communication (45)
- Colonoscopy (1)
- Communication (45)
- Community-Acquired Infections (11)
- Community-Based Practice (14)
- Community Partnerships (1)
- Comparative Effectiveness (26)
- Complementary and Alternative Medicine (3)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (11)
- COVID-19 (47)
- Critical Care (62)
- Cultural Competence (9)
- Data (9)
- Dental and Oral Health (24)
- Depression (43)
- Diabetes (17)
- Diagnostic Safety and Quality (74)
- Digestive Disease and Health (8)
- Disabilities (24)
- Disparities (50)
- Domestic Violence (13)
- Ear Infections (5)
- Education (19)
- Education: Continuing Medical Education (17)
- Education: Curriculum (1)
- Education: Patient and Caregiver (27)
- Electronic Health Records (EHRs) (62)
- Emergency Department (109)
- Emergency Medical Services (EMS) (23)
- Emergency Preparedness (1)
- Evidence-Based Practice (104)
- Eye Disease and Health (5)
- Falls (1)
- Family Health and History (45)
- Genetics (8)
- Guidelines (46)
- Healthcare-Associated Infections (HAIs) (44)
- Healthcare Cost and Utilization Project (HCUP) (73)
- Healthcare Costs (56)
- Healthcare Delivery (48)
- Healthcare Utilization (49)
- Health Information Exchange (HIE) (3)
- Health Information Technology (HIT) (110)
- Health Insurance (42)
- Health Literacy (14)
- Health Promotion (12)
- Health Services Research (HSR) (35)
- Health Status (13)
- Health Systems (1)
- Heart Disease and Health (13)
- Hepatitis (4)
- Home Healthcare (12)
- Hospital Discharge (31)
- Hospitalization (108)
- Hospital Readmissions (34)
- Hospitals (94)
- Human Immunodeficiency Virus (HIV) (12)
- Imaging (13)
- Implementation (17)
- Infectious Diseases (36)
- Influenza (13)
- Injuries and Wounds (20)
- Inpatient Care (48)
- Intensive Care Unit (ICU) (75)
- Kidney Disease and Health (4)
- Labor and Delivery (2)
- Lifestyle Changes (15)
- Long-Term Care (21)
- Low-Income (39)
- Maternal Care (10)
- Medicaid (67)
- Medical Devices (3)
- Medical Errors (26)
- Medical Expenditure Panel Survey (MEPS) (30)
- Medication (170)
- Medication: Safety (27)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (15)
- Mortality (18)
- Neonatal Intensive Care Unit (NICU) (2)
- Neurological Disorders (36)
- Newborns/Infants (41)
- Nursing (13)
- Nutrition (35)
- Obesity (83)
- Obesity: Weight Management (31)
- Opioids (16)
- Organizational Change (1)
- Orthopedics (2)
- Osteoporosis (1)
- Outcomes (72)
- Pain (7)
- Palliative Care (10)
- Patient-Centered Healthcare (52)
- Patient-Centered Outcomes Research (108)
- Patient Adherence/Compliance (16)
- Patient and Family Engagement (38)
- Patient Experience (26)
- Patient Safety (123)
- Patient Self-Management (9)
- Payment (5)
- Pneumonia (17)
- Policy (40)
- Practice Patterns (34)
- Pregnancy (14)
- Pressure Ulcers (1)
- Prevention (89)
- Primary Care (81)
- Primary Care: Models of Care (8)
- Provider (17)
- Provider: Clinician (4)
- Provider: Health Personnel (7)
- Provider: Nurse (3)
- Provider: Pharmacist (5)
- Provider: Physician (16)
- Provider Performance (3)
- Public Health (20)
- Quality Improvement (71)
- Quality Indicators (QIs) (21)
- Quality Measures (47)
- Quality of Care (109)
- Quality of Life (19)
- Racial and Ethnic Minorities (79)
- Registries (16)
- Research Methodologies (13)
- Respiratory Conditions (110)
- Risk (75)
- Rural/Inner-City Residents (3)
- Rural Health (13)
- Screening (64)
- Sepsis (27)
- Sex Factors (5)
- Sexual Health (17)
- Shared Decision Making (51)
- Sickle Cell Disease (24)
- Simulation (5)
- Skin Conditions (31)
- Sleep Problems (17)
- Social Determinants of Health (50)
- Social Media (7)
- Social Stigma (4)
- Stress (9)
- Stroke (2)
- Substance Abuse (27)
- Surgery (68)
- Surveys on Patient Safety Culture (1)
- Teams (10)
- Telehealth (27)
- Tobacco Use (8)
- Tobacco Use: Smoking Cessation (4)
- Tools & Toolkits (3)
- Training (16)
- Transitions of Care (25)
- Transplantation (28)
- Trauma (26)
- Treatments (17)
- U.S. Preventive Services Task Force (USPSTF) (41)
- Uninsured (6)
- Urban Health (13)
- Urinary Tract Infection (UTI) (4)
- Vaccination (59)
- Vitamins and Supplements (2)
- Vulnerable Populations (52)
- Web-Based (5)
- Women (18)
- Workflow (4)
- Workforce (1)
- Young Adults (37)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
76 to 100 of 1566 Research Studies DisplayedMcCarthy IM, Raval MV
Price spillovers and specialization in health care: the case of children's hospitals.
The purpose of this study was to explore a possible differentiation effect in which patients perceive specialty hospitals as different from other hospitals, so that specialty hospitals effectively compete in a separate market from general acute care hospitals. The researchers examined this effect in the context of routine pediatric procedures offered by both specialty children's hospitals and general acute care hospitals. The study found substantial empirical evidence of a differentiation effect in which competitive forces from non-children's hospitals appear largely irrelevant for specialty children's hospitals.
AHRQ-funded; HS024712.
Citation: McCarthy IM, Raval MV .
Price spillovers and specialization in health care: the case of children's hospitals.
Health Econ 2023 Oct; 32(10):2408-23. doi: 10.1002/hec.4734..
Keywords: Children/Adolescents, Hospitals, Healthcare Delivery
Feldman AG, Beaty BL, Ferrolino Ja
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
This study’s objective was to determine the safety and immunogenicity of live vaccines in pediatric liver and kidney transplant recipients. This cohort study included 281 children, of which 270 had received a liver transplant, 9 a kidney transplant, and 2 were liver-kidney transplant recipients. None of the children included had completed their primary measles-mumps-rubella (MMR) and varicella-zoster virus (VZV) vaccine series and/or had displayed nonprotective serum antibody levels at enrollment between January 1, 2002, and February 28, 2023. Safety data was collected after these transplant recipients had received 1 to 3 doses or MMR vaccine and/or 1 to 3 doses of VZV vaccine. The median time from transplant to enrollment was 6.3 years, with the median age at first posttransplant vaccine 8.9 years. The majority of children developed protective antibodies following vaccination (107 of 149 varicella, 130 of 152 measles, 100 of 120 mumps, and 124 of 125 rubella). One year post vaccination, the majority of children who initially mounted protective antibodies maintained this protection (34 of 44 varicella, 45 of 49 measles, 35 of 42 mumps, 51 of 54 rubella). Five children developed varicella, all of which resolved within 1 week, and there were no cases of measles or rubella and no episodes or graft rejection within 1 month of vaccination. There was also no association between antibody response and immunosuppression level at the time of vaccination.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty BL, Ferrolino Ja .
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
JAMA Netw Open 2023 Oct; 6(10):e2337602. doi: 10.1001/jamanetworkopen.2023.37602..
Keywords: Children/Adolescents, Vaccination, Transplantation
Pantell MS, Holmgren AJ, Leary JC
Social and medical care integration practices among children's hospitals.
This study sought to describe screening practices for adverse social determinants of health (SDOH) among a national sample of children’s hospitals. The authors analyzed responses to the 2020 American Hospital Association Annual Survey. Among children's hospitals, they calculated the prevalence of screening for social needs, strategies to address social risks/needs, partnerships with community-based organizations to address social risks/needs at the individual and community level, and rates of impact assessments of how social risk-related interventions affect outcomes. They also used χ2 tests to compare results by hospital characteristics and weighted results to adjust for nonresponse. Out of 82 children’s hospitals in the sample, a total of 79.6% screened for and 96.0% had strategies to address at least 1 social risk factor, although rates varied by SDOH domain. These hospitals more commonly partnered with community-based organizations to address patient-level social risks than participated in community-level initiatives. SDOH intervention effectiveness was assessed in a total of 39.2% of hospitals. The authors found differences in social risk-related care practices commonly varied by hospital ownership and Medicaid population but not by region.
AHRQ-funded; HS028473.
Citation: Pantell MS, Holmgren AJ, Leary JC .
Social and medical care integration practices among children's hospitals.
Hosp Pediatr 2023 Oct; 13(10):886-94. doi: 10.1542/hpeds.2023-007246..
Keywords: Children/Adolescents, Hospitals, Social Determinants of Health
Soulsby WD, Lawson E, Okumura M
Socioeconomic factors are associated with severity of hospitalization in pediatric lupus: an analysis of the 2016 Kids' Inpatient Database.
This study’s goal was to investigate the relationship of income level and other socioeconomic factors with length of stay (LOS) in the hospital and severe lupus features using the 2016 Kids' Inpatient Database (KID). The cohort included children aged 2-20 identified with lupus hospitalization in the 2016 KID using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes (M32). A total of 3,367 unweighted lupus hospitalizations were identified. Income level was found to be a statistically significant predictor of increased LOS in the hospital for those in the lowest income quartile. Black race, "other" race, and public insurance were also associated with severe lupus features.
AHRQ-funded; HS026383.
Citation: Soulsby WD, Lawson E, Okumura M .
Socioeconomic factors are associated with severity of hospitalization in pediatric lupus: an analysis of the 2016 Kids' Inpatient Database.
Arthritis Care Res 2023 Oct; 75(10):2073-81. doi: 10.1002/acr.25121..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Chronic Conditions
Oke I, Hunter DG, Mantagos IS
The impact of the COVID-19 pandemic on the surgical volume of pediatric ophthalmology and strabismus fellows.
This article described a study that used data from the annual fellowship survey to describe trends in surgical experience for pediatric ophthalmology and strabismus fellows, and to quantify the impact of the COVID-19 pandemic on trainee surgical volume. The findings showed that the overall number of procedures performed by fellows in the primary surgeon role declined during the first academic year of the pandemic but recovered in the second year. The number of intraocular cases performed per year increased during the study’s 7-year interval.
AHRQ-funded; HS000063.
Citation: Oke I, Hunter DG, Mantagos IS .
The impact of the COVID-19 pandemic on the surgical volume of pediatric ophthalmology and strabismus fellows.
J AAPOS 2023 Oct; 27(5):305-07. doi: 10.1016/j.jaapos.2023.06.006..
Keywords: COVID-19, Children/Adolescents, Surgery
Wagner L, Corona L, Khan N
Development of an app for tracking family engagement with early intervention services: focus groups and pilot evaluation study.
This paper describes the results of a two-part study to develop a mobile health app to help young families navigate the early intervention (EI) system for their young children, focusing on underserved communities. In Study 1, the authors conducted focus groups to access a broad range of perspectives on the process of navigating the EI system, with the dual goals of identifying ways in which a patient-facing app might facilitate this process and identifying barriers to use with traditionally underrepresented and underserved groups. In Study 2, the focus group input informed the development of a patient-facing app, which was subsequently tested with a pilot sample of 5 families. Study 1 included 29 participants from 4 shareholder groups, who provided information about barriers families experience as they navigate the EI system, and their ideal features of a patient-facing app designed to track family engagement with the EI system, and potential barriers. In Study 2, 5 families used the Family on Track pilot app, and then provided information on app functionality and usability. App features included were survey customization, timing and delivery of prompts, and questions related to barriers and service satisfaction. Implementation supports that were included were a visual guide for app installation, resources related to common family questions, and availability of study personnel to guide families through installation and provide ongoing support.
AHRQ-funded; HS026395.
Citation: Wagner L, Corona L, Khan N .
Development of an app for tracking family engagement with early intervention services: focus groups and pilot evaluation study.
JMIR Hum Factors 2023 Sep 12; 10:e45957. doi: 10.2196/45957..
Keywords: Patient and Family Engagement, Health Information Technology (HIT), Children/Adolescents
Benziger CP, Suess M, Allen CI
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
This paper’s objective is to describe the protocol for a study that will adapt an electronic health record linked, web-based clinical decision support (CDS) tool called PedsBP that identifies hypertension (HTN) in children for use in a mostly rural health system and to evaluate the effectiveness of PedsBP for repeat of hypertensive level blood pressure (BP) measurements and HTN recognition among youth 6-17 years of age in primary care settings, comparing low-intensity and high-intensity implementation approaches. A pilot of the tool was conducted in 2 primary care clinics and modified prior to the full trial. Forty community-based primary care clinics (or clusters of clinics) were randomly allocated equally to usual care, low-intensity implementation (CDS only), or high-intensity implementation (CDS plus in-person training, monthly use reports, and ongoing communication between study staff and clinics). Eligible patient recruitment started on August 1, 2022 and will continue for 18 months. Primary outcomes will include repeating hypertensive level BP measurements at office visits and clinical recognition of HTN. Secondary outcomes will include lifestyle counseling, dietician referral, and BP at follow-up.
AHRQ-funded; HS027402.
Citation: Benziger CP, Suess M, Allen CI .
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
Contemp Clin Trials 2023 Sep; 132:107293. doi: 10.1016/j.cct.2023.107293..
Keywords: Clinical Decision Support (CDS), Children/Adolescents, Rural Health, Rural/Inner-City Residents, Blood Pressure
Weaver MS, Ulrich CM, Moon MR
Adherence to the AAP's institutional ethics committee policy recommendations.
The aim of this study was to determine the level at which pediatric institutional ethics committees (IECs) comply with to the American Academy of Pediatrics (AAP) IEC Policy Statement recommendations. The researchers utilized a convenience sample taken from the Children's Hospital Association membership who were invited to complete an electronic survey in spring 2022. A total of 117 out of 181 surveys were completed (65%). The study found that stark gaps in IEC practice included: lack of membership diversity, needs for training to maintain members' competencies, organizational quality improvement, and scope of ethics service. Results indicated that 25% of IECs did not have a systematic method for informing hospital staff about ethics consultancy services and how to place an ethics consult. Further, 19% of responding IEC services did not inform patients or families about the availability of ethics consult services. 33% of the responding children's hospitals did not provide resources for the IECs to provide ethics education at their facility.
AHRQ-funded; HS028427.
Citation: Weaver MS, Ulrich CM, Moon MR .
Adherence to the AAP's institutional ethics committee policy recommendations.
Hosp Pediatr 2023 Sep; 13(9):e246-e50. doi: 10.1542/hpeds.2023-007124..
Keywords: Children/Adolescents, Policy, Hospitals
Franklin MK, Karpyn A, Christofferson J
Barriers and facilitators to discussing parent mental health within child health care: perspectives of parents raising a child with congenital heart disease.
This study’s objective was to identify barriers and facilitators to the discussion of parental mental health within child health care for children with congenital heart disease (CHD). Participants were parents of young children with CHD who received care across 40 hospitals in the US. They responded to questions about discussing their mental health with their child's health care providers and described multiple barriers including perceived expectation to "stay strong," and fear of negative judgment or repercussions. Facilitators included care team ability to provide support and personal connections with health care providers. The authors concluded that is important that health care providers normalize the impact of child illness on the family and create an environment in which parents feel comfortable discussing mental health challenges.
AHRQ-funded; HS026393.
Citation: Franklin MK, Karpyn A, Christofferson J .
Barriers and facilitators to discussing parent mental health within child health care: perspectives of parents raising a child with congenital heart disease.
J Child Health Care 2023 Sep; 27(3):360-73. doi: 10.1177/13674935211058010..
Keywords: Children/Adolescents, Behavioral Health, Heart Disease and Health, Cardiovascular Conditions
Mauskar S, Ngo T, Haskell H
In their own words: safety and quality perspectives from families of hospitalized children with medical complexity.
The purpose of this study was to address the gap of research on inpatient safety/quality experience of Children with medical complexity (CMC) and identify otherwise unrecognized, family-prioritized areas for improving safety/quality of children with medical complexity (CMC). Out of 208 families surveyed, 237 (88%) families completed surveys; 83 families offered 138 free-text safety responses about medications, feeds, cares, and other categories. The study found that themes included unmet expectations of hospital care/environment, lack of consistency, provider-patient communication lapses, families' expertise about care, and the value of transparency.
AHRQ-funded; HS025781.
Citation: Mauskar S, Ngo T, Haskell H .
In their own words: safety and quality perspectives from families of hospitalized children with medical complexity.
J Hosp Med 2023 Sep; 18(9):777-86. doi: 10.1002/jhm.13178..
Keywords: Children/Adolescents, Patient Safety, Quality of Care, Chronic Conditions
Rao S, Armistead I, Tyler A
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
This study compared demographic characteristics, clinical features, and outcomes of children hospitalized with respiratory syncytial virus (RSV), influenza, or severe acute respiratory syndrome coronavirus 2 during their cocirculation 2021-2022 respiratory virus season. The authors conducted a retrospective cohort study using Colorado's hospital respiratory surveillance data comparing coronavirus disease 2019 (COVID-19)-, influenza-, and RSV-hospitalized cases < 18 years of age admitted and undergoing standardized molecular testing between October 1, 2021, and April 30, 2022. The cohort consisted of 847 hospitalized cases, of which 490 (57.9%) were RSV associated, 306 (36.1%) were COVID-19 associated, and 51 (6%) were influenza associated. Most RSV cases were children less than 4 years of age (92.9%), whereas influenza hospitalizations were observed in older children. RSV cases were more likely to require oxygen support higher than nasal cannula compared with COVID-19 and influenza cases, although COVID-19 cases were more likely to require invasive mechanical ventilation than influenza and RSV cases. Compared with children with COVID-19, the risk of intensive care unit admission was highest among children with influenza, whereas the risk of pneumonia, bronchiolitis, longer hospital length of stay, and need for oxygen were more likely among children with RSV.
AHRQ-funded; HS026512.
Citation: Rao S, Armistead I, Tyler A .
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
J Pediatr 2023 Sep; 260:113491. doi: 10.1016/j.jpeds.2023.113491..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Influenza, Hospitalization, Infectious Diseases
Feldman AG, Beaty B, Everitt M
Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.
This study’s objective was to assess COVID-19 policies at US pediatric solid organ transplant centers. A 79-item survey was created and emailed between March and April 2022 to 200 UNOS Medical Directors detailing center COVID-19 vaccine policies for transplant candidates and living donors and use of grafts from COVID-19-positive deceased donors. The response rate was 77%. For children aged 5-15 years, 23% of centers have a COVID-19 vaccine mandate, 27% anticipate implementing a future mandate, and 47% have not considered or do not anticipate implementing a mandate. For children ≥16 years, 32% of centers have a COVID-19 vaccine mandate, 25% anticipate implementing a future mandate, and 40% have not considered or do not anticipate implementing a mandate. The top two reasons provided for not implementing a COVID-19 vaccine mandate were concerns about penalizing a child for their parent's decision and worsening inequities in transplant. Almost a third of 85 (27/85) kidney and liver living donor centers require vaccinations of donors. Twenty percent of centers accept organs from COVID-19-positive deceased donors.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty B, Everitt M .
Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.
Pediatr Transplant 2023 Sep; 27(6):e14513. doi: 10.1111/petr.14513..
Keywords: COVID-19, Children/Adolescents, Transplantation
Darling KE, West C, Jelalian E
The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes.
This study examined the buffering effect that family support on the association between weight-based victimization (WBV) and adolescent weight management options. Parents of adolescents (n = 78) completed psychosocial measures at baseline of a clinical weight management program. Objective height and weight were measured at baseline and follow-up at Visit 3. There was a significant moderating effect of family support on the association between WBV and weight change (p = .04), accounting for 5.0% of the variance in weight change.
AHRQ-funded; HS02707.
Citation: Darling KE, West C, Jelalian E .
The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes.
J Fam Psychol 2023 Sep; 37(6):942-46. doi: 10.1037/fam0001084..
Keywords: Children/Adolescents, Obesity, Obesity: Weight Management
Overhage L, Hailu R, Busch AB
Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic.
This study’s objective was to examine youth acute mental health care use (emergency department [ED], boarding, and subsequent inpatient care) during the second year of the COVID-19 pandemic. This cross-sectional analysis used data from national, deidentified commercial health insurance claims of youth mental health ED and hospital care that took place between March 2019 and February 2022. Among 4.1 million commercial insurance enrollees aged 5 to 17 years, 17,614 in the baseline year (March 2019-February 2020) and 16,815 youth in pandemic year 2 (March 2021-February 2022) had at least 1 mental health ED visit. Comparing baseline to pandemic year 2, there was a 6.7% increase in youth with any mental health ED visits. Among adolescent females, there was a larger increase (22.1%). The fraction of ED visits that resulted in a psychiatric admission increased by 8.4%. Mean length of inpatient psychiatric stay increased 3.8%. The fraction of episodes with prolonged boarding increased 76.4%.
AHRQ-funded; HS026503.
Citation: Overhage L, Hailu R, Busch AB .
Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic.
JAMA Psychiatry 2023 Sep; 80(9):924-32. doi: 10.1001/jamapsychiatry.2023.2195..
Keywords: COVID-19, Behavioral Health, Children/Adolescents
Warnick J, Darling KE, Topor LS
Formative development of a weight management intervention for adolescents with type 1 diabetes mellitus and obesity.
Researchers interviewed overweight or obese adolescents with type 1 diabetes mellitus (T1D), their caregivers, and pediatric endocrinologists to understand if they would be interested in a weight management intervention adapted for youth with T1D. The results provided detailed recommendations for the adaptation of a behavioral weight management intervention. Five central themes emerged: program content, programmatic messaging, program structure, social support, and risk of eating disorders.
AHRQ-funded; HS027071.
Citation: Warnick J, Darling KE, Topor LS .
Formative development of a weight management intervention for adolescents with type 1 diabetes mellitus and obesity.
Pediatr Diabetes 2023; 2023. doi: 10.1155/2023/9584419..
Keywords: Children/Adolescents, Obesity, Chronic Conditions, Obesity: Weight Management
Allende-Richter S, Benitez AD, Ramirez M
A patient portal intervention to promote adolescent and young adult self-management skills.
This study’s objective was to examine whether a patient portal educational intervention is acceptable and can improve adolescent and young adult (AYA) self-management skills toward transition readiness to adult care. The authors conducted a single site feasibility study using a mixed research method consisting of 1) a patient portal one-on-one educational intervention with pre- and postsurveys adapted from the Transition Readiness Assessment Questionnaire to assess participant self-management skills and portal user activity; 2) a portal user experience that was assessed through semistructured interviews until thematic saturation was reached. Study participants were 13 to 25 years old and received care at an academic-affiliated community pediatric clinic, of whom 78 (60%) completed the pre- and post-surveys. Following the educational intervention, they observed an increase in participants self-reporting knowing how to access their protected health information and in the proportion of participants self-reporting to strongly agree to know their medication. They also observed an increase in portal user access at 3 weeks. The median number of logins was 2 per participant.
AHRQ-funded; HS000063.
Citation: Allende-Richter S, Benitez AD, Ramirez M .
A patient portal intervention to promote adolescent and young adult self-management skills.
Acad Pediatr 2023 Aug; 23(6):1252-58. doi: 10.1016/j.acap.2023.02.003..
Keywords: Children/Adolescents, Young Adults, Patient Self-Management, Electronic Health Records (EHRs), Health Information Technology (HIT)
Anan YH, Kahn NF, Garrison MM
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
The objective of this paper was to understand associations between low sleep duration and positive mental health screens among adolescents seen for preventive visits in primary care. Data were taken from two randomized controlled trials that tested the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. The results showed that low sleep duration was associated with greater odds of positive depression screen, but not with a positive anxiety or co-occurring positive depression and anxiety screens. The authors concluded that, as pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are necessary to ensure effective early intervention for adolescent sleep and mental health problems.
AHRQ-funded; HS023383.
Citation: Anan YH, Kahn NF, Garrison MM .
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
Acad Pediatr 2023 Aug; 23(6):1242-46. doi: 10.1016/j.acap.2023.02.013..
Keywords: Children/Adolescents, Sleep Problems, Primary Care, Behavioral Health, Screening
Sequeira GM, Kahn NF, Ricklefs C
Barriers pediatric PCP's identify to providing gender-affirming care for adolescents.
The purpose of this study was to explore pediatric primary care providers’ (PCPs) perspectives on barriers experienced in providing gender-affirming care to transgender and gender diverse (TGD) youth. Pediatric PCPs who had sought support from the Seattle Children's Gender Clinic were recruited to participate in semi-structured, one-hour interviews. They identified both health system and community-level barriers to providing gender-affirming care. The authors concluded that these barriers must be overcome in the pediatric primary care setting to ensure that TGD youth receive timely, effective, and more equitable gender-affirming care.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Kahn NF, Ricklefs C .
Barriers pediatric PCP's identify to providing gender-affirming care for adolescents.
J Adolesc Health 2023 Aug; 73(2):367-74. doi: 10.1016/j.jadohealth.2023.04.007..
Keywords: Children/Adolescents, Primary Care, Access to Care
Krishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Volerman A, Balachandran U, Zhu M
Evaluating inhaler education interventions for hospitalized children with asthma: a randomized controlled trial.
The objective of this study was to evaluate whether the technology-based intervention-Virtual Teach-to-Goal (V-TTG) could lead to less inhaler misuse among children hospitalized with asthma. A single-center randomized controlled trial of V-TTG vs brief intervention was conducted with children aged 5-10 with asthma. At baseline, nearly all children misused inhalers; inhaler misuse decreased significantly in both V-TTG and brief intervention. The researchers suggested that future studies evaluate V-TTG intervention across diverse populations and disease severities to identify its greatest impact.
AHRQ-funded; HS027804.
Citation: Volerman A, Balachandran U, Zhu M .
Evaluating inhaler education interventions for hospitalized children with asthma: a randomized controlled trial.
Ann Allergy Asthma Immunol 2023 Aug; 131(2):217-23.e1. doi: 10.1016/j.anai.2023.02.023..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Education: Patient and Caregiver, Inpatient Care
Jones SA, Schlundt DG, Bonnet KR
Head Start's role in addressing food and nutrition insecurity: focus group findings.
The purpose of this study was to explore the perspectives of Head Start (HS) families' and employees' on family experiences with food and nutrition insecurity (FNI) and determine if and how HS addresses them. From August 2021 to January 2022, the researchers conducted 4 virtual focus groups with 27 HS employee and family participants. The study found that when addressing multilevel factors affecting FNI, HS's 2-generational method is useful for families. It was also determined that the role of the family advocate is critical. Finally, in addition to improving access to nutritious foods, skills and education to decrease generational unhealthy behaviors should be emphasized.
AHRQ-funded; HS026122.
Citation: Jones SA, Schlundt DG, Bonnet KR .
Head Start's role in addressing food and nutrition insecurity: focus group findings.
J Nutr Educ Behav 2023 Aug; 55(8):612-20. doi: 10.1016/j.jneb.2023.04.004..
Keywords: Children/Adolescents, Nutrition
Young AL, Monuteaux MC, Cooney TM
Predictors of delayed diagnosis of pediatric CNS tumors in the emergency department.
Delays in the diagnosis of central nervous system (CNS) tumors in children may lead to adverse outcomes and undue burdens on families. The purpose of this study was to examine factors related with delayed emergency department (ED) diagnosis to identify approaches to reduce delays. Researchers included 2828 children, 76% were controls, 24% were cases). Among cases, 68% had 1 preceding ED visit, 21% had 2, and 11% had 3 or more. The study found significant predictors of delayed diagnosis included presence of a complex chronic condition, rural hospital location, nonteaching hospital status, age younger than 5 years, public insurance, and black race.
AHRQ-funded; HS026503.
Citation: Young AL, Monuteaux MC, Cooney TM .
Predictors of delayed diagnosis of pediatric CNS tumors in the emergency department.
Pediatr Emerg Care 2023 Aug; 39(8):617-22. doi: 10.1097/pec.0000000000002943..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Cancer, Emergency Department
Campbell JI, Shanahan KH, Bartick M
Racial and ethnic differences in length of stay for US Children hospitalized for acute osteomyelitis.
The objective of this cross-sectional study was to examine the association between race/ethnicity and length of stay (LOS) for US children with acute osteomyelitis. Data was taken from the Kids' Inpatient Database. The median LOS was 5 days, but the findings indicated that Black, Hispanic, and other non-White race/ethnicity children with acute osteomyelitis experienced longer LOS than White children. The researchers concluded that elucidation of the mechanisms underlying these race- and ethnicity-based differences, including social drivers, may improve management and outcomes.
AHRQ-funded; HS000063.
Citation: Campbell JI, Shanahan KH, Bartick M .
Racial and ethnic differences in length of stay for US Children hospitalized for acute osteomyelitis.
J Pediatr 2023 Aug; 259:113424. doi: 10.1016/j.jpeds.2023.113424..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Hospitalization
Heerman WJ, Sneed NM, Sommer EC
Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.
The purpose of this study was to assess the relationship between baseline ultra-processed food consumption in early childhood and child BMI Z-score over 36 months. Among 595 children, median baseline age was 4.3 years, 65.4% had normal weight, 33.8% were overweight, and 0.8% were obese. When compared with low ultra-processed consumption (300 kcals/day), High ultra-processed intake (1300 kcals/day) was related with a 1.2 higher BMI-Z at 36 months for 3-year-olds and a 0.6 higher BMI-Z for 4-year-olds. The difference was not statistically significant for 5-year-olds or overall.
AHRQ-funded; HS026122.
Citation: Heerman WJ, Sneed NM, Sommer EC .
Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.
Pediatr Obes 2023 Aug; 18(8):e13037. doi: 10.1111/ijpo.13037..
Keywords: Children/Adolescents, Obesity, Low-Income, Nutrition, Vulnerable Populations
Loo S, Brady KJS, Ragavan MI
Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings.
This study examined the validity of the Clinicians’ Cultural Sensitivity Survey (CCCS) for use in pediatric primary care, which was developed as a patient-reported survey assessing clinicians' recognition of cultural factors affecting care quality for older Latino patients. The authors adapted the survey for use with parents of pediatric patients. A convenience sampling approach was used to identify eligible parents during well-child visits at urban pediatric primary care clinic, and parents were administered the survey via electronic tablet. They first conducted exploratory factor analyses (EFAs) to explore the dimensionality of survey responses in the adapted CCSS, and then conducted a series of confirmatory factor analyses (CFAs) using maximum likelihood estimation based on the results of the EFAs. Exploratory and confirmatory factor analyses (N = 212 parent surveys) supported a three-factor structure assessing racial discrimination, culturally-affirming practices, and causal attribution of health problems. The 3-factor model also outperformed other potential factors in terms of fit statistics and demonstrated adequate fit.
AHRQ-funded; HS022242; HS026395.
Citation: Loo S, Brady KJS, Ragavan MI .
Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings.
J Immigr Minor Health 2023 Aug; 25(4):790-802. doi: 10.1007/s10903-023-01469-2..
Keywords: Children/Adolescents, Primary Care, Cultural Competence, Healthcare Delivery