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
126 to 150 of 171 Research Studies DisplayedWilliamson HC, Altman N, Hsueh J
Effects of relationship education on couple communication and satisfaction: a randomized controlled trial with low-income couples.
Data from the Supporting Healthy Marriage Project-a randomized, controlled trial of relationship education for couples living with low incomes were analyzed to test whether intervention effects on relationship satisfaction would be mediated by observational assessments of relationship communication. Results suggested that relationship education programs produce small improvements in relationship satisfaction and communication, particularly for couples at elevated sociodemographic risk.
AHRQ-funded; 233030034.
Citation: Williamson HC, Altman N, Hsueh J .
Effects of relationship education on couple communication and satisfaction: a randomized controlled trial with low-income couples.
J Consult Clin Psychol 2016 Feb;84(2):156-66. doi: 10.1037/ccp0000056.
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Keywords: Communication, Education: Patient and Caregiver, Low-Income, Outcomes
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: evidence from the National Health and Nutrition Examination Survey.
This paper examined whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. Findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: evidence from the National Health and Nutrition Examination Survey.
Soc Sci Med 2016 Feb;150:258-67. doi: 10.1016/j.socscimed.2015.10.055.
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Keywords: Access to Care, Eye Disease and Health, Health Insurance, Low-Income, Medicaid
Sommers BD, Blendon RJ, Orav EJ
Both the 'private option' and traditional Medicaid expansions improved access to care for low-income adults.
This study found that other than coverage type and trouble paying medical bills (which decreased more in Kentucky than in Arkansas), there were no significant differences between Kentucky's traditional Medicaid expansion and Arkansas's private option, which suggests that both approaches improved access among low-income adults.
AHRQ-funded; HS021291.
Citation: Sommers BD, Blendon RJ, Orav EJ .
Both the 'private option' and traditional Medicaid expansions improved access to care for low-income adults.
Health Aff 2016 Jan;35(1):96-105. doi: 10.1377/hlthaff.2015.0917.
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Keywords: Medicaid, Low-Income, Healthcare Costs, Access to Care, Policy
Kreider AR, French B, Aysola J
Quality of health insurance coverage and access to care for children in low-income families.
This study compared health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. It found that children with all insurance types experienced challenges in access to specialty care, with caregivers of children insured by the Children’s Health Insurance Program reporting the highest rates of difficulty accessing specialty care, problems obtaining a referral, and frustration obtaining health care services.
AHRQ-funded; HS021706.
Citation: Kreider AR, French B, Aysola J .
Quality of health insurance coverage and access to care for children in low-income families.
JAMA Pediatr 2016 Jan;170(1):43-51. doi: 10.1001/jamapediatrics.2015.3028..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Access to Care, Low-Income
Quan J, Lee AK, Handley MA
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
The objective was to determine whether automated telephone self-management support for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. It found no significant differences in emergency department visits and hospitalizations or in costs.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Quan J, Lee AK, Handley MA .
Automated telephone self-management support for diabetes in a low-income health plan: a health care utilization and cost analysis.
Popul Health Manag 2015 Dec;18(6):412-20. doi: 10.1089/pop.2014.0154.
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Keywords: Diabetes, Chronic Conditions, Patient Self-Management, Low-Income, Healthcare Costs
Waehrer G, Deb P, Decker SL
AHRQ Author: Decker SL
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income). In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality.
AHRQ-authored.
Citation: Waehrer G, Deb P, Decker SL .
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
Econ Hum Biol 2015 Dec;19:170-83. doi: 10.1016/j.ehb.2015.08.006..
Keywords: Nutrition, Social Determinants of Health, Low-Income, Vulnerable Populations
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
Chao MT, Handley MA, Quan J
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
The authors identified sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. Disclosure was associated with language concordance, physicians' interpersonal communication scores, shared decision making, and explanatory-type communication.
AHRQ-funded; HS020684; HS017261; HS022561.
Citation: Chao MT, Handley MA, Quan J .
Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes.
Patient Educ Couns 2015 Nov;98(11):1360-6. doi: 10.1016/j.pec.2015.06.011.
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Keywords: Low-Income, Diabetes, Complementary and Alternative Medicine, Racial and Ethnic Minorities, Healthcare Delivery
Kennedy-Hendricks A, Schwartz HL, Griffin BA
Health implications of social networks for children living in public housing.
This study sought to examine whether the health composition of the social networks of children living in subsidized housing differs from those living in public housing developments; and whether children's social network composition is associated with children's own health. The authors found no significant differences in the health characteristics of the social networks of children based on housing, but social network composition was significantly associated with several aspects of children's own health.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Schwartz HL, Griffin BA .
Health implications of social networks for children living in public housing.
Health Place 2015 Nov;36:145-51. doi: 10.1016/j.healthplace.2015.11.001.
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Keywords: Children/Adolescents, Health Status, Low-Income, Social Determinants of Health
Kennedy-Hendricks A, Schwartz H, Thornton RJ
Intergenerational social networks and health behaviors among children living in public housing.
The researchers investigated whether caretakers' social networks are linked with children's health status. They found that caretaker social networks are independently associated with certain aspects of child health, suggesting the importance of the broader social environment for low-income children's health.
AHRQ-funded; HS023009.
Citation: Kennedy-Hendricks A, Schwartz H, Thornton RJ .
Intergenerational social networks and health behaviors among children living in public housing.
Am J Public Health 2015 Nov;105(11):2291-7. doi: 10.2105/ajph.2015.302663.
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Keywords: Caregiving, Children/Adolescents, Family Health and History, Health Status, Low-Income
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
AHRQ-funded; HS021291.
Citation: Ndumele CD, Sommers BD, Trivedi AN .
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0..
Keywords: Health Insurance, Medicare, Elderly, Low-Income
Garcia Mosqueira A, Hua LM, Sommers BD
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
The researchers explored potential factors related to racial/ethnic differences in ACA enrollment - awareness of the law and receipt of application assistance such as navigator services. Their results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations to close existing disparities in coverage.
AHRQ-funded; HS021291.
Citation: Garcia Mosqueira A, Hua LM, Sommers BD .
Racial differences in awareness of the Affordable Care Act and application assistance among low-income adults in three Southern states.
Inquiry 2015 Oct 8;52. doi: 10.1177/0046958015609607.
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Keywords: Disparities, Health Insurance, Low-Income, Medicaid, Racial and Ethnic Minorities
Golberstein E, Gonzales G, Sommers BD
California's early ACA expansion increased coverage and reduced out-of-pocket spending for the state's low-income population.
The researchers used data from the National Health Interview Survey to examine the impact of California’s Low Income Health Program. Their study demonstrates that the county-by-county rollout of expanded public insurance coverage in California significantly increased coverage, by 7 percentage points, and significantly reduced the likelihood of any family out-of-pocket medical spending in the previous year, by 10 percentage points, among low-income adults.
AHRQ-funded; HS021291.
Citation: Golberstein E, Gonzales G, Sommers BD .
California's early ACA expansion increased coverage and reduced out-of-pocket spending for the state's low-income population.
Health Aff 2015 Oct;34(10):1688-94. doi: 10.1377/hlthaff.2015.0290..
Keywords: Low-Income, Healthcare Costs, Health Insurance, Uninsured
Higashi RT, Craddock Lee SJ, Leonard T
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
The researchers sought to better understand the health needs of a nonclinical population to inform future research and interventions. Their analysis of focus group findings led them to conclude that Crossroads Community Services clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges.
AHRQ-funded; HS022418.
Citation: Higashi RT, Craddock Lee SJ, Leonard T .
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
Clin Transl Sci 2015 Oct;8(5):584-90. doi: 10.1111/cts.12325.
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Keywords: Nutrition, Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations
Brenner AT, Ko LK, Janz N
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to colorectal cancer (CRC) screening differ by race/ethnicity and primary language. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations.
AHRQ-funded; HS013853.
Citation: Brenner AT, Ko LK, Janz N .
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
J Health Care Poor Underserved 2015 Aug;26(3):824-38. doi: 10.1353/hpu.2015.0075.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Low-Income, Racial and Ethnic Minorities, Screening
Ratanawongsa N, Karter AJ, Quan J
Reach and validity of an objective medication adherence measure among safety net health plan members with diabetes: a cross-sectional study.
The objective of this study was to evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. It concluded that CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable with its performance in studies among other insured populations.
AHRQ-funded; HS020684; HS022561; HS017261.
Citation: Ratanawongsa N, Karter AJ, Quan J .
Reach and validity of an objective medication adherence measure among safety net health plan members with diabetes: a cross-sectional study.
J Manag Care Spec Pharm 2015 Aug;21(8):688-98. doi: 10.18553/jmcp.2015.21.8.688..
Keywords: Diabetes, Patient Adherence/Compliance, Patient Self-Management, Medication, Low-Income
Balaban RB, Galbraith AA, Burns ME
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
The researchers sough to determine if an intervention by patient navigators, hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. They found that, overall, 30-day readmission rates did not differ between intervention and control patients.
AHRQ-funded; HS020628.
Citation: Balaban RB, Galbraith AA, Burns ME .
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
J Gen Intern Med 2015 Jul;30(7):907-15. doi: 10.1007/s11606-015-3185-x..
Keywords: Hospital Readmissions, Low-Income, Social Determinants of Health, Patient Safety
Buys DR, Howard VJ, McClure LA
Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
The investigators evaluated the effect of neighborhood disadvantage (ND) on older adults' prevalence, awareness, treatment, and control of hypertension. Using data from the University of Alabama at Birmingham Study of Aging along with US Census data, they created tertiles of ND and found that living in mid-ND and high-ND tertiles was associated with higher hypertension prevalence, and living in high-ND tertiles was further associated with lower odds of controlled hypertension.
AHRQ-funded; HS019465; HS013852.
Citation: Buys DR, Howard VJ, McClure LA .
Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
Am J Public Health 2015 Jun;105(6):1181-8. doi: 10.2105/ajph.2014.302048.
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Keywords: Elderly, Blood Pressure, Low-Income, Social Determinants of Health, Cardiovascular Conditions, Chronic Conditions
Sommers BD, Maylone B, Nguyen KH
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
The researchers surveyed nearly 3,000 low-income adults in late 2014 to compare experiences in three states with markedly different policies: Kentucky, Arkansas, and Texas. They found that application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Limited awareness remains a critical barrier: Fewer than half of adults had heard some or a lot about the coverage expansions.
AHRQ-funded; HS021291.
Citation: Sommers BD, Maylone B, Nguyen KH .
The impact of state policies on ACA applications and enrollment among low-income adults in Arkansas, Kentucky, and Texas.
Health Aff 2015 Jun;34(6):1010-8. doi: 10.1377/hlthaff.2015.0215..
Keywords: Policy, Low-Income, Medicaid, Health Insurance
Sasson C, Haukoos JS, Ben-Youssef L
Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado.
The goal of this study was to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO. Six key barriers to calling 911 were identified: fear of becoming involved because of distrust of law enforcement, financial, immigration status, lack of recognition of cardiac arrest event, language, and violence.
AHRQ-funded; HS017526; HS021749.
Citation: Sasson C, Haukoos JS, Ben-Youssef L .
Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado.
Ann Emerg Med 2015 May;65(5):545-52.e2. doi: 10.1016/j.annemergmed.2014.10.028..
Keywords: Emergency Medical Services (EMS), Social Determinants of Health, Racial and Ethnic Minorities, Low-Income
Hudson JL, Hill SC, Selden TM
AHRQ Author: Hudson JL, Hill SC, Selden TM
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
This study investigated the potential health insurance options available to low-income children if federal CHIP funding ends in 2017 or if federal requirements change in 2019, allowing states to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels. It found that the percentage of low-income children ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children).
Citation: Hudson JL, Hill SC, Selden TM .
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
Health Aff 2015 May;34(5):864-70. doi: 10.1377/hlthaff.2015.0004..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Health Insurance, Low-Income
Leis JA, Solomon BS, Wasserman KE
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
The goal of this study was to integrate an evidence-based preventive intervention for perinatal depression—the Mothers and Babies (MB) Course—into a pediatric primary care clinic serving low-income, minority families, and to explore intervention acceptability and preliminary outcomes. Findings from this pilot study provide preliminary evidence for the acceptability and feasibility of implementing an evidence-based preventive intervention for postpartum depression.
AHRQ-funded; HS017596.
Citation: Leis JA, Solomon BS, Wasserman KE .
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
Clin Pediatr 2015 May;54(5):487-90. doi: 10.1177/0009922814536775..
Keywords: Pregnancy, Primary Care, Evidence-Based Practice, Low-Income, Racial and Ethnic Minorities
Latulipe C, Gatto A, Nguyen HT
Design considerations for patient portal adoption by low-income, older adults.
This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. The authors then present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated 'meaningful use' requirements.
AHRQ-funded; HS021679.
Citation: Latulipe C, Gatto A, Nguyen HT .
Design considerations for patient portal adoption by low-income, older adults.
Proc SIGCHI Conf Hum Factor Comput Syst 2015 Apr;2015:3859-68. doi: 10.1145/2702123.2702392..
Keywords: Health Information Technology (HIT), Web-Based, Low-Income, Elderly
Hill SC
AHRQ Author: Hill SC
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
This study simulated potential differences in out-of-pocket spending for uninsured adults gaining eligibility for Marketplace coverage (silver plan) because their states have not used the provisions of the Affordable Care Act to expand Medicaid. Compared with having a Marketplace silver plan, being able to take advantage to expanded Medicaid would reduce average out-of-pocket spending by more than 50 percent for these adults and their families.
AHRQ-authored.
Citation: Hill SC .
Medicaid expansion in opt-out states would produce consumer savings and less financial burden than exchange coverage.
Health Aff. 2015 Feb;34(2):340-9. doi: 10.1377/hlthaff.2014.1058..
Keywords: Healthcare Costs, Health Insurance, Policy, Low-Income, Medicaid, Uninsured
Ejebe IH, Jacobs EA, Wisk LE
Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.
The objective of this population-based study was to determine if and to what extent there are differences in asthma self-efficacy by race/ethnicity and income, and whether health status, levels of acculturation, and health care factors may explain these differences. It found that racial/ethnic minorities and individuals living in poverty have the lowest levels of asthma self-efficacy.
AHRQ-funded; HS000063.
Citation: Ejebe IH, Jacobs EA, Wisk LE .
Persistent differences in asthma self-efficacy by race, ethnicity, and income in adults with asthma.
J Asthma 2015 Feb;52(1):105-13. doi: 10.3109/02770903.2014.947429..
Keywords: Asthma, Patient Self-Management, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities