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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 88 Research Studies DisplayedAustin N, Kristensen-Cabrera A, Sherman J
Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design.
This study evaluated the effect of space and design on labor and deliver (L&D) hospital units. A quantitative analysis was done to see if it made an impact on the risk of deliveries. The researchers recommend standardization of the space based on number of deliveries and cesarean sections.
AHRQ-funded; HS023506.
Citation: Austin N, Kristensen-Cabrera A, Sherman J .
Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design.
PLoS One 2018 Dec 26;13(12):e0209339. doi: 10.1371/journal.pone.0209339..
Keywords: Labor and Delivery, Pregnancy, Women
Kung SA, Saavedra-Avendano B, Velez EA
Capturing compassion: a survey of Mexican Catholics assessing abortion support by reason for abortion and degree of Catholicism.
No standard exists to measure religiosity in abortion studies. In this study, the investigators test whether religiosity was associated with support for abortion among Mexican Catholics and whether different measures of degree of Catholicism alter the relationship. The investigators found that the majority of Mexican Catholics supported abortion in some circumstances. The only measure of degree of Catholicism significantly associated with all the outcomes was belief that a person who helps someone who aborts can be a good Catholic.
AHRQ-funded; HS022981.
Citation: Kung SA, Saavedra-Avendano B, Velez EA .
Capturing compassion: a survey of Mexican Catholics assessing abortion support by reason for abortion and degree of Catholicism.
Contraception 2018 Dec;98(6):504-09. doi: 10.1016/j.contraception.2018.06.008..
Keywords: Racial and Ethnic Minorities, Pregnancy, Women
Danilack VA, Brousseau EC, Phipps MG
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
Weight retention after pregnancy is a concern for adolescents who may be entering adulthood at unhealthy weights. In this article, the investigators studied associations between each of three measures: pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and post-pregnancy BMI in a longitudinal follow-up of an adolescent pregnancy study cohort. They concluded that teens experienced an increase in BMI from pre-pregnancy to within 4 years after their first delivery, and this increase was related to GWG.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Phipps MG .
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
J Womens Health 2018 Dec;27(12):1456-58. doi: 10.1089/jwh.2017.6635..
Keywords: Children/Adolescents, Pregnancy, Obesity: Weight Management, Obesity, Women
Neal JL, Lowe NK, Caughey AB
Applying a physiologic partograph to Consortium on Safe Labor data to identify opportunities for safely decreasing cesarean births among nulliparous women.
The aims of this study were to assess associations of labor status at admission (i.e., preactive or active) and active labor progress (i.e., dystocic or physiologic) with oxytocin augmentation, cesarean birth, and adverse neonatal outcome rates. The authors suggest that adoption of evidence-based, standardized approaches for diagnosing active labor onset, assessing labor progress, and diagnosing dystocia may safely decrease oxytocin augmentation and cesarean birth rates in the United States.
AHRQ-funded; HS024733.
Citation: Neal JL, Lowe NK, Caughey AB .
Applying a physiologic partograph to Consortium on Safe Labor data to identify opportunities for safely decreasing cesarean births among nulliparous women.
Birth 2018 Dec;45(4):358-67. doi: 10.1111/birt.12358..
Keywords: Labor and Delivery, Pregnancy, Women
Neal JL, Lowe NK, Phillippi JC
Likelihood of cesarean birth among parous women after applying leading active labor diagnostic guidelines.
The goals of this study were: Determine the proportions of women admitted to the hospital before or in active labor per the leading National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) guidelines; Compare associations of labor status at admission with oxytocin augmentation, cesarean birth, and adverse birth outcomes when using the different active labor diagnostic guidelines. Active labor diagnostic guidelines were applied retrospectively to cervical examination data. The authors conclude that many parous women with spontaneous labor onset are admitted to the hospital before active labor, and these women are more likely to receive oxytocin augmentation during labor and to have a cesarean birth. Implications for practice are discussed.
AHRQ-funded; HS024733.
Citation: Neal JL, Lowe NK, Phillippi JC .
Likelihood of cesarean birth among parous women after applying leading active labor diagnostic guidelines.
Midwifery 2018 Dec;67:64-69. doi: 10.1016/j.midw.2018.09.007..
Keywords: Shared Decision Making, Guidelines, Hospitalization, Labor and Delivery, Pregnancy, Women
Renfro T, Johnson E, Lambert DN
The MEDIA model: an innovative method for digitizing and training community members to facilitate an HIV prevention intervention.
This article describes an effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV-prevention intervention using digital media. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. The research team worked with topical experts and a production company to develop storyboards for core curriculum activities, which were scripted and filmed. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. The article concludes that creating digital media can be a time-consuming process, that pilot testing in the new format is necessary even for previously tested interventions, and that the structure provided by facilitators in face-to-face training must be embedded within the format of the digitized trainings.
AHRQ-funded; HS022059.
Citation: Renfro T, Johnson E, Lambert DN .
The MEDIA model: an innovative method for digitizing and training community members to facilitate an HIV prevention intervention.
Transl Behav Med 2018 Nov 21;8(6):815-23. doi: 10.1093/tbm/iby012..
Keywords: Health Promotion, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities, Women
Lee CI, Zhu W, Onega TL
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
This study examined whether adoption of digital breast tomosynthesis (DBT) was associated with a decrease in screening mammography capacity across Breast Cancer Screening Consortium facilities. Facility characteristics and examination volume data were collected from facilities that adopted DBT from 2011 and 2014. The majority of facilities had no academic affiliation (73%), were nonprofit (80%) and were general radiology practices (66.7%). Monthly screening volumes were slightly higher after the adoption period but otherwise remained relatively stable before and after adoption of DBT.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega TL .
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
AJR Am J Roentgenol 2018 Nov;211(5):957-63. doi: 10.2214/ajr.17.19350..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women
Rice WS, Turan B, White K
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
This study investigated the role of unintended pregnancy norms and stigma in contraceptive use among young women in Alabama. A total of 390 women aged 18-24 were surveyed from November 2014 to October 2015 at university and public health clinics. These women were considered at risk for unintended pregnancy and sexually transmitted diseases. Compared to nonusers, users of contraceptives were more likely to be White, nulliparous, from the university and had higher income. Disapproval of unintended pregnancy by close family and friends was associated with greater contraceptive use.
AHRQ-funded; HS013852.
Citation: Rice WS, Turan B, White K .
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
Women Health 2018 Nov-Dec;58(10):1151-66. doi: 10.1080/03630242.2017.1414099.
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Keywords: Sexual Health, Pregnancy, Social Stigma, Women, Young Adults
Guo M, Quensell M, Chang A
Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: implications for patient engagement and health equity.
In this study, women in Oahu, Hawai'i with a recent delivery were interviewed about their understanding of ten common obstetric terms. Health literacy was assessed by the rapid estimate of adult literacy in medicine (REALM). Multivariable models predicted total terms comprehended by demographic factors. The investigators found that participants were unfamiliar with common obstetrics terminology. Comprehension struggles were more common among populations with maternal health disparities, including Asian and Pacific Islander subgroups, and those with low health literacy.
AHRQ-funded; HS021903.
Citation: Guo M, Quensell M, Chang A .
Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups: implications for patient engagement and health equity.
Matern Child Health J 2018 Nov;22(11):1543-49. doi: 10.1007/s10995-018-2597-8..
Keywords: Health Literacy, Patient and Family Engagement, Pregnancy, Women
Lee SC, Higashi RT, Sanders JM
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Effects of geographic program expansion to rural areas on mammogram screening program outcomes are understudied. The authors of this study sought to determine whether time-to-resolution (TTR) varied significantly by service delivery time period, location, and participant characteristics across 19 North Texas counties.
AHRQ-funded; HS022418.
Citation: Lee SC, Higashi RT, Sanders JM .
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Cancer Causes Control 2018 Oct;29(10):995-1005. doi: 10.1007/s10552-018-1074-4..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Rural Health, Access to Care, Prevention
Moniz MH, Kirch MA, Solway E
Association of access to family planning services with Medicaid expansion among female enrollees in Michigan.
The purpose of this study was to evaluate the association of Medicaid expansion coverage with access to birth control and family planning services among women of reproductive age enrolled in the Michigan expansion plan. The investigators found that one in 3 women of reproductive age reported better ability to access birth control and family planning services through Healthy Michigan Plan compared with before enrollment.
AHRQ-funded; HS025465.
Citation: Moniz MH, Kirch MA, Solway E .
Association of access to family planning services with Medicaid expansion among female enrollees in Michigan.
JAMA Network Open 2018 Aug 31;1(4). doi: 10.1001/jamanetworkopen.2018.1627..
Keywords: Medicaid, Women, Sexual Health, Access to Care, Policy
Wu JP, Moniz MH, Ursu AN
Long-acting reversible contraception-highly efficacious, safe, and underutilized.
This paper described long-acting reversible contraception (LARC) options, myths about LARCs, benefits of LARCs and features of various LARC methods.
AHRQ-funded; HS025465.
Citation: Wu JP, Moniz MH, Ursu AN .
Long-acting reversible contraception-highly efficacious, safe, and underutilized.
JAMA 2018 Jul 24;320(4):397-98. doi: 10.1001/jama.2018.8877..
Keywords: Sexual Health, Women
Phillippi JC, Doersam JK, Neal JL
Electronic informed consent to facilitate recruitment of pregnant women into research.
This study examined the use of electronic informed consent to increase the participation of racially and geographically diverse pregnant women in prospective research. They evaluated the feasibility and utility of e-consent in the first year of a multiyear clinical trial involving pregnant women. Out of 86 women screened, 71 were eligible, 65 agreed to review the e-consent form, and 61 completed the process. Even those women who reported low health literacy were able to complete the form and may expedite enrollment of a representative sample.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Doersam JK, Neal JL .
Electronic informed consent to facilitate recruitment of pregnant women into research.
J Obstet Gynecol Neonatal Nurs 2018 Jul;47(4):529-34. doi: 10.1016/j.jogn.2018.04.134.
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Keywords: Women, Pregnancy, Health Literacy
Connor KA, Duran G, Faiz-Nassar M
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
The aim of this qualitative study was to assess stakeholder perspectives on the feasibility of implementing Centering Parenting (CP) in federally qualified health centers (FQHCs) in Baltimore. The investigators concluded that perceptions regarding facilitators and barriers to CP implementation in FQHCs were similar to existing group well-child care literature; however the benefit of emphasis on maternal wellness was a unique finding. The investigators suggested that a maternal wellness integration might make CP a particularly desirable model for implementation at FQHCs, but potential systems barriers must be addressed.
AHRQ-funded; HS017596.
Citation: Connor KA, Duran G, Faiz-Nassar M .
Feasibility of implementing group well baby/well woman dyad care at federally qualified health centers.
Acad Pediatr 2018 Jul;18(5):510-15. doi: 10.1016/j.acap.2017.09.011..
Keywords: Caregiving, Children/Adolescents, Education: Patient and Caregiver, Health Promotion, Healthcare Delivery, Maternal Care, Newborns/Infants, Pregnancy, Women
Hedderson MM, Brown SD, Ehrlich SF
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
The purpose of this study was to evaluate whether a tailored letter improved gestational weight gain (GWG) and whether GWG mediated a multicomponent intervention's effect on postpartum weight retention among women with gestational diabetes mellitus (GDM). The authors concluded that a tailored electronic health record-based letter improved GWG, which mediated the effect of a multicomponent intervention in reducing postpartum weight retention.
AHRQ-funded; HS019367.
Citation: Hedderson MM, Brown SD, Ehrlich SF .
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
Diabetes Care 2018 Jul;41(7):1370-77. doi: 10.2337/dc17-1133..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Lifestyle Changes, Patient-Centered Outcomes Research, Pregnancy, Women
Wilson LE, Pollack CE, Greiner MA
Association between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008-2011.
This study sought to determine whether physician-level characteristics were associated with 21-gene recurrence score (RS) genomic testing to evaluate recurrence risk and benefit of adjuvant chemotherapy in patients with estrogen receptor-positive, node-negative breast cancer. The study concluded that although most RS testing was ordered by medical oncologists, physicians in other specialties ordered roughly one-third of the tests. Physician characteristics, including gender and time in practice, were associated with receiving testing.
AHRQ-funded; HS022189.
Citation: Wilson LE, Pollack CE, Greiner MA .
Association between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008-2011.
Breast Cancer Res Treat 2018 Jul;170(2):361-71. doi: 10.1007/s10549-018-4746-6..
Keywords: Cancer, Cancer: Breast Cancer, Genetics, Practice Patterns, Women
Rice WS, Logie CH, Napoles TM
Perceptions of intersectional stigma among diverse women living with HIV in the United States.
This study conducted 76 interviews with diverse women with HIV from varied socioeconomic backgrounds in Birmingham AL, Jackson MI, Atlanta GA, and San Francisco CA, who were enrolled in the Women's Interagency HIV Study (WIHS). The purpose was to examine perceptions of intersectional stigma among women living with HIV. The women interviewed shared their perceptions of the various forms of stigma and discrimination they had experienced, most commonly related to gender, race, income level, as well as their incarceration histories and weight. The study’s findings highlight the complexity of the social processes of marginalization, and the need for public health strategies to promote wellbeing among women living with HIV and to reduce social structural and health disparities.
AHRQ-funded; HS013852.
Citation: Rice WS, Logie CH, Napoles TM .
Perceptions of intersectional stigma among diverse women living with HIV in the United States.
Soc Sci Med 2018 Jul;208:9-17. doi: 10.1016/j.socscimed.2018.05.001..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Social Stigma, Women
Dalton VK, Carlos RC, Kolenic GE
The impact of cost sharing on women's use of annual examinations and effective contraception.
The goal of this study was to describe the relationship between the elimination of out-of-pocket costs and women's use of preventive care office visits and long-acting reversible contraception after accounting for baseline levels of cost sharing. Researchers found that out-of-pocket costs were low prior to the Affordable Care Act, and that eliminating costs was associated with increases in preventive service use among those with high levels of cost, but effect sizes were low, suggesting that cost is only one barrier. They concluded that failing to recognize that cost sharing was already low could lead to a false inference that the elimination of cost sharing was ineffective.
AHRQ-funded; HS023784.
Citation: Dalton VK, Carlos RC, Kolenic GE .
The impact of cost sharing on women's use of annual examinations and effective contraception.
Am J Obstet Gynecol 2018 Jul;219(1):93.e1-93.e13. doi: 10.1016/j.ajog.2018.04.051..
Keywords: Healthcare Costs, Women, Sexual Health
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation: Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Screening, Shared Decision Making, Women, Prevention, Imaging
Kung SA, Darney BG, Saavedra-Avendano B
Access to abortion under the health exception: a comparative analysis in three countries.
Access to abortion under the health exception varies widely. This study examines factors that result in heterogeneous application of health exception laws and consequences for access to legal abortion. The study concluded that the health exception is a valuable tool for expanding access to legal abortion. Differences in the use of the health exception as an indication for legal abortion resulted in wide access for women in Britain to nearly no access in Mexican states. The findings highlight the difference between theoretical and real access to legal abortion.
AHRQ-funded; HS022981.
Citation: Kung SA, Darney BG, Saavedra-Avendano B .
Access to abortion under the health exception: a comparative analysis in three countries.
Reprod Health 2018 Jun 13;15(1):107. doi: 10.1186/s12978-018-0548-x..
Keywords: Access to Care, Policy, Women
Childers KK, Maggard-Gibbons M, Macinko J
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
Identifying mutation carriers is critical for treatment decisions, cancer prevention, and early detection. This study analyzed the 2015 US National Health Interview Survey (NHIS), a cross-sectional in-person interview gathering self-reported health data for the US population. The study found that while cancer genetic testing seems to reach a broad geographic and sociodemographic population in the national survey, there remain underrepresented groups, including Hispanics, the uninsured, noncitizens, and those with less education.
AHRQ-funded; HS025079.
Citation: Childers KK, Maggard-Gibbons M, Macinko J .
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
JAMA Oncol 2018 Jun;4(6):876-79. doi: 10.1001/jamaoncol.2018.0340..
Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Genetics, Racial and Ethnic Minorities, Screening, Social Determinants of Health, Women
Hoffman SR, Vines AI, Halladay JR
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
The objective of the study was to develop an electronic health record-based algorithm to identify women with symptomatic uterine fibroids for a comparative effectiveness study of medical or surgical treatments on quality-of-life measures. The study concluded that an electronic health record-based algorithm is capable of identifying cases of symptomatic uterine fibroids with moderate positive predictive value and may be an efficient approach for large-scale study recruitment.
AHRQ-funded; HS023418.
Citation: Hoffman SR, Vines AI, Halladay JR .
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
Am J Obstet Gynecol 2018 Jun;218(6):610.e1-10.e7. doi: 10.1016/j.ajog.2018.02.002..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Research Methodologies, Women
Housten AJ, Pappadis MR, Krishnan S
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. This study used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. The authors found that among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels.
AHRQ-funded; HS022134.
Citation: Housten AJ, Pappadis MR, Krishnan S .
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Psychooncology 2018 Jun;27(6):1635-41. doi: 10.1002/pon.4708..
Keywords: Cancer: Breast Cancer, Elderly, Screening, Prevention, Women
Stewart EA, Lytle BL, Thomas L
The comparing options for management: patient-centered results for uterine fibroids (COMPARE-UF) registry: Rationale and design.
The purpose of the study was to design and establish a uterine fibroid (UF) registry based in the United States to provide comparative effectiveness data regarding UF treatment. This registry, called Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF), will generate evidence on the comparative effectiveness of different procedural options for UF, in order to help patients and their caregivers make informed decisions that best meet an individual patient's short- and long-term preferences.
AHRQ-funded; HS023418.
Citation: Stewart EA, Lytle BL, Thomas L .
The comparing options for management: patient-centered results for uterine fibroids (COMPARE-UF) registry: Rationale and design.
Am J Obstet Gynecol 2018 May 8. doi: 10.1016/j.ajog.2018.05.004..
Keywords: Comparative Effectiveness, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Registries, Women
Glazer KB, Eliot MN, Danilack VA
Residential green space and birth outcomes in a coastal setting.
The objective of this study was to evaluate associations between green and blue space and birth outcomes in a coastal area of the northeastern US. Findings from this study did not support the hypothesis that residential green space was associated with reduced risk of preterm birth or higher birthweight after adjustment for individual and contextual socioeconomic factors, but variation in results with incremental adjustment raised questions about the optimal degree of control for confounding by markers of SES. The investigators found that living near a freshwater body was associated with higher birthweight.
AHRQ-funded; HS025013.
Citation: Glazer KB, Eliot MN, Danilack VA .
Residential green space and birth outcomes in a coastal setting.
Environ Res 2018 May;163:97-107. doi: 10.1016/j.envres.2018.01.006..
Keywords: Pregnancy, Newborns/Infants, Outcomes, Adverse Events, Women