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 (1)
- (-) Anxiety (23)
- Asthma (1)
- Behavioral Health (17)
- Cancer: Breast Cancer (1)
- (-) Children/Adolescents (23)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Community-Based Practice (3)
- Comparative Effectiveness (1)
- Depression (7)
- Diagnostic Safety and Quality (2)
- Disabilities (1)
- Domestic Violence (1)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Falls (1)
- Family Health and History (3)
- Guidelines (2)
- Health Information Technology (HIT) (3)
- Implementation (2)
- Injuries and Wounds (1)
- Medication (3)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (1)
- Primary Care (2)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Risk (1)
- Screening (2)
- Substance Abuse (1)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Young Adults (3)
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
1 to 23 of 23 Research Studies DisplayedStiles-Shields C, Archer J, Zhang J
A scoping review of associations between cannabis use and anxiety in adolescents and young adults.
This review sought to examine the association between anxiety and cannabis in adolescents and young adults. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use via a database search; 23 studies found a positive association that greater anxiety was associated with greater cannabis use and 7 found a negative association. The remainder found no clear association. The authors concluded that further research is needed to understand the relationship between anxiety and cannabis use.
AHRQ-funded; HS026385.
Citation: Stiles-Shields C, Archer J, Zhang J .
A scoping review of associations between cannabis use and anxiety in adolescents and young adults.
Child Psychiatry Hum Dev 2023 Jun; 54(3):639-58. doi: 10.1007/s10578-021-01280-w..
Keywords: Children/Adolescents, Anxiety, Substance Abuse, Behavioral Health
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Bushnell GA, Rynn MA, Crystal S
Simultaneous benzodiazepine and SSRI initiation in young people with anxiety disorders.
Researchers investigated how often adolescents and young adults with anxiety disorders simultaneously initiate benzodiazepine (BZD) treatment with selective serotonin reuptake inhibitor (SSRI) treatment and examined whether SSRI treatment duration varies by simultaneous BZD initiation. Using a commercial claims database, they found that 4% of adolescents and 17% of young adults simultaneously initiated BZD treatment, varying by age, anxiety disorder, comorbidities, health care utilization, and provider type. They concluded that simultaneous initiation of both treatments is relatively common in young adults with anxiety disorders and was not associated with longer SSRI persistence.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Rynn MA, Crystal S .
Simultaneous benzodiazepine and SSRI initiation in young people with anxiety disorders.
J Clin Psychiatry 2021 Oct 19;82(6). doi: 10.4088/JCP.20m13863..
Keywords: Anxiety, Behavioral Health, Medication, Practice Patterns, Children/Adolescents, Young Adults
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Radovic A, Odenthal K, Flores AT
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
Supporting Our Valued Adolescents (SOVA) is a web-based technology intervention designed to increase depression and anxiety treatment uptake by adolescents in the context of an anonymous peer community with an accompanying website for parents. With a goal of informing the design of a hybrid effectiveness-implementation randomized controlled trial, we conducted a pre-implementation study in two primary care practices to guide implementation strategy development. We conducted focus groups with primary care providers (PCPs) at three different timepoints with PCPs (14 total) from two community practices.
AHRQ-funded; HS022989.
Citation: Radovic A, Odenthal K, Flores AT .
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
J Clin Psychol Med Settings 2020 Dec;27(4):766-82. doi: 10.1007/s10880-019-09669-5.
.
.
Keywords: Children/Adolescents, Depression, Anxiety, Behavioral Health, Primary Care, Health Information Technology (HIT), Implementation
Bushnell GA, Gerhard T, Crystal S
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
This study examined whether benzodiazepine treatment increases fall and fracture risk in young persons as it has been shown to do in older adults. They examined whether children (6-17 years) and young adults (18-24) recently diagnosed with anxiety disorder had an increased fracture risk. A cohort of commercially insured children and young adults who had initiated use of benzodiazepine or SSRIs were followed for 3 months, or until fracture, treatment discontinuation or switching or disenrollment occurred. The cohort consisted of 120,715 children and 179,768 young adults. There was an increased fracture rate found in children, but not young adults.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Gerhard T, Crystal S .
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
Pediatrics 2020 Jul;146(1):e20193478. doi: 10.1542/peds.2019-3478..
Keywords: Children/Adolescents, Young Adults, Medication, Falls, Injuries and Wounds, Risk, Anxiety, Behavioral Health
Whiteside SPH, Sim LA, Morrow AS
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement.
AHRQ-funded; 290201500013I.
Citation: Whiteside SPH, Sim LA, Morrow AS .
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Clin Child Fam Psychol Rev 2020 Mar;23(1):102-21. doi: 10.1007/s10567-019-00303-2..
Keywords: Children/Adolescents, Anxiety, Behavioral Health, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Bardach NS, Neel C, Kleinman LC
Depression, anxiety, and emergency department use for asthma.
This study examined whether pediatric patients with asthma who use the emergency department (ED) experience increased depression and anxiety in the same way that adult asthma patients do. Out of 65,342 patients identified from the Massachusetts All-Payer Claims Database for 2014 to 2015 who had ED visits, 24.7% had a diagnosis of anxiety, depression, or both. Asthma rates were shown to be higher than those of patients who had no diagnosis of anxiety or depression.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Neel C, Kleinman LC .
Depression, anxiety, and emergency department use for asthma.
Pediatrics 2019 Oct;144(4). doi: 10.1542/peds.2019-0856..
Keywords: Asthma, Depression, Anxiety, Children/Adolescents, Emergency Department, Behavioral Health
Adrian M, Jenness JL, Kuehn KS
Emotion regulation processes linking peer victimization to anxiety and depression symptoms in adolescence.
This study examined emotional regulation processes linked to anxiety and depression symptoms in adolescents experiencing peer victimization. A total of 287 adolescents aged 16-17 years were recruited in three urban centers in the United States. They completed baseline and follow-up assessments 4 months apart. Three models of emotion regulation were evaluated using confirmatory factor analysis. Difficulties with emotion regulation were associated with increased depression in adolescents experiencing peer victimization and increased anxiety associated with cognitive regulation difficulties.
AHRQ-funded; HS022982.
Citation: Adrian M, Jenness JL, Kuehn KS .
Emotion regulation processes linking peer victimization to anxiety and depression symptoms in adolescence.
Dev Psychopathol 2019 Aug;31(3):999-1009. doi: 10.1017/s0954579419000543..
Keywords: Anxiety, Depression, Children/Adolescents, Behavioral Health
Perez S, Greenzang KA
Completion of adolescent cancer treatment: excitement, guilt, and anxiety.
The completion of cancer treatment in adolescents and young adults is a time that many patients and families approach with hope and excitement but is often tinged with anxiety and fear. In this paper, the authors present a young man’s personal experience moving from treatment to survivorship as well as that of his oncologist, and together we offer recommendations for supporting children and teenagers with serious illness at the completion of therapy.
AHRQ-funded; HS022986.
Citation: Perez S, Greenzang KA .
Completion of adolescent cancer treatment: excitement, guilt, and anxiety.
Pediatrics 2019 Mar;143(3). doi: 10.1542/peds.2018-3073..
Keywords: Children/Adolescents, Young Adults, Cancer: Breast Cancer, Anxiety, Clinician-Patient Communication
Wang Z, Whiteside SPH, Sim L
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
This review evaluated the comparative effectiveness and adverse events of cognitive behavioral therapy (CBT) and pharmacotherapy for childhood anxiety disorders. Evidence supports the effectiveness of CBT and selective serotonin reuptake inhibitors (SSRIs) for reducing childhood anxiety symptoms. Serotonin-norepinephrine reuptake inhibitors also appear to be effective based on less consistent evidence.
AHRQ-funded; 290201500013I.
Citation: Wang Z, Whiteside SPH, Sim L .
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
JAMA Pediatr 2017 Nov;171(11):1049-56. doi: 10.1001/jamapediatrics.2017.3036.
.
.
Keywords: Anxiety, Behavioral Health, Children/Adolescents, Comparative Effectiveness, Medication
McBride NM, Johnco C, Salloum A
Prevalence and clinical differences of suicidal thoughts and behaviors in a community sample of youth receiving cognitive-behavioral therapy for anxiety.
This study examined the incidence of suicidal thoughts and behaviors in youth with anxiety before initiating cognitive behavioral therapy, as well as the emergence of suicidal thoughts and behaviors during treatment. Findings suggest that the assessment of suicidality at a single time-point and from one informant is not sufficient to identify at-risk youth. Ongoing assessment of suicidal risk during treatment is important in this population.
AHRQ-funded; HS018665.
Citation: McBride NM, Johnco C, Salloum A .
Prevalence and clinical differences of suicidal thoughts and behaviors in a community sample of youth receiving cognitive-behavioral therapy for anxiety.
Child Psychiatry Hum Dev 2017 Oct;48(5):705-13. doi: 10.1007/s10578-016-0696-6..
Keywords: Anxiety, Behavioral Health, Children/Adolescents, Depression
Garber J, Brunwasser SM, Zerr AA
Treatment and prevention of depression and anxiety in youth: test of cross-over effects.
The present meta-analytic review examined whether interventions for children and adolescents that explicitly targeted either anxiety or depression showed treatment specificity or also impacted the other outcome (i.e. cross-over effects). Anxiety prevention studies (n = 14) significantly affected anxious, but not depressive symptoms, indicating no cross-over effect of anxiety prevention trials on depression. For depression prevention studies (n = 15), the effects were not significant for either depressive or anxiety symptoms, although the effect was significantly larger for depressive than for anxious symptoms.
AHRQ-funded; HS022990.
Citation: Garber J, Brunwasser SM, Zerr AA .
Treatment and prevention of depression and anxiety in youth: test of cross-over effects.
Depress Anxiety 2016 Oct;33(10):939-59. doi: 10.1002/da.22519.
.
.
Keywords: Anxiety, Children/Adolescents, Depression, Patient-Centered Outcomes Research
Salloum A, Johnco C, Lewin AB
Barriers to access and participation in community mental health treatment for anxious children.
The authors examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. They found that the most common access barrier was parents not knowing where or from whom to seek services. They concluded that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.
AHRQ-funded; HS018665.
Citation: Salloum A, Johnco C, Lewin AB .
Barriers to access and participation in community mental health treatment for anxious children.
J Affect Disord 2016 May 15;196:54-61. doi: 10.1016/j.jad.2016.02.026.
.
.
Keywords: Access to Care, Anxiety, Children/Adolescents, Community-Based Practice, Behavioral Health
Johnco C, Lewin AB, Salloum A
Adverse prenatal, perinatal and neonatal experiences in children with anxiety disorders.
The authors examined the incidence of adverse prenatal, perinatal, and neonatal experiences among children with anxiety disorders. They found several associations between neonatal complications and subsequent clinical symptomology, including attention deficit hyperactivity disorder and depressive comorbidity, anxiety severity and functional impairment.
AHRQ-funded; HS018665.
Citation: Johnco C, Lewin AB, Salloum A .
Adverse prenatal, perinatal and neonatal experiences in children with anxiety disorders.
Child Psychiatry Hum Dev 2016 Apr;47(2):317-25. doi: 10.1007/s10578-015-0569-4.
.
.
Keywords: Anxiety, Children/Adolescents, Disabilities, Pregnancy
Hamblin RJ, Lewin AB, Salloum A
Clinical characteristics and predictors of hoarding in children with anxiety disorders.
This investigation was conducted to describe the clinical characteristics of anxious children with significant hoarding behavior and to examine the contributions of anxiety, obsessive compulsive, and inattentive and hyperactive/impulsive symptoms in the prediction of hoarding. Its findings suggest a pattern of behavioral and emotional dysregulation for children who hoard and provide further insight into the relationships between anxiety, attention problems, and hoarding.
AHRQ-funded; HS018665.
Citation: Hamblin RJ, Lewin AB, Salloum A .
Clinical characteristics and predictors of hoarding in children with anxiety disorders.
J Anxiety Disord 2015 Dec;36:9-14. doi: 10.1016/j.janxdis.2015.07.006.
.
.
Keywords: Children/Adolescents, Anxiety, Behavioral Health
Storch EA, Salloum A, King MA
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
This study aimed to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. It found that relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, King MA .
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
Depress Anxiety 2015 Nov;32(11):843-52. doi: 10.1002/da.22399.
.
.
Keywords: Anxiety, Children/Adolescents, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Johnco CJ, Salloum A, Lewin AB
Refining clinical judgment of treatment response and symptom remission identification in childhood anxiety using a signal detection analysis on the pediatric anxiety rating scale.
The purpose of this study was to determine guidelines for delineating treatment response and symptom remission for children with anxiety disorder based on the five item Pediatric Anxiety Rating Scale (PARS5), and replicate guidelines using the six item PARS (PARS6). Optimal prediction of treatment response based on gold standard criteria was achieved at 15-20 percent reduction in symptoms on the PARS5 (with 20 percent reduction achieving marginally higher accuracy), and 20 percent reduction on the PARS6.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, Lewin AB .
Refining clinical judgment of treatment response and symptom remission identification in childhood anxiety using a signal detection analysis on the pediatric anxiety rating scale.
J Child Adolesc Psychopharmacol 2015 Nov;25(9):674-83. doi: 10.1089/cap.2015.0102.
.
.
Keywords: Children/Adolescents, Anxiety, Diagnostic Safety and Quality, Guidelines
Storch EA, Salloum A, Johnco C
Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.
This study assessed the nature and clinical correlates of family accommodation in pediatric anxiety, as well as validating a mechanistic model. It concluded that family accommodation was associated with increased anxiety severity and externalizing behaviors, having a diagnosis of separation anxiety, and increased functional impairment. Family accommodation partially mediated the relationship between anxiety severity and functional impairment.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, Johnco C .
Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.
J Anxiety Disord 2015 Oct;35:75-81. doi: 10.1016/j.janxdis.2015.09.001.
.
.
Keywords: Children/Adolescents, Anxiety, Behavioral Health, Children/Adolescents, Family Health and History
Johnco CJ, Salloum A, De Nadai AS
Incidence, clinical correlates and treatment effect of rage in anxious children.
This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. It found that rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, De Nadai AS .
Incidence, clinical correlates and treatment effect of rage in anxious children.
Psychiatry Res 2015 Sep 30;229(1-2):63-9. doi: 10.1016/j.psychres.2015.07.071..
Keywords: Anxiety, Behavioral Health, Children/Adolescents, Family Health and History
Johnco CJ, Salloum A, Lewin AB
The impact of comorbidity profiles on clinical and psychosocial functioning in childhood anxiety disorders.
This study compared the profile of children with a primary anxiety disorder without comorbidity to those with different comorbidity profiles in a treatment-seeking sample of 111 children recruited from community mental health settings. It found that anxiety severity and depressive symptomatology did not vary by comorbidity profile. Anxious children without comorbidity had lower levels of aggressive and externalizing behaviors compared to the comorbid ADHD group.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, Lewin AB .
The impact of comorbidity profiles on clinical and psychosocial functioning in childhood anxiety disorders.
Psychiatry Res 2015 Sep 30;229(1-2):237-44. doi: 10.1016/j.psychres.2015.07.027..
Keywords: Children/Adolescents, Anxiety, Behavioral Health
Salloum A, Crawford EA, Lewin AB
Consumers' and providers' perceptions of utilizing a computer-assisted cognitive behavioral therapy for childhood anxiety.
The purpose of this study was to explore consumers’ and providers’ perceptions of utilizing a Computer-Assisted Cognitive Behavioral Therapy (CCBT) for childhood anxiety in community mental health centers (CMHC) in an effort to identify factors that may impact implementation of CCBT in CMHC. Results suggest that both consumers and providers were highly receptive to participation in and implementation of CCBT in CMHC.
AHRQ-funded; HS018665.
Citation: Salloum A, Crawford EA, Lewin AB .
Consumers' and providers' perceptions of utilizing a computer-assisted cognitive behavioral therapy for childhood anxiety.
Behav Cogn Psychother 2015 Jan;43(1):31-41. doi: 10.1017/s1352465813000647..
Keywords: Anxiety, Children/Adolescents, Community-Based Practice, Health Information Technology (HIT), Patient Experience
Gilbert AL, Bauer NS, Carroll AE
Child exposure to parental violence and psychological distress associated with delayed milestones.
The researchers examined the association between parental report of intimate partner violence (IPV) and parental psychological distress (PPD) with child attainment of developmental milestones. They found that parental report of both IPV and PPD during the first 72 months of a child’s life is significantly associated with developmental milestone failure across all 4 developmental domains and within the domains of language, personal-social, and gross motor development.
AHRQ-funded; HS017939; HS018453.
Citation: Gilbert AL, Bauer NS, Carroll AE .
Child exposure to parental violence and psychological distress associated with delayed milestones.
Pediatrics 2013 Dec;132(6):e1577-83. doi: 10.1542/peds.2013-1020..
Keywords: Children/Adolescents, Domestic Violence, Family Health and History, Depression, Anxiety, Behavioral Health