National Healthcare Quality and Disparities Report
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Topics
- Access to Care (4)
- Alcohol Use (1)
- Anxiety (2)
- Behavioral Health (10)
- Blood Thinners (1)
- Cardiovascular Conditions (2)
- Care Management (4)
- Case Study (1)
- Children/Adolescents (6)
- Chronic Conditions (3)
- Clinician-Patient Communication (1)
- Community-Acquired Infections (1)
- (-) Community-Based Practice (44)
- Community Partnerships (3)
- Comparative Effectiveness (1)
- Cultural Competence (1)
- Dental and Oral Health (1)
- Depression (1)
- Diabetes (5)
- Disabilities (1)
- Disparities (2)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Genetics (1)
- Healthcare Delivery (8)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (5)
- Health Promotion (3)
- Health Services Research (HSR) (4)
- Implementation (1)
- Learning Health Systems (1)
- Medicaid (4)
- Medication (4)
- Medication: Safety (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Obesity (2)
- Organizational Change (1)
- Outcomes (2)
- Pain (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Experience (3)
- Practice-Based Research Network (PBRN) (2)
- Prevention (6)
- Primary Care (12)
- Primary Care: Models of Care (3)
- Provider: Pharmacist (6)
- Quality Improvement (2)
- Quality of Care (3)
- Racial and Ethnic Minorities (4)
- Research Methodologies (1)
- Risk (1)
- Rural Health (2)
- Screening (3)
- Shared Decision Making (2)
- Substance Abuse (1)
- Teams (1)
- Tobacco Use (1)
- Training (1)
- Uninsured (1)
- Vulnerable Populations (3)
- Young Adults (1)
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 44 Research Studies DisplayedRodriguez HP, Friedberg MW, Vargas-Bustamante A
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
The purpose of this study was to compare the impact of implementing team-based diabetes care management involving community health workers (CHWs) vs. medical assistants (MA) in community health centers (CHCs) on diabetes care processes, intermediate outcomes, and patients' experiences of chronic care. The investigators found that diabetes care improved in CHCs integrating CHWs and MAs onto primary care teams, but the improvements were no different than improvements observed among matched control group patients.
AHRQ-funded; HS02012001.
Citation: Rodriguez HP, Friedberg MW, Vargas-Bustamante A .
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
BMC Health Serv Res 2018 Nov 20;18(1):875. doi: 10.1186/s12913-018-3710-9..
Keywords: Community-Based Practice, Diabetes, Healthcare Delivery, Teams
Tung EL, Gunter KE, Bergeron NQ
Cross-sector collaboration in the high-poverty setting: qualitative results from a community-based diabetes intervention.
The purpose of this study was to characterize the motivations of stakeholders from diverse sectors who engaged in cross-sector collaboration with an academic medical center. The investigators identified several factors that motivated collaboration across diverse sectors with health care systems to promote health in a high-poverty, urban setting.
AHRQ-funded; HS023007.
Citation: Tung EL, Gunter KE, Bergeron NQ .
Cross-sector collaboration in the high-poverty setting: qualitative results from a community-based diabetes intervention.
Health Serv Res 2018 Oct;53(5):3416-36. doi: 10.1111/1475-6773.12824..
Keywords: Community-Based Practice, Diabetes, Health Promotion
Davis MM, Gunn R, Gowen LK
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
In this study, the authors examined, using qualitative methods, patients' experiences of care in integrated settings. The study included 24 patients receiving care across five practices participating in Advancing Care Together (ACT)-a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. The investigators found that patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Gowen LK .
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
Transl Behav Med 2018 Sep 8;8(5):649-59. doi: 10.1093/tbm/ibx001..
Keywords: Community-Based Practice, Healthcare Delivery, Behavioral Health, Patient Experience, Primary Care
Andreae SJ, Andreae LJ, Cherrington AL
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
The investigators presented an iterative developmental approach to cognitive behavioral therapy (CBT) that combined program adaptation, pretesting, and community health workers (CHW) training processes for a CBT-based diabetes self-care program for individuals living with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Cherrington AL .
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
Fam Community Health 2018 Jul/Sep;41(3):178-84. doi: 10.1097/fch.0000000000000197.
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Keywords: Behavioral Health, Chronic Conditions, Community-Based Practice, Diabetes, Rural Health
Mullins CD, Wingate LT, Edwards HA
Transitioning from learning healthcare systems to learning health care communities.
The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. This paper discusses transitioning from learning healthcare systems to learning healthcare communities.
AHRQ-funded; HS022135.
Citation: Mullins CD, Wingate LT, Edwards HA .
Transitioning from learning healthcare systems to learning health care communities.
J Comp Eff Res 2018 Jun;7(6):603-14. doi: 10.2217/cer-2017-0105..
Keywords: Community-Based Practice, Healthcare Delivery, Learning Health Systems, Patient-Centered Healthcare
Harrison KL, Taylor HA, Merritt MW
Action guide for addressing ethical challenges of resource allocation within community-based healthcare organizations.
This article proposes an action guide to making decisions regarding the ethical allocation of resources that affect access to healthcare services offered by community-based healthcare organizations. The authors suggest that the action guide provides community-based healthcare organizations with a conceptually grounded, empirically informed framework for ethical decision making.
AHRQ-funded; HS000029.
Citation: Harrison KL, Taylor HA, Merritt MW .
Action guide for addressing ethical challenges of resource allocation within community-based healthcare organizations.
J Clin Ethics 2018 Summer;29(2):124-38..
Keywords: Community-Based Practice, Shared Decision Making, Health Services Research (HSR)
Cole MB, Wright B, Wilson IB
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
The purpose of this study was to evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. The authors found that within- and between-center racial/ethnic disparities in quality were evident and although quality outcomes in health centers continued to compare favorably to other care settings, there was no evidence of improved quality or reduced disparities in diabetes control, hypertension control, or birthweight from 2009 to 2014.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
J Gen Intern Med 2018 Jun;33(6):906-13. doi: 10.1007/s11606-018-4305-1..
Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Cole MB, Wright B, Wilson IB
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Investigators studied the impact of Medicaid expansion in rural areas. Data from 2011-2015 found that there was an 11.4% decline in uninsured patients and a 13.5% increase in Medicaid patients at community health centers (CHCs). Relative improvements were shown in patients with chronic conditions such as asthma and hypertension; and an increase in visits for mammograms and substance abuse disorders.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Health Aff 2018 Jun;37(6):900-07. doi: 10.1377/hlthaff.2017.1542..
Keywords: Medicaid, Community-Based Practice, Rural Health, Access to Care, Quality of Care, Healthcare Utilization, Primary Care
Baggett TP, Berkowitz SA, Fung V
Prevalence of housing problems among community health center patients.
This study used data from a national survey to assess the prevalence and health-related correlates of housing problems among community health center patients. It found that, compared with those without housing problems, participants with housing problems were more likely to report health problems, emergency department use, and delays in care.
AHRQ-funded; HS025378.
Citation: Baggett TP, Berkowitz SA, Fung V .
Prevalence of housing problems among community health center patients.
JAMA 2018 Feb 20;319(7):717-19. doi: 10.1001/jama.2017.19869.
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Keywords: Community-Based Practice, Health Services Research (HSR), Vulnerable Populations
Leung LB, Vargas-Bustamante A, Martinez AE
Disparities in diabetes care quality by English language preference in community health centers.
Researchers conducted a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. There were no significant differences in glycemic control by language for either Latino or Asian patients.
AHRQ-funded; HS020120.
Citation: Leung LB, Vargas-Bustamante A, Martinez AE .
Disparities in diabetes care quality by English language preference in community health centers.
Health Serv Res 2018 Feb;53(1):509-31. doi: 10.1111/1475-6773.12590.
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Keywords: Community-Based Practice, Cultural Competence, Diabetes, Disparities, Racial and Ethnic Minorities
Martsolf GR, Ashwood S, Friedberg MW
Linking structural capabilities and workplace climate in community health centers.
This study examined the relationship between workplace climate and structural capabilities. Twenty-five community health centers (CHCs) were surveyed to determine workplace climate. CHC directors and adult primary care clinicians and staff were surveyed. Positive attributes included a manageable workload, staff relationships, a quality improvement orientation, and manager readiness. Lower electronic record functionality did not seem to improve workplace climates.
AHRQ-funded; HS020120.
Citation: Martsolf GR, Ashwood S, Friedberg MW .
Linking structural capabilities and workplace climate in community health centers.
Inquiry 2018 Jan-Dec;55:46958018794542. doi: 10.1177/0046958018794542..
Keywords: Community-Based Practice, Organizational Change, Quality Improvement, Quality of Care
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.
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Keywords: Anxiety, Children/Adolescents, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Patel P, Hemmeger H, Kozak MA
Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).
The researchers described the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation.
AHRQ-funded; HS022119.
Citation: Patel P, Hemmeger H, Kozak MA .
Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).
J Am Pharm Assoc (2003) 2015 Nov-Dec;55(6):649-55. doi: 10.1331/JAPhA.2015.14244.
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Keywords: Community-Based Practice, Medication: Safety, Practice-Based Research Network (PBRN), Provider: Pharmacist
Taveras EM, Marshall R, Sharifi M
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
The Connect for Health study is designed to assess whether a novel approach to care delivery that leverages clinical and community resources and addresses socio-contextual factors will improve body mass index and family-centered, obesity-related outcomes of interest to parents and children. The intervention is informed by clinical, community, parent, and youth stakeholders and incorporates successful strategies and best practices learned from 'positive outlier' families.
AHRQ-funded; HS022986.
Citation: Taveras EM, Marshall R, Sharifi M .
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
Contemp Clin Trials 2015 Nov;45(Pt B):287-95. doi: 10.1016/j.cct.2015.09.022.
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Keywords: Children/Adolescents, Obesity, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Persell SD, Brown T, Lee JY
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
The researchers conducted a randomized trial to determine if mailed outreach containing patients’ individualized CVD risk and uncontrolled risk factors followed by telephone discussion with trained lay health workers would improve statin use for primary prevention among community health center patients with moderately high cardiovascular risk. They found that the intervention, led to more cholesterol treatment discussions with primary care clinicians but had little impact on statin prescribing.
AHRQ-funded; HS021141.
Citation: Persell SD, Brown T, Lee JY .
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. doi: 10.1161/circoutcomes.115.001723..
Keywords: Cardiovascular Conditions, Prevention, Community-Based Practice, Clinician-Patient Communication, Risk
Davis MM, Balasubramanian BA, Cifuentes M
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
This study examined the interrelationship among behavioral health clinician staffing, scheduling, and a primary care practice's approach to delivering integrated care. It concluded that practices' approaches to staffing by primary care clinicians and behavioral health clinicians, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context.
AHRQ-funded; HS022981.
Citation: Davis MM, Balasubramanian BA, Cifuentes M .
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S32-40. doi: 10.3122/jabfm.2015.S1.150087.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Community-Based Practice
Cohen DJ, Davis M, Balasubramanian BA
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. It concluded that primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Davis M, Balasubramanian BA .
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042.
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Keywords: Healthcare Delivery, Community-Based Practice, Shared Decision Making, Behavioral Health, Primary Care
Hall J, Cohen DJ, Davis M
Preparing the workforce for behavioral health and primary care integration.
The researchers sought to identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. They concluded that insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. Until the training capacity grows to meet the demand, practices must put forth considerable effort and resources to train their own employees.
AHRQ-funded; HS022981.
Citation: Hall J, Cohen DJ, Davis M .
Preparing the workforce for behavioral health and primary care integration.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S41-51. doi: 10.3122/jabfm.2015.S1.150054.
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Keywords: Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Behavioral Health, Training, Community-Based Practice
Balasubramanian BA, Fernald D, Dickinson LM
REACH of interventions integrating primary care and behavioral health.
This study reports REACH (the extent to which an intervention or program was delivered to the identified target population) of interventions integrating primary care and behavioral health implemented by real-world practices. Practices that implemented systematic protocols to identify patients needing integrated care had a significantly higher screening REACH compared with practices that used clinicians' discretion.
AHRQ-funded; HS022981.
Citation: Balasubramanian BA, Fernald D, Dickinson LM .
REACH of interventions integrating primary care and behavioral health.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S73-85. doi: 10.3122/jabfm.2015.S1.150055.
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Keywords: Behavioral Health, Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Community-Based Practice, Implementation, Community-Based Practice, Implementation
Okumura MJ, Saunders M, Rehm RS
The role of health advocacy in transitions from pediatric to adult care for children with special health care needs: bridging families, provider and community services.
The aim of this study was to develop a theoretical understanding of how family, healthcare providers, and community supports can assist youth and young adults with special healthcare needs (YASHCN) during the transition from pediatric to adult healthcare and services. Transition Advocacy consists of the presence of, or need for, a healthcare advocate who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. If advocates were identified, youth were more likely to obtain needed services.
AHRQ-funded; HS017716.
Citation: Okumura MJ, Saunders M, Rehm RS .
The role of health advocacy in transitions from pediatric to adult care for children with special health care needs: bridging families, provider and community services.
J Pediatr Nurs 2015 Sep-Oct;30(5):714-23. doi: 10.1016/j.pedn.2015.05.015.
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Keywords: Children/Adolescents, Community-Based Practice, Disabilities, Health Services Research (HSR), Young Adults
Cohen DJ, Balasubramanian BA, Davis M
Understanding care integration from the ground up: five organizing constructs that shape integrated practices.
The authors identified 5 key organizing constructs influencing integration of primary care and behavioral health. They concluded that the interaction among 5 organizing constructs and practice context produces diverse expressions of integrated care. These constructs provide a framework for understanding how primary care and behavioral health services can be integrated in routine practice.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Balasubramanian BA, Davis M .
Understanding care integration from the ground up: five organizing constructs that shape integrated practices.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S7-20. doi: 10.3122/jabfm.2015.S1.150050.
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Keywords: Behavioral Health, Healthcare Delivery, Community-Based Practice, Primary Care
Goldman SN, Liss DT, Brown T
Comparative effectiveness of multifaceted outreach to initiate colorectal cancer screening in community health centers: a randomized controlled trial.
The researchers sought to determine whether outreach increases fecal immune-chemical test (FIT) uptake among patients with no CRC screening history compared to usual care. They found that patients who received outreach were more likely to complete FIT than those in usual care (36.7 percent vs. 14.8 percent).
AHRQ-funded; HS021141.
Citation: Goldman SN, Liss DT, Brown T .
Comparative effectiveness of multifaceted outreach to initiate colorectal cancer screening in community health centers: a randomized controlled trial.
J Gen Intern Med 2015 Aug;30(8):1178-84. doi: 10.1007/s11606-015-3234-5..
Keywords: Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention, Screening
Pardos de la Gandara M, Raygoza Garay JA, Mwangi M
Molecular types of methicillin-resistant staphylococcus aureus and methicillin-sensitive S. aureus strains causing skin and soft tissue infections and nasal colonization, identified in community health centers in New York City.
In November 2011, a research and learning collaborative project with six community health centers in the New York City metropolitan area was launched to determine the nature (clonal type) of community-acquired Staphylococcus aureus strains causing skin and soft tissue infections (SSTIs). It found that of 63 patients with S. aureus infections, 16 of the colonizing isolates were MRSA, and 14 were MSSA, and the majority of the colonizing isolates belonged to the USA300 clonal group.
AHRQ-funded; HS021667.
Citation: Pardos de la Gandara M, Raygoza Garay JA, Mwangi M .
Molecular types of methicillin-resistant staphylococcus aureus and methicillin-sensitive S. aureus strains causing skin and soft tissue infections and nasal colonization, identified in community health centers in New York City.
J Clin Microbiol 2015 Aug;53(8):2648-58. doi: 10.1128/jcm.00591-15..
Keywords: Community-Acquired Infections, Community Partnerships, Community-Based Practice, Genetics, Methicillin-Resistant Staphylococcus aureus (MRSA)
Connolly Gibbons MB, Kurtz JE, Thompson DL
The effectiveness of clinician feedback in the treatment of depression in the community mental health system.
This article described the development and evaluation of a clinician feedback intervention for use in community mental health settings. The Community Clinician Feedback System (CCFS) was developed in collaboration with a community partner to meet the needs of providers working in such community settings. Satisfaction ratings of the CCFS indicated that the system was widely accepted by clinicians and patients.
AHRQ-funded; HS022124.
Citation: Connolly Gibbons MB, Kurtz JE, Thompson DL .
The effectiveness of clinician feedback in the treatment of depression in the community mental health system.
J Consult Clin Psychol 2015 Aug;83(4):748-59. doi: 10.1037/a0039302..
Keywords: Community-Based Practice, Community Partnerships, Depression, Behavioral Health, Patient Experience
DeVoe JE, Marino M, Gold R
Community health center use after Oregon's randomized medicaid experiment.
To better understand the effect of new Medicaid coverage on community health center (CHC)use over time, the researchers studied Oregon’s 2008 randomized Medicaid expansion (the “Oregon Experiment”). Their results suggest that use of many different types of CHC services will increase as patients gain Medicaid through Affordable Care Act expansions.
AHRQ-funded; HS021522.
Citation: DeVoe JE, Marino M, Gold R .
Community health center use after Oregon's randomized medicaid experiment.
Ann Fam Med 2015 Jul;13(4):312-20. doi: 10.1370/afm.1812..
Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care