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
51 to 75 of 85 Research Studies DisplayedJavier SJ, Belgrave FZ
"I'm not white, I have to be pretty and skinny": a qualitative exploration of body image and eating disorders among Asian American women.
The authors examined the relationships between body image, eating disorders, and treatment-seeking motivations among Asian American women ages 18-24. Using focus groups, they developed a model to be utilized by practitioners or clinicians to help obtain a better understanding of the societal, interpersonal, and intrapersonal forces that may shape conceptualizations about body image and eating behaviors among Asian American women. In addition, findings from this study can be incorporated into prevention programs and interventions that focus on mental health among this population.
AHRQ-funded; HS023731.
Citation: Javier SJ, Belgrave FZ .
"I'm not white, I have to be pretty and skinny": a qualitative exploration of body image and eating disorders among Asian American women.
Asian Am J Psychol 2019 Jun;10(2):141-53. doi: 10.1037/aap0000133..
Keywords: Behavioral Health, Racial and Ethnic Minorities, Women, Young Adults
Simpson KR, Lyndon A, Spetz J
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Labor and delivery nurses were surveyed to determine if their units adhere to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Labor nurses in selected hospitals in California, Michigan and New Jersey were invited via email to participate in the study. Their nurse leaders facilitated the invitations. A total of 615 labor nurses from 67 hospitals participated. Most nurses did report that staffing guidelines were adhered to. The hospitals with smaller annual birth volumes (500-999 range) were significantly more like to be perceived as compliant than hospitals with 2,500 or more annual births.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Nurs Womens Health 2019 Jun;23(3):217-23. doi: 10.1016/j.nwh.2019.03.003..
Keywords: Care Management, Guidelines, Labor and Delivery, Maternal Care, Patient Safety, Pregnancy, Provider, Provider: Nurse, Women
Campbell KH, Illuzzi JL, Lee HC
Optimal maternal and neonatal outcomes and associated hospital characteristics.
The goal of this study was to examine hospital variation in both maternal and neonatal morbidities and to identify institutional characteristics associated with hospital performance in a combined measure of maternal and neonatal outcomes. The authors found that hospitals with low maternal morbidity rates may not have low neonatal morbidity rates and vice versa, highlighting the importance of assessing joint maternal-newborn outcomes in order to fully characterize a hospital's obstetrical performance.
AHRQ-funded; HS023801.
Citation: Campbell KH, Illuzzi JL, Lee HC .
Optimal maternal and neonatal outcomes and associated hospital characteristics.
Birth 2019 Jun;46(2):289-99. doi: 10.1111/birt.12400.
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Keywords: Hospitals, Newborns/Infants, Outcomes, Pregnancy, Provider Performance, Quality of Care, Women
Hoover DS, Pappadis MR, Housten AJ
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
The purpose of this study was to examine preferences for communicating about screening mammography among racially/ethnically diverse older women. Through in-depth interviews, findings revealed that older women desire information about the benefits and harms of screening mammography and would prefer to learn this information through discussions with healthcare providers and multiple other formats. Results were consistent regardless of participants' age, race/ethnicity, or education.
AHRQ-funded; HS022134.
Citation: Hoover DS, Pappadis MR, Housten AJ .
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
Health Commun 2019 Jun;34(7):702-06. doi: 10.1080/10410236.2018.1431026..
Keywords: Cancer, Cancer: Breast Cancer, Clinician-Patient Communication, Communication, Elderly, Women, Prevention, Racial and Ethnic Minorities, Screening
Arana E, Carroll-Scott A, Massey PM
Racial/ethnic disparities in mammogram frequency among women with intellectual disability.
The purpose of this study was to collect survey and medical record data to examine associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. Hispanic and Black women with ID are more likely than White women with ID to have mammograms every 2 years. Women who live in State-funded residences, are aged 50 and over, and had a mild or moderate level of ID impairment were more likely to have mammograms compared to those who lived with family or alone, were under 50, or who had severe ID impairment. The authors conclude that further research is needed to understand the mechanisms that explain these disparities.
AHRQ-funded; HS023966.
Citation: Arana E, Carroll-Scott A, Massey PM .
Racial/ethnic disparities in mammogram frequency among women with intellectual disability.
Intellect Dev Disabil 2019 Jun;57(3):177-87. doi: 10.1352/1934-9556-57.3.177..
Keywords: Disabilities, Disparities, Imaging, Prevention, Racial and Ethnic Minorities, Screening, Women
Dorst MT, Anders SH, Chennupati S
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
This study’s objective was to determine the number and nature of the components of the support systems of pregnant women and their caregivers (family members) and the role of health information technologies (HIT) in these support systems. Pregnant women and their caregivers were enrolled from advanced maternal-fetal and group prenatal care clinics. Participants filled out surveys which addressed stress levels, socioeconomic status, health literacy, and they drew a diagram of their support systems. Pregnant women overall had a larger support system than their caregivers. Their source of medical information was more likely to be specific medical information websites, while caregivers used more general internet search engines. No association was found between stress, support system size, and support system components.
AHRQ-funded; HS021496.
Citation: Dorst MT, Anders SH, Chennupati S .
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
J Med Internet Res 2019 May 9;21(5):e10865. doi: 10.2196/10865..
Keywords: Health Information Technology (HIT), Pregnancy, Caregiving, Women, Social Media
Vanderlaan J, Rochat R, Williams B
Associations between hospital maternal service level and delivery outcomes.
This study explored the associations between delivery hospital self-reported level of maternal service, as defined by the American Hospital Association, and both maternal and neonatal outcomes among women at high maternal risk, as defined by the Obstetric Comorbidity Index. The investigators concluded that for the group of pregnant women in need of maternal transfer, delivery hospital self-reported level of maternal care was not associated with the odds of poor maternal or neonatal outcomes.
AHRQ-funded; HS024655.
Citation: Vanderlaan J, Rochat R, Williams B .
Associations between hospital maternal service level and delivery outcomes.
Womens Health Issues 2019 May - Jun;29(3):252-58. doi: 10.1016/j.whi.2019.02.004..
Keywords: Maternal Care, Labor and Delivery, Pregnancy, Women, Outcomes, Hospitals, Quality of Care, Newborns/Infants, Mortality
Wu J, Braunschweig Y, Harris LH
Looking back while moving forward: a justice-based, intersectional approach to research on contraception and disability.
This paper discusses the higher use of female sterilization than long-acting reversible contraception use among women with disabilities compared to women without disabilities. The reasons for that were discussed and the authors advocate for a justice-based intersectional approach to research on contraception and disability.
AHRQ-funded; HS022981.
Citation: Wu J, Braunschweig Y, Harris LH .
Looking back while moving forward: a justice-based, intersectional approach to research on contraception and disability.
Contraception 2019 May;99(5):267-71. doi: 10.1016/j.contraception.2019.01.006..
Keywords: Disabilities, Sexual Health, Vulnerable Populations, Women
Arasu VA, Miglioretti DL, Sprague BL
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
The purpose of this study was to evaluate comparative associations of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) and mammographic breast density with subsequent breast cancer risk. The investigators concluded that BPE was associated with future invasive breast cancer risk independent of breast density. They suggest that BPE should be considered for risk prediction models for women undergoing breast MRI.
AHRQ-funded; HS018366.
Citation: Arasu VA, Miglioretti DL, Sprague BL .
Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk.
J Clin Oncol 2019 Apr 20;37(12):954-63. doi: 10.1200/jco.18.00378..
Keywords: Cancer, Cancer: Breast Cancer, Imaging, Patient-Centered Outcomes Research, Risk, Women
Cantor AG, Hendrickson R, Blazina I
Screening for elevated blood lead levels in childhood and pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to synthesize evidence on the effects of screening, testing, and treatment for elevated blood lead level in pregnant women and children aged 5 years and younger in the primary care setting to inform the US Preventive Services Task Force. The investigators found that screening questionnaires were not accurate for identifying children with elevated blood lead levels. Additionally, chelating agents in children were not significantly associated with sustained effects on blood level levels but were associated with harms.
AHRQ-funded; 290201500009I.
Citation: Cantor AG, Hendrickson R, Blazina I .
Screening for elevated blood lead levels in childhood and pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Apr 16;321(15):1510-26. doi: 10.1001/jama.2019.1004..
Keywords: Children/Adolescents, Evidence-Based Practice, Pregnancy, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF), Women
Balk EM, Rofeberg VN, Adam GP
Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.
The purpose of this study was to compare the effectiveness of pharmacologic and nonpharmacologic interventions to improve or cure stress, urgency, or mixed UI in nonpregnant women. The investigators concluded that most nonpharmacologic and pharmacologic interventions were more likely than no treatment to improve UI outcomes. They also concluded that behavioral therapy, alone or in combination with other interventions, was generally more effective than pharmacologic therapies alone in treating both stress and urgency UI.
AHRQ-funded; 290201500002I.
Citation: Balk EM, Rofeberg VN, Adam GP .
Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.
Ann Intern Med 2019 Apr 2;170(7):465-79. doi: 10.7326/m18-3227..
Keywords: Care Management, Comparative Effectiveness, Evidence-Based Practice, Medication, Outcomes, Patient-Centered Outcomes Research, Women
Horner-Johnson W, Moe EL, Stoner RC
Contraceptive knowledge and use among women with intellectual, physical, or sensory disabilities: a systematic review.
The objective of this study was to systematically review published literature on women with disabilities and: 1) contraceptive knowledge; 2) attitudes and preferences regarding contraception; 3) contraceptive use; 4) barriers and facilitators to informed contraceptive use; and 5) effectiveness of interventions to improve informed contraceptive decision-making and use. The investigators concluded that women with disabilities may use a more narrow mix of contraceptive methods and were often less knowledgeable about contraceptives than women without disabilities.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Moe EL, Stoner RC .
Contraceptive knowledge and use among women with intellectual, physical, or sensory disabilities: a systematic review.
Disabil Health J 2019 Apr;12(2):139-54. doi: 10.1016/j.dhjo.2018.11.006..
Keywords: Disabilities, Sexual Health, Women
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Maurer M, Carman KL, Yang M
Increasing the use of comparative quality information in maternity care: results from a randomized controlled trial.
The authors tested an intervention to increase uptake of hospital-level maternity care quality reports among 245 pregnant women in North Carolina. They found that intervention participants were significantly more likely to report adopting behaviors to inform care, such as thinking through preferences, talking with their doctor, or creating a birth plan. They concluded that reports designed to put quality information into the larger context of what consumers want and need to know, along with targeted and timely communications, can increase consumer use of quality information and prompt them to talk with providers about care preferences and evidence-based practices.
AHRQ-funded; HS021873.
Citation: Maurer M, Carman KL, Yang M .
Increasing the use of comparative quality information in maternity care: results from a randomized controlled trial.
Med Care Res Rev 2019 Apr;76(2):208-28. doi: 10.1177/1077558717712290.
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Keywords: Maternal Care, Patient and Family Engagement, Quality Improvement, Women, Pregnancy
Giess CS, Wang A, Ip IK
Patient, radiologist, and examination characteristics affecting screening mammography recall rates in a large academic practice.
This retrospective study examined patient, radiologist and examination characteristics affecting screening mammography recall rates. This study used 61,198 examinations from an academic center and two outpatient centers from October 1, 2012 to May 31, 2015. Radiologists’ risk aversion, stress from uncertainty, and malpractice concerns and cancer detection rates were derived from the survey. Their annual screening volumes, clinical experience, and concentration in breast imaging was calculated. About 9.3% of screening examinations were recalled. There was no association found with radiologists’ risk aversion, stress from uncertainty, malpractice concerns and cancer detection rates and high recall rates. The most variation was found with radiologists’ annual reading volume and experience.
AHRQ-funded; HS24722.
Citation: Giess CS, Wang A, Ip IK .
Patient, radiologist, and examination characteristics affecting screening mammography recall rates in a large academic practice.
J Am Coll Radiol 2019 Apr;16(4 Pt A):411-18. doi: 10.1016/j.jacr.2018.06.016..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Imaging, Prevention, Screening, Women
Muzny CA, Tamhane AR, Eaton EF
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients.
Trichomonas vaginalis infection contributes to HIV transmission. The purpose of this retrospective cohort study was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. The investigators indicated that T. vaginalis reinfection was high among HIV-infected women in the sample, necessitating enhanced disease control efforts in this high-risk population.
AHRQ-funded; HS023009.
Citation: Muzny CA, Tamhane AR, Eaton EF .
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients.
Trichomonas vaginalis infection contributes to HIV transmission. The purpose of this retrospective cohort study was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. The investigators indicated that T. vaginalis reinfection was high among HIV-infected women in the sample, necessitating enhanced disease control efforts in this high-risk population..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Women
Milla C, Guo M, Chang A
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Childbirth is a national priority area for healthcare quality improvement. Patient perspectives are increasingly valued in healthcare, yet Asian American and Pacific Islander (AAPI) perspectives of healthcare quality are often understudied, particularly from individuals with limited English proficiency (LEP). In this study, the goal was to understand factors that consumers in Hawai'i, including AAPI and those with LEP, used to compare patient care in hospitals, especially for childbirth.
AHRQ-funded; HS021903.
Citation: Milla C, Guo M, Chang A .
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Hawaii J Med Public Health 2019 Mar;78(3):89-97..
Keywords: Labor and Delivery, Pregnancy, Hospitals, Quality Improvement, Quality of Care, Cultural Competence, Women
Dinan MA, Wilson LE, Reed SD
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
This study examined whether associations between 21-gene recurrence score (RS) genomic testing and lower costs among patients with early-stage, estrogen receptor-positive breast cancer were observable in real-world data from the Medicare population. The investigators found that RS testing was associated with lower overall and chemotherapy-related costs in patients with high-risk disease, consistent with lower chemotherapy use among these patients. Higher overall costs for patients with intermediate-risk and low-risk disease were driven largely by non-treatment-related costs.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
J Natl Compr Canc Netw 2019 Mar;17(3):245-54. doi: 10.6004/jnccn.2018.7097..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Healthcare Costs, Medicare, Women
Horner-Johnson W, Biel FM, Caughey AB
Differences in prenatal care by presence and type of maternal disability.
This study examined timing and frequency of prenatal care of women with disabilities by disability type. A retrospective cohort study was done of all births in California from 2000-2012. Women with intellectual/developmental disabilities, or limited hearing had the most significant risk of receiving less prenatal care compared to women with physical disabilities. However women with intellectual/developmental or physical disabilities may have a higher than normal number of prenatal visits. Delays in prenatal care may result in poorer birth outcomes.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Biel FM, Caughey AB .
Differences in prenatal care by presence and type of maternal disability.
Am J Prev Med 2019 Mar;56(3):376-82. doi: 10.1016/j.amepre.2018.10.021..
Keywords: Disabilities, Healthcare Utilization, Pregnancy, Vulnerable Populations, Women
fRIEDMAN j, Saavedra-Avendano B, Schiavon R
Quantifying disparities in access to public-sector abortion based on legislative differences within the Mexico City metropolitan area.
This study examined abortion access and use in the Mexico City metropolitan area, where it is only legal in the city center. Researchers calculated abortion rates for 75 municipalities in the metropolitan area for 2011-2012. Abortion rates were much lower for women who had to travel into the city center (18.6%) than if they had local access. Each additional 15 minutes of travel reduced access by 33.7%. Women who did travel were most likely in a higher socioeconomic status with a higher education level.
AHRQ-funded; HS025155; HS022981.
Citation: fRIEDMAN j, Saavedra-Avendano B, Schiavon R .
Quantifying disparities in access to public-sector abortion based on legislative differences within the Mexico City metropolitan area.
Contraception 2019 Mar;99(3):160-64. doi: 10.1016/j.contraception.2018.11.012..
Keywords: Access to Care, Disparities, Policy, Women
Mehra R, Shebi FM, Cunningham SD
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
This research studied the association between area-level deprivation and preterm birth. A retrospective cohort study was conducted using data obtained from the Health Care Cost Institute that uses national, commercial health claims data from 2011. The highest quartile of area-level deprivation experienced the highest number of preterm birth (24.9%) as opposed to the lowest quarter (9.6%). This was true even among commercially-insured women.
AHRQ-funded; HS017589; HS022242.
Citation: Mehra R, Shebi FM, Cunningham SD .
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
BMC Public Health 2019 Feb 27;19(1):236. doi: 10.1186/s12889-019-6533-7..
Keywords: Health Insurance, Newborns/Infants, Pregnancy, Social Determinants of Health, Women
O'Connor E, Senger CA, Henninger ML
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
This evidence review, funded by the U.S. Preventive Services Task Force examined if interventions to prevent perinatal depression was effective. A large number of studies were identified, and 50 were included in the review. There was an absolute difference in the risk of perinatal depression from 1.3% reduction in the control group to 31.8% greater reduction in the intervention group. Most of the studies were limited to women at increased risk for perinatal depression. Counseling interventions seemed to be the most effective.
AHRQ-funded; 290201500017I.
Citation: O'Connor E, Senger CA, Henninger ML .
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Feb 12;321(6):588-601. doi: 10.1001/jama.2018.20865.
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Keywords: Depression, Evidence-Based Practice, Pregnancy, U.S. Preventive Services Task Force (USPSTF), Women, Behavioral Health, Maternal Care
Herrick CJ, Keller MR, Trolard AM
Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010-2015.
This study looked at postpartum screening for type 2 diabetes among low-income women who were previously diagnosed with gestational diabetes. Gestational diabetes increases risk for developing type 2 diabetes 7-fold so it is recommended that screening is done within months after delivery. Results in a Missouri population found that almost 20% were screened within the first year of delivery.
AHRQ-funded; HS019455.
Citation: Herrick CJ, Keller MR, Trolard AM .
Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010-2015.
BMC Public Health 2019 Feb 4;19(1):148. doi: 10.1186/s12889-019-6475-0..
Keywords: Diabetes, Low-Income, Pregnancy, Screening, Women
Gadgil MD, Ehrlich SF, Zhu Y
Dietary quality and glycemic control among women with gestational diabetes mellitus.
Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with GDM. The authors concluded that clinicians should be aware that even a small improvement in diet quality may be beneficial for the achievement of improved glycemic control in women with GDM.
AHRQ-funded; HS019367.
Citation: Gadgil MD, Ehrlich SF, Zhu Y .
Dietary quality and glycemic control among women with gestational diabetes mellitus.
J Womens Health 2019 Feb;28(2):178-84. doi: 10.1089/jwh.2017.6788..
Keywords: Pregnancy, Diabetes, Nutrition, Women, Risk, Prevention
Gourevitch RA, Mehrotra A, Galvin G
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
This study examined whether pregnant women who use cesarean delivery rate data from hospitals influences their choice of obstetric hospital. A randomized controlled trial of 18,293 users of the Ovia Health mobile app from 2016-2017 was conducted. Enrollees were given an explanation of the cesarean rate data and were randomized to an intervention group who also were given an interactive tool to display data for the 10 closest hospitals with obstetric services. There was no significant difference between the intervention and control groups in their hospital selection.
AHRQ-funded; HS000055.
Citation: Gourevitch RA, Mehrotra A, Galvin G .
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
Am J Manag Care 2019 Feb;25(2):e33-e38..
Keywords: Pregnancy, Women, Hospitals, Maternal Care, Labor and Delivery