National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (4)
- COVID-19 (2)
- Diabetes (7)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Elderly (4)
- Electronic Health Records (EHRs) (2)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (7)
- Health Promotion (1)
- Home Healthcare (1)
- Hospital Discharge (2)
- Human Immunodeficiency Virus (HIV) (2)
- Injuries and Wounds (1)
- Lifestyle Changes (2)
- Medical Devices (1)
- Medication (2)
- Medication: Safety (2)
- Nutrition (1)
- Pain (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (3)
- Patient Safety (2)
- (-) Patient Self-Management (19)
- Primary Care (1)
- Racial and Ethnic Minorities (1)
- Stroke (1)
- Surgery (1)
- Telehealth (4)
- 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 19 of 19 Research Studies DisplayedReistetter T, Hreha K, Dean JM
The pre-adaptation of a stroke-specific self-management program among older adults.
To understand the management of multimorbidity in aging stroke survivors and to examine the complex relationships between comorbidities, researchers used visual analytics to identify patient subgroup. Five significant subgroups of comorbidities such as obesity and cancer were identified. An interdisciplinary team constructed six vignettes that highlighted multimorbidity to customize a self-management program that fitted the needs of older adult stroke survivors.
AHRQ-funded; HS026133.
Citation: Reistetter T, Hreha K, Dean JM .
The pre-adaptation of a stroke-specific self-management program among older adults.
J Aging Health 2023 Oct; 35(9):632-42. doi: 10.1177/08982643231152520..
Keywords: Stroke, Cardiovascular Conditions, Elderly, Patient Self-Management
Hooper M, Reinhart M, Dusetzina SB
Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.
The purpose of this study was to evaluate changes in self-reported health outcomes during the COVID-19 pandemic, and to examine trends in health-related behaviors that may be associated with the observed health changes. The researchers utilized an interrupted time series design stratified by age, gender, race/ethnicity, educational attainment, household income, and employment status. Health outcomes were self-reported by participants and included the number of days per month that respondents spent in poor mental health, physical health, or when poor health prevented their usual activities of daily living. The study found that the national rate of days spent in poor physical health decreased. The researchers also witnessed overall increases in average sleep hours per day, the percentage of adults who report any exercise activity, increased alcohol consumption days, and decreased prevalence of smoking.
AHRQ-funded; HS026395.
Citation: Hooper M, Reinhart M, Dusetzina SB .
Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.
PLoS One 2023 Sep 19; 18(9):e0291667. doi: 10.1371/journal.pone.0291667..
Keywords: COVID-19, Patient Self-Management
Allende-Richter S, Benitez AD, Ramirez M
A patient portal intervention to promote adolescent and young adult self-management skills.
This study’s objective was to examine whether a patient portal educational intervention is acceptable and can improve adolescent and young adult (AYA) self-management skills toward transition readiness to adult care. The authors conducted a single site feasibility study using a mixed research method consisting of 1) a patient portal one-on-one educational intervention with pre- and postsurveys adapted from the Transition Readiness Assessment Questionnaire to assess participant self-management skills and portal user activity; 2) a portal user experience that was assessed through semistructured interviews until thematic saturation was reached. Study participants were 13 to 25 years old and received care at an academic-affiliated community pediatric clinic, of whom 78 (60%) completed the pre- and post-surveys. Following the educational intervention, they observed an increase in participants self-reporting knowing how to access their protected health information and in the proportion of participants self-reporting to strongly agree to know their medication. They also observed an increase in portal user access at 3 weeks. The median number of logins was 2 per participant.
AHRQ-funded; HS000063.
Citation: Allende-Richter S, Benitez AD, Ramirez M .
A patient portal intervention to promote adolescent and young adult self-management skills.
Acad Pediatr 2023 Aug; 23(6):1252-58. doi: 10.1016/j.acap.2023.02.003..
Keywords: Children/Adolescents, Young Adults, Patient Self-Management, Electronic Health Records (EHRs), Health Information Technology (HIT)
Shannon EM, Mueller SK, Schnipper JL
Patient, caregiver, and clinician experience with a technologically enabled pillbox: a qualitative study.
The purpose of this study was to explore whether medication safety could be improved by the use of a technologically-enabled pillbox prescribed to patients at hospital discharge. The study included semi-structured telephone interviews with patients, patient caregivers, and inpatient and outpatient clinicians who participated in the Smart Pillbox Transition Study. The researchers utilized the Systems Engineering Initiative for Patient Safety (SEIPS) framework to develop an interview guide, which included the a priori domains of 1) barriers to implementation, 2) facilitators of the intervention, and 3) general feedback regarding experience with the intervention. The study found patient-endorsed barriers in the theme of technology and tools included signal issues, inappropriate alarms, and portability. Barriers in the theme of logistics and tasks included coordination with pharmacists in the event of a prescription change. Barriers mentioned by clinicians included patients who were poor fits for the intervention and competing demands at discharge (under the themes of personnel and patients, and logistics and tasks, respectively). Facilitators that were reported often by patients and caregivers in the theme of technology and tools included useful alarms and ease of use. Clinicians reported that communication with pharmacy and study staff facilitated the intervention.
AHRQ-funded.
Citation: Shannon EM, Mueller SK, Schnipper JL .
Patient, caregiver, and clinician experience with a technologically enabled pillbox: a qualitative study.
ACI Open 2023 Jul; 7(2):e61-e70..
Keywords: Medication, Health Information Technology (HIT), Patient Self-Management, Hospital Discharge, Medication: Safety, Patient Safety
Wendel CL, LaPierre TA, Sullivan DL
"Anything that benefits the workers should benefit the client": opportunities and constraints in self-directed care during the COVID-19 pandemic.
The purpose of this study was to assess how self-directed care (SDC) models reacted to the COVID-19 pandemic and to examine the impact of COVID-19 on Home and Community Based Services (HCBS) services in Kansas. The study found that self-directed consumers carried levels of employer responsibility with limited resources and systemic barriers contributing to unmet care needs, stress, and burden. Flexibilities in policies related to the hiring of family members were helpful, but inadequate to address working conditions lacking in resources and labor shortages that were amplified by the pandemic.
AHRQ-funded; HS028172.
Citation: Wendel CL, LaPierre TA, Sullivan DL .
"Anything that benefits the workers should benefit the client": opportunities and constraints in self-directed care during the COVID-19 pandemic.
J Appl Gerontol 2023 Apr; 42(4):7334648221143604. doi: 10.1177/07334648221143604.
Keywords: COVID-19, Patient Self-Management
Schnall R, Sanabria G, Jia R, Sanabria G, Jia H
Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.
This study’s objective was to determine the efficacy of WiseApp, a user-centered design mHealth intervention to improve antiretroviral therapy (ART) adherence and viral suppression in persons living with HIV (PLWH). This randomized case-control trial had two study arms: a randomized controlled efficacy trial arm (n = 99) and an attention control intervention arm (n = 101) among PLWH living in New York City. The authors found a significant improvement in ART adherence in the intervention arm compared to the attention control arm from day 1 (69.7% vs 48.3%) to day 59 (51.2% vs 37.2%) of the study period. From day 60 to 120, the intervention had higher but not statistically significant adherence rates. Secondary analyses showed no difference in change from baseline to 3 or 6 months between the 2 study arms.
AHRQ-funded; HS025071.
Citation: Schnall R, Sanabria G, Jia R, Sanabria G, Jia H .
Efficacy of an mHealth self-management intervention for persons living with HIV: the WiseApp randomized clinical trial.
J Am Med Inform Assoc 2023 Feb 16; 30(3):418-26. doi: 10.1093/jamia/ocac233..
Keywords: Telehealth, Patient Self-Management, Human Immunodeficiency Virus (HIV), Chronic Conditions, Health Information Technology (HIT)
Weiner M, Adeoye P, Boeh MJ
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
The purpose of this study was to assess whether vulnerable older adults could use wearable devices, and explore Hypoglycemia frequency over a two week period. The researchers recruited 10 participants with diabetes mellitus to pilot test a continuous glucometer, physical activity monitor, electronic medication bottles, and smartphones which that provided prompts about medications, behaviors, and symptoms. A sample of 70 then wore glucometers and activity monitors and used the smartphone and bottles for a duration of 2 weeks and provided feedback. The study found that patients were interested in assistance with the interpretation of graphs, had challenges with keeping the glucometers attached. Nearly 23% of respondents indicated that they never check their blood sugars. In two weeks of monitoring, 73% had HG and 42% had serious, clinically significant HG.
AHRQ-funded; HS024384.
Citation: Weiner M, Adeoye P, Boeh MJ .
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
Appl Clin Inform 2023 Jan; 14(1):37-44. doi: 10.1055/a-1975-4136..
Keywords: Elderly, Diabetes, Chronic Conditions, Ambulatory Care and Surgery, Patient Self-Management, Medical Devices
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Nundy S, Mishra A, Hogan P
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. It found that the intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating).
AHRQ-funded; HS015054.
Citation: Nundy S, Mishra A, Hogan P .
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
Diabetes Educ 2014 Nov-Dec;40(6):806-19. doi: 10.1177/0145721714551992..
Keywords: Diabetes, Health Information Technology (HIT), Patient Self-Management, Telehealth
Mitchell SE, Mako M, Sadikova E
The comparative experiences of women in control: diabetes self-management education in a virtual world.
The investigators characterized participants' experiences of a diabetes self-management (DSM) education program delivered via a virtual world (VW) versus a face-to-face (F2F) format. They found that VW and F2F groups both reported mastery of DSM knowledge, attitudes, and skills, and there were no differences in peer-derived social support between groups. The technological aspects of VW participation afforded VW participants a unique sense of personal agency and diabetes self-efficacy not reported by F2F participants. They concluded that DSM education in a VW is feasible and educational outcomes are similar to a F2F classroom experience.
AHRQ-funded; HS019771.
Citation: Mitchell SE, Mako M, Sadikova E .
The comparative experiences of women in control: diabetes self-management education in a virtual world.
J Diabetes Sci Technol 2014 Nov;8(6):1185-92. doi: 10.1177/1932296814549829.
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Keywords: Education: Patient and Caregiver, Diabetes, Health Promotion, Patient Self-Management
Chen R, Cheadle A, Johnson D
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
The purpose of this study was to examine trends in the receipt of 8 recommended diabetes clinical and self-care indicators from 2001 to 2010 and assess racial/ethnic disparities in care. There were significant increases from 2001 to 2010 in A1C tests, annual foot exams, flu shots, diabetes self-management education and self management of blood glucose but declines in eye and self feet exams.
AHRQ-funded; HS013853.
Citation: Chen R, Cheadle A, Johnson D .
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
Diabetes Educ 2014 Nov-Dec;40(6):756-66. doi: 10.1177/0145721714546721..
Keywords: Diabetes, Patient Self-Management, Disparities, Racial and Ethnic Minorities, Racial and Ethnic Minorities
Cohen MJ, Morton S, Scholle SH
Self-management support activities in patient-centered medical home practices.
This study is a survey of small practices of fewer than 5 physicians with National Committee for Quality Assurance recognition. Practices reported a high proportion of self-management support activities, while practices that perform more of these activities have more nonindependent health care providers.
AHRQ-funded; HS019162.
Citation: Cohen MJ, Morton S, Scholle SH .
Self-management support activities in patient-centered medical home practices.
J Ambul Care Manage 2014 Oct-Dec;37(4):349-58. doi: 10.1097/jac.0000000000000040.
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Keywords: Patient-Centered Healthcare, Patient Self-Management, Primary Care
Leung LA, Swaminathan S, Trivedi AN
Diabetes diagnosis and exercise initiation among older Americans.
The investigators sought to determine whether exercise participation increased following a new diagnosis of diabetes using a sample of U.S. individuals aged 50 and over who did not report exercise prior to diagnosis. They found that over 35% of persons with a new diagnosis of diabetes initiated moderate or vigorous exercise in the year following their diagnosis.
AHRQ-funded; HS000011.
Citation: Leung LA, Swaminathan S, Trivedi AN .
Diabetes diagnosis and exercise initiation among older Americans.
Prev Med 2014 Aug;65:128-32. doi: 10.1016/j.ypmed.2014.05.001.
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Keywords: Diabetes, Diagnostic Safety and Quality, Elderly, Lifestyle Changes, Patient Self-Management
Chrischilles EA, Hourcade JP, Doucette W
Personal health records: a randomized trial of effects on elder medication safety.
The purpose of this study was to compare patient-reported medication self-management behaviors and safety indicators among older adult participants invited to use an electronic personal health record (PHR). Among the 16.1 percent of participants who used the PHR frequently, there were significantly more changes in medication use, improved medication reconciliation behaviors, and more recognition of side effects.
AHRQ-funded; HS017034
Citation: Chrischilles EA, Hourcade JP, Doucette W .
Personal health records: a randomized trial of effects on elder medication safety.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):679-86. doi: 10.1136/amiajnl-2013-002284..
Keywords: Elderly, Medication, Medication: Safety, Health Information Technology (HIT), Patient Safety, Patient Self-Management
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
AHRQ-funded; HS000079.
Citation: Voils CI, Gierisch JM, Yancy WS, Jr. .
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
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Keywords: Nutrition, Patient Adherence/Compliance, Patient Self-Management, Lifestyle Changes
Nundy S, Dick JJ, Chou CH
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. The researchers examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes. In addition to pre-post improvements in glycemic control and patients’ satisfaction with overall care, they observed a net cost savings of 8.8 percent.
AHRQ-funded; HS000084.
Citation: Nundy S, Dick JJ, Chou CH .
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Health Aff 2014 Feb;33(2):265-72. doi: 10.1377/hlthaff.2013.0589..
Keywords: Diabetes, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Telehealth
Fuji KT, Abbott AA, Galt KA
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Few studies have examined the barriers to personal health record (PHR) use resulting from design issues identified by actual users. The researchers conducted interviews with 59 patients who had received training in using Microsoft Health Vault for PHRs to manage their diabetes-related health information. Three barriers to use (difficulty of use, lack of value, life got in the way) could be traced back to PHR design considerations.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Diabetes Care 2014;37(1):e13-4. doi: 10.2337/dc13-1630..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Self-Management