National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Anxiety (2)
- Asthma (1)
- Autism (2)
- (-) Behavioral Health (21)
- Burnout (1)
- Caregiving (1)
- Case Study (1)
- (-) Children/Adolescents (21)
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- Comparative Effectiveness (1)
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- Patient-Centered Outcomes Research (7)
- Patient Safety (1)
- Primary Care (3)
- Primary Care: Models of Care (2)
- Provider (1)
- Provider: Physician (1)
- Quality Measures (1)
- Quality of Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Sex Factors (1)
- Social Determinants of Health (1)
- Stress (2)
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- Trauma (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedRudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Liu FF, Adrian MC
Is treatment working? Detecting real change in the treatment of child and adolescent depression.
Effectiveness of evidence-based treatments for youth remain modest at best; while practice parameters recommend measurement-based care to enhance youth depression treatment, the literature offers few guidelines on how to use assessment results to inform care decisions or to detect real and clinically meaningful change. The purpose of this study was to produce reliable change indices for two commonly used standardized assessments of youth depression: Patient Health Questionnaire-9 items, Modified for Adolescents (PHQ-9A) and the Short Moods and Feelings Questionnaire (SMFQ).
AHRQ-funded; HS022982.
Citation: Liu FF, Adrian MC .
Is treatment working? Detecting real change in the treatment of child and adolescent depression.
J Am Acad Child Adolesc Psychiatry 2019 Dec;58(12):1157-64. doi: 10.1016/j.jaac.2019.02.011..
Keywords: Children/Adolescents, Depression, Behavioral Health, Evidence-Based Practice, Patient-Centered Outcomes Research
Riley AR, Walker BL, Wilson AC
Parents' consumer preferences for early childhood behavioral intervention in primary care.
In this study, the investigators sought to better understand parents' preferences for the content and delivery method of behavioral health guidance in pediatric primary care and to determine the relationship of those preferences with demographic characteristics, child behavior problems, and parenting style. The investigators found that most parents were interested in behavioral guidance as part of primary care, but their preferences for the content and delivery of that guidance varied by known socioeconomic, child, and parenting risk factors.
AHRQ-funded; HS022981.
Citation: Riley AR, Walker BL, Wilson AC .
Parents' consumer preferences for early childhood behavioral intervention in primary care.
J Dev Behav Pediatr 2019 Dec;40(9):669-78. doi: 10.1097/dbp.0000000000000736..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Caregiving, Healthcare Delivery
Rawlett KE, N'Dri LA, dosReis S
Perceived needs for adolescent mental health in an urban community.
This paper discusses a set of focus groups that were conducted with teachers, families, and students in an urban middle school to discuss needs for adolescent psychological well-being. Six focus groups were conducted with a total of 29 participants. Approximately 70% of participants were female, African American (n=22), and the rest were multiracial (n=4), White (n=2) and Latino (n=1). Participants focused on needs for educational support, strengthening social skills, and changing the community landscape.
AHRQ-funded; HS022135.
Citation: Rawlett KE, N'Dri LA, dosReis S .
Perceived needs for adolescent mental health in an urban community.
J Pediatr Health Care 2019 Nov - Dec;33(6):633-38. doi: 10.1016/j.pedhc.2019.03.003..
Keywords: Children/Adolescents, Behavioral Health, Urban Health
Olin S, Storfer-Isser A, Morden E
Quality measures for managing prescription of antipsychotic medication among youths: factors associated with health plan performance.
This study examined the performance of health plans on two Healthcare Effectiveness Data and Information Set (HEDIS) measures: metabolic monitoring of children and adolescents prescribed an antipsychotic and use of first-line psychosocial care for children and adolescents prescribed an antipsychotic for a nonindicated use. This study then identified key plan characteristics and other contextual factors associated with health plan performance on quality measures related to pediatric antipsychotic prescribing. Findings suggested that quality measures, in conjunction with policies such as prior authorization, can encourage better care delivery to vulnerable populations.
ARHQ-funded; HS020503; HS025296.
Citation: Olin S, Storfer-Isser A, Morden E .
Quality measures for managing prescription of antipsychotic medication among youths: factors associated with health plan performance.
Psychiatr Serv 2019 Nov;70(11):1020-26. doi: 10.1176/appi.ps.201900089..
Keywords: Children/Adolescents, Medication, Behavioral Health, Quality Measures, Quality of Care, Health Insurance
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, McCauley E, Berk MS
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
This study compared outcomes for treatment of adolescents who have engaged in self-harm including suicide attempts and nonsuicidal self-injury. This randomized controlled tiral compared results with dialectical behavior therapy (DBT) to treatment with individual/group supportive therapy (IGST). 173 adolescents were randomized to receive 6 months of DBT or IGST. Assessments were made at baseline, midtreatment (3 months), and end of treatment at 6 months using the Suicide Attempt and Self –Injury Interview. Overall, DBT showed better rates of improvement than IGST. These was especially true of adolescents with higher levels of emotion dysregulation and parental psychopathology.
AHRQ-funded; HS022982.
Citation: Adrian M, McCauley E, Berk MS .
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
J Child Psychol Psychiatry 2019 Oct;60(10):1123-32. doi: 10.1111/jcpp.13099..
Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Family Health and History, Outcomes
Adrian M, Zeman J, Erdley C
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization.
This study explored the growth of non-suicidal self-injury (NSSI) frequency over 2.5 years in a clinical sample of adolescent girls. The investigators concluded that their findings highlighted the stable nature of NSSI and the contribution of emotion dysregulation and internalizing symptoms to NSSI patterns. The investigators asserted that developing interventions targeting these NSSI predictors early in girls' development may prevent the emergence and maintenance of NSSI.
AHRQ-funded; HS022982.
Citation: Adrian M, Zeman J, Erdley C .
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization.
Clin Child Psychol Psychiatry 2019 Oct;24(4):831-46. doi: 10.1177/1359104519839732..
Keywords: Children/Adolescents, Evidence-Based Practice, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Brunsberg KA, Landrigan CP, Garcia BM
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
The objective of this paper was to determine whether higher rates of medical errors were associated with positive screenings for depression or burnout among resident physicians. Results of this prospective cohort study showed that resident physicians with a positive depression screen were three times more likely than those who screened negative to make harmful errors, indicating the importance of determining what interventions might mitigate the patient safety risk.
AHRQ-funded; HS019456.
Citation: Brunsberg KA, Landrigan CP, Garcia BM .
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
Acad Med 2019 Aug;94(8):1150-56. doi: 10.1097/acm.0000000000002778..
Keywords: Children/Adolescents, Provider: Physician, Provider, Medical Errors, Adverse Events, Burnout, Patient Safety, Depression, 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
Sultan RS, Wang S, Crystal S
Antipsychotic treatment among youths with attention-deficit/hyperactivity disorder.
This retrospective longitudinal cohort analysis sought to describe the percentage of youths who fill antipsychotic prescriptions in the year following a new diagnosis of ADHD and characterize the clinical and demographic factors associated with antipsychotic initiation. The investigators found that approximately half of youths with a new ADHD diagnosis may have had an evidence-supported indication for an antipsychotic medication. In addition, less than half of the youths received a stimulant; the evidence-supported first line treatment for ADHD, before the antipsychotic was initiated.
AHRQ-funded; HS026001; HS021112.
Citation: Sultan RS, Wang S, Crystal S .
Antipsychotic treatment among youths with attention-deficit/hyperactivity disorder.
JAMA Netw Open 2019 Jul 3;2(7):e197850. doi: 10.1001/jamanetworkopen.2019.7850..
Keywords: Children/Adolescents, Behavioral Health, Medication
Adams JS, Chien AT, Wisk LE
Mental illness among youth with chronic physical conditions.
Using MEPS data, the authors compared the risk of incident mental health conditions (MHCs) in youth with and without chronic physical conditions (CPCs), and explored whether activity limitations might contribute to any association. They found that youth with CPCs have increased risk for MHCs and that limitations on activity may play a role in MHC development. They recommended that youth with CPCs may benefit from services that bolster their ability to participate in developmentally important activities and that may help to detect and treat new onset MHCs.
AHRQ-funded; HS022986.
Citation: Adams JS, Chien AT, Wisk LE .
Mental illness among youth with chronic physical conditions.
Pediatrics 2019 Jul;141(1):pii: e20181819. doi: 10.1542/peds.2018-1819..
Keywords: Children/Adolescents, Chronic Conditions, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Riley AR, Paternostro JK, Walker BL
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
This retrospective match-controlled study examined the impact of behavioral health consultations on medical visit duration in pediatric primary care. Patient encounters involving behavioral health consultants were significantly longer (11 plus minutes) than matched controls, and had less time allowed for medical care. The authors of the study recommend that behavioral health consultants work with the clinician to improve time efficiency.
AHRQ-funded; HS022981.
Citation: Riley AR, Paternostro JK, Walker BL .
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
Fam Syst Health 2019 Jun;37(2):162-66. doi: 10.1037/fsh0000406..
Keywords: Behavioral Health, Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care
Knutsen J, Crossman M, Perrin J
Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: an Autism Treatment Network study.
Researchers examined sex differences in clinically identified (Autism Diagnostic Observation Schedule) restricted and repetitive behavior symptoms of age-matched and intelligence quotient-matched female and male children with autism spectrum disorder. Their findings identified key restricted and repetitive behavior similarities and differences among young females and males with autism spectrum disorder and emphasized the need for a deeper understanding of the female autism phenotype.
AHRQ-funded; HS022986; HS000063.
Citation: Knutsen J, Crossman M, Perrin J .
Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: an Autism Treatment Network study.
Autism 2019 May;23(4):858-68. doi: 10.1177/1362361318786490..
Keywords: Autism, Behavioral Health, Children/Adolescents, Patient-Centered Outcomes Research, Sex Factors
Nasol E, Lindly OJ, Chavez AE
Unmet need and financial impact disparities for US children with ADHD.
The 5.1million US children with attention-deficit/hyperactivity disorder (ADHD) have pronounced needs in education, occupational and speech therapy, and medical and behavioral treatments. Given known associations of ADHD diagnosis with race/ethnicity and parent education, this study aimed to assess how measures of socioeconomic status correlate with both adverse family financial impact of ADHD and disparities in unmet treatment need for ADHD.
AHRQ-funded; HS000063.
Citation: Nasol E, Lindly OJ, Chavez AE .
Unmet need and financial impact disparities for US children with ADHD.
Acad Pediatr 2019 Apr;19(3):315-24. doi: 10.1016/j.acap.2018.09.001..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Costs, Social Determinants of Health
Bauer NS, Ofner S, Moore C
Assessment of the effects of pediatric attention deficit hyperactivity disorder on family stress and well-being: development of the IMPACT 1.0 scale.
This paper describes the IMPACT (Impact Measure of Parenting-Related ADHD Challenges and Treatment) 1.0 Scale which was codeveloped with input from parent advisors and administered to 79 parents of children with ADHD. It is a brief measure to assess ADHD impacts on family in the context of everyday family life. Exploratory factor analysis, correlations with validated instruments, and test-retest reliability were examined in the study.
AHRQ-funded; HS022434.
Citation: Bauer NS, Ofner S, Moore C .
Assessment of the effects of pediatric attention deficit hyperactivity disorder on family stress and well-being: development of the IMPACT 1.0 scale.
Glob Pediatr Health 2019 Mar 15;6:2333794x19835645. doi: 10.1177/2333794x19835645..
Keywords: Children/Adolescents, Behavioral Health, Family Health and History, Patient-Centered Outcomes Research, Quality of Life
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Fogler J, Kuhn J, Prock L
Diagnostic uncertainty in a complex young man: autism versus psychosis.
This paper provides a case study of boy, diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) who was born in Vietnam to a mother with mental illness.
AHRQ-funded; HS022242.
Citation: Fogler J, Kuhn J, Prock L .
Diagnostic uncertainty in a complex young man: autism versus psychosis.
J Dev Behav Pediatr 2019 Jan;40(1):72-74. doi: 10.1097/dbp.0000000000000635..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Autism, Behavioral Health, Case Study
Kim DH, Bassett SM, So S
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
This study assessed whether future orientation and self-esteem affected the relationship between family stress and mental health problems among African American youth in predominantly low-income neighborhoods. Youths (mainly female, average age 15.83 years old) were sampled for family stress, self-esteem, future orientation, mental health and other covariates such as gender and sexual orientation. A correlation was found between future orientation and self-esteem levels and family stress and mental health problems.
AHRQ-funded; HS000078.
Citation: Kim DH, Bassett SM, So S .
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
Am J Orthopsychiatry 2019;89(2):125-33. doi: 10.1037/ort0000371..
Keywords: Children/Adolescents, Family Health and History, Low-Income, Behavioral Health, Racial and Ethnic Minorities, Stress, Vulnerable Populations
Banks DE, Hershberger AR, Pemberton T
Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology.
Juvenile offenders engage in both cannabis use and polysubstance use at higher rates than the general adolescent population. Yet, limited research has examined the relationship between cannabis poly-use (e.g., cannabis and alcohol use) and functional or psychological problems among juvenile offenders. The current study addresses this gap by examining the association of polysubstance use of cannabis compared to cannabis only use with cognitive functioning, psychological distress, and substance-related problems among juvenile detainees.
AHRQ-funded; HS024296.
Citation: Banks DE, Hershberger AR, Pemberton T .
Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology.
Am J Drug Alcohol Abuse 2019;45(3):313-22. doi: 10.1080/00952990.2018.1558450..
Keywords: Children/Adolescents, Behavioral Health, Substance Abuse, Vulnerable Populations
Liu X, Shah V, Kubilis P
Psychotropic treatment pattern in Medicaid pediatric patients with concomitant ADHD and ODD/CD.
This study analyzed the use of psychotropic treatments in children with concomitant ADHD and oppositional defiant disorder/conduct disorder (ODD/CD). The data from a cross-sectional drug utilization study based on Medicaid fee-for-service programs in 26 U.S. states from 1999 to 2006. Children ages 4 to 18 were included, with a total of 121,740 children identified. There was a period prevalence of 38.1% for “no psychotropic therapy”, 44.7% for psychotropic monotherapy, and 9% for psychotropic dual therapy. Stimulants were the most common drug class prescribed. Psychotropic combination therapy was used most with whites, males, and children in foster care.
AHRQ-funded; HS0185606.
Citation: Liu X, Shah V, Kubilis P .
Psychotropic treatment pattern in Medicaid pediatric patients with concomitant ADHD and ODD/CD.
J Atten Disord 2019 Jan;23(2):140-48. doi: 10.1177/1087054715596574..
Keywords: Children/Adolescents, Behavioral Health, Medicaid, Medication