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
26 to 50 of 63 Research Studies DisplayedConnell SK, To T, Arora K, Ramos J, SK, To T, Arora K
Perspectives of parents and providers on reasons for mental health readmissions: a content analysis study.
This retrospective study is a survey of parents and providers on the reasons for pediatric mental health readmissions. The survey was administered to parents and providers of patients with a 14-day readmission to an inpatient pediatric psychiatry unit between May 2017 and August 2018. The authors had completed survey responses from 89 (64%) of 138 readmission encounters. The top three readmission reasons given by parents were discordant inpatient stay expectations with providers (41%), discharge hesitancy (34%), and treatment plan failure (13%). Among providers, the top reasons were access to inpatient care (30%), treatment adherence (13%), a challenging home (11%) and social environment (11%).
AHRQ-funded; HS024299.
Citation: Connell SK, To T, Arora K, Ramos J, SK, To T, Arora K .
Perspectives of parents and providers on reasons for mental health readmissions: a content analysis study.
Adm Policy Ment Health 2021 Sep;48(5):830-38. doi: 10.1007/s10488-021-01134-6..
Keywords: Children/Adolescents, Behavioral Health, Hospital Readmissions
Ing C, Landau R, DeStephano D
Prenatal exposure to general anesthesia and childhood behavioral deficit.
This study looked at the association of prenatal exposure to general anesthesia and childhood behavioral deficits. The Raine Study was an observational cohort study of children born in Perth, Western Australia with 2 generations of participations. The first generation (Gen1) were mothers enrolled during pregnancy, and the second generation (Gen2) were the children born from 1989 to 1992 with neuropsychological and behavioral tests evaluated at age 10. Six neuropsychological and behavioral tests were used with the Child Behavior Checklist (CBCL) as the main test. Among 2024 children with available outcome scores, 22 were prenatally exposed to general anesthesia. These children had higher CBCL Externalizing behavioral scores than unexposed children. Of the six tests used, only CBCL Externalizing behavioral scores remained significant after multiple comparisons adjustment.
AHRQ-funded; HS026493.
Citation: Ing C, Landau R, DeStephano D .
Prenatal exposure to general anesthesia and childhood behavioral deficit.
Anesth Analg 2021 Sep 1;133(3):595-605. doi: 10.1213/ane.0000000000005389..
Keywords: Children/Adolescents, Behavioral Health, Pregnancy, Adverse Drug Events (ADE), Adverse Events
Connell SK, Burkhart Q, Tolpadi A
Quality of care for youth hospitalized for suicidal ideation and self-harm.
The authors examined performance on quality measures for pediatric inpatient suicidal ideation/self-harm care, and whether performance is associated with reutilization. Subjects were patients aged 5 to 17 years hospitalized for suicidal ideation/self-harm. Their findings revealed disparities and deficits in the quality of care received by youth with suicidal ideation/self-harm. They recommended providing caregivers lethal means restriction counseling prior to discharge in order to help prevent readmission.
AHRQ-funded; HS025291.
Citation: Connell SK, Burkhart Q, Tolpadi A .
Quality of care for youth hospitalized for suicidal ideation and self-harm.
Acad Pediatr 2021 Sep-Oct;21(7):1179-86. doi: 10.1016/j.acap.2021.05.019..
Keywords: Children/Adolescents, Behavioral Health, Inpatient Care, Quality Measures, Quality of Care
Crits-Christoph P, King C, Goldstein E
Use of cognitive techniques is associated with change in positive compensatory skills in the treatment of major depressive disorder in a community mental health setting.
Investigators sought to examine the association between adherence and competence in cognitive therapy (CT) techniques and change in positive compensatory skills and depressive symptoms within a community mental health setting. They found that adherence and competence were both significantly associated with linear change in positive compensatory skills from baseline to month 5. They concluded that their results support the hypothesis that use of CT techniques is associated with change in compensatory skills in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Crits-Christoph P, King C, Goldstein E .
Use of cognitive techniques is associated with change in positive compensatory skills in the treatment of major depressive disorder in a community mental health setting.
Psychother Res 2021 Sep;31(7):909-20. doi: 10.1080/10503307.2020.1866785..
Keywords: Depression, Behavioral Health, Treatments
Wallace DD, Lytle LA, Albrecht S
All of that causes me stress: an exploration of the sources of stress experienced by Latinxs living with prediabetes.
Latinxs immigrants in the United States experience sources of stress (i.e., stressors) that can limit their ability to engage in healthy behaviors. Stress has been linked to increased type 2 diabetes (T2D) risk in Latinxs living with prediabetes, a group disproportionately affected by T2D. The purpose of this qualitative study was to describe and contextualize the variety of stressors experienced by Latinxs immigrants diagnosed with prediabetes.
AHRQ-funded; HS000032.
Citation: Wallace DD, Lytle LA, Albrecht S .
All of that causes me stress: an exploration of the sources of stress experienced by Latinxs living with prediabetes.
J Lat Psychol 2021 Aug;9(3):204-16. doi: 10.1037/lat0000168..
Keywords: Stress, Racial and Ethnic Minorities, Diabetes, Chronic Conditions, Behavioral Health
Zuvekas SH, Grosse SD, Lavelle TA
AHRQ Author: Zuvekas SH
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
Published healthcare cost estimates for children with autism spectrum disorder (ASD) vary widely. One possible contributor is different methods of case ascertainment. In this study, autism spectrum disorder (ASD) case status was determined using two sources of parent reports among 45,944 children ages 3-17 years in the Medical Expenditure Panel Survey (MEPS) linked to the National Health Interview Survey (NHIS) Sample Child Core questionnaire. In this paper, the investigators describe their process and conclusions.
AHRQ-authored.
Citation: Zuvekas SH, Grosse SD, Lavelle TA .
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
J Autism Dev Disord 2021 Aug;51(8):2950-58. doi: 10.1007/s10803-020-04704-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Autism, Healthcare Costs, Behavioral Health
Hickey EJ, Stransky M, Kuhn J
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
This study examined trajectories of parenting stress, coping, and perceived family impact over time throughout the autism diagnostic process among Hispanic and non-Hispanic families. Findings showed that Hispanic families reported lower levels of parenting stress, coping, and negative family impact across time. Further, there were differences in the change in use of coping and the amount of negative family impact reported between Hispanic and non-Hispanic parents over time.
AHRQ-funded; HS022242.
Citation: Hickey EJ, Stransky M, Kuhn J .
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
Autism 2021 Aug;25(6):1694-708. doi: 10.1177/13623613211001611..
Keywords: Children/Adolescents, Autism, Stress, Behavioral Health, Racial and Ethnic Minorities
Olfson M, Stroup TS, Huang C
Suicide risk in Medicare patients with schizophrenia across the life span.
The purpose of this study was to describe suicide mortality rates and correlates among adults with schizophrenia across the life span and standardized mortality ratios (SMRs) for suicide compared with the general US population. The investigators concluded that in this cohort study of adult Medicare patients with schizophrenia, suicide risk was elevated, with the highest absolute and relative risk among young adults. They indicated that these patterns supported suicide prevention efforts with a focus on young adults with schizophrenia, especially those with suicidal symptoms and substance use.
AHRQ-funded; HS023258.
Citation: Olfson M, Stroup TS, Huang C .
Suicide risk in Medicare patients with schizophrenia across the life span.
JAMA Psychiatry 2021 Aug;78(8):876-85. doi: 10.1001/jamapsychiatry.2021.0841..
Keywords: Medicare, Behavioral Health
Klawetter S, Glaze K, Sward A
Warm Connections: integration of infant mental health services into WIC.
Warm Connections is an innovative integrated behavioral health program delivered in the Special Supplemental Nutrition Program for Women, Infants, and Children and rooted in an infant and early childhood mental health framework. This exploratory study describes Warm Connections and provides evaluation results from its pilot implementation. Findings suggest Warm Connections may reduce distress and increase parenting efficacy among low-income mothers and support further research of this program's feasibility.
AHRQ-funded; HS026370.
Citation: Klawetter S, Glaze K, Sward A .
Warm Connections: integration of infant mental health services into WIC.
Community Ment Health J 2021 Aug;57(6):1130-41. doi: 10.1007/s10597-020-00744-y..
Keywords: Newborns/Infants, Maternal Care, Behavioral Health, Patient-Centered Healthcare, Low-Income, Vulnerable Populations
Sico JJ, Kundu S, So-Armah K
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
Background HIV infection and depression are each associated with increased ischemic stroke risk. Whether depression is a risk factor for stroke within the HIV population is unknown. In this study the investigators examined depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study. The investigators concluded that depression is associated with an increased risk of stroke among HIV-positive people after adjusting for sociodemographic characteristics, traditional cerebrovascular risk factors, and HIV-specific factors.
AHRQ-funded; HS023464.
Citation: Sico JJ, Kundu S, So-Armah K .
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
J Am Heart Assoc 2021 Jul 6;10(13):e017637. doi: 10.1161/jaha.119.017637..
Keywords: Depression, Behavioral Health, Risk, Human Immunodeficiency Virus (HIV), Stroke, Cardiovascular Conditions
Choi KR, Martinez-Hollingsworth A, Mead M
Adolescent psychiatric emergencies precipitated by the COVID-19 pandemic.
The purpose of this retrospective case series was to describe adolescent psychiatric emergencies precipitated by the coronavirus disease 2019 (COVID-19) pandemic. Findings showed that COVID-19-precipitated admissions were 24% of total admissions from March 15 to May 31, 2020; however, total admissions during this time period were reduced from the same time period in prior years. The COVID-19 pandemic and corresponding shelter-in-place orders may precipitate psychiatric emergencies among adolescents both with and without existing mental health disorders.
AHRQ-funded; HS026407.
Citation: Choi KR, Martinez-Hollingsworth A, Mead M .
Adolescent psychiatric emergencies precipitated by the COVID-19 pandemic.
J Psychosoc Nurs Ment Health Serv 2021 Jul;59(7):17-21. doi: 10.3928/02793695-20201203-05..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Emergency Department
Wilkinson ST, Kitay BM, Harper A
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder; yet, its use is confined to <1% of individuals with this disorder. In this study, the authors aimed to examine barriers to ECT from the perspective of the provider. The investigators concluded that coordinated efforts to overcome identified barriers may allow ECT to be more broadly implemented. Investments in education may increase the number of competent practitioners.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Kitay BM, Harper A .
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Psychiatr Serv 2021 Jul;72(7):752-57. doi: 10.1176/appi.ps.202000387..
Keywords: Depression, Behavioral Health, Treatments
Lillie KM, Shaw J, Jansen KJ
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). The investigators concluded that younger patients and those with co-occurring substance use remained at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people.
AHRQ-funded; HS023207.
Citation: Lillie KM, Shaw J, Jansen KJ .
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
J Addict Med 2021 Jul-Aug 01;15(4):297-302. doi: 10.1097/adm.0000000000000757..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Racial and Ethnic Minorities, Vulnerable Populations
Jennissen S, Connolly Gibbons MB, Crits-Christoph P
Insight as a mechanism of change in dynamic therapy for major depressive disorder.
This study’s goal was to investigate change in insight into maladaptive interpersonal patterns over the course of psychotherapy, as well as the specificity of insight as a change mechanism in dynamic treatments. Participants received up to 16 sessions of either cognitive or dynamic therapy for major depressive disorder in a randomized clinical trial. Results provided support for insight as a change factor in dynamic therapies. Better self-understanding of dysfunctional interaction patterns could help patients to find more adaptive ways of behaving, to form more satisfying relationships, and to improve their depression.
AHRQ-funded; HS018440.
Citation: Jennissen S, Connolly Gibbons MB, Crits-Christoph P .
Insight as a mechanism of change in dynamic therapy for major depressive disorder.
J Couns Psychol 2021 Jul;68(4):435-45. doi: 10.1037/cou0000554..
Keywords: Depression, Behavioral Health
Coley RY, Johnson E, Simon GE
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
This study looked at racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visit. The main outcome measured was the suicide rate within 90 days after a mental health visit. The study used a 50% sample of visits from a random set of outpatients at 7 large integrated health care systems by patients 13 years and older (6,984,184 visits). Suicide rates were highest for visits by patients with no race/ethnicity recorded, followed by Asian, White, American Indian/Alaskan Native, Hispanic, and Black. Sensitivity of both models used were high for White, Hispanic, and Asian patients and poor for Black and American Indian/Alaskan Native patients and patients with no race/ethnicity recorded.
AHRQ-funded; HS026369.
Citation: Coley RY, Johnson E, Simon GE .
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
JAMA Psychiatry 2021 Jul;78(7):726-34. doi: 10.1001/jamapsychiatry.2021.0493..
Keywords: Disparities, Racial and Ethnic Minorities, Behavioral Health, Mortality, Risk
Calthorpe LM, Baer RJ, Chambers BD
The association between preterm birth and postpartum mental healthcare utilization among California birthing people.
This study’s objective was to determine whether preterm birth is associated with postpartum inpatient and emergency mental healthcare utilization. The study sample was taken from a database of live-born neonates delivered in California, 2011-2017, and included all births to singleton infants between the gestational ages of 20 and 44 weeks. The findings indicate found that preterm birth is an independent risk factor for postpartum mental healthcare utilization. These findings suggest that screening for and providing mental health resources to birthing people after delivery are crucial, particularly among people giving birth to preterm infants, regardless of mental health history.
AHRQ-funded; HS026383.
Citation: Calthorpe LM, Baer RJ, Chambers BD .
The association between preterm birth and postpartum mental healthcare utilization among California birthing people.
Am J Obstet Gynecol MFM 2021 Jul;3(4):100380. doi: 10.1016/j.ajogmf.2021.100380..
Keywords: Behavioral Health, Pregnancy, Women, Labor and Delivery, Risk
Bushnell GA, Crystal S, Olfson M
Trends in antipsychotic medication use in young privately insured children.
This study’s objective was to estimate trends in annual antipsychotic medication use by privately insured young children (aged 2-7 years) in the United States and to describe the clinical and treatment characteristics of these children. Young children from a nationwide commercial claims database from 2007-2017 was used to estimate annual antipsychotic use by age and sex. Annual antipsychotic use decreased over the time period, from a peak of 0.29% in 2009 and significantly declined to 0.17% in 2017. Antipsychotic use was higher in boys than in girls with a greater proportion receiving a mental disorder diagnosis in 2017 than in 2009. The most common clinical diagnoses were pervasive development disorder, conduct or disruptive behavior disorder, and attention-deficit/hyperactivity disorder. In 2017, 32% had 4+ psychotherapy claims, 43% had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant.
AHRQ-funded; HS023258; HS026001.
Citation: Bushnell GA, Crystal S, Olfson M .
Trends in antipsychotic medication use in young privately insured children.
J Am Acad Child Adolesc Psychiatry 2021 Jul;60(7):877-86. doi: 10.1016/j.jaac.2020.09.023..
Keywords: Children/Adolescents, Medication, Behavioral Health
Adams LB, Baxter SLK, Lightfoot AF
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
This study’s goal was to look at why prevalence of depression is lower for Black males despite cumulative socioeconomic disadvantage and risk factors. For Black men, emotional vulnerability is often seen as a sign of weakness which may potentially mask the timely identification of mental health needs in this population. The authors use concept mapping, which is a structured mixed methods approach to determine how stakeholders of Black men’s health conceptualize their depressive symptoms. Thirty-six stakeholders comprised of Black men, Black women, and primary care providers participated in separate stakeholder groups in 2018. Participants generated 68 characteristics of Black men’s depression reflected in six conceptual clusters: 1) physical states; 2) emotional states; 3) diminished drive; 4) internal conflicts; 5) communication with others; and 6) social pressures. Using a content analysis approach, they found that items comprising the “social pressures” cluster were not reflected in any common depression scales.
AHRQ-funded; HS000032.
Citation: Adams LB, Baxter SLK, Lightfoot AF .
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
BMC Public Health 2021 Jun 22;21(1):1194. doi: 10.1186/s12889-021-11137-5..
Keywords: Men's Health, Racial and Ethnic Minorities, Depression, Behavioral Health, Diagnostic Safety and Quality
Levis B, Benedetti A, Ioannidis JPA
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
The authors compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. They found that PHQ-9 ≥10 substantially overestimated depression prevalence, as there was too much heterogeneity to correct statistically in individual studies.
AHRQ-funded; HS018246.
Citation: Levis B, Benedetti A, Ioannidis JPA .
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
J Clin Epidemiol 2020 Jun;122:115-28.e1. doi: 10.1016/j.jclinepi.2020.02.002..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality
Simon CB, Klein JW, Bradley KA
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
One potential challenge of treating OUD in primary care is comorbidity. Mental health and substance use disorders and chronic pain are common in patients with Opioid Use Disorders (OUDs) in specialty OUD treatment settings and on confidential surveys, but the prevalence of such comorbidity in primary care patients with OUD has not been confirmed. This brief report addressed that gap.
AHRQ-funded; HS023173.
Citation: Simon CB, Klein JW, Bradley KA .
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
J Gen Intern Med 2021 Jun;36(6):1799-801. doi: 10.1007/s11606-020-05820-3..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Simmel C, Bowden CF, Neese-Todd S
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
AHRQ-funded; HS026001.
Citation: Simmel C, Bowden CF, Neese-Todd S .
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
Am J Orthopsychiatry 2021;91(2):258-70. doi: 10.1037/ort0000532..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Medication, Patient Experience
Nash KA, Zima BT, Rothenberg C
Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015).
Children seeking care in the emergency department (ED) for mental health conditions are at risk for prolonged length of stay (LOS). A more contemporary description of trends and visit characteristics associated with prolonged ED LOS at the national level is lacking in the literature. The objectives of this study were to (1) compare LOS trends for pediatric mental health versus non-mental health ED visits and (2) explore patient-level characteristics associated with prolonged LOS for mental health ED visits.
AHRQ-funded; HS026385.
Citation: Nash KA, Zima BT, Rothenberg C .
Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015).
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-030692..
Keywords: Children/Adolescents, Emergency Department, Behavioral Health
Hua CL, Cornell PY, Zimmerman S
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
This study examined trends in the prevalence of serious mental illness (SMI) in assisted living (AL) communities in the United States over time and in relationship to characteristics such as dual eligibility and health conditions. Using Medicare data, findings showed that the prevalence of SMI in AL increased by 54% from 2007 to 2017. Residents with SMI were more likely to be dually eligible for Medicare and Medicaid than residents without SMI. Approximately 10% of AL communities had over half of the sample's AL residents with SMI.
AHRQ-funded; HS000011.
Citation: Hua CL, Cornell PY, Zimmerman S .
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
Am J Geriatr Psychiatry 2021 May;29(5):434-44. doi: 10.1016/j.jagp.2020.09.011..
Keywords: Elderly, Behavioral Health, Nursing Homes, Long-Term Care, Medicare
Pfaff N, DaSilva A, Ozer E
Adolescent risk behavior screening and interventions in hospital settings: a scoping review.
Risky behaviors are the main threats to adolescents' health; consequently, evidence-based guidelines recommend annual comprehensive risk behavior screening. The objective of this research was to review studies of adolescent risk behavior screening and interventions in urgent care, emergency department (ED), and hospital settings. Data sources included PubMed (1965-2019) and Embase (1947-2019). The investigators concluded that rates of adolescent risk behavior screening were low in urgent care, ED, and hospital settings.
AHRQ-funded; HS024592; HS027041.
Citation: Pfaff N, DaSilva A, Ozer E .
Adolescent risk behavior screening and interventions in hospital settings: a scoping review.
Pediatrics 2021 Apr;147(4). doi: 10.1542/peds.2020-020610..
Keywords: Children/Adolescents, Behavioral Health, Screening
Gurka MJ, Siddiqi SU, Filipp SL
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Investigators estimated the proximal change in BMI associated with start of medication and to assess whether medication-specific departures in BMI varied by age and sex in patients with attention deficit hyperactivity disorder (ADHD). Longitudinal electronic health records from children aged 4-19 years with an ADHD diagnosis at one healthcare system were analyzed. They found that all medications had larger impacts at younger ages; decreased BMI was observed with stimulants, while antidepressants and antipsychotics led to BMI increases as did alpha-agonists, significantly varying by sex and age. They recommended future research to study further the interactions of these medications on long-term impacts on obesity.
AHRQ-funded; HS025298.
Citation: Gurka MJ, Siddiqi SU, Filipp SL .
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Pediatr Obes 2021 Apr;16(4):e12738. doi: 10.1111/ijpo.12738..
Keywords: Children/Adolescents, Behavioral Health, Medication, Obesity