National Healthcare Quality and Disparities Report
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Topics
- Asthma (1)
- Blood Pressure (1)
- Cancer (2)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Community-Based Practice (2)
- Comparative Effectiveness (3)
- Cultural Competence (2)
- Diabetes (3)
- Disparities (3)
- Education: Patient and Caregiver (2)
- Elderly (1)
- Emergency Department (1)
- (-) Evidence-Based Practice (14)
- Guidelines (1)
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- Healthcare Utilization (1)
- Health Information Technology (HIT) (3)
- Health Promotion (1)
- Heart Disease and Health (1)
- Implementation (2)
- Low-Income (1)
- Medicare (1)
- Medication (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (6)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- Patient Self-Management (1)
- Pregnancy (1)
- Prevention (3)
- Primary Care (2)
- (-) Racial and Ethnic Minorities (14)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Screening (2)
- Sex Factors (1)
- Social Determinants of Health (1)
- Telehealth (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Women (2)
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 14 of 14 Research Studies DisplayedKrishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Jain A, Brooks JR, Alford CC
AHRQ Author: Jain A, Alford CC, Chang CS, Mueller NM, Umscheid CA, Bierman AS
Awareness of racial and ethnic bias and potential solutions to address bias with use of health care algorithms.
This AHRQ-authored study examined the increased use of health care algorithms in health decision tools, and whether including a patient's race or ethnicity among their inputs can lead clinicians and decision-makers to make choices that vary by race and potentially affect inequities. This qualitative survey included 42 organization representatives (e.g., clinical professional societies, universities, government agencies, payers, and health technology organizations) and individuals. The respondents identified 18 algorithms currently in use with the potential for bias. Seven qualitative themes with 31 subthemes were identified including: (1) algorithms are in widespread use and have significant repercussions, (2) bias can result from algorithms whether or not they explicitly include race, (3) clinicians and patients are often unaware of the use of algorithms and potential for bias, (4) race is a social construct used as a proxy for clinical variables, (5) there is a lack of standardization in how race and social determinants of health are collected and defined, (6) bias can be introduced at all stages of algorithm development, and (7) algorithms should be discussed as part of shared decision-making between the patient and clinician.
AHRQ-authored.
Citation: Jain A, Brooks JR, Alford CC .
Awareness of racial and ethnic bias and potential solutions to address bias with use of health care algorithms.
JAMA Health Forum 2023 Jun 2; 4(6):e231197. doi: 10.1001/jamahealthforum.2023.1197..
Keywords: Racial and Ethnic Minorities, Disparities, Healthcare Delivery, Evidence-Based Practice
Lin JS, Hoffman L, Bean SI
Addressing racism in preventive services: methods report to support the US Preventive Services Task Force.
The purpose of this report was to articulate the definitional and conceptual issues around racism and health inequity and to describe how racism and health inequities are currently addressed in preventive health. An audit was conducted assessing published literature on policy and position statements addressing racism, a subset of cancer and cardiovascular topics in USPSTF reports, recent systematic reviews on interventions to reduce health inequities, and societies, organizations, agencies, and funding bodies to gather information about how they address racism and health equity. Findings showed that racism is complex and pervasive, operates at multiple interrelated levels, and exerts negative effects on other social determinants and health and well-being through multiple pathways. The most directly relevant and immediately useful guidance identified is that from the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.
AHRQ-funded; 290201600006C.
Citation: Lin JS, Hoffman L, Bean SI .
Addressing racism in preventive services: methods report to support the US Preventive Services Task Force.
JAMA 2021 Dec 21;326(23):2412-20. doi: 10.1001/jama.2021.17579..
Keywords: U.S. Preventive Services Task Force (USPSTF), Social Determinants of Health, Racial and Ethnic Minorities, Disparities, Research Methodologies, Prevention, Evidence-Based Practice
Danan ER, White KM, Wilt TJ
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
This study looked at differences in attitudes about recommendations and evidence on prostate cancer screening among White and Black male veterans. The authors provided a draft educational pamphlet about the benefits and harms of Prostate Specific Antigen (PSA) screening to 44 men, ages 55-81 at a midwestern VA medical center in 2013 and 2015. The groups were divided into four White and two Black focus groups. Three universal themes were low baseline familiarity with prostate cancer, surprise and resistance to the guidelines not to test routinely, and negative emotions in response to ambiguity. Discussions in the White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Discussions in Black groups devoted almost no time to benefits, considered harms significant, and emphasized personal and collective responsibility for cancer prevention through diet, exercise, and alternative medicine. Discussion in Black groups also emphasized the history of racism and discrimination in healthcare and medical research.
AHRQ-funded; HS026379.
Citation: Danan ER, White KM, Wilt TJ .
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
Am J Mens Health 2021 May-Jun;15(3):15579883211022110. doi: 10.1177/15579883211022110..
Keywords: Cancer: Prostate Cancer, Cancer, Screening, Prevention, Racial and Ethnic Minorities, Evidence-Based Practice, Health Promotion, Education: Patient and Caregiver
Reese TJ, Schlechter CR, Potter LN
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
The purpose of this study was to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations using a large nationwide survey. The investigators concluded that the revised USPSTF guideline may likely increase lung cancer screening rates for female, Black, and Hispanic populations. However, despite these potential improvements, lung cancer screening inequities may persist without tailored eligibility criteria.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Potter LN .
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
JAMA Netw Open 2021 Jan;4(1):e2033769. doi: 10.1001/jamanetworkopen.2020.33769..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Racial and Ethnic Minorities, Women, Guidelines, Evidence-Based Practice
Rosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
This hybrid type II implementation-effectiveness cohort study aimed at evaluating appropriateness, acceptability and feasibility implementation outcomes, while also systematically examining the clinical effectiveness of a preconception care (PCC) intervention, the Gabby System, for Black and African American women receiving health services in community-based sites. Contextual factors that influenced uptake and appropriate implementation strategies were identified to inform future scalability of the intervention.
AHRQ-funded; HS025131.
Citation: Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N .
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
BMC Health Serv Res 2020 Sep 21;20(1):889. doi: 10.1186/s12913-020-05726-0..
Keywords: Racial and Ethnic Minorities, Women, Health Information Technology (HIT), Evidence-Based Practice, Community-Based Practice, Implementation
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Rosas LG, Lv N, Lewis MA
A Latino patient-centered, evidence-based approach to diabetes prevention.
Cultural tailoring of evidence-based diabetes prevention program (DPP) interventions is needed to effectively address obesity and its related chronic diseases among Latinos in primary care. This article described the patient-centered process used to adapt the DPP and reported cultural adaptations. The investigators concluded that the 2-stage approach actively engaging patients, family members, providers, and health care system leaders reinforced the cultural congruence of the existing intervention while further strengthening it with adaptations promoting Latino family and community support.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Lewis MA .
A Latino patient-centered, evidence-based approach to diabetes prevention.
J Am Board Fam Med 2018 May-Jun;31(3):364-74. doi: 10.3122/jabfm.2018.03.170280..
Keywords: Cultural Competence, Diabetes, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Racial and Ethnic Minorities
Rich NE, Oji S, Mufti AR
Racial and ethnic disparities in nonalcoholic fatty liver disease prevalence, severity, and outcomes in the United States: a systematic review and meta-analysis.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, affecting 75-100 million Americans. However, the disease burden may not be equally distributed among races or ethnicities. In this study, the investigators conducted a systematic review and meta-analysis to characterize racial and ethnic disparities in NAFLD prevalence, severity, and prognosis.
AHRQ-funded; HS022418.
Citation: Rich NE, Oji S, Mufti AR .
Racial and ethnic disparities in nonalcoholic fatty liver disease prevalence, severity, and outcomes in the United States: a systematic review and meta-analysis.
Clin Gastroenterol Hepatol 2018 Feb;16(2):198-210.e2. doi: 10.1016/j.cgh.2017.09.041..
Keywords: Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Castro FG, Yasui M
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
This introduction examines major issues and challenges as presented in this special issue of Prevention Science, "Challenges to the Dissemination and Implementation of Evidence Based Prevention Interventions for Diverse Populations." The authors describe the Fidelity-Adaptation Dilemma that generated controversies and debates and new perspectives on the dissemination and implementation of evidence-based interventions (EBIs) within diverse populations. The five articles in this special issue address many of these controversies and challenges.
AHRQ-funded; HS023007.
Citation: Castro FG, Yasui M .
Advances in EBI development for diverse populations: towards a science of intervention adaptation.
Prev Sci 2017 Aug;18(6):623-29. doi: 10.1007/s11121-017-0809-x.
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Keywords: Communication, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Racial and Ethnic Minorities, Implementation
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Leis JA, Solomon BS, Wasserman KE
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
The goal of this study was to integrate an evidence-based preventive intervention for perinatal depression—the Mothers and Babies (MB) Course—into a pediatric primary care clinic serving low-income, minority families, and to explore intervention acceptability and preliminary outcomes. Findings from this pilot study provide preliminary evidence for the acceptability and feasibility of implementing an evidence-based preventive intervention for postpartum depression.
AHRQ-funded; HS017596.
Citation: Leis JA, Solomon BS, Wasserman KE .
Preventing postpartum depression in a pediatric primary care clinic: a pilot study.
Clin Pediatr 2015 May;54(5):487-90. doi: 10.1177/0009922814536775..
Keywords: Pregnancy, Primary Care, Evidence-Based Practice, Low-Income, Racial and Ethnic Minorities