National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Alcohol Use (1)
- Autism (1)
- Behavioral Health (8)
- Blood Pressure (4)
- Breast Feeding (1)
- Cancer (4)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (8)
- Caregiving (3)
- Care Management (2)
- Case Study (1)
- Children/Adolescents (35)
- Chronic Conditions (10)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (3)
- Communication (1)
- Community-Based Practice (2)
- Community Partnerships (2)
- Comparative Effectiveness (4)
- Critical Care (1)
- Data (1)
- Depression (1)
- Diabetes (7)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (7)
- Disabilities (3)
- Disparities (2)
- Domestic Violence (2)
- Education (8)
- Education: Patient and Caregiver (6)
- Elderly (11)
- Electronic Health Records (EHRs) (1)
- Emergency Department (3)
- Evidence-Based Practice (19)
- Family Health and History (5)
- Guidelines (6)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
- Healthcare Costs (4)
- Health Information Technology (HIT) (8)
- Health Insurance (1)
- Health Promotion (3)
- Health Status (4)
- Heart Disease and Health (5)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (4)
- Hospital Readmissions (1)
- Human Immunodeficiency Virus (HIV) (5)
- Infectious Diseases (1)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (2)
- Lifestyle Changes (27)
- Long-Term Care (3)
- Low-Income (12)
- Maternal Care (4)
- Medicaid (3)
- Medication (1)
- Men's Health (1)
- Mortality (2)
- Neurological Disorders (2)
- Newborns/Infants (8)
- Nursing Homes (1)
- (-) Nutrition (135)
- Obesity (28)
- Obesity: Weight Management (11)
- Orthopedics (2)
- Osteoporosis (1)
- Outcomes (9)
- Pain (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (9)
- Patient Adherence/Compliance (4)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (3)
- Patient Self-Management (15)
- Payment (1)
- Policy (9)
- Practice Patterns (2)
- Pregnancy (3)
- Prevention (12)
- Primary Care (1)
- Provider (2)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Physician (1)
- Public Health (3)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (7)
- Respiratory Conditions (2)
- Risk (11)
- Rural/Inner-City Residents (1)
- Rural Health (2)
- Screening (4)
- Sex Factors (1)
- Skin Conditions (1)
- Social Determinants of Health (15)
- Social Media (5)
- Social Stigma (1)
- Stress (1)
- Substance Abuse (1)
- Surgery (3)
- Telehealth (1)
- Tools & Toolkits (1)
- Treatments (3)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Urban Health (3)
- Vitamins and Supplements (1)
- Vulnerable Populations (11)
- Women (4)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 135 Research Studies DisplayedJones SA, Schlundt DG, Bonnet KR
Head Start's role in addressing food and nutrition insecurity: focus group findings.
The purpose of this study was to explore the perspectives of Head Start (HS) families' and employees' on family experiences with food and nutrition insecurity (FNI) and determine if and how HS addresses them. From August 2021 to January 2022, the researchers conducted 4 virtual focus groups with 27 HS employee and family participants. The study found that when addressing multilevel factors affecting FNI, HS's 2-generational method is useful for families. It was also determined that the role of the family advocate is critical. Finally, in addition to improving access to nutritious foods, skills and education to decrease generational unhealthy behaviors should be emphasized.
AHRQ-funded; HS026122.
Citation: Jones SA, Schlundt DG, Bonnet KR .
Head Start's role in addressing food and nutrition insecurity: focus group findings.
J Nutr Educ Behav 2023 Aug; 55(8):612-20. doi: 10.1016/j.jneb.2023.04.004..
Keywords: Children/Adolescents, Nutrition
Heerman WJ, Sneed NM, Sommer EC
Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.
The purpose of this study was to assess the relationship between baseline ultra-processed food consumption in early childhood and child BMI Z-score over 36 months. Among 595 children, median baseline age was 4.3 years, 65.4% had normal weight, 33.8% were overweight, and 0.8% were obese. When compared with low ultra-processed consumption (300 kcals/day), High ultra-processed intake (1300 kcals/day) was related with a 1.2 higher BMI-Z at 36 months for 3-year-olds and a 0.6 higher BMI-Z for 4-year-olds. The difference was not statistically significant for 5-year-olds or overall.
AHRQ-funded; HS026122.
Citation: Heerman WJ, Sneed NM, Sommer EC .
Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.
Pediatr Obes 2023 Aug; 18(8):e13037. doi: 10.1111/ijpo.13037..
Keywords: Children/Adolescents, Obesity, Low-Income, Nutrition, Vulnerable Populations
Sneed NM, Azuero A, Moss J
Total added sugar consumption is not significantly associated with risk for prediabetes among U.S. adults: National Health and Nutrition Examination Survey, 2013-2018.
This study examined if total grams/day and percent intakes of <10%, 10-15%, or >15% added sugar increase the odds for prediabetes in U.S. adults. A cross-sectional secondary analysis of 2013-2018 National Health and Nutrition Examination Survey (NHANES) data was conducted. The study included data from adults ≥ 20 years with normoglycemia (N = 2,154) and prediabetes (N = 3,152) with 1-2 days of dietary recall information. The National Cancer Institute Method was used to estimate odds ratios of prediabetes based on usual intakes of added sugar (total and percent intakes). Total energy intake of the sample from added sugar was 13.9%. Total and percent intakes of added sugar and adjusted intakes were not significantly associated with an increased odds of prediabetes. Prediabetes did not differ by race/ethnicity or percent of added sugar intakes.
AHRQ-funded; HS026122.
Citation: Sneed NM, Azuero A, Moss J .
Total added sugar consumption is not significantly associated with risk for prediabetes among U.S. adults: National Health and Nutrition Examination Survey, 2013-2018.
PLoS One 2023 Jun 20; 18(6):e0286759. doi: 10.1371/journal.pone.0286759..
Keywords: Diabetes, Nutrition
Brown T, Brody R, Sackey J
Dietary intake correlated to waist-to-hip ratio in patients on maintenance hemodialysis.
Patients with end-stage renal disease (ESRD) undergoing regular hemodialysis (RHD) are susceptible to protein-energy malnutrition (PEM). Insufficient dietary consumption and changes in body measurements are among the diagnostic criteria for PEM. The purpose of this study was to measure the adherence of ESRD patients on RHD to the 2020 National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF-KDOQI) recommendations for nutritional sufficiency during a dialysis day (DD) and analyze the association between dietary energy (DEI) and protein (DPI) intake and body measurements. The study utilized a secondary review of clinical and demographic data from 142 adults in the Rutgers Nutrition and Kidney Disease database. The correlations between DEI, DPI, and body measurements such as body mass index (BMI), BMI classification, waist circumference, and waist-to-hip ratio (WHR) were evaluated. The study found that the median age of the participants was 55.7 years, with 58% being male and 83.8% identifying as Black/African American. The median time spent on dialysis was 42.0 months (approximately 3.5 years). Seventy-five percent of the participants were classified as overweight or obese. The WHR was 1.0 ± 0.8 cm for males and 0.9 ± 0.1 cm for females. Neither DEI nor DPI on a DD complied with the NKF-KDOQI 2020 recommendations. The median DEI was 17.6 ± 8.4 kcal/kg, and DPI was 0.7 ± 0.4 g/kg. Significant positive correlations were found between DEI and DPI and WHR for the entire sample. In females, a significant positive correlation emerged between DPI and WHR. The researchers concluded that the nutritional consumption of ESRD patients undergoing RHD falls short of the NKF-KDOQI 2020 guidelines on a DD.
AHRQ-funded; HS023434
Citation: Brown T, Brody R, Sackey J .
Dietary intake correlated to waist-to-hip ratio in patients on maintenance hemodialysis.
J Ren Nutr 2023 Mar;33(2):355-62. doi: 10.1053/j.jrn.2022.09.012.
Keywords: Kidney Disease and Health, Nutrition, Chronic Conditions
Sonik RA, Coleman-Jensen A, Creedon TB
SNAP participation and emergency department use.
The objectives of this study were to examine whether Supplemental Nutrition Assistance Program (SNAP) participation is associated with emergency department use among low-income children, and whether any such association is mediated by household food hardship and child health status and/or moderated by special health care needs (SHCN) status. Researched pooled cross-sectional samples of children in low-income households from 2016-19 National Survey of Children's Health. SNAP participation was found to be associated with lower likelihoods of emergency department use. The researchers concluded that food hardship relief may improve outcomes for vulnerable children as well as the health systems that serve them.
poverty food
Citation: Sonik RA, Coleman-Jensen A, Creedon TB .
SNAP participation and emergency department use.
Pediatrics 2023 Feb;151(2):e2022058247. doi: 10.1542/peds.2022-058247.
Keywords: Children/Adolescents, Nutrition, Vulnerable Populations, Low-Income, Emergency Department
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Egan KA, Lo BK, Haneuse S
Associations of maternal consumption of sugary beverages in pregnancy with infant weight status.
Researchers studied mother-infant dyads from a prospective cohort study in order to examine links between maternal consumption of 100% juice and sugar-sweetened beverages in the third trimester of pregnancy with infant weight status at 6 and 12 months. 100% juice consumption was found to be associated with higher infant weight-for-length at 6 months and higher odds of rapid infant weight gain from birth to 6 months and birth to 12 months. 100% juice consumption was not associated with weight-for-length at 12 months and sugar-sweetened beverage consumption was not associated with any of the outcome measures.
AHRQ-funded; HS022242.
Citation: Egan KA, Lo BK, Haneuse S .
Associations of maternal consumption of sugary beverages in pregnancy with infant weight status.
Acad Pediatr 2023 Jan-Feb; 23(1):109-16. doi: 10.1016/j.acap.2022.05.007..
Keywords: Pregnancy, Nutrition, Newborns/Infants, Maternal Care, Women
Sneed NM, Ukwuani S, Sommer EC
Reliability and validity of assigning ultraprocessed food categories to 24-h dietary recall data.
The objective of this study was to test the reliability and validity of training coders and assigning Nova categories to individual foods collected via 24-hour dietary recalls. The Nutrition Data System for Research (NDSR) software was used to collect 2-3 dietary recalls at baseline and annually for 3 years. Over 3000 unique foods were categorized. This method of Nova classifying NDSR-based 24-hour dietary recalls was found to be reliable and valid for identifying individual intake of processed foods.
AHRQ-funded; HS026122.
Citation: Sneed NM, Ukwuani S, Sommer EC .
Reliability and validity of assigning ultraprocessed food categories to 24-h dietary recall data.
Am J Clin Nutr 2023 Jan; 117(1):182-90. doi: 10.1016/j.ajcnut.2022.10.016..
Keywords: Nutrition
Hashemi-Arend A, Vasquez KS, Guishard D
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Investigators implemented two evidence-based interventions not previously tested in senior centers, DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. Using the RE-AIM framework to analyze implementation, they found that change in systolic BP at Month 1 trended towards significance and change in SMBP reached significance at Month 6; food costs increased by 10%. They concluded that this RE-AIM analysis highlighted the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers.
AHRQ-funded; HS021667.
Citation: Hashemi-Arend A, Vasquez KS, Guishard D .
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Nutrients 2022 Nov 18;14(22):4890. doi: 10.3390/nu14224890..
Keywords: Blood Pressure, Patient Self-Management, Elderly, Nutrition, Lifestyle Changes
Sneed NM, Azuero A, Morrison SA
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
This study examined whether prediabetes awareness is associated with lower consumption of self-reported added sugar in US adults 20 years and older. Cross-sectional data for 3314 adults with prediabetes were analyzed from 2013-2018 National Health and Nutrition Examination Survey data. Among 3314 adults, 528 reported being aware and 2786 were unaware of their condition. Prediabetes awareness was not significantly associated with added sugar consumption with no differences for age, sex, or race/Hispanic origin.
AHRQ-funded; HS026122.
Citation: Sneed NM, Azuero A, Morrison SA .
Prediabetes awareness is not associated with lower consumption of self-reported added sugar in U.S. adults.
Ann Epidemiol 2022 Nov;75:21-24. doi: 10.1016/j.annepidem.2022.08.039..
Keywords: Diabetes, Chronic Conditions, Education: Patient and Caregiver, Nutrition, Health Promotion
Harris S, Inoue S
AHRQ Author: Harris S
Behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention in adults without CVD risk factors.
In this Putting Prevention into Practice case study to increase understanding of the USPSTF final recommendation on behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention in adults without CVD risk factors, a 49-year old patient presents for a wellness visit. The patient’s vital signs are described as well as their daily habits, diet, and other medical history. Three multiple-choice questions are presented regarding risk factors, interventions to be recommended, and the benefits of behavioral counseling to promote a healthy diet and physical activity, followed by their answers.
AHRQ-authored.
Citation: Harris S, Inoue S .
Behavioral counseling interventions to promote a healthy diet and physical activity for CVD prevention in adults without CVD risk factors.
Am Fam Physician 2022 Oct;106(4):439-40..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention, Nutrition, Lifestyle Changes
Venkataramani M, Ogunwole SM, Caulfield LE
Maternal, infant, and child health outcomes associated with the Special Supplemental Nutrition Program for Women, Infants, and Children: a systematic review.
The purpose of this study was to determine whether WIC participation was associated with improved maternal, neonatal-birth, and infant-child health outcomes or differences in outcomes by subgroups and WIC enrollment duration. Findings showed moderate strength of evidence (SOE) that maternal WIC participation during pregnancy is likely associated with lower risk for preterm birth, low birthweight infants, and infant mortality; low SOE that maternal WIC participation may be associated with a lower likelihood of inadequate gestational weight gain, as well as increased well-child visits and childhood immunizations; and low SOE that child WIC participation may be associated with increased childhood immunizations. Further, findings showed low SOE for differences in some outcomes by race and ethnicity but insufficient evidence for differences by WIC enrollment duration.
AHRQ-funded; 75Q80120D00003.
Citation: Venkataramani M, Ogunwole SM, Caulfield LE .
Maternal, infant, and child health outcomes associated with the Special Supplemental Nutrition Program for Women, Infants, and Children: a systematic review.
pediatric pediatrics food.
Keywords: Newborns/Infants, Children/Adolescents, Women, Maternal Care, Outcomes, Nutrition
Gupta N, Patel HD, Taylor J
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
The objective of this study was to perform a systematic review of plant-based diets and prostate cancer. Findings showed that interventional studies displayed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Further, observational studies demonstrated either a lower risk of prostate cancer or no significant difference.
AHRQ-funded; HS026120.
Citation: Gupta N, Patel HD, Taylor J .
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
Prostate Cancer Prostatic Dis 2022 Sep;25(3):444-52. doi: 10.1038/s41391-022-00553-2..
Keywords: Cancer: Prostate Cancer, Cancer, Evidence-Based Practice, Nutrition, Outcomes
Wang HS, Panagides J, Cahill D
Dietary risk factors for pediatric kidney stones: a case-control study.
This study’s objective was to perform a case-control study of the association of dietary nutrients with pediatric urolithiasis. Researchers obtained dietary information from pediatric urolithiasis patients and healthy controls; survey results were converted to standard nutrient intakes. Findings showed that higher dietary intake of calcium, sodium, and beta carotene, and lower potassium intake were associated with pediatric urolithiasis.
AHRQ-funded; HS000063.
Citation: Wang HS, Panagides J, Cahill D .
Dietary risk factors for pediatric kidney stones: a case-control study.
J Urol 2022 Aug;208(2):434-40. doi: 10.1097/ju.0000000000002687..
Keywords: Children/Adolescents, Nutrition, Kidney Disease and Health, Risk
Hashemi A, Vasquez K, Guishard D
Implementing dash-aligned congregate meals and self-measured blood pressure in two senior centers: An open label study.
This study tested whether implementing two evidence-based interventions--DASH-aligned meals provided through an existing congregate meal program, and support for home Self-Measured Blood Pressure (SMBP) monitoring--lowers blood pressure among participants at two senior centers serving low-income, racially diverse communities. Participants were clients aged ≥60, eating ≥4 meals/week at two NYC senior centers. They received DASH-aligned congregate meals, and training in nutrition, BP management education, and personal SMBP device. Primary outcomes was a) change in systolic BP measured by independent health professionals, and b) change in percent with "controlled BP" (Eighth Joint National Committee (JNC-8) Guidelines), at Month 1 compared to Baseline. The authors enrolled 94 participants, with COVID closures interrupting implementation mid-study. Mean systolic BP at Month-1 changed by -4.41 mmHg compared to Baseline. Participants with controlled BP increased at Month 1 and changes in mean BP at Month 1 was significantly correlated with BMI, age, and baseline BP. Mean systolic mean SMBP changed by -6.9 mmHg at Months 5/6.
AHRQ-funded; HS021667.
Citation: Hashemi A, Vasquez K, Guishard D .
Implementing dash-aligned congregate meals and self-measured blood pressure in two senior centers: An open label study.
Nutr Metab Cardiovasc Dis 2022 Aug;32(8):1998-2009. doi: 10.1016/j.numecd.2022.05.018..
Keywords: Elderly, Blood Pressure, Community-Based Practice, Patient Self-Management, Nutrition, Lifestyle Changes, Vulnerable Populations
Wallace DD, Barrington C, Albrecht S
The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes.
This study used qualitative methods to understand how Latinos with prediabetes attempted to modify their diet and physical activity behaviors to slow type-2 diabetes progression and how stress affected their engagement in these behaviors. Findings showed that stress affected behavioral and cognitive progresses that adversely altered primarily dietary behaviors.
AHRQ-funded; HS000032.
Citation: Wallace DD, Barrington C, Albrecht S .
The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes.
Ethn Health 2022 Aug;27(6):1395-409. doi: 10.1080/13557858.2021.1880549..
Keywords: Stress, Nutrition, Lifestyle Changes, Racial and Ethnic Minorities, Diabetes, Chronic Conditions
Patnode CD, Redmond N, Iacocca MO
Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Serv
This paper’s objective was to synthesize the evidence on benefits and harms of behavioral counseling interventions to promote a healthy diet and physical activity in adults without known cardiovascular disease (CVD) risk factors to inform a USPSTF recommendation. Findings showed that healthy diet and physical activity behavioral counseling interventions for persons without a known risk of CVD were associated with small but statistically significant benefits across a variety of important intermediate health outcomes and small to moderate effects on dietary and physical activity behaviors.
AHRQ-funded; 290201500007I.
Citation: Patnode CD, Redmond N, Iacocca MO .
Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Serv
JAMA 2022 Jul 26;328(4):375-88. doi: 10.1001/jama.2022.7408..
Keywords: U.S. Preventive Services Task Force (USPSTF), Lifestyle Changes, Cardiovascular Conditions, Risk, Prevention, Nutrition
Uhl S, Siddique SM, Bloschichak A
Interventions for malnutrition in hospitalized adults: a systematic review and meta-analysis.
The purpose of this review of existing research was to evaluate the effectiveness of hospital-initiated interventions for patients with malnutrition. The study found 11 randomized controlled trials (RCTs) that evaluated 2 types of interventions: 1) specialized nutrition care, and 2) increased protein provision, with moderate evidence in pooled findings that specialized nutrition care and increased protein provision reduced mortality by 21%. Decrease in length of stay was not significant. The researchers concluded that in patients at risk for or diagnosed with malnutrition, specialized nutrition care and increased protein provision reduced mortality.
AHRQ-funded; 75Q80120D00002.
Citation: Uhl S, Siddique SM, Bloschichak A .
Interventions for malnutrition in hospitalized adults: a systematic review and meta-analysis.
J Hosp Med 2022 Jul;17(7):556-64. doi: 10.1002/jhm.12891..
Keywords: Nutrition, Inpatient Care, Treatments
Cha P, Escarce JJ
The Affordable Care Act Medicaid expansion: a difference-in-differences study of spillover participation in SNAP.
Medicaid expansion through the Affordable Care Act increased access to insurance coverage to adults under 138% of the federal poverty level and connected individuals to SNAP (the Supplemental Nutrition Assistance Food Program – formerly the Food Stamp Program). The purpose of this study was to estimate the effect of Medicaid expansion on SNAP participation among 414,000 individuals across the U.S. The study found that there was a 2.9% increase in SNAP participation produced by Medicaid expansion among individuals living under 138% of the federal poverty level. In subgroup analyses the researchers discovered a 5% increase in households without children below 75% of the federal poverty level, and an increase in SNAP households with zero dollars in income. The study concluded that the impact of the Medicaid expansion on access to SNAP participation was the greatest in very-low-income individuals, and that the impact of Medicaid expansion reaches beyond healthcare by increasing access to other supports like food which is a social determinant of health.
AHRQ-funded; HS000046.
Citation: Cha P, Escarce JJ .
The Affordable Care Act Medicaid expansion: a difference-in-differences study of spillover participation in SNAP.
PLoS One 2022 May 4;17(5):e0267244. doi: 10.1371/journal.pone.0267244..
Keywords: Medicaid, Nutrition, Low-Income, Health Insurance
Ong T, Onchiri FM, Britto MT
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
This study’s purpose was to characterize nutrition management for infants with cystic fibrosis (CF) with inadequate weight gain and to assess association of dietitian assessments and center-level weight-for-age Z-scores (WAZ). Encounter data from 226 infants was used from across 28 US CF Centers from the Baby Observational Nutritional study between January 2012 through December 2017. The authors identified dietitian assessments and consensus guideline-recommended responses to inadequate weight gain: calorie increases, pancreatic enzyme replacement therapy (PERT) increases, or shortened time to next visit. They compared center assessments by funnel plot and summarized median WAZ by center. Of 2,527 visits, 808 visits had identified inadequate weight gain, distributed in 216 infants. Assessments occurred in 77% of visits but varied widely between centers (range 17% - 98%). They used funnel plot analysis to identify high-performers for frequent dietitian assessments (range 92% - 98%) and 4 under-performers (range 17% - 56%). High-performers treated inadequate weight gain more often with adequate calories (80% vs 52%) and closer follow-up (63% vs 49%) compared to underperformers. Three of 4 high-performing sites met center nutrition goals for positive median WAZ at 2 years old unlike 3 under-performers, despite similar patient characteristics.
AHRQ-funded; HS026393.
Citation: Ong T, Onchiri FM, Britto MT .
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
J Cyst Fibros 2022 Jan; 21(1):115-22. doi: 10.1016/j.jcf.2021.08.005..
Keywords: Newborns/Infants, Respiratory Conditions, Chronic Conditions, Nutrition, Evidence-Based Practice, Guidelines
Tucher Keeney, T Cohen, AJ
Conceptualizing food insecurity among older adults: development of a summary indicator in the National Health and Aging Trends Study.
Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was to construct a summary indicator of food insecurity incorporating these domains. The investigators concluded that food insecurity among older adults is broader than lacking adequate financial resources to obtain food; it is also associated with social and functional limitations.
AHRQ-funded; HS000011.
Citation: Tucher Keeney, T Cohen, AJ .
Conceptualizing food insecurity among older adults: development of a summary indicator in the National Health and Aging Trends Study.
J Gerontol B Psychol Sci Soc Sci 2021 Nov 15;76(10):2063-72. doi: 10.1093/geronb/gbaa147..
Keywords: Elderly, Nutrition, Health Status
Cullen D, Abel D, Attridge M
Exploring the gap: food insecurity and resource engagement.
Researchers investigated participant interest in referral and engagement with resources provided by pediatric health care institutions implementing food insecurity (FI) screens. They found that, through hospital-community partnership in an initial attempt to screen and offer direct-referral for FI, they elicited considerable interest among families for connection to resource agencies. However, there was a substantial gap between referral acceptance and ultimate connection with the resource agency.
AHRQ-funded; HS026116.
Citation: Cullen D, Abel D, Attridge M .
Exploring the gap: food insecurity and resource engagement.
Acad Pediatr 2021 Apr;21(3):440-45. doi: 10.1016/j.acap.2020.08.005..
Keywords: Children/Adolescents, Nutrition, Social Determinants of Health
Sonik RA, Coleman-Jensen A, Parish SL
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
The purpose of this study was to compare exposure to household food insufficiency and the relationship between household food insufficiency and both health status and emergency healthcare utilization among children with and without special healthcare needs (SHCN). The investigators concluded that compared with other children, children with SHCN have an elevated risk of exposure to household food insufficiency and experiencing greater reductions in health status when exposed.
AHRQ-funded; HS026317.
Citation: Sonik RA, Coleman-Jensen A, Parish SL .
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
Public Health Nutr 2020 Dec;23(17):3204-10. doi: 10.1017/s1368980020000361..
Keywords: Children/Adolescents, Nutrition, Health Status, Emergency Department, Public Health
Brewster AL, Fraze TK, Gottlieb LM
The role of value-based payment in promoting innovation to address social risks: a cross-sectional study of social risk screening by US physicians.
The authors studied the conditions under which value-based payment will encourage health care providers to innovate to address upstream social risks. Their results indicated that implementation of social risk screening was not associated with overall exposure to value-based payment for physician practices. They recommended expanding social risk screening in order to reduce the level of innovative capacity required.
AHRQ-funded; HS024075.
Citation: Brewster AL, Fraze TK, Gottlieb LM .
The role of value-based payment in promoting innovation to address social risks: a cross-sectional study of social risk screening by US physicians.
Milbank Q 2020 Dec;98(4):1114-33. doi: 10.1111/1468-0009.12480..
Keywords: Payment, Social Determinants of Health, Practice Patterns, Vulnerable Populations, Screening, Risk, Nutrition
O'Connor EA, Evans CV, Rushkin MC
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers reviewed the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors. They found that medium- and high-contact multisession behavioral counseling interventions to improve diet and increase physical activity for people with elevated blood pressure and lipid levels were effective in reducing cardiovascular events, blood pressure, low-density lipoproteins, and adiposity-related outcomes, with little to no risk of serious harm.
AHRQ-funded; 290201200015I.
Citation: O'Connor EA, Evans CV, Rushkin MC .
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Nov 24;324(20):2076-94. doi: 10.1001/jama.2020.17108..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Nutrition, Lifestyle Changes, Risk, Prevention, Evidence-Based Practice, Guidelines