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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 25 of 152 Research Studies DisplayedKalofonos I, Zito M, Fletcher E
A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States.
This paper described the effects of participation of a pilot trial of Veterans Voices and Visions (VVV) groups, which is an adaptation of the Hearing Voices (HV) groups which were created to assist patients undergoing psychosis. The trial was conducted at the VA and were co-led by clinicians and Veteran peer support specialists. Over a 16-week period, quantitative analysis showed a statistically significant reduction in distress, due to auditory hallucinations, as measured by the Psychotic Symptom Rating Scales (PSYRATS). A reduction in malevolence and omnipotence and an increase in benevolence related to auditory hallucinations was shown with the Beliefs about Voices Questionnaire- Revised (BAVQ-R), but there was no change in resistance. Qualitative data from Week 8 and the endpoint (Week 16) interviews revealed several perceived benefits from groups: 1) normalization and camaraderie, 2) increased hope and confidence, 3) self-understanding and reframing of experiences, and 4) building relationships outside of groups.
AHRQ-funded.
Citation: Kalofonos I, Zito M, Fletcher E .
A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States.
Int J Soc Psychiatry 2024 Feb; 70(1):122-31. doi: 10.1177/00207640231196747.
Keywords: Community-Based Practice, Behavioral Health
Berbakov ME, Hoffins EL, Stone JA
AHRQ-funded; HS028475.
A study team collaborated with Aurora Pharmacy, Inc. to develop Senior Safe, a community pharmacy-based intervention designed to increase awareness of safe over-the-counter medication use for older adults. Senior Safe was adapted through pilot testing and a randomized control trial before a finalized version was provided to Aurora Pharmacy to integrate into all its pharmacy sites. The authors concluded that this multiphase study illustrated that refining an intervention is possible and welcomed by pharmacy staff, but requires time, resources, and funds to create an impactful, sustainable community pharmacy intervention.
AHRQ-funded; HS024490; HS027737.
Citation: Berbakov ME, Hoffins EL, Stone JA .
AHRQ-funded; HS028475.
J Am Pharm Assoc 2024 Jan-Feb; 64(1):159-68. doi: 10.1016/j.japh.2023.11.009.
Keywords: Medication, Medication: Safety, Provider: Pharmacist, Patient Safety, Community-Based Practice
Lopez JM, Wing H, Ackerman SL
Community health center staff perspectives on financial payments for social care.
The purpose of this study was to examine how community health center (CHC) staff perceive the current and potential influence of fee-for-service payments on clinical teams' engagement in these activities. The researchers interviewed 42 clinicians, frontline staff, and administrative leaders employed by12 Oregon CHC clinical sites about their social care initiatives. The study grouped the findings into three categories: 1. participants' awareness of existing or anticipated financial incentives, 2. uses for incentive dollars, and 3. perceived impact of financial incentives on social care activities in clinical practices. Current or anticipated important uses for incentive dollars included paying for social care staff, providing social services, and supporting additional fundraising efforts. Frontline staff reported that the strongest influence on clinic social care practices was the ability to provide responsive social services. Clinic leaders reported that for financial incentives to significantly change CHC practices would necessitate payments large enough to expand the social care workforce as well.
AHRQ-funded; HS026435.
Citation: Lopez JM, Wing H, Ackerman SL .
Community health center staff perspectives on financial payments for social care.
Milbank Q 2023 Dec; 101(4):1304-26. doi: 10.1111/1468-0009.12667..
Keywords: Community-Based Practice, Payment, Healthcare Delivery
Beidler LB, Fichtenberg C, Fraze TK
"Because there's experts that do that": lessons learned by health care organizations when partnering with community organizations.
This study’s goal was to understand how health care organizations interact with community-based organizations (CBOs) to implement social care. The authors conducted 33 semi-structured telephone interviews with administrators at 29 diverse health care organizations with active programming from April to July 2019. The majority (26 out of 29) of organizations relied on CBOs to improve their patients’ social needs. Three main themes emerged: 1) One-way referrals to CBOs did not require formal relationships or frequent interactions with CBOs; 2) When health care organizations contracted with CBOs to deliver discrete services, leadership-level relationships were required to launch programs while staff-to-staff interactions were used to maintain programs; and 3) Some health care organizations engaged in community-level activities with multiple CBOs which required more expansive, ongoing leadership-level partnerships. There were 4 recommendations highlighted by administrators for collaborating with CBOs: (1) engage early; (2) establish shared purpose for the collaboration; (3) determine who is best suited to lead activities; and (4) avoid making assumptions about partner organizations.
AHRQ-funded; HS024075.
Citation: Beidler LB, Fichtenberg C, Fraze TK .
"Because there's experts that do that": lessons learned by health care organizations when partnering with community organizations.
J Gen Intern Med 2023 Nov; 38(15):3348-54. doi: 10.1007/s11606-023-08308-y..
Keywords: Community-Based Practice, Healthcare Delivery
Kang-Yi CD, Kuriyan A, Kinkler G
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
This paper reported the key findings of evaluations of Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The evaluations included acute mental health service use of children who received school-based care and Medicaid expenditure, children's behaviors to measure school mental health providers' performance, and effects of school mental health programs on children's behavioral health functioning, school outcomes, and other service usage. The paper discussed how programs have been refined based on evaluation results, and shared lessons learned for successful public-academic partnership-based evaluations.
AHRQ-funded; HS026862.
Citation: Kang-Yi CD, Kuriyan A, Kinkler G .
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
Community Ment Health J 2023 Nov; 59(8):1588-600. doi: 10.1007/s10597-023-01147-5..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Community-Based Practice
Heintzman J, Springer R, Marino M
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Researchers examined the association between adolescent-mother language concordance and neighborhood social deprivation with adolescent vaccination completion in order to understand social/family factors related to Latino adolescent vaccination. They used a multistate, EHR-based dataset of community health center patients to compare three Latino groups; their sample included over 56,000 adolescent-mother dyads. Their findings indicated that English-preferring adolescents with Spanish-preferring mothers had the highest completion rates. The researchers concluded that future studies could attempt to understand what advantage this language dyad may have in adolescent vaccination completion.
AHRQ-funded; HS025962.
Citation: Heintzman J, Springer R, Marino M .
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Matern Child Health J 2023 Nov; 27(11):2026-37. doi: 10.1007/s10995-023-03742-0..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Vaccination, Children/Adolescents, Vulnerable Populations, Social Determinants of Health
Putnam KE, Biel FM, Hoopes M
Landscape of pregnancy care in US community health centers.
This retrospective cohort study utilized EHR data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) to describe clinic and patient characteristics associated with longitudinal prenatal care delivery in community health centers (CHCs). Results showed that 41% of CHCs provided longitudinal prenatal care, and these CHCs were more likely to be larger, have multidisciplinary teams, and serve higher proportions of nonwhite or non-English speaking patients. Patients who received longitudinal prenatal care at CHCs were racially and ethnically diverse and many had comorbidities. The authors concluded that CHCs provided critical access to care for vulnerable populations and will be important in addressing inequities in maternal morbidity and mortality.
AHRQ-funded; HS025155.
Citation: Putnam KE, Biel FM, Hoopes M .
Landscape of pregnancy care in US community health centers.
J Am Board Fam Med 2023 Aug 9; 36(4):574-82. doi: 10.3122/jabfm.2023.230025R1..
Keywords: Maternal Care, Community-Based Practice, Women, Access to Care
Ackerman SL, Wing H, Acves B
“We were trying to do quality versus quantity”: challenges and opportunities at the intersection of standardized and personalized social care in community health centers.
The purpose of this study was to explore activities to incorporate social risk programs into community health centers (CHCs) providing primary care services in Oregon. CHCs took part in either one or both of two large programs with the goal of incorporating standardized social risk screening and referral processes. The researchers conducted 42 semi-structured interviews with clinicians, managers and staff at 12 clinics affiliated with five CHCs to understand implementation procedures and challenges to those procedures. Thematic analysis utilized the Normalization Process Theory (NPT) to discover the dynamic, interactional nature of activities to integrate a complex sociotechnical intervention. The study found that standardized social care was expected to correspond well with institutional commitments and priorities. However, challenges maintaining support among staff was encountered, affected by competing priorities, staff turnover, and uncertainties about roles and responsibilities. The new tools were frequently altered or abandoned to retain the advantages of existing social care practices. Across clinics, the association between standardized procedures and existing social care activities, had a key role in patterns of adoption, non-adoption and adaptation, with standardized tools frequently experienced as undermining more relational, team-based social care.
AHRQ-funded; HS026435.
Citation: Ackerman SL, Wing H, Acves B .
“We were trying to do quality versus quantity”: challenges and opportunities at the intersection of standardized and personalized social care in community health centers.
SSM Qual Res Health 2023 Jun; 3:100267. doi: 10.1016/j.ssmqr.2023.100267..
Keywords: Community-Based Practice, Social Determinants of Health, Primary Care
Hogg-Graham R, Mamaril CB, Benitez JA
Impact of state Medicaid expansion on cross-sector health and social service networks: evidence from a longitudinal cohort study.
This study’s objective was to examine the impact of state Medicaid expansion on the delivery of population health activities in cross-sector health and social services networks. The authors used data measuring the composition of cross-sector population health networks from the 2006-2018 National Longitudinal Survey of Public Health Systems (NALSYS) linked with the Area Health Resource File. They restricted their data to jurisdictions serving populations of 100,000 or more and states that had NALSYS observations across all time periods, resulting in a final sample size of 667. Results indicated that Medicaid expansion was associated with a 2.3 percentage point increase in the density of population health networks. Communities in states with expanded Medicaid experienced significant increases in the participation of local public health, local government, hospitals, nonprofits, insurers, and K-12 schools. Of the organizations with significant increases in expansion communities, nonprofits (7.7 percentage points,), local public health agencies (6.5 percentage points), hospitals (5.8 percentage points), and local government agencies (6.0 percentage points) had the largest gains.
AHRQ-funded; HS025494.
Citation: Hogg-Graham R, Mamaril CB, Benitez JA .
Impact of state Medicaid expansion on cross-sector health and social service networks: evidence from a longitudinal cohort study.
Health Serv Res 2023 Jun; 58(3):634-41. doi: 10.1111/1475-6773.14144..
Keywords: Medicaid, Health Insurance, Community-Based Practice, Access to Care
Shi M, Fiori K, Kim RS
Social needs assessment and linkage to community health workers in a large urban hospital system.
The purpose of this study was to determine predictors of successful linkage with a community health worker (CHW) in patients with social needs. The researchers utilized a cross-sectional analysis of social needs assessments administered in an urban health system between April 2018 and December 2019. Social needs in the study included safety, getting along with household members, housing quality, housing instability, food insecurity, care for dependents, healthcare cost, healthcare related transportation, utilities, and legal assistance. Patients were entered into a separate database when they encountered a CHW. The main outcome was a successful "linkage," which was defined as having a positive social needs assessment in the medical record with a corresponding record in the CHW database. The study found that 25% of patients with at least 1 social need accepting help were linked to a CHW. Positive predictors included female gender, Spanish language preference compared to English, and having a food-related need. Negative predictors included age 18 to 65 and 0 to 5 compared to over 65, non-Hispanic White race compared to Hispanic race, and having needs of getting along with household members and safety.
AHRQ-funded; HS026396.
Citation: Shi M, Fiori K, Kim RS .
Social needs assessment and linkage to community health workers in a large urban hospital system.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231166918. doi: 10.1177/21501319231166918..
Keywords: Urban Health, Healthcare Delivery, Social Determinants of Health, Community-Based Practice, Rural/Inner-City Residents
Stallings SC, Richmond SC, Canedo JR
Assessing patient-level knowledge of precision medicine in a community health center setting.
Researchers used a mixed-methods approach to identify patient-level factors that influenced understanding of cancer risk among federally qualified community health center (FQCHC) patients. Participants were English-speaking adults aged 40-79 years enrolled in focus groups; they completed surveys to assess patient-level understanding of precision medicine, numeracy, and health literacy. The findings suggested that patients may lack familiarity with precision medicine concepts relevant for understanding cancer treatment decisions. The researchers concluded that future educational efforts might help to bridge the gap in patient understanding and facilitate equitable opportunities for precision medicine for patients, including those seeking care from community health centers.
AHRQ-funded; HS026122.
Citation: Stallings SC, Richmond SC, Canedo JR .
Assessing patient-level knowledge of precision medicine in a community health center setting.
J Community Genet 2023 Apr; 14(2):197-210. doi: 10.1007/s12687-023-00632-4..
Keywords: Community-Based Practice, Health Literacy, Genetics
AA Payán, DD Brown, TT
AHRQ Author: Tierney
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
In a cohort study, researchers examined the association of care continuity with diabetes and hypertension care quality in community health centers (CHCs) before and during COVID-19, and the mediating effect of telehealth. Patients with diabetes and/or hypertension with at least 2 encounters per year during 2019 and 2020 were identified via electronic health record data from 166 CHCs; multivariable logistic regression models estimated the association of care continuity with telehealth use and care processes. The results showed that higher care continuity was associated with telehealth use and A1c testing, and lower A1c and blood pressure. The researchers concluded that care continuity might facilitate telehealth use and resilient performance on process measures.
AHRQ-funded; HS022241.
Citation: AA Payán, DD Brown, TT .
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
Med Care 2023 Apr 1;61(Suppl 1):S62-s69. doi: 10.1097/mlr.0000000000001811.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Community-Based Practice, Public Health
Goldstein E, King C, Crits-Cristoph P
The association between trauma and interpersonal problems in a United States community mental health setting.
Prior studies have established connections between traumatic experiences and issues in interpersonal relationships. The purpose of this study was to explore the influence of trauma on interpersonal difficulties in depressed individuals seeking assistance within a community mental health framework. The study included 453 patients who sought treatment and were screened for a comparative effectiveness analysis of depression therapies. The relationship between the 32-item Inventory of Interpersonal Problems (IIP-32) and trauma indicators was investigated. The study found that a staggering 99.1% of participants had undergone a traumatic event. Notable correlations were identified between the total count of traumas, the number of sexually and physically abusive traumas, and factors such as gender and ethnicity. The number of sexually abusive traumas demonstrated a significant connection to the IIP-32 "excessively nurturing" subscale. After adjusting for demographic variables and other IIP-32 subscales, the overall number of traumas retained a significant association with the IIP-32 "excessively nurturing" category.
AHRQ-funded; HS018440
Citation: Goldstein E, King C, Crits-Cristoph P .
The association between trauma and interpersonal problems in a United States community mental health setting.
J Clin Psychol 2023 Apr;79(4):1192-207. doi: 10.1002/jclp.23467.
Keywords: Trauma, Behavioral Health, Community-Based Practice
Wirth AN, Cushman NA, Reilley BA
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
Researchers evaluated the extent to which Indian Country Extension for Community Healthcare Outcomes (ECHO) telehealth clinics increase access to hepatitis C virus (HCV) treatment and serve American Indians/Alaska Native (AI/AN) patients holistically. They conducted a retrospective descriptive analysis of Indian Country ECHO treatment recommendations from 2017 to 2021. Most patients received recommendations for HCV treatment by their primary care providers, along with recommendations beyond the scope of HCV. The researchers concluded that Indian Country ECHO telehealth clinic provided comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
AHRQ-funded; HS026370.
Citation: Wirth AN, Cushman NA, Reilley BA .
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
J Rural Health 2023 Mar;39(2):358-66. doi: 10.1111/jrh.12733.
Keywords: Hepatitis, Access to Care, Racial and Ethnic Minorities, Community-Based Practice, Telehealth, Health Information Technology (HIT), Chronic Conditions
Safon CB, Estela MG, Rosenberg J
Implementation of a novel pediatric behavioral health integration initiative.
The purpose of this concurrent, qualitative-dominant mixed methods empirical study was to explore healthcare professionals' perceptions of the impact of behavioral health integration (BHI) on pediatric primary care delivery in community health centers (CHCs). The researchers utilized semi-structured interviews with healthcare professionals at the end of the implementation phase of a 3-year process and surveys administered at three time points. Qualitative themes were mapped onto the Relational Coordination (RC) conceptual framework to triangulate and complement final qualitative results with quantitative results. The researchers round five emergent themes aligning with RC domains. The results of the survey showed that healthcare professionals reported both greater behavioral healthcare integration into clinic practice and greater clinic readiness to address behavioral health needs. The researchers concluded that effective pediatric BHI and care delivery at CHCs may depend on solid professional relationships and communication.
AHRQ-funded; HS022242.
Citation: Safon CB, Estela MG, Rosenberg J .
Implementation of a novel pediatric behavioral health integration initiative.
J Behav Health Serv Res 2023 Jan;50(1):1-17. doi: 10.1007/s11414-022-09803-6..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Primary Care, Patient-Centered Healthcare, Community-Based Practice
Beidler LB, Razon N, Lang H
"More than just giving them a piece of paper": interviews with primary care on social needs referrals to community-based organizations.
The purpose of this qualitative study was to describe primary care practice’s referrals to community-based organizations. The researchers utilized semi-structured interviews with 50 healthcare administrators in charge of social care efforts within their organization. Fifty diverse United States healthcare organizations and agencies were included. The study found that social needs referrals were an essential element of administrator’s social care activities. Administrators described the optimal referral program as one which places limited burden on care teams, provides patients with customized referrals, and facilitates closed-loop referrals. The researchers identified three key challenges organizations encounter when trying to implement the optimal referrals program: 1) developing and maintaining resources lists; 2) aligning referrals with patient needs; and 3) measuring the efficacy of referrals. Administrators The study concluded that primary care practice referrals to community-based organizations were used to improve patients' social conditions, but administrators report challenges providing customized and current information to their patients.
AHRQ-funded; HS024075.
Citation: Beidler LB, Razon N, Lang H .
"More than just giving them a piece of paper": interviews with primary care on social needs referrals to community-based organizations.
J Gen Intern Med 2022 Dec;37(16):4160-67. doi: 10.1007/s11606-022-07531-3..
Keywords: Primary Care, Social Determinants of Health, Community-Based Practice, Healthcare Delivery
White A, Fulda KG, Blythe R
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
The purpose of this narrative review was to further define the nature of collaboration between pharmacists and primary care providers in improving medication safety in community settings, and to describe related barriers and strategies. The researchers searched PubMed studies published between January 2000 and December 2020 using search terms including: "collaboration," "community pharmacy," "patient safety," "medication safety," and "primary care physician." The identified articles were placed into 3 categories: 1) defining collaboration, 2) types of collaboration, and 3) barriers and solutions to collaboration. The authors concluded that medication review and other strategies are a common form of collaboration between pharmacists and primary care providers, and that barriers to that collaboration can include erroneous beliefs regarding roles, variation in access to clinical information, and differences in community pharmacy practice.
AHRQ-funded; HS027277.
Citation: White A, Fulda KG, Blythe R .
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
Expert Opin Drug Saf 2022 Nov;21(11):1357-64. doi: 10.1080/14740338.2022.2147923..
Keywords: Provider: Pharmacist, Primary Care, Medication, Patient Safety, Community-Based Practice
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
Luo Q, Moghtaderi A, Markus A
Financial impacts of the Medicaid expansion on community health centers.
This study’s objective was to determine the impact of Medicaid expansion on community health centers. The authors combined data from the Uniform Data System, IRS nonprofit tax returns, and county-level characteristics from the Census Bureau. Their final dataset included 5841 center-year observations. They found a $2.08 million relative increase in Medicaid revenues, offset by a $0.44 million decrease in total grants among community health centers in expansion states compared with centers in non-expansion states. They found a large but not statistically significant $0.98 million relative increase in total expenditures among expansion state centers. Uncompensated care for health centers in expansion states decreased by $1.19 million relative to their counterparts in non-expansion states.
AHRQ-funded; HS026816.
Citation: Luo Q, Moghtaderi A, Markus A .
Financial impacts of the Medicaid expansion on community health centers.
Health Serv Res 2022 Jun;57(3):634-43. doi: 10.1111/1475-6773.13897..
Keywords: Medicaid, Community-Based Practice, Healthcare Costs
McDowell A, Myong C, Tevis D
Sexual orientation and gender identity data reporting among U.S. health centers.
This study examined sexual orientation and gender identity data reporting among community health centers. The study used the 2016-2019 Uniform Data System for 1,381 community health centers to look at trends in reporting. From 2016 to 2016, the percentage of community health centers with sexual orientation and gender identity data for ≥75% of patients increased from 14.9% to 53.0%. In 2019, community health centers were more likely to have this data for ≥75% of patients if they were in nonmetro counties versus metro, were in the South or West (versus Northeast), and had more patients aged between 18 and 39 years, between 40 and 64 years (versus <18 years), or veterans. This was less likely among smaller community health centers serving 10-20,000 patients or >20,000 patients, and centers with more patients of American Indian/Alaskan Native or unknown race (versus White).
AHRQ-funded; HS025378.
Citation: McDowell A, Myong C, Tevis D .
Sexual orientation and gender identity data reporting among U.S. health centers.
Am J Prev Med 2022 Jun;62(6):e325-e32. doi: 10.1016/j.amepre.2021.12.017..
Keywords: Vulnerable Populations, Community-Based Practice
King C, Goldstein E, Crits-Christoph P
The association between medical comorbidity and psychotherapy processes and outcomes for major depressive disorder in a community mental health setting.
The purpose of this study was to: examine the comorbidities of mental health issues and a medical condition in a community mental health setting with a primarily Medicare and Medicaid population; describe the range of comorbid medical conditions in this setting; and explore the association between medical conditions on the alliance, attrition from services and outcome. The researchers accessed patient charts and conducted structured clinical interviews to collect medical diagnoses from 353 participants who had previously had a baseline evaluation as a participant in a study of therapies for major depressive disorder. The researchers reported that a high percentage of patients in the study experienced a comorbid medical condition. There were no significant correlations between the number of medical conditions and treatment outcome or early attrition from treatment. Further analyses revealed that the presence of a nervous system disorder was correlated with poorer treatment outcomes. The researchers concluded that patients undergoing treatment for major depressive disorder may benefit from simultaneously attending to the impact of medical conditions on physical functioning.
AHRQ-funded; HS018440.
Citation: King C, Goldstein E, Crits-Christoph P .
The association between medical comorbidity and psychotherapy processes and outcomes for major depressive disorder in a community mental health setting.
Psychotherapy 2022 Jun;59(2):199-208. doi: 10.1037/pst0000380..
Keywords: Depression, Behavioral Health, Community-Based Practice
Hatch B, Tillotson C, Hoopes M
Patient-level factors associated with receipt of preventive care in the safety net.
Researchers used electronic health record data from a national network of community health centers in the U.S. to measure patient-level status with preventive ratios for twelve preventive services and an aggregate preventive index. The results indicated that smoking, homelessness, and lack of health insurance were associated with lower preventive ratios for cancer and cardiovascular screenings; more ambulatory visits, better continuity of care, and enrollment in the patient portal were associated with higher preventive ratios for most services but the receipt of preventive services overall was low. The researchers concluded that these associations should inform future efforts to improve delivery of preventive healthcare.
AHRQ-funded; HS025155.
Citation: Hatch B, Tillotson C, Hoopes M .
Patient-level factors associated with receipt of preventive care in the safety net.
Prev Med 2022 May; 158:107024. doi: 10.1016/j.ypmed.2022.107024..
Keywords: Prevention, Community-Based Practice, Access to Care
Kranz AM, Steiner ED, Mitchell JM
School-based health services in Virginia and the COVID-19 pandemic.
The purpose of this study was to examine how the COVID-19 pandemic may have impacted the provision of school health services and related student needs. In May 2021, all 1178 Virginia public elementary schools received a web-based survey regarding the impact of the pandemic on school-based health services, with 65% of schools responding (N=767). Schools reported providing fewer school-based health services during the pandemic than before, with dental screenings declining the most (51% before vs 15% after). The study also reported that mental health as a top concern for students increased from 15% before the pandemic to 27% during the pandemic. The study concluded that schools reported providing fewer health services to students during pandemic in the 2020-2021 school year and increased concern about students' mental health.
AHRQ-funded; HS025430.
Citation: Kranz AM, Steiner ED, Mitchell JM .
School-based health services in Virginia and the COVID-19 pandemic.
J Sch Health 2022 May;92(5):436-44. doi: 10.1111/josh.13147..
Keywords: COVID-19, Children/Adolescents, Public Health, Healthcare Delivery, Community-Based Practice
Shadowen H, O'Loughlin K, Cheung K
Exploring the relationship between community program location and community needs.
Investigators identified and geolocated community programs in Richmond, Virginia, that aid with 9 domains of needs. They identified 280 community programs that provide aid for the 9 domains, with programs most often providing financial assistance and housing support. They found no relationship between the number of community programs and the level of need, with 2 exceptions: A positive association between financial programs and financial need, and a negative association between housing programs and housing need. They concluded that community programs were generally not co-located with need.
AHRQ-funded; HS026223.
Citation: Shadowen H, O'Loughlin K, Cheung K .
Exploring the relationship between community program location and community needs.
J Am Board Fam Med 2022 Jan-Feb;35(1):55-72. doi: 10.3122/jabfm.2022.01.210310..
Keywords: Social Determinants of Health, Community-Based Practice
Holcomb J, Ferguson G, Roth I
Adoption of an evidence-based intervention for mammography screening adherence in safety net clinics.
This paper describes an evidence-based intervention that was created to reduce mammography appointment no-show rates in underserved women at safety net clinics. An academic-community partnership was used to implement four strategies to improve the adoption and scale-up of the interventions with Federally Qualified Health Centers and charity care clinics. The interventions implemented were: (1) an outreach email blast targeting the community partner member clinics to increase program awareness, (2) an adoption video encouraging enrollment in the program, (3) an outreach webinar educating the community partner member clinics about the program, encouraging enrollment and outlining adoption steps, and (4) an adoption survey adapted from Consolidated Framework for Implementation Research constructs from the Cancer Prevention and Control Research Network for cancer control interventions with Federally Qualified Health Centers.
AHRQ-funded; HS023255.
Citation: Holcomb J, Ferguson G, Roth I .
Adoption of an evidence-based intervention for mammography screening adherence in safety net clinics.
Front Public Health 2021 Nov 4;9:748361. doi: 10.3389/fpubh.2021.748361..
Keywords: Evidence-Based Practice, Imaging, Screening, Women, Community-Based Practice