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Topics
- Behavioral Health (3)
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- (-) Telehealth (22)
- Transitions of Care (2)
- Vulnerable Populations (2)
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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 22 of 22 Research Studies DisplayedHahn AL, Michaels CL, Khawly G
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
The purpose of this study was to compare two usability evaluation methods for adapting an evidence-based mHealth tool from English into Spanish. The authors conducted cognitive interviews and usability assessments using a think-aloud protocol to evaluate the usability of an HIV mHealth application among 40 Spanish-speaking adults with HIV in New York City and in La Romana in the Dominican Republic. Findings highlighted contributions and limitations of including these methods in mHealth usability testing. The authors concluded that future research should employ a multi-method approach that incorporated complementary usability evaluation methods and engaged participants in multiple assessments.
AHRQ-funded; HS028523.
Citation: Hahn AL, Michaels CL, Khawly G .
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
Int J Med Inform 2024 Apr; 184:105355. doi: 10.1016/j.ijmedinf.2024.105355.
Keywords: Telehealth, Health Information Technology (HIT)
Bui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Weiss CR, Roberts M, Florell M
Best Practices for telehealth in nurse-led care settings-a qualitative study.
This study explored the implementation of telehealth in nurse-led care models during the COVID-19 pandemic in Colorado. Through interviews with 18 providers and 30 patients, best practices such as: using multiple modalities, tailored triage and scheduling, safety measures, and managing patient relationships emerged. These findings indicate that telehealth can enhance equitable care delivery, particularly in diverse communities, with nurse leaders playing a vital role in its effective utilization.
AHRQ-funded; HS028085.
Citation: Weiss CR, Roberts M, Florell M .
Best Practices for telehealth in nurse-led care settings-a qualitative study.
Policy Polit Nurs Pract 2024 Feb; 25(1):47-57. doi: 10.1177/15271544231201417.
Keywords: Telehealth, Health Information Technology (HIT), Nursing, Provider: Nurse, COVID-19
Sequeira GM, Asante PG, Bocek K
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
An electronic consultation (e-consult) platform was introduced to conduct a study to aid pediatric primary care providers (PCPs) in providing gender-affirming care to transgender and nonbinary (TNB) adolescents. A study assessed its impact on PCP confidence and referral patterns. Results showed increased confidence and a 19% decrease in specialty referrals among PCPs. The platform received positive usability feedback, suggesting its potential to enhance care access and reduce specialty referrals for TNB adolescents.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Asante PG, Bocek K .
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
Telemed J E Health 2024 Feb; 30(2):595-600. doi: 10.1089/tmj.2023.0266.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Primary Care, Vulnerable Populations
Olaya F, Brin M, Caraballo PB
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
The purpose of this study is to test the effectiveness of an mHealth tool to improve adherence to HIV medication in Spanish-speaking people living in New York City and the Dominican Republic. The researchers developed the WiseApp study as a two-arm randomized controlled trial. The 248 participants from New York and the Dominican Republic were randomly assigned to receive a CleverCap pill bottle that is linked to the WiseApp (intervention) or to the standard of care (control). The participants completed surveys at the baseline, 3-month, 6-month, and 12-month follow-up visits. Through blood draws at each study timepoint, the study team collected HIV-1 viral load and CD4 count results. Results will be forthcoming.
AHRQ-funded; HS028523.
Citation: Olaya F, Brin M, Caraballo PB .
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
BMC Public Health 2024 Jan 17; 24(1):201. doi: 10.1186/s12889-023-17538-y..
Keywords: Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Cultural Competence, Outcomes
Jolliff A, Coller RJ, Kearney H
An mHealth design to promote medication safety in children with medical complexity.
This study describes an effort to design a health information technology tool to improve medication safety for children with medical complexity (CMC). The study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a co-design process to identify: 1) medication safety challenges experienced by CMC caregivers and, 2) design requirements for a mobile health application to improve medication safety for CMC in the home. Family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program participated in virtual co-design sessions. During these sessions, the facilitator guided 16 co-designers in generating and converging upon medication safety challenges and design requirements. These sessions were recorded and reviewed after conclusion to confirm that all designer comments had been captured. An analysis yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines.
AHRQ-funded; HS028409.
Citation: Jolliff A, Coller RJ, Kearney H .
An mHealth design to promote medication safety in children with medical complexity.
Appl Clin Inform 2024 Jan; 15(1):45-54. doi: 10.1055/a-2214-8000..
Keywords: Children/Adolescents, Medication: Safety, Medication, Health Information Technology (HIT), Chronic Conditions, Telehealth, Caregiving
Senft N, Everson J
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
The goal of this study was to determine how the negative healthcare experiences of low patient centeredness and care coordination problems motivate the use of different eHealth activities, and whether more highly educated individuals are more likely than those less highly educated to use eHealth following negative experiences. Researchers used factor analysis to group 25 different eHealth activities into categories, based on the correlation between respondents' reports of their usage. Their findings indicate that individuals use a greater number of eHealth activities, especially activities independent of healthcare providers, when they experience problems with their healthcare; people with lower levels of education who have had negative healthcare experiences seem more inclined to use eHealth. The researchers recommend that, in order to maximize the potential for eHealth to meet the needs of all patients, especially those who are underserved, additional work is needed to ensure that eHealth resources are accessible to all members of the population.
AHRQ-funded; HS026122.
Citation: Senft N, Everson J .
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
J Med Internet Res 2018 Dec 5;20(12):e11034. doi: 10.2196/11034..
Keywords: Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Patient Experience, Telehealth
Yu J, Mink PJ, Huckfeldt PJ
Population-level estimates of telemedicine service provision using an all-payer claims database.
Researchers used information from the Minnesota All Payer Claims Database to conduct a population-level analysis of telemedicine service provision from 2010 to 2015. Variations in provision by coverage type, provider type, and rurality of patient residence were documented. During the 2010-15 period, the number of telemedicine visits increased enormously; rates of use varied by coverage type and location. Telemedicine visits in metropolitan areas were usually direct-to-consumer services covered by commercial insurance and provided by nurse practitioners or physician assistants, while telemedicine use in nonmetropolitan areas was more often real-time provider-initiated, publicly insured services. The researchers conclude that expanded coverage and increased provider reimbursement for telemedicine services could lead to expanded use of telemedicine and new approaches to reach new patient populations.
AHRQ-funded; HS026088.
Citation: Yu J, Mink PJ, Huckfeldt PJ .
Population-level estimates of telemedicine service provision using an all-payer claims database.
Health Aff 2018 Dec;37(12):1931-39. doi: 10.1377/hlthaff.2018.05116..
Keywords: Health Information Technology (HIT), Health Insurance, Payment, Telehealth
Chudy-Onwugaje K, Abutaleb A, Buchwald A
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
This study researched the association between age and increased depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease (IBD). It was found that patients 40 and older had worse adherence than patients younger than 40 with depressive symptoms.
AHRQ-funded; HS018975.
Citation: Chudy-Onwugaje K, Abutaleb A, Buchwald A .
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
Inflamm Bowel Dis 2018 Nov 29;24(12):2648-54. doi: 10.1093/ibd/izy194..
Keywords: Chronic Conditions, Depression, Digestive Disease and Health, Patient Adherence/Compliance, Patient Self-Management, Telehealth
Jonassaint CR, Kang C, Abrams DM
Understanding patterns and correlates of daily pain using the Sickle cell disease Mobile Application to Record Symptoms via Technology (SMART).
The authors used a mobile e-diary app to describe day-to-day patterns in sickle cell disease (SCD)-related pain symptoms and to identify the clinical and demographic factors associated with differences in daily pain level among adult patients with SCD. They suggest that future studies of the app would benefit from implementation of strategies to increase engagement. They also conclude that, despite a limited sample size, this study provides strong evidence supporting the use of mobile technology for measuring daily pain and symptoms in SCD.
AHRQ-funded; HS023989.
Citation: Jonassaint CR, Kang C, Abrams DM .
Understanding patterns and correlates of daily pain using the Sickle cell disease Mobile Application to Record Symptoms via Technology (SMART).
Br J Haematol 2018 Oct;183(2):306-08. doi: 10.1111/bjh.14956..
Keywords: Chronic Conditions, Health Information Technology (HIT), Pain, Sickle Cell Disease, Telehealth
Abutaleb A, Buchwald A, Chudy-Onwugaje K
Inflammatory bowel disease telemedicine clinical trial: impact of educational text messages on disease-specific knowledge over 1 year.
The authors aimed to determine if delivery of educational messages through a telemedicine system improves inflammatory bowel disease (IBD) knowledge. They found that, although telemedicine improves IBD-specific knowledge through text messaging, telemedicine is not superior to education given through standard visits at referral centers.
AHRQ-funded; HS018975.
Citation: Abutaleb A, Buchwald A, Chudy-Onwugaje K .
Inflammatory bowel disease telemedicine clinical trial: impact of educational text messages on disease-specific knowledge over 1 year.
Inflamm Bowel Dis 2018 Sep 15;24(10):2191-97. doi: 10.1093/ibd/izy149..
Keywords: Telehealth, Health Information Technology (HIT), Digestive Disease and Health, Education: Patient and Caregiver, Health Literacy, Quality of Life
Auger KA, Shah SS, Tubbs-Cooley HL
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
The purpose of this study was to determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. The investigators concluded that although postdischarge nurse contact did not decrease the reutilization rate of postdischarge urgent health care services, the method showed promise to bolster postdischarge education.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Tubbs-Cooley HL .
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
JAMA Pediatr 2018 Sep;172(9):e181482. doi: 10.1001/jamapediatrics.2018.1482..
Keywords: Care Coordination, Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Healthcare Delivery, Healthcare Utilization, Hospital Discharge, Outcomes, Provider, Provider: Nurse, Telehealth, Transitions of Care
Moreno A, Schwamm LH, Siddiqui KA
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
This study investigated the association of a strong hub-spoke hospital connection with improved spoke hospital performance for acute ischemic stroke patients associated with the Massachusetts General Hospital Telestroke Network. Investigators identified 375 patients treated with tPA by conventional or telestroke methods from 2006-2015 with 16 spoke hospitals. There was a positive association between more frequent contact between a telestroke spoke and its hub and faster tPA delivery for patients.
AHRQ-funded; HS024561.
Citation: Moreno A, Schwamm LH, Siddiqui KA .
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
Telemed J E Health 2018 Sep;24(9):678-83. doi: 10.1089/tmj.2017.0252..
Keywords: Health Information Technology (HIT), Hospitals, Provider Performance, Quality of Care, Stroke, Telehealth
Badawy SM, Cronin RM, Hankins J
Patient-centered eHealth Interventions for children, adolescents, and adults with sickle cell disease: systematic review.
In this study, researchers systematically evaluated the most recent evidence in the literature to (1) review the different types of technological tools used for self-management of sickle cell disease, (2) discover and describe what self-management activities these tools were used for, and (3) assess the efficacy of these technologies in self-management. They concluded that despite the promising feasibility and acceptability of eHealth interventions in improving self-management of sickle cell disease, the evidence overall is modest.
AHRQ-funded; HS023011.
Citation: Badawy SM, Cronin RM, Hankins J .
Patient-centered eHealth Interventions for children, adolescents, and adults with sickle cell disease: systematic review.
J Med Internet Res 2018 Jul 19;20(7):e10940. doi: 10.2196/10940..
Keywords: Children/Adolescents, Health Information Technology (HIT), Patient-Centered Healthcare, Sickle Cell Disease, Telehealth
Lakshminarayan K, Westberg S, Northuis C
A mHealth-based care model for improving hypertension control in stroke survivors: pilot RCT.
Hypertension (HTN) is significantly under-treated in stroke survivors. The study authors examined usability and efficacy of a mHealth -based care model for improving post-stroke HTN control. They concluded that a mHealth-based HTN care model had excellent usability and provided better HTN control than usual care in stroke survivors.
AHRQ-funded; HS021794.
Citation: Lakshminarayan K, Westberg S, Northuis C .
A mHealth-based care model for improving hypertension control in stroke survivors: pilot RCT.
Contemp Clin Trials 2018 Jul;70:24-34. doi: 10.1016/j.cct.2018.05.005..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Stroke, Cardiovascular Conditions
Regenhardt RW, Mecca AP, Flavin SA
Delays in the air or ground transfer of patients for endovascular thrombectomy.
This study’s objective was to examine associations between transfer time, modes of transfer, endovascular therapy (ET), and outcomes within a hub-and-spoke telestroke network. Results showed an association between longer transfer time and decreased likelihood of undergoing ET. Nocturnal transfers were associated with a substantial delay relative to daytime transfers. In contrast, delivery of tPA was not associated with delays, underscoring the impact of effective protocols at spoke hospitals. More efficient transfer may enable higher ET treatment rates.
AHRQ-funded; HS024561.
Citation: Regenhardt RW, Mecca AP, Flavin SA .
Delays in the air or ground transfer of patients for endovascular thrombectomy.
Stroke 2018 Jun;49(6):1419-25. doi: 10.1161/strokeaha.118.020618.
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Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Telehealth, Transitions of Care, Stroke
Yellowlees P, Burke Parish M, Gonzalez A
Asynchronous telepsychiatry: a component of stepped integrated care.
The article reports findings from a clinical trial comparing asynchronous telepsychiatry (ATP) with synchronous telepsychiatry (STP) consultations. Patients were randomly assigned to either an ATP or STP treatment group, and data on clinical outcomes, economic information, and patient satisfaction collected at intervals. The authors conclude that ATP implementation in existing integrated behavioral healthcare models might increase efficiency in mental healthcare.
AHRQ-funded; HS021477.
Citation: Yellowlees P, Burke Parish M, Gonzalez A .
Asynchronous telepsychiatry: a component of stepped integrated care.
Telemed J E Health 2018 May;24(5):375-78. doi: 10.1089/tmj.2017.0103..
Keywords: Behavioral Health, Health Information Technology (HIT), Patient-Centered Healthcare, Telehealth
Stringer KL, Azuero A, Ott C
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
The purpose of this study was to present feasibility and acceptability data on the use of an electronic adherence monitor (EAM) among African American women in remote areas of the Southeastern United States with HIV and co-occurring depression. EAM and self-reported antiretroviral therapy (ART) adherence was monitored among 25 participants recruited at four HIV clinics in Alabama. Intra-class correlation showed a low degree of concordance between EAM and self-reported adherence. 83% of data collected via EAM was transmitted in real-time; the remainder was delayed though technological failures or was lost entirely. The authors conclude that EAM monitoring is feasible in a rural US setting but that technological difficulties may impede the device's usefulness for just-in-time adherence interventions.
AHRQ-funded; HS013852.
Citation: Stringer KL, Azuero A, Ott C .
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
AIDS Behav 2018 May;23(5):1306-14. doi: 10.1007/s10461-018-2322-z..
Keywords: Depression, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Rural Health, Telehealth, Women
Couture B, Lilley E, Chang F
Applying user-centered design methods to the development of an mHealth application for use in the hospital setting by patients and care partners.
This article describes user-centered design methods and results for developing the patient and family facing user interface and functionality of MySafeCare, a safety reporting tool for hospitalized patients and their family members. Results showed that user-centered design should focus on workflow functionality, terminology, and user interface issues for mHealth applications.
AHRQ-funded; HS023535.
Citation: Couture B, Lilley E, Chang F .
Applying user-centered design methods to the development of an mHealth application for use in the hospital setting by patients and care partners.
Appl Clin Inform 2018 Apr;9(2):302-12. doi: 10.1055/s-0038-1645888..
Keywords: Telehealth, Health Information Technology (HIT), Hospitals, Caregiving
Molfenter T, Brown R, O'Neill A
Use of telemedicine in addiction treatment: current practices and organizational implementation characteristics.
Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations. The top three self-reported telemedicine applications being used were (1) computerized screening/assessments (44.6 percent), (2) telephone-based recovery supports (29.5 percent), and (3) telephone-based therapy (28.37 percent).
AHRQ-funded; HS024086.
Citation: Molfenter T, Brown R, O'Neill A .
Use of telemedicine in addiction treatment: current practices and organizational implementation characteristics.
Int J Telemed Appl. 2018 Mar 11;2018:3932643. doi: 10.1155/2018/3932643. .
Keywords: Health Information Technology (HIT), Substance Abuse, Telehealth
Gunter RL, Fernandes-Taylor S, Rahman S
Feasibility of an image-based mobile health protocol for postoperative wound monitoring.
Many surgical site infections (SSIs) develop in the postdischarge period and are inadequately recognized by patients. To address this, the authors developed a mobile health protocol of remote wound monitoring using smartphone technology. The current study aims to establish its feasibility among patients and providers. It found that participant and provider satisfaction was universally high.
AHRQ-funded; HS023395.
Citation: Gunter RL, Fernandes-Taylor S, Rahman S .
Feasibility of an image-based mobile health protocol for postoperative wound monitoring.
J Am Coll Surg 2018 Mar;226(3):277-86. doi: 10.1016/j.jamcollsurg.2017.12.013.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Telehealth, Patient Safety, Health Information Technology (HIT)
Hantsoo L, Criniti S, Khan A
A mobile application for monitoring and management of depressed mood in a vulnerable pregnant population.
The researchers tested whether a mood tracking and alert (MTA) mobile application (app) improved mental health care delivery in a high-risk obstetric population. They found that a mobile MTA app improved service delivery and patient engagement among patients with perinatal depression symptoms.
AHRQ-funded; HS022441.
Citation: Hantsoo L, Criniti S, Khan A .
A mobile application for monitoring and management of depressed mood in a vulnerable pregnant population.
Psychiatr Serv 2018 Jan;69(1):104-07. doi: 10.1176/appi.ps.201600582.
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Keywords: Healthcare Delivery, Depression, Pregnancy, Telehealth, Vulnerable Populations