National Healthcare Quality and Disparities Report
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Topics
- Cardiovascular Conditions (5)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Community-Based Practice (1)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Falls (1)
- Guidelines (1)
- Health Information Technology (HIT) (3)
- Heart Disease and Health (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (3)
- Lifestyle Changes (1)
- Maternal Care (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Self-Management (1)
- Pregnancy (1)
- Prevention (2)
- (-) Primary Care (13)
- Provider Performance (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (1)
- Research Methodologies (1)
- (-) Risk (13)
- Screening (1)
- Sexual Health (2)
- Shared Decision Making (1)
- Social Determinants of Health (2)
- Stroke (1)
- Telehealth (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urban Health (1)
- Vulnerable Populations (1)
- Women (1)
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 13 of 13 Research Studies DisplayedShear K, Rice H, Garabedian PM
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
The purpose of this study was to conduct usability testing of the ASPIRE fall risk management tool for use in divergent primary care clinics. Participants recruited from two sites with different electronic health records and clinical organizations used ASPIRE across two clinical scenarios; they rated ASPIRE usability as above average, based on usability benchmarks. Time spent on tasks decreased significantly between the first and second scenarios, indicating ease of learnability. The authors conclude that ASPIRE could be integrated into diverse organizations, since it allows a tailored implementation without the need to build a new system for each organization. ASPIRE is therefore well positioned to impact the challenge of falls at scale.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
Appl Clin Inform 2023 Mar;14(2):212-26. doi: 10.1055/a-2006-4936.
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Falls, Primary Care, Risk, Prevention
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation: Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Davidson KW, Krist AH, Tseng CW
AHRQ Author: Mills J, Borsky A
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
The authors assessed how social risks have been considered in USPSTF recommendation statements and identified current gaps in evidence needed to expand the systematic inclusion of social risks in future recommendations. They concluded that their report serves as a benchmark and foundation for ongoing work to advance the goal of ensuring that health equity and social risks are incorporated into USPSTF methods and recommendations.
AHRQ-authored.
Citation: Davidson KW, Krist AH, Tseng CW .
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
JAMA 2021 Oct 12;326(14):1410-15. doi: 10.1001/jama.2021.12833..
Keywords: U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Risk, Evidence-Based Practice, Research Methodologies, Guidelines
Richardson L, Parker EO, Zhou C
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
Health risk behaviors are the most common sources of morbidity among adolescents. Adolescent health guidelines (Guidelines for Preventive Services by the AMA and Bright Futures by the Maternal Child Health Bureau) recommend screening and counseling, but the implementation is inconsistent. This study aimed to test the efficacy of electronic risk behavior screening with integrated patient-facing feedback on the delivery of adolescent-reported clinician counseling and risk behaviors over time.
AHRQ-funded; HS023383.
Citation: Richardson L, Parker EO, Zhou C .
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
J Med Internet Res 2021 Mar 12;23(3):e24135. doi: 10.2196/24135..
Keywords: Children/Adolescents, Primary Care, Risk, Screening
Tuzzio L, O'Meara ES, Holden E
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
The uptake of cardiovascular disease risk calculators in primary care has been slow despite the recommendation in national cardiovascular disease prevention guidelines. Identifying the barriers to the implementation of cardiovascular disease risk calculators is essential for promoting their adoption. In this study, the authors qualitatively analyzed structured physician educator notes written during an outreach education intervention with 44 small- and medium-sized primary care clinics that participated in the Agency for Healthcare Research and Quality‒funded EvidenceNOW Healthy Hearts Northwest trial.
AHRQ-funded; HS023908.
Citation: Tuzzio L, O'Meara ES, Holden E .
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
Am J Prev Med 2021 Feb;60(2):250-57. doi: 10.1016/j.amepre.2020.07.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Risk, Evidence-Based Practice, Implementation
Cykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
AHRQ-funded; HS023912.
Citation: Cykert S, Keyserling TC, Pignone M .
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Makelarski JA, DePumpo M, Boyd K
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
The purpose of this study was to describe outcomes from implementation of a community resource referral system into small clinical practices to reduce cardiovascular disease risk. HealtheRx-H3, a printed list of resources for patients, was created. It was feasible to create practice-specific HealtheRx-H3s; however, systematic distribution of HealtheRx-H3s using digital electronic health record integration was found to be infeasible. Successful implementation of quality improvement strategies to systematize community resource referral solutions was feasible at small practices, but more research was recommended in order to understand what motivates small practices to participate in implementation of these solutions.
AHRQ-funded; HS023921.
Citation: Makelarski JA, DePumpo M, Boyd K .
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
J Healthc Qual 2020 Sep/Oct;42(5):278-86. doi: 10.1097/jhq.0000000000000234..
Keywords: Cardiovascular Conditions, Risk, Community-Based Practice, Patient Self-Management, Education: Patient and Caregiver, Primary Care, Implementation, Lifestyle Changes
Heller CG, Parsons AS, Chambers EC
Social risks among primary care patients in a large urban health system.
The objective of this study was to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. Participants across nineteen ambulatory sites in the Bronx, New York, completed a 10-item screener. Findings showed that there were important differences in the prevalence of overall and individual social risks by subgroup. These findings should be considered to inform clinical care and social risk screening and interventions.
AHRQ-funded; HS026396.
Citation: Heller CG, Parsons AS, Chambers EC .
Social risks among primary care patients in a large urban health system.
Am J Prev Med 2020 Apr;58(4):514-25. doi: 10.1016/j.amepre.2019.11.011..
Keywords: Social Determinants of Health, Primary Care, Urban Health, Risk, Vulnerable Populations
Parchman ML, Anderson ML, Dorr DA
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Researchers conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. They concluded that, although they found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Dorr DA .
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S40-s49. doi: 10.1370/afm.2407..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Provider Performance, Quality Measures, Quality of Care, Risk, Evidence-Based Practice, Patient-Centered Healthcare, Chronic Conditions
Fredericksen RJ, Walcott M, Yang FM
Circumstances surrounding high-risk sexual experiences among primary care patients living with and without HIV.
In this study, the investigators interviewed primary care patients living with and without HIV, regarding circumstances surrounding sexual risk behavior, to identify opportunities for providers to address and reduce STI risk. The investigators found that circumstances surrounding perceived STI exposure risk were diverse, often overlapping, and dependent on internal, environmental, and partner-related factors and inadequate communication. They suggest that meaningful care-based interventions regarding HIV/STI transmission behavior must address the diversity and interplay of these factors.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Walcott M, Yang FM .
Circumstances surrounding high-risk sexual experiences among primary care patients living with and without HIV.
J Gen Intern Med 2018 Dec;33(12):2163-70. doi: 10.1007/s11606-018-4675-4..
Keywords: Human Immunodeficiency Virus (HIV), Primary Care, Risk, Sexual Health
Fredericksen RJ, Mayer KH, Gibbons LE
Development and content validation of a patient-reported sexual risk measure for use in primary care.
The objective of this study was to develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. The SRBI is a brief, skip-patterned, clinically relevant measure that ascertains sexual risk behavior across sex, sexual orientation, gender identity, partner HIV serostatus, and partner treatment status, furnishing providers with context to determine gradations of risk for HIV/STI.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Mayer KH, Gibbons LE .
Development and content validation of a patient-reported sexual risk measure for use in primary care.
J Gen Intern Med 2018 Oct;33(10):1661-68. doi: 10.1007/s11606-018-4496-5..
Keywords: Primary Care, Risk, Sexual Health
Sanders BD, Davis MG, Holley SL
Pregnancy-associated stroke.
This article reviews assessment and treatment of pregnant and postpartum women experiencing stroke. There are 2 main types of stroke, ischemic and hemorrhagic that present similar symptoms but have very different pathophysiology and treatment. This article provides guidance for subsequent maternity and primary care for front-line perinatal care providers.
AHRQ-funded; HS024733.
Citation: Sanders BD, Davis MG, Holley SL .
Pregnancy-associated stroke.
J Midwifery Womens Health 2018 Jan;63(1):23-32. doi: 10.1111/jmwh.12720..
Keywords: Cardiovascular Conditions, Maternal Care, Pregnancy, Primary Care, Risk, Stroke, Women
Haas JS, Baer HJ, Eibensteiner K
A cluster randomized trial of a personalized multi-condition risk assessment in primary care.
This study evaluated whether collection of risk factors to generate electronic health record (EHR)-linked health risk appraisal (HRA) for coronary heart disease, diabetes, breast cancer, and colorectal cancer was associated with improved patient-provider communication, risk assessment, and plans for breast cancer screening. It concluded that patient-reported risk factors and EHR-linked multi-condition HRAs in primary care can modestly improve communication and promote accuracy of self-perceived risk.
AHRQ-funded; HS018644.
Citation: Haas JS, Baer HJ, Eibensteiner K .
A cluster randomized trial of a personalized multi-condition risk assessment in primary care.
Am J Prev Med 2017 Jan;52(1):100-05. doi: 10.1016/j.amepre.2016.07.013.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Clinician-Patient Communication, Risk