National Healthcare Quality and Disparities Report
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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
26 to 50 of 135 Research Studies DisplayedAnderson AC, Akre E, Chen J
Exploring national trends of patient- and family-centered care among US children.
This study examined national trends in the receipt of high-quality patient-physician communication and patient empowerment through behavioral health counseling among children in the United States. They used Medical Expenditure Panel Survey (MEPS) data from 2010 to 2014. Two measures of patient- and family-centered care (PFCC) were analyzed: 1) a composite measure of high-quality patient-physician communication, and 2) patient empowerment through behavioral health counseling about healthy eating and exercise. There were high rates of receiving high-quality physician-patient communication (92-93%) as opposed to behavioral counseling about healthy eating (53-60%) and exercise (37-42%). There was a higher rate of high-quality physician-patient communication in 2014 than in 2010, but there was not a similar increase in receiving behavioral health counseling. Lower odds of receiving behavioral health counseling were found for parents with low income and low educational attainment as well as lack of insurance.
AHRQ-funded; HS022135.
Citation: Anderson AC, Akre E, Chen J .
Exploring national trends of patient- and family-centered care among US children.
J Child Health Care 2019 Jun;23(2):200-12. doi: 10.1177/1367493518786015..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Clinician-Patient Communication, Communication, Patient and Family Engagement, Patient-Centered Outcomes Research, Family Health and History, Lifestyle Changes
Gibbs BB, Tudorascu D, Bryce CL
Lifestyle habits associated with weight regain after intentional loss in primary care patients participating in a randomized trial.
This study examined lifestyle habits associated with weight regain at 6 and 24 months after intentional loss in primary care patients. This randomized trial used adult primary care patients who had a recent weight loss of at least 5%. Lifestyle habits measured using the Connor Diet Habit Survey included consumption of low-fat foods, fish, desserts, sugary beverages, fruits and vegetables and eating at restaurants; moderate-vigorous physical activity by self-report; steps recorded on a pedometer; and sedentary behavior by self-report. Participants had a mean age of 53.4 years, were 26% male and 88% white. Overall, they maintained weight loss at 6 months, but began to regain weight at 24 months. The habits most attributed to weight regain included more eating at restaurants, less fish consumption, and less physical activity. More sedentary behavior was associated with weight regain at 6 months, and reduced consumption of low-fat foods and more desserts and sugary beverages were associated with weight regain at 24 months.
AHRQ-funded; HS021162.
Citation: Gibbs BB, Tudorascu D, Bryce CL .
Lifestyle habits associated with weight regain after intentional loss in primary care patients participating in a randomized trial.
J Gen Intern Med 2020 Nov;35(11):3227-33. doi: 10.1007/s11606-020-06056-x..
Keywords: Obesity: Weight Management, Obesity, Lifestyle Changes, Primary Care, Nutrition
Rundle AG, Chen Y, Quinn JW
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. In this study, the Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area.
AHRQ-funded; HS026120.
Citation: Rundle AG, Chen Y, Quinn JW .
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
J Urban Health 2019 Aug;96(4):583-90. doi: 10.1007/s11524-019-00370-4
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Keywords: Urban Health, Lifestyle Changes, Health Status, Social Determinants of Health
Brown SD, Fotuhi O, Grijalva CS
A randomized study of values affirmation to promote interest in diabetes prevention among women with a history of gestational diabetes.
The purpose of this study was to test whether two interventions promote interest in diabetes prevention among women with a history of gestational diabetes mellitus. The researchers designed an email outreach message incorporating ‘values affirmation,’ a theory-based intervention, and promoting an existing preventive lifestyle program. Selected patients were randomized to read an outreach message containing either no affirmation (control) or 1 of 2 affirmations. Results showed that participants randomized to the values affirmation more frequently demonstrated interest in the lifestyle program and sought information about diabetes prevention, while the parenting affirmation yielded no significant differences in either outcome.
AHRQ-funded; HS019367.
Citation: Brown SD, Fotuhi O, Grijalva CS .
A randomized study of values affirmation to promote interest in diabetes prevention among women with a history of gestational diabetes.
Med Care 2019 Jul;57(7):528-35. doi: 10.1097/mlr.0000000000001133..
Keywords: Diabetes, Chronic Conditions, Pregnancy, Women, Health Promotion, Prevention, Lifestyle Changes
Kalkhoran S, Thorndike AN, Rigotti NA
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
This study compared current smoking and quitting-related characteristics of low-income US adults with and without serious mental illness (SMI) who received healthcare at federally funded health centers. Using data from the Health Center Patient Survey, researchers concluded that the lower quit ratio in the SMI population suggests that advice alone is unlikely to be sufficient. They recommend augmented strategies to promote smoking cessation and to reduce the excess burden of tobacco-related disease in patients with SMI.
AHRQ-funded; HS025378.
Citation: Kalkhoran S, Thorndike AN, Rigotti NA .
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
J Gen Intern Med 2019 Jun;34(6):986-91. doi: 10.1007/s11606-019-04857-3..
Keywords: Behavioral Health, Lifestyle Changes, Low-Income, Tobacco Use, Vulnerable Populations
Derose KP, Williams MV, Florez KR
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
The purpose of this study was to implement a multilevel, church-based intervention with diverse disparity populations using community-based participatory research and evaluate feasibility, acceptability, and preliminary effectiveness in improving obesity-related outcomes. The investigators concluded that the intervention resulted in small improvements in obesity outcomes. They assert that a longer time line is needed to fully implement and assess effects of community and congregation environmental strategies and to allow for potential larger impacts of the intervention.
AHRQ-funded; HS000046.
Citation: Derose KP, Williams MV, Florez KR .
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
Am J Health Promot 2019 May;33(4):586-96. doi: 10.1177/0890117118813333..
Keywords: Lifestyle Changes, Nutrition, Obesity, Outcomes, Racial and Ethnic Minorities
Kazemi DM, Borsari B, Levine MJ
Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking.
The authors developed a smartphone application (SmarTrek) that targets college students and aims to reduce risky alcohol use. They found that the majority of participants agreed that SmarTrek was easy to use and that the information provided was useful and had a positive effect on decreasing their drinking.
AHRQ-funded; HS023875.
Citation: Kazemi DM, Borsari B, Levine MJ .
Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking.
Psychol Serv 2019 May;16(2):255-59. doi: 10.1037/ser0000310..
Keywords: Alcohol Use, Behavioral Health, Lifestyle Changes, Health Information Technology (HIT), Substance Abuse, Telehealth, Young Adults
Hoffman SA, Ledford G, Cameron KA
A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.
This study examined perceived social and environmental barriers and encouragers for patients undergoing knee replacement surgery who are overweight or obese. Twenty patients were surveyed about factors that helped or hindered healthy behaviors. Many mentioned availability of healthy food, attending social gatherings, social support, and the weather.
AHRQ-funded; HS023011.
Citation: Hoffman SA, Ledford G, Cameron KA .
A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.
J Clin Nurs 2019 Apr;28(7-8):1156-63. doi: 10.1111/jocn.14719..
Keywords: Lifestyle Changes, Nutrition, Orthopedics, Surgery
Baskind MJ, Taveras EM, Gerber MW
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. In this study, the investigators studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. The investigators found that among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity.
AHRQ-funded; HS024332; HS022986.
Citation: Baskind MJ, Taveras EM, Gerber MW .
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Prev Chronic Dis 2019 Mar 28;16:E39. doi: 10.5888/pcd16.180368..
Keywords: Children/Adolescents, Family Health and History, Lifestyle Changes, Obesity, Obesity: Weight Management, Risk, Stress
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Whooten R, Kerem L, Stanley T
Physical activity in adolescents and children and relationship to metabolic health.
The purpose of this review was to summarize recent developments relating to the role of physical activity in insulin resistance and increased metabolic health in children and adolescents. Recent findings confirm the role of physical activity in decreasing insulin resistance and metabolic syndrome, but the authors note that the current literature is limited by unstandardized research methods and definitions. Future research that addresses these issues in order to offer targeted physical activity interventions is recommended.
AHRQ-funded; HS000063.
Citation: Whooten R, Kerem L, Stanley T .
Physical activity in adolescents and children and relationship to metabolic health.
Curr Opin Endocrinol Diabetes Obes 2019 Feb;26(1):25-31. doi: 10.1097/med.0000000000000455..
Keywords: Children/Adolescents, Diabetes, Lifestyle Changes, Obesity, Obesity: Weight Management
Echeverria SE, Divney A, Rodriguez F
Nativity and occupational determinants of physical activity participation among Latinos.
This study examined associations of race/ethnicity; nativity; and leisure-time, transportation, and occupation-related physical activity among Latino and non-Latino white adults. Using National Health and Nutrition Examination Survey self-reported data, results showed variability in the relationship between nativity and the physical activity domain Latinos engage in compared with non-Latino whites, with occupation contributing substantially to meeting physical activity recommendations for all population groups.
AHRQ-funded; HS000066.
Citation: Echeverria SE, Divney A, Rodriguez F .
Nativity and occupational determinants of physical activity participation among Latinos.
Am J Prev Med 2019 Jan;56(1):84-92. doi: 10.1016/j.amepre.2018.07.036..
Keywords: Lifestyle Changes, Racial and Ethnic Minorities, Social Determinants of Health
Badawy SM, Payne AB, Rodeghier MJ
Exercise capacity and clinical outcomes in adults followed in the Cooperative Study of Sickle Cell Disease (CSSCD).
The purpose of this study was to determine the factors associated with exercise capacity in adults with sickle cell disease (SCD) and its relationship to hospitalizations and mortality. The investigators asserted that prospective studies are needed to further evaluate the impact of regular exercise and improved fitness on clinical outcomes and mortality in SCD.
AHRQ-funded; HS023011.
Citation: Badawy SM, Payne AB, Rodeghier MJ .
Exercise capacity and clinical outcomes in adults followed in the Cooperative Study of Sickle Cell Disease (CSSCD).
Eur J Haematol 2018 Oct;101(4):532-41. doi: 10.1111/ejh.13140..
Keywords: Sickle Cell Disease, Lifestyle Changes
Sterling MR, Silva AF, Robbins L
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
This qualitative study examined the role of numeracy (basic number skills) in the management of patients with heart failure (HF). Thirty men and women aged 47-89 years with a history of HF were recruited from an urban academic primary care practice. Participants all had a history of HF within the past year, were seen at the practice within the last year, and had been hospitalized for HF within the last 6 months. They were interviewed about their numeracy to help manage monitoring weight, maintaining a low-salt diet, and monitoring blood pressure. A wide range of knowledge and understanding was found and fear served as a barrier and facilitator to carrying out HF self-care tasks involving numbers. If the patient has a caregiver who also lacks those skills or does not have HF care training, patients may not be managing their HF as well as they should.
AHRQ-funded; HS000066.
Citation: Sterling MR, Silva AF, Robbins L .
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
BMJ Open 2018 Sep 19;8(9):e023073. doi: 10.1136/bmjopen-2018-023073..
Keywords: Patient Self-Management, Education: Patient and Caregiver, Care Management, Heart Disease and Health, Nutrition, Lifestyle Changes, Obesity: Weight Management, Obesity, Blood Pressure, Cardiovascular Conditions
Kline CE, Burke LE, Sereika SM
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
This study examined the relationship between weight change and obstructive sleep apnea (OSA) in the context of behavioral weight loss intervention. A total of 114 adults who were overweight or obese participated in a 12-month behavioral weight loss intervention program from April 2012 to February 2015. Over half (58%) had OSA at the baseline. Those with OSA were found to lose less weight and were less adherent to daily calorie and activity goals. The results suggest that OSA screening should be used before attempting weight loss and also may indicate additional behavioral counseling.
AHRQ-funded; HS022989.
Citation: Kline CE, Burke LE, Sereika SM .
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
Mayo Clin Proc 2018 Sep;93(9):1290-98. doi: 10.1016/j.mayocp.2018.04.026..
Keywords: Sleep Problems, Obesity: Weight Management, Obesity, Lifestyle Changes, Respiratory Conditions
Bailey SR, Stevens VJ, Fortmann SP
Long-term outcomes from repeated smoking cessation assistance in routine primary care.
This study assessed the importance of primary care support for smokers trying to quit. This retrospective, observational cohort study followed over 33,000 patients at six diverse health systems over 4 years. Long-term quit (LTQ) status (longer than 365 days) was measured, and it was determined that frequent visits (more than 75% of visits) had almost 3 times the success than patients who visited less than 25%.
AHRQ-funded; HS019828.
Citation: Bailey SR, Stevens VJ, Fortmann SP .
Long-term outcomes from repeated smoking cessation assistance in routine primary care.
Am J Health Promot 2018 Sep;32(7):1582-90. doi: 10.1177/0890117118761886..
Keywords: Comparative Effectiveness, Lifestyle Changes, Outcomes, Patient-Centered Outcomes Research, Primary Care, Tobacco Use
Barone Gibbs B, Kline CE
When does sedentary behavior become sleep? A proposed framework for classifying activity during sleep-wake transitions.
The Sedentary Behavior Research Network recently published a consensus definition for sedentary. The authors of this paper indicated that further clarity around issues of classifying sedentary behavior while in bed is needed, specifically during sleep-wake transitions. In this paper they propose a framework for classifying activity during sleep-wake transitions.
AHRQ-funded; HS021162.
Citation: Barone Gibbs B, Kline CE .
When does sedentary behavior become sleep? A proposed framework for classifying activity during sleep-wake transitions.
Int J Behav Nutr Phys Act 2018 Aug 22;15(1):81. doi: 10.1186/s12966-018-0712-2..
Keywords: Lifestyle Changes, Sleep Problems
Wong MS, Roberts ET, Arnold CM
HUD housing assistance and levels of physical activity among low-income adults.
The objective of this study was to assess whether participation in HUD housing assistance programs was associated with increased physical activity among low-income adults. The investigators found that receiving HUD housing assistance was associated with being physically active among nonsenior low-income adults.
AHRQ-funded; HS000029.
Citation: Wong MS, Roberts ET, Arnold CM .
HUD housing assistance and levels of physical activity among low-income adults.
Prev Chronic Dis 2018 Jul 19;15:E94. doi: 10.5888/pcd15.170517..
Keywords: Lifestyle Changes, Low-Income, Vulnerable Populations
Hedderson MM, Brown SD, Ehrlich SF
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
The purpose of this study was to evaluate whether a tailored letter improved gestational weight gain (GWG) and whether GWG mediated a multicomponent intervention's effect on postpartum weight retention among women with gestational diabetes mellitus (GDM). The authors concluded that a tailored electronic health record-based letter improved GWG, which mediated the effect of a multicomponent intervention in reducing postpartum weight retention.
AHRQ-funded; HS019367.
Citation: Hedderson MM, Brown SD, Ehrlich SF .
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
Diabetes Care 2018 Jul;41(7):1370-77. doi: 10.2337/dc17-1133..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Lifestyle Changes, Patient-Centered Outcomes Research, Pregnancy, Women
Hanna RM, Fischer G, Conroy MB
Online lifestyle modification intervention: survey of primary care providers' attitudes and views.
The aim of this study was to evaluate the response of primary care providers (PCPs) to a referral model for implementing a year-long online intervention for weight loss to obese adult patients. The investigators suggest that understanding providers' views and barriers regarding the integration of online tools will facilitate widespread implementation of an online lifestyle modification intervention.
AHRQ-funded; HS018155.
Citation: Hanna RM, Fischer G, Conroy MB .
Online lifestyle modification intervention: survey of primary care providers' attitudes and views.
J Med Internet Res 2018 Jun 8;20(6):e167. doi: 10.2196/jmir.8616..
Keywords: Health Information Technology (HIT), Lifestyle Changes, Obesity, Primary Care, Provider
Sorkin DH, Rook KS, Campos B
AHRQ Author: Ngo-Metzger Q
Rationale and study protocol for Unidas por la Vida (United for Life): a dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters.
The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. Both the dyadic and individual lifestyle interventions are expected to produce greater weight loss at 6, 12, and 18 months than those in minimal intervention control group.
AHRQ-authored.
Citation: Sorkin DH, Rook KS, Campos B .
Rationale and study protocol for Unidas por la Vida (United for Life): a dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters.
Contemp Clin Trials 2018 Jun;69:10-20. doi: 10.1016/j.cct.2018.03.013.
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Keywords: Diabetes, Lifestyle Changes, Obesity, Racial and Ethnic Minorities, Obesity: Weight Management
Collins DM, Downer B, Kumar A
Impact of multiple chronic conditions on activity limitations among older Mexican-American care recipients.
The authors examined the impact of multiple chronic conditions on basic activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations. They found that care recipients with three or more chronic conditions had higher odds of having mobility limitations, self-care limitations, more than three ADL limitations, and more than three IADL limitations.
AHRQ-funded; HS022134.
Citation: Collins DM, Downer B, Kumar A .
Impact of multiple chronic conditions on activity limitations among older Mexican-American care recipients.
Prev Chronic Dis 2018 May 3;15:E51. doi: 10.5888/pcd15.170358.
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Keywords: Chronic Conditions, Elderly, Lifestyle Changes, Racial and Ethnic Minorities
Bachmann JM, Mayberry LS, Wallston KA
Relation of perceived health competence to physical activity in patients with coronary heart disease.
The authors evaluated the effect of perceived health competence--a patient's belief in his or her ability to achieve health-related goals--on cumulative physical activity levels in the Mid-South Coronary Heart Disease Cohort Study. They found that low perceived health competence was strongly associated with less physical activity in patients with coronary heart disease. They suggested that this may represent a potential target for behavioral interventions.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Mayberry LS, Wallston KA .
Relation of perceived health competence to physical activity in patients with coronary heart disease.
Am J Cardiol 2018 May 1;121(9):1032-38. doi: 10.1016/j.amjcard.2018.01.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Lifestyle Changes
Lieberman JA, Greenhawt M, Nowak-Wegrzyn A
The environment and food allergy.
The authors argue that, with the recent global increase in non-communicable inflammatory conditions, including atopic disorders and food allergy specifically, identification of the environmental modifiers of the genetic susceptibility and deciphering their mechanism of action are of utmost importance. This knowledge will enable mitigation of the impact of lifestyle and dietary changes, pollution, and global warming on the expression of genetic susceptibility to atopic disorders.
AHRQ-funded; HS024599.
Citation: Lieberman JA, Greenhawt M, Nowak-Wegrzyn A .
The environment and food allergy.
Ann Allergy Asthma Immunol 2018 May;120(5):455-57. doi: 10.1016/j.anai.2018.01.010.
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Keywords: Evidence-Based Practice, Lifestyle Changes, Nutrition