National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Arthritis (1)
- Behavioral Health (3)
- Children/Adolescents (5)
- Clinician-Patient Communication (1)
- Communication (1)
- Depression (1)
- Disabilities (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Family Health and History (2)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Health Status (1)
- Lifestyle Changes (3)
- Maternal Care (1)
- Medicare (1)
- Medication (2)
- Nutrition (2)
- Obesity (14)
- (-) Obesity: Weight Management (17)
- Outcomes (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (2)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Shared Decision Making (1)
- Surgery (5)
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 17 of 17 Research Studies DisplayedPersaud A, Castro I, Simione M
Multi-sector stakeholder's perceptions of determinants of successful implementation of a pediatric weight management intervention.
The objective of this study was to examine the perspectives of local, state, and national clinic and community stakeholders as an aid to developing successful pediatric weight management interventions (PWMI) in primary care and community settings, and to identify barriers and facilitators to implementation. Stakeholders in health centers and predominantly lower income, Hispanic community YMCAs were interviewed. Twenty-six of the stakeholders perceived formal curriculum with illustrative examples, patient- and family-centered programs, group visits, and high-quality multidisciplinary personnel to be components needed for a PWMI. These responses led to the creation of a group visit curriculum, implementation trainings, and cross-site collaborative technical assistance. The authors conclude that their findings highlight the importance of engaging multi-sector stakeholders during pre-implementation to ensure that valued components are included.
AHRQ-funded; HS022986; HS024332.
Citation: Persaud A, Castro I, Simione M .
Multi-sector stakeholder's perceptions of determinants of successful implementation of a pediatric weight management intervention.
Front Public Health 2022 Aug 25;10:954063. doi: 10.3389/fpubh.2022.954063..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity
Chao GF, Chhabra KR, Yang J
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
The purpose of this study was to compare safety and healthcare use after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. The researchers analyzed Medicare claims from 2012-2017 for 30,105 bariatric surgery patients receiving benefits due to age or disability and compared all outcomes between sleeve and bypass for each benefit group at 30 days, 1 year, and 3 years. The study found that among the disabled patients (n = 21,595), sleeve gastrectomy was associated with lower 3-year ED utilization, complications, reinterventions, rehospitalizations, and mortality. Cumulative expenditures were $46,277 after sleeve gastrectomy and $48,211 after gastric bypass. Among the elderly (n = 8510), sleeve was associated with lower 3-year ED utilization, complications, reinterventions, and rehospitalizations. Expenditures were $38,632 after sleeve gastrectomy and $39,270 after gastric bypass. Procedure treatment effect significantly differed by benefit group for paraesophageal hernia repair, revision, and mortality. The study concluded that healthcare utilization benefits of sleeve over bypass are maintained across Medicare elderly populations and Medicare disabled subpopulations.
AHRQ-funded; HS025778.
Citation: Chao GF, Chhabra KR, Yang J .
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
Ann Surg 2022 Jul 1;276(1):133-39. doi: 10.1097/sla.0000000000004526..
Keywords: Obesity: Weight Management, Obesity, Surgery, Medicare, Elderly, Disabilities
Huo T, Li Q, Cardel MI
AHRQ Author: Mistry K
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Crockett KB, Borgatti A, Tan F
Weight discrimination experienced prior to enrolling in a behavioral obesity intervention is associated with treatment response among Black and White adults in the Southeastern U.S.
This study examined the role that weight discrimination and race is associated with pre-treatment depressive symptoms. A cohort of Black and White adults were enrolled in a 16-week obesity intervention treatment (N = 271; mean BMI = 35.7 kg/m2); 59% Black; 92% women). They reported prior experiences of weight discrimination and completed the Center for Epidemiological Studies Depression (CES-D) Scale at baseline. Their weekly attendance at group sessions was recorded, and weight was measured at baseline and post-treatment. Participants with a history of weight discrimination scored 2.4 points higher on the CES-D and lost 2% less weight relative to those without weight discrimination. Race modified the association between weight discrimination and treatment session attendance, such that Black participants attended fewer sessions if they had prior experience of weight discrimination. However, this association was not true among White individuals.
AHRQ-funded; HS013852.
Citation: Crockett KB, Borgatti A, Tan F .
Weight discrimination experienced prior to enrolling in a behavioral obesity intervention is associated with treatment response among Black and White adults in the Southeastern U.S.
Int J Behav Med 2022 Apr;29(2):152-59. doi: 10.1007/s12529-021-10009-x..
Keywords: Obesity, Obesity: Weight Management, Behavioral Health, Racial and Ethnic Minorities, Depression
Chhabra KR, Telem DA, Chao GF
Comparative safety of sleeve gastrectomy and gastric bypass: an instrumental variables approach.
This study compared the safety of sleeve gastrectomy versus gastric bypass surgery. Sleeve gastrectomy has become the most common bariatric surgery, rising from 52.6% in 2012 to 75% in 2016 among the cohort of 38,153 patients identified using commercially insured patients in the IBM MarketScan claims database. At 2 years from surgery, patients undergoing sleeve gastrectomy had fewer re-interventions (sleeve 9.9%, bypass 15.6%) and complications (sleeve 6.6%, bypass 9.6%), and lower overall healthcare spending ($47,891 vs $55,213), than patients undergoing gastric bypass. However, at the 2-year mark, revisions were slightly more common in sleeve gastrectomy than in gastric bypass (sleeve 0.6%, bypass 0.4%).
AHRQ-funded; HS025778.
Citation: Chhabra KR, Telem DA, Chao GF .
Comparative safety of sleeve gastrectomy and gastric bypass: an instrumental variables approach.
Ann Surg 2022 Mar;275(3):539-45. doi: 10.1097/sla.0000000000004297..
Keywords: Obesity: Weight Management, Obesity, Surgery, Patient Safety
Howard R, Chao GF, Yang J
Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass.
The purpose of this comparative effectiveness research study was to evaluate prior laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass patients and compare the incidence of medication discontinuation and restart of diabetes, hypertension, and hyperlipidemia medications. The researchers reviewed the records of adult Medicare beneficiaries who underwent sleeve gastrectomy or gastric bypass between January 1, 2012, to December 31, 2018, and had a claim for diabetes, hypertension, or hyperlipidemia medication in the 6 months before surgery with a corresponding diagnosis. The study found that when compared with sleeve gastrectomy, gastric bypass was associated with a slightly higher 5-year cumulative incidence of medication discontinuation among 30,588 patients with diabetes medication use and diagnosis at the time of surgery, 5,081 patients with antihypertensive medication use and diagnosis at the time of surgery and 35,055 patients with lipid-lowering medication use and diagnosis at the time of surgery. Among the patients who discontinued medication, gastric bypass was also associated with a slightly lower incidence of medication restart up to 5 years after discontinuation. The researchers concluded that gastric bypass was associated with a slightly higher incidence of medication discontinuation and a slightly lower incidence of medication restart among patients who discontinued medication than sleeve gastrectomy.
AHRQ-funded; HS025778; HS025365.
Citation: Howard R, Chao GF, Yang J .
Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass.
JAMA Surg 2022 Mar;157(3):248-56. doi: 10.1001/jamasurg.2021.6898..
Keywords: Obesity, Obesity: Weight Management, Surgery, Medication
Berge JM, Truesdale KP, Sherwood NE
Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
This study examined the frequency of eating breakfast, lunch or dinner family meals and associations with pre-school children's overall diet quality and BMI percentile. The authors concluded that breakfast family meal frequency and total weekly family meal frequency were associated with healthier diet quality in non-Hispanic pre-school children but not in Hispanic children. Longitudinal research is needed to clarify the association between family meal type and child diet quality and BMI percentile.
AHRQ-funded; HS022990.
Citation: Berge JM, Truesdale KP, Sherwood NE .
Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
Public Health Nutr 2017 Dec;20(18):3275-84. doi: 10.1017/s1368980017002348..
Keywords: Children/Adolescents, Family Health and History, Nutrition, Obesity: Weight Management, Racial and Ethnic Minorities
Robinson A, Fiechtner L, Roche B
Association of maternal gestational weight gain with the infant fecal microbiota.
The researchers aimed to examine associations of maternal gestational weight gain with infant fecal microbiota composition, bacterial community richness, and Shannon diversity index. Their prospective cohort study of healthy infants concluded that maternal gestational weight gain was associated with the infant fecal microbiota profiles, bacterial community richness, and Shannon diversity index.
AHRQ-funded; HS022986.
Citation: Robinson A, Fiechtner L, Roche B .
Association of maternal gestational weight gain with the infant fecal microbiota.
J Pediatr Gastroenterol Nutr 2017 Nov;65(5):509-15. doi: 10.1097/mpg.0000000000001566.
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Keywords: Maternal Care, Pregnancy, Obesity: Weight Management
Varban OA, Cassidy RB, Bonham A
Factors associated with achieving a body mass index of less than 30 after bariatric surgery.
This study identified predictors for achieving a BMI of less than 30 after bariatric surgery. Patients who had a sleeve gastrectomy, gastric bypass, or duodenal switch were more likely to achieve a BMI of less than 30 compared with those who underwent adjustable gastric banding. Only 8.5 percent of patients with a BMI greater than 50 achieved a BMI of less than 30 after bariatric surgery.
AHRQ-funded; HS023621.
Citation: Varban OA, Cassidy RB, Bonham A .
Factors associated with achieving a body mass index of less than 30 after bariatric surgery.
JAMA Surg 2017 Nov;152(11):1058-64. doi: 10.1001/jamasurg.2017.2348.
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Keywords: Health Status, Obesity, Outcomes, Obesity: Weight Management
Halbert CH, Jefferson M, Melvin CL
Provider advice about weight loss in a primary care sample of obese and overweight patients.
In this study the investigators examined receipt of provider advice to lose weight among primary care patients who were overweight and obese. The investigators found that patient beliefs about their weight status and perceptions about shared decision-making are important to receiving provider advice about weight loss/management among primary care patients.
AHRQ-funded; HS023047.
Citation: Halbert CH, Jefferson M, Melvin CL .
Provider advice about weight loss in a primary care sample of obese and overweight patients.
J Prim Care Community Health 2017 Oct;8(4):239-46. doi: 10.1177/2150131917715336..
Keywords: Shared Decision Making, Obesity, Obesity: Weight Management, Practice Patterns, Primary Care
Pellegrini CA, Song J, Semanik PA
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Semanik PA .
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
J Clin Rheumatol 2017 Oct;23(7):355-60. doi: 10.1097/rhu.0000000000000579..
Keywords: Obesity: Weight Management, Arthritis, Patient-Centered Outcomes Research, Surgery
Pellegrini CA, Ledford G, Hoffman SA
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss attempts as well as strategies used to facilitate behavior changes. It provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Ledford G, Hoffman SA .
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
BMC Musculoskelet Disord 2017 Aug 1;18(1):327. doi: 10.1186/s12891-017-1687-x.
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Keywords: Patient-Centered Healthcare, Surgery, Obesity, Obesity: Weight Management
Lv N, Azar KMJ, Rosas LG
Behavioral lifestyle interventions for moderate and severe obesity: a systematic review.
This study reviews evidence of behavioral lifestyle interventions for weight loss in this population. Evidence for the effectiveness of behavioral interventions versus pharmacological or surgical treatment was limited. Comprehensive and intensive behavioral interventions can result in clinically significant, albeit modest, weight loss in this obese subpopulation but may not result in significant improvements in other cardiometabolic risk factors.
AHRQ-funded; HS022702.
Citation: Lv N, Azar KMJ, Rosas LG .
Behavioral lifestyle interventions for moderate and severe obesity: a systematic review.
Prev Med 2017 Jul;100:180-93. doi: 10.1016/j.ypmed.2017.04.022.
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Keywords: Behavioral Health, Lifestyle Changes, Obesity, Obesity: Weight Management
Bossick AS, Barone C, Alexander GL
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
This study examined family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Providers recognize several challenges and barriers to discussing weight management in the well-child visit.
AHRQ-funded; HS022417.
Citation: Bossick AS, Barone C, Alexander GL .
Teen, parent, and clinician expectations about obesity and related conditions during the annual well-child visit.
J Patient Cent Res Rev 2017 Summer;4(3):114-24. doi: 10.17294/2330-0698.1444.
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Keywords: Children/Adolescents, Clinician-Patient Communication, Obesity, Obesity: Weight Management, Patient-Centered Healthcare
Aschbrenner KA, Mueser KT, Naslund JA
Facilitating partner support for lifestyle change among adults with serious mental illness: a feasibility pilot study.
The purpose of this pilot study was to explore the feasibility of an intervention designed to facilitate partner support for lifestyle change among overweight and obese adults with serious mental illness. After 12 weeks, approximately two-thirds of participants were below their baseline weight at follow-up, including 27 percent who achieved clinically significant weight loss.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Mueser KT, Naslund JA .
Facilitating partner support for lifestyle change among adults with serious mental illness: a feasibility pilot study.
Community Ment Health J 2017 May;53(4):394-404. doi: 10.1007/s10597-017-0100-4.
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Keywords: Family Health and History, Lifestyle Changes, Behavioral Health, Obesity, Obesity: Weight Management
Biener A, Cawley J, Meyerhoefer C
AHRQ Author: Biener A
The high and rising costs of obesity to the US health care system.
The purpose of this editorial is to provide new information on the medical care costs of obesity that help motivate various weight loss interventions. The editorial is a part of a special issue with articles examining behavioral, pharmacotherapy, and surgical interventions for weight loss, based on a 2016 conference on state-of-the-art weight management hosted by the Veterans Health Administration.
AHRQ-authored.
Citation: Biener A, Cawley J, Meyerhoefer C .
The high and rising costs of obesity to the US health care system.
J Gen Intern Med 2017 Apr;32(Suppl 1):6-8. doi: 10.1007/s11606-016-3968-8.
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Keywords: Obesity, Healthcare Costs, Obesity: Weight Management, Lifestyle Changes, Nutrition
Turer CB, Barlow SE, Montano S
Discrepancies in communication versus documentation of weight-management benchmarks: analysis of recorded visits with Latino children and associated health-record documentation.
To examine gaps in communication versus documentation of weight-management clinical practices, communication was recorded during primary care visits with 6- to 12-year-old overweight/obese Latino children. The researchers found that benchmarks were neither communicated nor documented in up to 42 percent of visits, and communicated but not documented or documented but not communicated in up to 20 percent of visits.
AHRQ-funded; HS022418.
Citation: Turer CB, Barlow SE, Montano S .
Discrepancies in communication versus documentation of weight-management benchmarks: analysis of recorded visits with Latino children and associated health-record documentation.
Glob Pediatr Health 2017 Feb 6;4:2333794x16685190. doi: 10.1177/2333794x16685190.
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Keywords: Children/Adolescents, Communication, Obesity, Primary Care, Obesity: Weight Management