National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
- Alcohol Use (6)
- Ambulatory Care and Surgery (2)
- Anxiety (3)
- (-) Behavioral Health (92)
- Cancer (1)
- Care Coordination (2)
- Caregiving (3)
- Care Management (3)
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- Community Partnerships (1)
- Comparative Effectiveness (1)
- COVID-19 (2)
- Depression (19)
- Diagnostic Safety and Quality (4)
- Disparities (3)
- Education: Continuing Medical Education (2)
- Elderly (2)
- Electronic Health Records (EHRs) (4)
- Evidence-Based Practice (10)
- Guidelines (3)
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- Health Services Research (HSR) (2)
- Hepatitis (1)
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- Human Immunodeficiency Virus (HIV) (1)
- Implementation (6)
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- Medical Expenditure Panel Survey (MEPS) (2)
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- Opioids (12)
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- Patient Experience (1)
- Payment (2)
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- (-) Primary Care (92)
- Primary Care: Models of Care (12)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Racial and Ethnic Minorities (5)
- Research Methodologies (2)
- Rural/Inner-City Residents (1)
- Rural Health (4)
- Screening (14)
- Shared Decision Making (3)
- Sleep Problems (1)
- Substance Abuse (21)
- Telehealth (3)
- Tobacco Use (2)
- Training (5)
- Treatments (3)
- U.S. Preventive Services Task Force (USPSTF) (8)
- Women (1)
- Young Adults (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
51 to 75 of 92 Research Studies DisplayedRiley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Graham AK, Minc A, Staab E
Validation of the computerized adaptive test for mental health in primary care.
This study compared the use of a computerized assessment tool with paper questionnaires to diagnose major depressive disorder (MDD) and general anxiety disorder (GAD). It was found that the majority of patients in the study preferred the computerized adaptive testing tool. Diagnostic accuracy of the tool was similar or higher than many of the traditional screening methods.
AHRQ-funded; HS000078.
Citation: Graham AK, Minc A, Staab E .
Validation of the computerized adaptive test for mental health in primary care.
Ann Fam Med 2019 Jan;17(1):23-30. doi: 10.1370/afm.2316..
Keywords: Anxiety, Depression, Diagnostic Safety and Quality, Behavioral Health, Primary Care, Screening
Moise N, Falzon L, Obi M
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
Researchers investigated interventions for increasing depression treatment initiation in primary care settings. They found that collaborative/integrated care, preference treatment matching, and case management strategies had the best evidence for improving depression treatment initiation, but none of the strategies had high strength of evidence. While primary care settings can consider using some of these strategies when referring depressed patients to treatment, their review highlights the need for further rigorous research in this area.
AHRQ-funded; HS025198.
Citation: Moise N, Falzon L, Obi M .
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1978-89. doi: 10.1007/s11606-018-4554-z..
Keywords: Patient-Centered Healthcare, Depression, Primary Care, Behavioral Health, Patient and Family Engagement
Lapham GT, Lee AK, Caldeiro RM
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
This population-based study of primary care patients reports on the prevalence of common behavioral health conditions across cannabis use frequency. The investigators concluded that their study found a strong association between the frequency of cannabis use and tobacco use, depression symptoms, and other drug use, and as well as diagnosed mental health and substance use disorders.
AHRQ-funded; HS023173.
Citation: Lapham GT, Lee AK, Caldeiro RM .
Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington state.
J Gen Intern Med 2018 Nov;33(11):1833-35. doi: 10.1007/s11606-018-4558-8..
Keywords: Behavioral Health, Depression, Primary Care, Substance Abuse, Tobacco Use
Moise N, Shah RN, Essock S
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
This study examined sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State. The investigators used descriptive statistics to assess implementation metrics in sustaining vs. opt-out clinics and trends in implementation fidelity 1 and 2 years into the sustainability phase among sustaining clinics.
AHRQ-funded; HS025198
Citation: Moise N, Shah RN, Essock S .
Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State.
Implement Sci 2018 Oct 12;13(1):128. doi: 10.1186/s13012-018-0818-6..
Keywords: Care Coordination, Depression, Behavioral Health, Primary Care
Davis MM, Gunn R, Gowen LK
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
In this study, the authors examined, using qualitative methods, patients' experiences of care in integrated settings. The study included 24 patients receiving care across five practices participating in Advancing Care Together (ACT)-a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. The investigators found that patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Gowen LK .
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
Transl Behav Med 2018 Sep 8;8(5):649-59. doi: 10.1093/tbm/ibx001..
Keywords: Community-Based Practice, Healthcare Delivery, Behavioral Health, Patient Experience, Primary Care
Yonek JC, Jordan N, Dunlop D
Patient-centered medical home care for adolescents in need of mental health treatment.
The patient-centered medical home (PCMH) has emerged as an optimal primary care model for all youth; however, little is known about the extent to which adolescents in need of mental health (MH) treatment receive care consistent with the PCMH. This study assessed (1) 10-year trends in PCMH care among U.S. adolescents according to MH need and (2) variations in PCMH care and its subcomponents among adolescents with MH need, by individual and family characteristics.
AHRQ-funded; HS024183.
Citation: Yonek JC, Jordan N, Dunlop D .
Patient-centered medical home care for adolescents in need of mental health treatment.
J Adolesc Health 2018 Aug;63(2):172-80. doi: 10.1016/j.jadohealth.2018.02.006..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care
Jones AL, Cochran SD, Leibowitz A
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
The researchers sought to guide post-ACA efforts to address mental health service disparities, by using a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. They found that all racial/ethnic groups were less likely than non-Latino Whites to have any primary care (PC) visit. Their conclusion was that racial-, ethnic-, and nativity-associated disparities persist in PC provided mental health services.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Racial, ethnic, and nativity differences in mental health visits to primary care and specialty mental health providers: analysis of the Medical Expenditures Panel Survey, 2010-2015.
Healthcare 2018 Mar 22;6(2). doi: 10.3390/healthcare6020029.
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Keywords: Disparities, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Primary Care, Racial and Ethnic Minorities
Riley AR, Grennan A, Menousek K
Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.
The aim of this study was to investigate the relationships between psychologists' reported billing practices, reimbursement rates, and model of integration in pediatric primary care. Survey results showed a clear pattern of higher integration being associated with greater utilization of health & behavior codes and better reimbursement for consultation activities.
AHRQ-funded; HS022981.
Citation: Riley AR, Grennan A, Menousek K .
Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.
Fam Syst Health 2018 Mar;36(1):108-12. doi: 10.1037/fsh0000306..
Keywords: Behavioral Health, Children/Adolescents, Payment, Primary Care, Provider
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Shared Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Etter DJ, McCord A, Ouyang F
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. The authors concluded that incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care was feasible and well utilized by providers.
AHRQ-funded; HS022681.
Citation: Etter DJ, McCord A, Ouyang F .
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
J Adolesc Health 2018 Feb;62(2):191-97. doi: 10.1016/j.jadohealth.2017.08.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Depression, Behavioral Health, Primary Care, Screening
Hubley S, Uebelacker LA, Nash J
Open trial of integrated primary care consultation for medically unexplained symptoms.
In this study, a behavioral consultation intervention for primary care patients with medically unexplained symptoms (n = 10) was developed and assessed. Notwithstanding the limitations of open trial designs, the findings demonstrated high feasibility for a behavioral health consultation treatment model for patients with medically unexplained symptoms and highlight the need for further research.
AHRQ-funded; HS022401.
Citation: Hubley S, Uebelacker LA, Nash J .
Open trial of integrated primary care consultation for medically unexplained symptoms.
J Behav Health Serv Res 2017 Oct;44(4):590-601. doi: 10.1007/s11414-016-9528-5..
Keywords: Behavioral Health, Primary Care, Primary Care: Models of Care
Bailey SR, Heintzman JD, Marino M
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 Meaningful Use (MU) implementation. Its findings suggest that incentives for MU of electronic health records increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations.
AHRQ-funded; HS021522.
Citation: Bailey SR, Heintzman JD, Marino M .
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
Am J Prev Med 2017 Aug;53(2):192-200. doi: 10.1016/j.amepre.2017.02.006.
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Keywords: Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Primary Care, Tobacco Use
Grove LR, Olesiuk WJ, Ellis AR
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
This study examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007-2010. It concluded that medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence.
AHRQ-funded; HS019659; HS000032.
Citation: Grove LR, Olesiuk WJ, Ellis AR .
Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia.
Gen Hosp Psychiatry 2017 Jul;47:14-19. doi: 10.1016/j.genhosppsych.2017.03.002.
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Keywords: Medication, Behavioral Health, Patient-Centered Healthcare, Patient Adherence/Compliance, Primary Care
Clark KD, Miller BF, Green LA
Implementation of behavioral health interventions in real world scenarios: managing complex change.
This paper reports the change management strategies employed by practice leaders making changes to integrate care, as observed by independent investigators. It offers an empirically based set of actionable recommendations that are relevant to a range of leaders (policymakers, medical directors) and practice members who wish to effectively manage the complex changes associated with integrated primary care.
AHRQ-funded; HS022981.
Citation: Clark KD, Miller BF, Green LA .
Implementation of behavioral health interventions in real world scenarios: managing complex change.
Fam Syst Health 2017 Mar;35(1):36-45. doi: 10.1037/fsh0000239.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Primary Care, Implementation, Organizational Change, Healthcare Delivery
Balasubramanian BA, Cohen DJ, Jetelina KK
Outcomes of integrated behavioral health with primary care.
The objective of this study was to evaluate the effects of integrated care, adapted to local contexts, on depression severity and patients' experience of care. It found that integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients' experience of care.
AHRQ-funded; HS022981.
Citation: Balasubramanian BA, Cohen DJ, Jetelina KK .
Outcomes of integrated behavioral health with primary care.
J Am Board Fam Med 2017 Mar-Apr;30(2):130-39. doi: 10.3122/jabfm.2017.02.160234.
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Keywords: Behavioral Health, Community Partnerships, Patient-Centered Outcomes Research, Primary Care
Richardson LP, McCarty CA, Radovic A
Research in the integration of behavioral health for adolescents and young adults in primary care settings: a systematic review.
Adolescents and young adults with mental health conditions have some of the lowest rates of treatment for their conditions of all age groups.. In this paper, the authors review the current research literature for behavioral health integration in the adolescent and young adult population and make recommendations for needed research to move the field forward.
AHRQ-funded; HS022989.
Citation: Richardson LP, McCarty CA, Radovic A .
Research in the integration of behavioral health for adolescents and young adults in primary care settings: a systematic review.
J Adolesc Health 2017 Mar;60(3):261-69. doi: 10.1016/j.jadohealth.2016.11.013.
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Keywords: Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care, Young Adults
Fulford D, Tuot DS, Mangurian C
Electronic psychiatric consultation in primary care in the safety net.
The authors examined the feasibility and acceptability of implementing a psychiatric eReferral program in a publicly funded, community-based primary care clinic in San Francisco staffed by eight primary care practitioners (PCPs). They found feasibility and acceptability of implementing an integrated electronic psychiatry consultation and referral service in a community-based primary care clinic and recommended future trials designed to examine the impact of this type of service on the delivery of high-quality mental health care and its cost-effectiveness in a safety-net health care system.
AHRQ-funded; HS021700.
Citation: Fulford D, Tuot DS, Mangurian C .
Electronic psychiatric consultation in primary care in the safety net.
Psychiatr Serv 2016 Oct;67(10):1160-61. doi: 10.1176/appi.ps.671003.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Behavioral Health, Primary Care, Health Information Technology (HIT)
Biegler K, Mollica R, Sim SE
AHRQ Author: Ngo-Metzger Q
Rationale and study protocol for a multi-component health information technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.
The authors described the rationale and protocol of a clustered randomized controlled trial to test the effectiveness of a health information technology (HIT) intervention that provides a multi-component approach to delivering culturally competent mental health care in the primary care setting. They expect the outcomes to include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder. They suggest that this technology has the potential to be adapted in order to facilitate mental health screening and treatment in the primary care setting.
AHRQ-authored.
Citation: Biegler K, Mollica R, Sim SE .
Rationale and study protocol for a multi-component health information technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.
Contemp Clin Trials 2016 Sep;50:66-76. doi: 10.1016/j.cct.2016.07.001.
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Keywords: Health Information Technology (HIT), Behavioral Health, Depression, Screening, Primary Care
Kennedy-Hendricks A, Busch SH, McGinty EE
Primary care physicians' perspectives on the prescription opioid epidemic.
The authors aimed to determine primary care physicians' perceptions of the seriousness of the prescription opioid epidemic, its causes, groups responsible for addressing it, attitudes toward individuals with prescription opioid use disorder, beliefs about the effectiveness of addiction treatments, and support for various policies. They found that respondents largely attributed the causes to individual-oriented factors and certain physician-oriented factors, and that respondents believed that individuals with prescription opioid use disorder and physicians were primarily responsible for addressing the problem. The researchers also found that negative attitudes toward people with prescription opioid use disorder were prevalent, but a majority believed that treatment could be effective.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Busch SH, McGinty EE .
Primary care physicians' perspectives on the prescription opioid epidemic.
Drug Alcohol Depend 2016 Aug 1;165:61-70. doi: 10.1016/j.drugalcdep.2016.05.010.
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Keywords: Behavioral Health, Medication, Opioids, Primary Care, Substance Abuse
Chavez LJ, Williams EC, Lapham GT
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
The researchers examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. They found that among patients with alcohol misuse, the adjusted prevalence of alcohol-related advice increased from 40.4% in 2007 to 55.5% in 2011. Rates of alcohol-related advice increased significantly each year except the last.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Williams EC, Lapham GT .
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
J Stud Alcohol Drugs 2016 May;77(3):500-8.
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Keywords: Alcohol Use, Behavioral Health, Primary Care, Substance Abuse
Domino ME, Jackson C, Beadles CA
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
The purpose of this manuscript is to assess outpatient follow-up rates with primary care and mental health providers following psychiatric discharge by medical home enrollment and medical complexity. Hospitalized persons with multiple chronic conditions including serious mental illness enrolled in a medical home were more likely to receive timely outpatient follow-up with a primary care provider but not with a mental health specialist.
AHRQ-funded; HS000032; HS019659.
Citation: Domino ME, Jackson C, Beadles CA .
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
Gen Hosp Psychiatry 2016 Mar-Apr;39:59-65. doi: 10.1016/j.genhosppsych.2015.11.002.
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Keywords: Primary Care, Patient-Centered Healthcare, Behavioral Health, Hospitalization, Chronic Conditions
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
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Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement
Jones AL, Cochran SD, Leibowitz A
Usual primary care provider characteristics of a patient-centered medical home and mental health service use.
This study sought to examine qualities of a usual provider that align with the patient-centered medical home (PCMH) goals of access, comprehensiveness, and patient-centered care, It concluded that access to a usual provider is associated with increased receipt of needed mental health services. Patients who have a usual provider with PCMH qualities are more likely to receive mental health counseling.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Usual primary care provider characteristics of a patient-centered medical home and mental health service use.
J Gen Intern Med 2015 Dec;30(12):1828-36. doi: 10.1007/s11606-015-3417-0.
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Keywords: Patient-Centered Healthcare, Behavioral Health, Primary Care
Radovic A, Reynolds K, McCauley HL
Parents' role in adolescent depression care: primary care provider perspectives.
This study aimed to understand how primary care providers (PCPs) perceive barriers to adolescent depression care in order to inform strategies to increase treatment engagement. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home.
AHRQ-funded; HS022989; HS019486.
Citation: Radovic A, Reynolds K, McCauley HL .
Parents' role in adolescent depression care: primary care provider perspectives.
J Pediatr 2015 Oct;167(4):911-8. doi: 10.1016/j.jpeds.2015.05.049..
Keywords: Caregiving, Children/Adolescents, Depression, Behavioral Health, Primary Care