National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Anxiety (1)
- Behavioral Health (10)
- COVID-19 (1)
- (-) Depression (10)
- Evidence-Based Practice (1)
- Guidelines (1)
- Health Information Technology (HIT) (1)
- Health Insurance (1)
- Maternal Care (2)
- Medicaid (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Payment (1)
- Pregnancy (1)
- Primary Care (1)
- Research Methodologies (1)
- Risk (1)
- Screening (2)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Women (2)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedAcolin J, Cadigan JM, Fleming CB
Trajectory of depressive symptoms in the context of romantic relationship breakup: characterizing the “natural course” of response and recovery in young adults.
This study’s objective was to characterize the trajectory of depressive symptoms before, during, and after relationship breakup in young adults and to examine subjective appraisal and sense of control. The authors used the PHQ-2 survey to screen for depressive symptoms. In their sample of participants reporting a single breakup during the 2-year study period (N = 156), breakup was associated with a temporary increase in depressive symptoms that returned to pre-breakup levels within 3 months. They observed increased symptoms among negatively appraised, but not positive or neutral, events. The lower the sense of control, the more depressive symptoms were demonstrated at all time points.
AHRQ-funded; HS013853.
Citation: Acolin J, Cadigan JM, Fleming CB .
Trajectory of depressive symptoms in the context of romantic relationship breakup: characterizing the “natural course” of response and recovery in young adults.
Emerging Adulthood 2023 Oct; 11(5):1211-22. doi: 10.1177/21676968231184922..
Keywords: Depression, Young Adults, Behavioral Health
Lewis A, Howland RE, Horwitz LI
Medicaid value-based payments and health care use for patients with mental illness.
This retrospective cohort study’s objective was to investigate if New York State's Medicaid value-based payment reform was associated with improved utilization patterns for patients with mental illness (major depression disorder, bipolar disorder, and/or schizophrenia). The cohort included Medicaid 306,290 individuals with depression (67.4% female; mean age, 38.6 years), 85,105 patients with bipolar disorder (59.6% female; mean age, 38.0 years), and 71,299 patients with schizophrenia (45.1% female mean age, 40.3 years). After adjustment, the analysis estimated a statistically significant, positive association between value-based payments and behavioral health visits for patients with depression (0.91 visits) and bipolar disorder (1.01 visits). There were no statistically significant changes to primary care visits for patients with depression and bipolar disorder, but value-based payments were associated with reductions in primary care visits for patients with schizophrenia (-1.31 visits). In every diagnostic population, value-based payment was associated with significant reductions in mental health emergency department visits (population with depression: -0.01 visits; population with bipolar disorder: -0.02 visits; population with schizophrenia: -0.04 visits).
AHRQ-funded; HS026980; HS026120.
Citation: Lewis A, Howland RE, Horwitz LI .
Medicaid value-based payments and health care use for patients with mental illness.
JAMA Health Forum 2023 Sep; 4(9):e233197. doi: 10.1001/jamahealthforum.2023.3197..
Keywords: Medicaid, Behavioral Health, Payment, Depression
Titus AR, Mezuk B, Hirschtick JL
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Researchers examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan. Data were taken from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 2020. Results indicated that relative risks for experiencing poor mental health outcomes varied by race/ethnicity, sex, age, and income. Symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" was associated with all outcomes. The researchers concluded that because of overlapping risk factors, integrated approaches to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.
AHRQ-funded; HS026120.
Citation: Titus AR, Mezuk B, Hirschtick JL .
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Soc Psychiatry Psychiatr Epidemiol 2023 Jul; 58(7):1099-108. doi: 10.1007/s00127-023-02453-9..
Keywords: COVID-19, Depression, Anxiety, Behavioral Health
O'Connor EA, Perdue LA, Coppola EL
Depression and suicide risk screening: updated evidence report and systematic review for the US Preventive Services Task Force.
The objectives of this article were to review the benefits and harms of depression and suicide risk screening and treatment and the accuracy of instruments to detect these conditions in primary care patients. Evidence gathered from the literature search supported screening for depression in primary care settings, including during pregnancy and postpartum. The authors noted, however, that there were numerous important gaps in the evidence for suicide risk screening.
AHRQ-funded; 290201500011I; 75Q80120D00004.
Citation: O'Connor EA, Perdue LA, Coppola EL .
Depression and suicide risk screening: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Jun 20; 329(23):2068-85. doi: 10.1001/jama.2023.7787..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Depression, Behavioral Health, Evidence-Based Practice, Guidelines, Risk
Steiger KG, Boehmer KR, Klanderman MC
Who is most burdened in health care? An analysis of responses to the ICAN Discussion Aid.
The objective of this study was to create a model based on patients' characteristics that predicted the number of burdens reported using the ICAN Discussion Aid, in order to target use of this tool to the patients most likely to benefit. Participants were 635 adult patients who completed the ICAN Aid at a Scottsdale, Arizona, family medicine clinic; patient characteristics were gathered from their health records. The results showed that the number of burdens a patient will report on the ICAN Aid can be approximated based on certain patient characteristics. Adults with major depression, a BMI of 26 or greater, and those of a younger age may have greater reported burdens on ICAN. The authors noted that these finding will need to be validated in independent samples.
AHRQ-funded; HS026379; HS026379.
Citation: Steiger KG, Boehmer KR, Klanderman MC .
Who is most burdened in health care? An analysis of responses to the ICAN Discussion Aid.
J Am Board Fam Med 2023 Apr 3;36(2):277-88. doi: 10.3122/jabfm.2022.220251R1.
Keywords: Depression, Behavioral Health
Franco MI, Staab EM, Zhu M
Pragmatic clinical trial of population health, portal-based depression screening: the PORTAL-Depression study.
Utilizing patient portals in a population health framework for depression screening presents a potentially effective method for proactively engaging and identifying individuals with depression. The purpose of this study was to evaluate the efficacy of a population health-based depression screening compared to in-clinic screening alone in detecting patients with depression. A practical clinical trial conducted at an urban, academic, tertiary care center's adult internal medicine outpatient clinic included a total of 2713 eligible adult patients due for depression screening with active portal accounts. Patients with known depression or bipolar disorder, and those who had been screened within the previous year were excluded. Participants were randomly allocated to receive either usual care (n = 1372) or population health care (n = 1341). In the usual care group, medical assistants screened patients during clinic visits. In the population health care group, patients were sent portal-based letters inviting them to complete an online screener, irrespective of appointment status. The Computerized Adaptive Test for Mental Health (CAT-MH™) was used for both in-clinic and portal-based screenings. The study found that the population health care group displayed a higher depression screening rate compared to the usual care group (43% (n = 578) vs. 33% (n = 459), p < 0.0001). Additionally, the rate of positive screens was greater in the population health care group than in the usual care group (10% (n = 58) vs. 4% (n = 17), p < 0.001).
AHRQ-funded; HS26151
Citation: Franco MI, Staab EM, Zhu M .
Pragmatic clinical trial of population health, portal-based depression screening: the PORTAL-Depression study.
J Gen Intern Med 2023 Mar;38(4):857-64. doi: 10.1007/s11606-022-07779-9.
Keywords: Depression, Behavioral Health, Screening, Health Information Technology (HIT)
Steenland MW, Trivedi AN
Association of Medicaid expansion with postpartum depression treatment in Arkansas.
This study examined the association of Medicaid expansion in Arkansas with postpartum antidepressant prescription fills and antidepressant continuation and supply during the first 6 months postpartum. This cohort study used data comparing persons with Medicaid and commercially financed childbirth using Arkansas' All-Payer Claims Database (2013-2016). A total of 60,990 births were included, with 72% of births paid for by Medicaid and 28% paid by a commercial payer. Before expansion, 4.2% of people with a Medicaid-paid birth filled an antidepressant prescription in the later postpartum period. Medicaid expansion was associated with a 4.6 percentage point increase in the likelihood, or a relative change of 110%, in this outcome. Among people with early postpartum depression, Medicaid expansion increased the continuity of antidepressant treatment by 20.5 percentage points and the number of days with antidepressant supply in the later postpartum period by 14.1 days.
AHRQ-funded; HS027464.
Citation: Steenland MW, Trivedi AN .
Association of Medicaid expansion with postpartum depression treatment in Arkansas.
JAMA Health Forum 2023 Feb; 4(2):e225603. doi: 10.1001/jamahealthforum.2022.5603..
Keywords: Depression, Behavioral Health, Medicaid, Maternal Care, Women, Access to Care
Crits-Christoph P, Gallop R, Duong L
Repeated assessments of depressive symptoms in randomized psychosocial intervention trials: best practice for analyzing symptom change over time.
Keywords: Depression, Behavioral Health, Research Methodologies
Optional keywords: mental psychotherapy
Summary
The purpose of this study was to investigate the optimal statistical model for analyzing time effects in psychotherapy randomized trials, specifically when the primary outcome involves repeated assessments of depression symptoms. The researchers utilized data from three studies comparing psychotherapy treatments for major depressive disorder. Self-report ratings were used in Study 1 (N=237) and Study 2 (N=100), while clinician ratings were utilized in Study 3 (N=120). Depression symptoms were assessed at every session in Studies 1 and 2 and monthly in Study 3. Time patterns examined included linear, quadratic, cubic, logarithmic transformation of time, piecewise linear, and unstructured models. The researchers found that in Study 1, a logarithmic-linear model demonstrated the best fit. Study 2 found that all models had negligible support compared to the unstructured model, which was the best fitting. In Study 3, although the cubic model displayed the best fit, it was not significantly superior to the log-linear or unstructured model. The study concluded that when evaluating repeated measures of depression symptoms as the primary outcome, trials should consistently compare various time models, including an unstructured model.
Optional keywords: mental psychotherapy
Summary
The purpose of this study was to investigate the optimal statistical model for analyzing time effects in psychotherapy randomized trials, specifically when the primary outcome involves repeated assessments of depression symptoms. The researchers utilized data from three studies comparing psychotherapy treatments for major depressive disorder. Self-report ratings were used in Study 1 (N=237) and Study 2 (N=100), while clinician ratings were utilized in Study 3 (N=120). Depression symptoms were assessed at every session in Studies 1 and 2 and monthly in Study 3. Time patterns examined included linear, quadratic, cubic, logarithmic transformation of time, piecewise linear, and unstructured models. The researchers found that in Study 1, a logarithmic-linear model demonstrated the best fit. Study 2 found that all models had negligible support compared to the unstructured model, which was the best fitting. In Study 3, although the cubic model displayed the best fit, it was not significantly superior to the log-linear or unstructured model. The study concluded that when evaluating repeated measures of depression symptoms as the primary outcome, trials should consistently compare various time models, including an unstructured model.
AHRQ-funded; HS018440
Citation: Crits-Christoph P, Gallop R, Duong L .
Repeated assessments of depressive symptoms in randomized psychosocial intervention trials: best practice for analyzing symptom change over time.
Psychother Res 2023 Feb;33(2):158-72. doi: 10.1080/10503307.2022.2073289.
Keywords: Depression, Behavioral Health, Research Methodologies
Moise N, Paniagua-Avila A, Barbecho JM
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
This study used a collaborative care (CC) use case to describe a novel, theory-informed, stakeholder engaged process for operationalizing strategies for sustainability using a behavioral lens. The goal is to optimize depression treatment in primary care clinics using the Transform DepCare shared decision-making and psychoeducation patient tool. The authors applied the Behaviour Change Wheel to their prior mixed methods to identify key sustainability behaviors and determinants of sustainability. The authors enlisted 22 national and local stakeholders to operationalize and adapt a multi-level, multi-component implementation strategy to maximally target behavioral and contextual determinants of sustainability. They identified ongoing care manager CC delivery, provider treatment optimization, and patient enrollment as key sustainability behaviors. They determined that a waiting room that delivered DepCare, the results of which are delivered to providers, as well as ongoing problem-solving meetings/local technical assistance with care managers would be the most acceptable and equitable multi-level strategy in diverse settings seeking to sustain CC programs. Key improvements would include expanding the DepCare tool to incorporate anxiety/suicide screening, triage support, multi-modal delivery, and patient activation (vs. shared decision making) (patient); pairing summary reports with decisional support and yearly onboarding/motivational educational videos (provider); incorporating behavioral health providers into problem-solving meetings and shifting from billing support to quality improvement and triage (system).
AHRQ-funded; HS025198.
Citation: Moise N, Paniagua-Avila A, Barbecho JM .
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
Implement Sci Commun 2023 Jan 25; 4(1):10. doi: 10.1186/s43058-022-00383-2..
Keywords: Depression, Primary Care, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Tabb KM, Dalton VK, Tilea A
Trends in antenatal depression and suicidal ideation diagnoses among commercially insured childbearing individuals in the United States, 2008-2018.
This study examined trends in antenatal depression and suicidal ideation among commercially insured childbearing individuals from 2008 to 2018. The study included 536,647 individuals aged 15-44 continuously enrolled in a single commercial health insurance plan for one year before childbirth from 2008 to 2018. Primary outcomes included depression or suicidal ideation based on relevant ICD-9 and ICD-10 diagnosis codes during pregnancy. Rates of depression increased by 39% from 540 per 10,000 individuals in 2008 to 750 per 10,000 individuals in 2018. Suicidal ideation increased by 100% from 15 per 10,000 individuals in 2008 to 44 per 10,000 individuals in 2018. Black persons experienced the sharpest proportional increases.
AHRQ-funded; HS027640.
Citation: Tabb KM, Dalton VK, Tilea A .
Trends in antenatal depression and suicidal ideation diagnoses among commercially insured childbearing individuals in the United States, 2008-2018.
J Affect Disord 2023 Jan 1;320:263-67. doi: 10.1016/j.jad.2022.09.120..
Keywords: Pregnancy, Maternal Care, Depression, Behavioral Health, Women, Health Insurance