National Healthcare Quality and Disparities Report
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- Access to Care (2)
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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
1 to 18 of 18 Research Studies DisplayedGiardina TD, Woodard LD, Singh H
Advancing diagnostic equity through clinician engagement, community partnerships, and connected care.
This article explores the persistent disparities in healthcare, particularly in the diagnostic process, which have been further exposed by the COVID-19 pandemic. The authors highlight the higher rates of infection, hospitalization, and death from COVID-19 among Black, Hispanic, and Asian patients, who are also less likely to be tested for the virus. Similar disparities are noted in cardiac testing, mental health diagnoses, appendicitis diagnosis, and receipt of diagnostic imaging in the Emergency Department. The authors propose a three-pronged approach to address these disparities: clinician engagement, community partnerships, and connected care. Clinician engagement involves fostering critical consciousness among healthcare providers to recognize and address systemic inequities. Community partnerships with Community Health Workers (CHWs) can help fill gaps in the diagnostic process. Lastly, connected care through telehealth can potentially eliminate traditional barriers to care, although disparities in access to technology and digital literacy remain a challenge. The authors call for further research and initiatives to address these disparities and promote diagnostic equity.
AHRQ-funded; HSP233201500022I; HS025474
Citation: Giardina TD, Woodard LD, Singh H .
Advancing diagnostic equity through clinician engagement, community partnerships, and connected care.
J Gen Intern Med 2023 Apr; 38(5):1293-95. doi: 10.1007/s11606-022-07966-8..
Keywords: Community Partnerships, Disparities, Telehealth, Health Information Technology (HIT)
Nguyen KH, Fields JD JD, Cemballi AG
The role of community-based organizations in improving chronic care for safety-net populations.
Researchers conducted a multi-stakeholder qualitative study to capture the multi-level influences on health for those living in socio-economically deprived contexts. Participants were patients with chronic illnesses in San Francisco neighborhoods with high chronic disease rates, community leaders serving the same neighborhoods, or providers from San Francisco's public health care delivery system. The researchers identified several key themes. They concluded that their results contributed new evidence toward the community domain of the Chronic Care Model, and health care systems must intentionally partner with community-based organizations to address social determinants of health and improve community resources for chronic care management.
AHRQ-funded; HS026383.
Citation: Nguyen KH, Fields JD JD, Cemballi AG .
The role of community-based organizations in improving chronic care for safety-net populations.
J Am Board Fam Med 2021 Jul-Aug;34(4):698-708. doi: 10.3122/jabfm.2021.04.200591..
Keywords: Community Partnerships, Chronic Conditions, Social Determinants of Health, Care Management
Olmos-Ochoa TT, Miake-Lye IM, Glenn BA
Sustaining successful clinical-community partnerships in medically underserved urban areas: a qualitative case study.
This qualitative case study examines the Faith Community Health Partnership, which is a collaboration between faith-community nurses and community organizations sustained over 25 years. Factors supporting partnership sustainability were identified through semi-structured interviews with 18 FHCP partners. Factors include maintaining partners’ commitment over time; strategic resource-sharing; facilitating engagement; and preserving partnership flexibility.
AHRQ-funded; HS000046.
Citation: Olmos-Ochoa TT, Miake-Lye IM, Glenn BA .
Sustaining successful clinical-community partnerships in medically underserved urban areas: a qualitative case study.
J Community Health Nurs 2021 Jan-Mar;38(1):1-12. doi: 10.1080/07370016.2021.1869423.
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Keywords: Community Partnerships, Vulnerable Populations, Urban Health, Case Study, Access to Care, Healthcare Delivery
Payán DD, Derose KP, Flórez KR
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
The authors developed a mapping component as part of a multilevel church-based intervention that used community-based participatory research to prevent obesity in African American and Latino churches in South Los Angeles. They developed neighborhood maps of local food environments and provided churches with standardized information on food access, availability, quality, and marketing practices. Including several tables as well as discussion, they stated that local food environment maps that are paired with data can inform community-based strategies to prevent obesity and food insecurity.
AHRQ-funded; HS000046.
Citation: Payán DD, Derose KP, Flórez KR .
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
Prev Chronic Dis 2020 Jul 16;17:E61. doi: 10.5888/pcd17.200028.
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Keywords: Obesity, Racial and Ethnic Minorities, Prevention, Prevention, Community Partnerships, Community-Based Practice, Nutrition
Wallace AS, Luther B, Guo JW
Implementing a social determinants screening and referral infrastructure during routine emergency department visits, Utah, 2017-2018.
Emergency departments see a disproportionate share of low-income and uninsured patients. In this study, the investigators developed and evaluated a process for identifying social needs among emergency department patients, for facilitating access to community-based resources, and for integrating clinical and community-based data. They leveraged an academic-community partnership to develop a social needs screening tool and referral process.
AHRQ-funded; HS026505.
Citation: Wallace AS, Luther B, Guo JW .
Implementing a social determinants screening and referral infrastructure during routine emergency department visits, Utah, 2017-2018.
Prev Chronic Dis 2020 Jun 18;17:E45. doi: 10.5888/pcd17.190339..
Keywords: Social Determinants of Health, Emergency Department, Screening, Community-Based Practice, Community Partnerships
Johnson A, Broughton S, Aponte-Soto L
Participatory genomic testing can effectively disseminate cardiovascular pharmacogenomics concepts within federally qualified health centers: a feasibility study.
Researchers assessed feasibility of an educational program designed to enhance stakeholder knowledge and perceptions of pharmacogenomics at a federally qualified health center. Twenty providers and 10 community members were recruited for a feasibility study via convenience sampling. The researchers determined that a pharmacogenomics educational program tailored for an underrepresented community was feasible and acceptable; outcomes will advise methodology for larger implementation studies.
AHRQ-funded; HS019461.
Citation: Johnson A, Broughton S, Aponte-Soto L .
Participatory genomic testing can effectively disseminate cardiovascular pharmacogenomics concepts within federally qualified health centers: a feasibility study.
Ethn Dis 2020 Apr;30(Suppl 1):167-76. doi: 10.18865/ed.30.S1.167..
Keywords: Genetics, Cardiovascular Conditions, Community Partnerships, Health Literacy, Education: Patient and Caregiver
Kranz AM, Mahmud A, Agniel D
Provision of social services and health care quality in US community health centers, 2017.
The authors describe the types of social services provided at community health centers (CHCs), characteristics of CHCs providing these services, and the association between on-site provision and health care quality. Their findings indicate that CHCs most often offered on-site assistance for needs related to food or nutriion, interpersonal violence, and housing. Participation in projects with community-based organizations was associated with providing services on-site. On-site provision was associated with better performance on measures of health care quality. They conclude that some CHCs provide social services on-site, and this was associated with better performance on measures of health care quality.
AHRQ-funded; HS024067.
Citation: Kranz AM, Mahmud A, Agniel D .
Provision of social services and health care quality in US community health centers, 2017.
Am J Public Health 2020 Apr;110(4):567-73. doi: 10.2105/ajph.2019.305519..
Keywords: Community Partnerships, Quality of Care, Domestic Violence, Nutrition
Reid R, Rising E, Kaufman A
The influence of a place-based foundation and a public university in growing a rural health workforce.
This article describes a partnership between a private, place-based foundation and the University of New Mexico's Office for Community Health. The university’s resources and the JF Maddox Foundation’s entrepreneurial nature, discretionary grant-making, and local convening capabilities combined to an innovative approach for addressing an acute shortage in the local health care delivery workforce in an isolated, rural setting in New Mexico. Results included a significant increase in recruitment of key health care professionals, a more cohesive medical community, a school-based clinic, and support for other community challenges such as the prevention of teen pregnancy.
AHRQ-funded; HS023904.
Citation: Reid R, Rising E, Kaufman A .
The influence of a place-based foundation and a public university in growing a rural health workforce.
J Community Health 2019 Apr;44(2):292-96. doi: 10.1007/s10900-018-0585-y..
Keywords: Access to Care, Community-Based Practice, Community Partnerships, Rural Health, Workforce
Eder MM, Evans E, Funes M
Defining and measuring community engagement and community-engaged research: clinical and translational science institutional practices.
The institutions that comprise the Clinical and Translational Science Award (CTSA) consortium and the National Center for Advancing Translational Sciences continue to explore and develop community-engaged research strategies and to study the role of community academic partnerships in advancing the science of community engagement. The purpose of this study was to explore CTSA institutions in relation to an Institute of Medicine recommendation that community engagement occur in all stages of translational research and be defined and evaluated consistently.
AHRQ-funded; HS020518.
Citation: Eder MM, Evans E, Funes M .
Defining and measuring community engagement and community-engaged research: clinical and translational science institutional practices.
Prog Community Health Partnersh 2018;12(2):145-56. doi: 10.1353/cpr.2018.0034..
Keywords: Community Partnerships, Evidence-Based Practice, Research Methodologies, Implementation
Huguet N, Hoopes MJ, Angier H
Medicaid expansion produces long-term impact on insurance coverage rates in community health centers.
This study assesses changes in insurance status of patients visiting community health centers (CHCs) comparing states that expanded Medicaid to those that did not. Rates of uninsured visits decreased pre- to post- Affordable Care Act with greater drops in expansion (-57 percent) versus nonexpansion (-20 percent) states. Medicaid-insured visits increased 60 percent in expansion states while remaining unchanged in nonexpansion states.
AHRQ-funded; HS024270.
Citation: Huguet N, Hoopes MJ, Angier H .
Medicaid expansion produces long-term impact on insurance coverage rates in community health centers.
J Prim Care Community Health 2017 Oct;8(4):206-12. doi: 10.1177/2150131917709403.
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Keywords: Community Partnerships, Health Insurance, Policy, Medicaid, Uninsured
Nagykaldi ZJ, Scheid D, Zhao D
An innovative community-based model for improving preventive care in rural counties.
This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. Six of the 7 PCPs in the county expressed interest in the project with the result that three of these practices fully implemented the 1-year outreach program starting in mid-2015.
AHRQ-funded; HS023237.
Citation: Nagykaldi ZJ, Scheid D, Zhao D .
An innovative community-based model for improving preventive care in rural counties.
J Am Board Fam Med 2017 Sep-Oct;30(5):583-91. doi: 10.3122/jabfm.2017.05.170035.
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Keywords: Community Partnerships, Patient-Centered Healthcare, Prevention, Primary Care, Rural Health
Fiechtner L, Puente GC, Sharifi M
A community resource map to support clinical-community linkages in a randomized controlled trial of childhood obesity, eastern Massachusetts, 2014-2016.
The researchers describe the process by which they created an online interactive community resources map for use in the Connect for Health randomized controlled trial. The trial was conducted in the 6 pediatric practices that cared for the highest percentage of children with overweight or obesity. Parents and community partners identified several community resources that could help support behavior change.
AHRQ-funded; HS024332.
Citation: Fiechtner L, Puente GC, Sharifi M .
A community resource map to support clinical-community linkages in a randomized controlled trial of childhood obesity, eastern Massachusetts, 2014-2016.
Prev Chronic Dis 2017 Jul 6;14:E53. doi: 10.5888/pcd14.160577.
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Keywords: Children/Adolescents, Obesity, Community Partnerships
Payan DD, Sloane DC, Illum J
Catalyzing implementation of evidence-based interventions in safety net settings: a clinical-community partnership in South Los Angeles.
This study was a process evaluation of a clinical-community partnership that implemented evidence-based interventions in clinical safety net settings. Key participants and health care providers, involved in the study, expressed a high level of satisfaction with the collaborative and the interventions, respectively. The authors provide key lessons learned for researchers and practitioners interested in partnering with Federally Qualified Health Centers to implement health promotion interventions.
AHRQ-funded; HS000046.
Citation: Payan DD, Sloane DC, Illum J .
Catalyzing implementation of evidence-based interventions in safety net settings: a clinical-community partnership in South Los Angeles.
Health Promot Pract 2017 Jul;18(4):586-97. doi: 10.1177/1524839917705418.
Keywords: Community Partnerships, Health Promotion, Evidence-Based Practice, Vulnerable Populations, Implementation
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
Pardos de la Gandara M, Raygoza Garay JA, Mwangi M
Molecular types of methicillin-resistant staphylococcus aureus and methicillin-sensitive S. aureus strains causing skin and soft tissue infections and nasal colonization, identified in community health centers in New York City.
In November 2011, a research and learning collaborative project with six community health centers in the New York City metropolitan area was launched to determine the nature (clonal type) of community-acquired Staphylococcus aureus strains causing skin and soft tissue infections (SSTIs). It found that of 63 patients with S. aureus infections, 16 of the colonizing isolates were MRSA, and 14 were MSSA, and the majority of the colonizing isolates belonged to the USA300 clonal group.
AHRQ-funded; HS021667.
Citation: Pardos de la Gandara M, Raygoza Garay JA, Mwangi M .
Molecular types of methicillin-resistant staphylococcus aureus and methicillin-sensitive S. aureus strains causing skin and soft tissue infections and nasal colonization, identified in community health centers in New York City.
J Clin Microbiol 2015 Aug;53(8):2648-58. doi: 10.1128/jcm.00591-15..
Keywords: Community-Acquired Infections, Community Partnerships, Community-Based Practice, Genetics, Methicillin-Resistant Staphylococcus aureus (MRSA)
Connolly Gibbons MB, Kurtz JE, Thompson DL
The effectiveness of clinician feedback in the treatment of depression in the community mental health system.
This article described the development and evaluation of a clinician feedback intervention for use in community mental health settings. The Community Clinician Feedback System (CCFS) was developed in collaboration with a community partner to meet the needs of providers working in such community settings. Satisfaction ratings of the CCFS indicated that the system was widely accepted by clinicians and patients.
AHRQ-funded; HS022124.
Citation: Connolly Gibbons MB, Kurtz JE, Thompson DL .
The effectiveness of clinician feedback in the treatment of depression in the community mental health system.
J Consult Clin Psychol 2015 Aug;83(4):748-59. doi: 10.1037/a0039302..
Keywords: Community-Based Practice, Community Partnerships, Depression, Behavioral Health, Patient Experience
Holzer J, Kass N
Understanding the supports of and challenges to community engagement in the CTSAs.
The researchers sought to understand the supports and challenges experienced by multiple Clinical and Translational Science Awards programs as they pursued community engagement. The interviews identified three support themes, including: funding, existing relationships with communities, and leadership and a partnership approach at the institution. Six challenge themes arose: need for capacity development, lack of positive relationships with communities, lack of leadership, funding constraints, time and staff constraints, and unsustainable models.
AHRQ-funded; HS017589.
Citation: Holzer J, Kass N .
Understanding the supports of and challenges to community engagement in the CTSAs.
Clin Transl Sci 2015 Apr;8(2):116-22. doi: 10.1111/cts.12205..
Keywords: Community Partnerships, Community-Based Practice, Health Services Research (HSR), Research Methodologies
Werner JJ, Stange KC
Praxis-based research networks: an emerging paradigm for research that is rigorous, relevant, and inclusive.
The authors argue that praxis-based research networks (PBRNs) are dynamically evolving to meet the needs of communities by partnering to generate new knowledge that can benefit community and population health. Furthermore, the praxis-based research network model facilitates adaptive partnering and provides a learning mechanism that enables the formation of new collaborations while remaining true to the core values of PBRNs.
AHRQ-funded; HS021648.
Citation: Werner JJ, Stange KC .
Praxis-based research networks: an emerging paradigm for research that is rigorous, relevant, and inclusive.
J Am Board Fam Med 2014 Nov-Dec;27(6):730-5. doi: 10.3122/jabfm.2014.06.140034..
Keywords: Practice-Based Research Network (PBRN), Implementation, Community Partnerships