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
101 to 125 of 171 Research Studies DisplayedHeerman WJ, Taylor JL, Wallston KA
Parenting self-efficacy, parent depression, and healthy childhood behaviors in a low-income minority population: a cross-sectional analysis.
The study’s objective was to measure the associations between parenting self-efficacy, parent depressive symptoms, and preschool child behaviors that support healthy growth. It found that in this minority population, higher parenting self-efficacy was associated with longer child sleep and fewer meals in front of the TV, but parent depressive symptoms mitigated that protective effect for child sleep duration.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Taylor JL, Wallston KA .
Parenting self-efficacy, parent depression, and healthy childhood behaviors in a low-income minority population: a cross-sectional analysis.
Matern Child Health J 2017 May;21(5):1156-65. doi: 10.1007/s10995-016-2214-7.
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Keywords: Children/Adolescents, Family Health and History, Depression, Racial and Ethnic Minorities, Low-Income
Burgette JM, Preisser JS, Jr., Weinberger M
Impact of early head start in North Carolina on dental care use among children younger than 3 years.
The researchers examined the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children. They concluded that EHS participation increases dental care use among disadvantaged young children.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Jr., Weinberger M .
Impact of early head start in North Carolina on dental care use among children younger than 3 years.
Am J Public Health 2017 Apr;107(4):614-20. doi: 10.2105/ajph.2016.303621.
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Keywords: Children/Adolescents, Dental and Oral Health, Access to Care, Health Promotion, Low-Income
Berridge C
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
The researchers examined the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. They found that assumptions built into the technology about how older adults live presented a problem for many users who experience unwanted disruptions and threats to their behavioral autonomy. Also, the resident responses challenged the dominant image of residents as passive subjects of a passive monitoring system.
AHRQ-funded; HS000011.
Citation: Berridge C .
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
Ageing Soc 2017 Mar;37(3):537-60. doi: 10.1017/s0144686x15001269.
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Keywords: Caregiving, Elderly, Health Information Technology (HIT), Low-Income
Cole MB, Galarraga O, Wilson IB
At federally funded health centers, Medicaid expansion was associated with improved quality of care.
In 2014 many uninsured, low-income nonelderly adults gained access to health insurance in states that expanded Medicaid eligibility under the Affordable Care Act. The researchers used a difference-in-differences approach to compare changes among 1,057 such centers in expansion versus nonexpansion States. Medicaid expansion was associated with improved quality for asthma treatment, Pap testing, body mass index assessment, and hypertension control.
AHRQ-funded; HS024652.
Citation: Cole MB, Galarraga O, Wilson IB .
At federally funded health centers, Medicaid expansion was associated with improved quality of care.
Health Aff 2017 Jan;36(1):40-48. doi: 10.1377/hlthaff.2016.0804.
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Keywords: Quality of Care, Policy, Uninsured, Low-Income, Access to Care
Heintzman J, Marino M, Hoopes M
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
The researchers sought to validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data. They concluded that EHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
J Am Med Inform Assoc 2015 Jul;22(4):909-13. doi: 10.1093/jamia/ocv033..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Low-Income, Children/Adolescents
Pruitt SL, Tiro JA, Xuan L
Hispanic and immigrant paradoxes in U.S. breast cancer mortality: impact of neighborhood poverty and Hispanic density.
The researchers tested the Hispanic and Immigrant Paradoxes-i.e., survival advantages despite a worse risk factor profile-and the modifying role of neighborhood context. They found no evidence of an Immigrant Paradox and some evidence of a Hispanic Paradox where protective effects were limited to U.S.-born Hispanics. Contrary to prior studies, foreign birthplace and residence in higher Hispanic density neighborhoods were associated with increased mortality.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Tiro JA, Xuan L .
Hispanic and immigrant paradoxes in U.S. breast cancer mortality: impact of neighborhood poverty and Hispanic density.
Int J Environ Res Public Health 2016 Dec 14;13(12):E1238. doi: 10.3390/ijerph13121238.
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Keywords: Cancer: Breast Cancer, Low-Income, Racial and Ethnic Minorities, Mortality, Racial and Ethnic Minorities
Fontil V, McDermott K, Tieu L
Adaptation and feasibility study of a digital health program to prevent diabetes among low-income patients: results from a partnership between a digital health company and an academic research team.
Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. They concluded that underserved prediabetic patients displayed high engagement and satisfaction with a digital diabetes prevention program despite lower digital literacy skills. The collaboration between researchers and a digital health company enabled iterative improvements in technology implementation to address challenges in low-income populations.
AHRQ-funded; HS022408.
Citation: Fontil V, McDermott K, Tieu L .
Adaptation and feasibility study of a digital health program to prevent diabetes among low-income patients: results from a partnership between a digital health company and an academic research team.
J Diabetes Res 2016;2016:8472391. doi: 10.1155/2016/8472391.
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Keywords: Diabetes, Health Information Technology (HIT), Low-Income, Prevention, Health Promotion
Bjarnadottir RI, Millery M, Fleck E
Correlates of online health information-seeking behaviors in a low-income Hispanic community.
The authors explored the correlates of online health information-seeking behaviors among Hispanic residents of a low-income urban neighborhood. They found that age and Spanish as preferred language were negatively associated with online health information-seeking, whereas education and health literacy were positively associated. They concluded that their findings have implications for designing online health information resources and interventions appropriate for the populations they are likely to reach.
AHRQ-funded; HS019853.
Citation: Bjarnadottir RI, Millery M, Fleck E .
Correlates of online health information-seeking behaviors in a low-income Hispanic community.
Inform Health Soc Care 2016 Dec;41(4):341-9. doi: 10.3109/17538157.2015.1064429.
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Keywords: Education: Patient and Caregiver, Low-Income, Racial and Ethnic Minorities, Urban Health, Web-Based
Mayberry LS, Berg CA, Harper KJ
The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes.
Through user-centered design and iterative usability/feasibility testing, the researchers developed a mobile Health intervention for disadvantaged adults with type 2 diabetes (T2D) called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs reported FAMS increased self-care and both PPs and support persons reported FAMS improved support for and communication about diabetes.
AHRQ-funded; HS022990.
Citation: Mayberry LS, Berg CA, Harper KJ .
The design, usability, and feasibility of a family-focused diabetes self-care support mHealth intervention for diverse, low-income adults with type 2 diabetes.
J Diabetes Res 2016;2016:7586385. doi: 10.1155/2016/7586385.
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Keywords: Diabetes, Low-Income, Patient and Family Engagement, Patient Self-Management, Telehealth
Tung EL, Peek ME, Makelarski JA
Adult BMI and access to built environment resources in a high-poverty, urban geography.
The purpose of this study is to examine the relationship between BMI and access to built environment resources in a high-poverty, urban geography. BMI was not associated with potential access to resources located nearest to home. Nearly all participants bypassed at least one nearby resource type; half bypassed nearby grocers (realized access >1 mile from home). Bypassing grocers was associated with a higher BMI.
AHRQ-funded; HS000078.
Citation: Tung EL, Peek ME, Makelarski JA .
Adult BMI and access to built environment resources in a high-poverty, urban geography.
Am J Prev Med 2016 Nov;51(5):e119-e27. doi: 10.1016/j.amepre.2016.04.019.
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Keywords: Low-Income, Obesity, Urban Health
Arora A, Spatz E, Herrin J
Population well-being measures help explain geographic disparities in life expectancy at the county level.
This study investigated whether population well-being - a comprehensive measure of physical, mental, and social health - helps explain geographic variation in life expectancy. At the county level, it found that for every 1-standard-deviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males.
AHRQ-funded; HS023000.
Citation: Arora A, Spatz E, Herrin J .
Population well-being measures help explain geographic disparities in life expectancy at the county level.
Health Aff 2016 Nov 01;35(11):2075-82. doi: 10.1377/hlthaff.2016.0715.
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Keywords: Disparities, Health Status, Low-Income, Social Determinants of Health
Sommers BD, Blendon RJ, Orav EJ
Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.
The researchers assessed changes in access to care, utilization, and self-reported health among low-income adults in 3 states taking alternative approaches to the ACA. They concluded that in the second year of expansion, Kentucky's Medicaid program and Arkansas's private option were associated with significant increases in outpatient utilization, preventive care, and improved health care quality; reductions in emergency department use; and improved self-reported health.
AHRQ-funded; HS021291.
Citation: Sommers BD, Blendon RJ, Orav EJ .
Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.
JAMA Intern Med 2016 Oct;176(10):1501-09. doi: 10.1001/jamainternmed.2016.4419.
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Keywords: Healthcare Utilization, Low-Income, Health Insurance, Medicaid, Access to Care
Nieman CL, Tunkel DE, Boss EF
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
The study’s objective was to analyze the association of patient- and neighborhood-level demographics and SES with clinical indications for tympanostomy tube (TT). It found that among children receiving tubes, those from high poverty areas were more likely than those from low poverty neighborhoods to receive tubes for the indication of chronic otitis media with effusion (OME) as opposed to recurrent acute otitis media (RAOM).
AHRQ-funded; HS022932.
Citation: Nieman CL, Tunkel DE, Boss EF .
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
Int J Pediatr Otorhinolaryngol 2016 Sep;88:98-103. doi: 10.1016/j.ijporl.2016.06.029.
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Keywords: Children/Adolescents, Ear Infections, Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Low-Income
Saab D, Nisenbaum R, Dhalla I
Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study.
The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group experiencing homelessness. It concluded that homeless patients had nearly four times the odds of being readmitted within 30-days as compared to low-income controls matched on age, sex and primary reason for admission to hospital.
AHRQ-funded; HS014129.
Citation: Saab D, Nisenbaum R, Dhalla I .
Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study.
J Gen Intern Med 2016 Sep;31(9):1011-8. doi: 10.1007/s11606-016-3680-8.
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Keywords: Low-Income, Hospital Readmissions, Vulnerable Populations
Steve SL, Tung EL, Schlichtman JJ
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
The authors reported on their narrative review of the literature that explores the associations between social disorder and diabetes-related health outcomes within vulnerable communities. They also proposed a multilevel ecosocial model for conceptualizing social disorder, specifically focusing on its role in racial disparities and its pathways to mediating diabetes outcomes.
AHRQ-funded; HS000078.
Citation: Steve SL, Tung EL, Schlichtman JJ .
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
Curr Diab Rep 2016 Aug;16(8):72. doi: 10.1007/s11892-016-0760-4.
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Keywords: Diabetes, Low-Income, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Mueller LE, Haidari LA, Wateska AR
The impact of implementing a demand forecasting system into a low-income country's supply chain.
The authors evaluated the potential impact and value of applications of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas. They used their HERMES software to study Niger's entire vaccine supply chain and found that demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose, when implemented with storage and transportation increases.
AHRQ-funded; HS023317.
Citation: Mueller LE, Haidari LA, Wateska AR .
The impact of implementing a demand forecasting system into a low-income country's supply chain.
Vaccine 2016 Jul 12;34(32):3663-9. doi: 10.1016/j.vaccine.2016.05.027.
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Keywords: Access to Care, Health Services Research (HSR), Low-Income, Medication, Vaccination
Osborn CY, Mayberry LS, Kim JM
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
The authors sought to identify which behaviors are most important for HbA1c among low-socioeconomic status patients with type 2 diabetes mellitus. They found that only medication adherence was significantly associated with lower HbA1c after adjusting for the other self-care behaviours and further adjusting for demographic and diabetes characteristics. They suggested that focused efforts to improve medication adherence among low-socioeconomic status patient populations may improve glycemic control.
AHRQ-funded; HS022990.
Citation: Osborn CY, Mayberry LS, Kim JM .
Medication adherence may be more important than other behaviours for optimizing glycaemic control among low-income adults.
J Clin Pharm Ther 2016 Jun;41(3):256-9. doi: 10.1111/jcpt.12360.
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Keywords: Diabetes, Low-Income, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
McManus KA, McGonigle KM, Engelhard CL
PPACA and low-income people living with HIV: 2014 qualified health plan enrollment in a Medicaid nonexpansion state.
This review examined qualified heallth plan enrollment of AIDS Drug Assistance Programs clients in Virginia, a Medicaid nonexpansion state, and explored some issues that affect people living with HIV in other Medicaid nonexpansion states. The authors recommend that as healthcare delivery models shift, the effects on patients and health outcomes achieved should be monitored, particularly for chronic diseases such as HIV.
AHRQ-funded; HS024196.
Citation: McManus KA, McGonigle KM, Engelhard CL .
PPACA and low-income people living with HIV: 2014 qualified health plan enrollment in a Medicaid nonexpansion state.
South Med J 2016 Jun;109(6):371-7. doi: 10.14423/smj.0000000000000469.
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Keywords: Medicaid, Low-Income, Human Immunodeficiency Virus (HIV), Health Insurance, Policy
Kaplan RM, Milstein A
AHRQ Author: Kaplan RM
Financial strain and cancer outcomes.
This editorial discusses an article by Lathan et al. in the same issue that documents the strong associations between socioeconomic status and longevity. The editorial argues that many of the variables in that article are measured with error and, as a result, the multivariable analysis resulted in only partial adjustment. Two variables of particular importance, education and ethnicity, are discussed.
AHRQ-authored.
Citation: Kaplan RM, Milstein A .
Financial strain and cancer outcomes.
J Clin Oncol 2016 May 20;34(15):1711-2. doi: 10.1200/jco.2016.66.8079.
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Keywords: Cancer, Health Status, Healthcare Costs, Low-Income, Outcomes, Social Determinants of Health, Stress
Heberlein EC, Frongillo EA, Picklesimer AH
Effects of group prenatal care on food insecurity during late pregnancy and early postpartum.
The researchers compared the effects of group to individual prenatal care in late pregnancy and early postpartum on women's food security and psychosocial outcomes among food-insecure women. They found that group prenatal care provided health education and the opportunity for women to share experiences and knowledge, potentially improving food security through increasing confidence and skills in managing household food resources.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Frongillo EA, Picklesimer AH .
Effects of group prenatal care on food insecurity during late pregnancy and early postpartum.
Matern Child Health J 2016 May;20(5):1014-24. doi: 10.1007/s10995-015-1886-8.
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Keywords: Pregnancy, Maternal Care, Nutrition, Education: Patient and Caregiver, Low-Income
Fierman AH, Beck AF, Chung EK
AHRQ Author: Mistry KB
Redesigning health care practices to address childhood poverty.
Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. The authors highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty.
AHRQ-authored.
Citation: Fierman AH, Beck AF, Chung EK .
Redesigning health care practices to address childhood poverty.
Acad Pediatr 2016 Apr;16(3 Suppl):S136-46. doi: 10.1016/j.acap.2016.01.004.
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Keywords: Healthcare Delivery, Children/Adolescents, Low-Income, Social Determinants of Health
Wherry LR, Kenney GM, Sommers BD
The role of public health insurance in reducing child poverty.
The researchers reviewed a growing body of evidence that public health insurance provides important financial benefits to low-income families and also reviewed the potential poverty-reducing effects of public health insurance coverage. They found that Medicaid plays a significant role in decreasing poverty for many children and families. They also reviewed emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. They concluded that the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children.
AHRQ-funded; HS021291.
Citation: Wherry LR, Kenney GM, Sommers BD .
The role of public health insurance in reducing child poverty.
Acad Pediatr 2016 Apr;16(3 Suppl):S98-s104. doi: 10.1016/j.acap.2015.12.011.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Low-Income, Medicaid
Nguyen OK, Makam AN, Halm EA
National use of safety-net clinics for primary care among adults with non-Medicaid insurance in the United States.
This study described the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare). It concluded that safety net clinics are important primary care delivery sites for non-Medicaid insured minority and low-income populations with a high burden of chronic illness.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Halm EA .
National use of safety-net clinics for primary care among adults with non-Medicaid insurance in the United States.
PLoS One 2016 Mar 30;11(3):e0151610. doi: 10.1371/journal.pone.0151610.
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Keywords: Primary Care, Health Insurance, Medicare, Low-Income, Healthcare Delivery
Beck AF, Tschudy MM, Coker TR
AHRQ Author: Mistry KB
Determinants of health and pediatric primary care practices.
This article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. It also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health.
AHRQ-authored.
Citation: Beck AF, Tschudy MM, Coker TR .
Determinants of health and pediatric primary care practices.
Pediatrics 2016 Mar;137(3):e20153673. doi: 10.1542/peds.2015-3673.
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Keywords: Primary Care, Low-Income, Children/Adolescents, Health Services Research (HSR), Policy
DeVoe JE, Tillotson CJ, Marino M
Trends in type of health insurance coverage for US children and their parents, 1998-2011.
The objective of this paper is to examine trends in health insurance type among US children and their parents. Using Medical Expenditure Panel Survey data (1998-2011), the authors found that low- and middle-income US families experienced a decrease in the percentage of child-parent pairs with private health insurance and pairs without insurance. At the same time, they found a rise in discordant coverage patterns - mainly publicly insured children with uninsured parents.
AHRQ-funded; HS018569.
Citation: DeVoe JE, Tillotson CJ, Marino M .
Trends in type of health insurance coverage for US children and their parents, 1998-2011.
Acad Pediatr 2016 Mar;16(2):192-9. doi: 10.1016/j.acap.2015.06.009.
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Keywords: Children/Adolescents, Health Insurance, Low-Income, Medical Expenditure Panel Survey (MEPS), Uninsured