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 152 Research Studies DisplayedSalloum A, Johnco C, Lewin AB
Barriers to access and participation in community mental health treatment for anxious children.
The authors examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. They found that the most common access barrier was parents not knowing where or from whom to seek services. They concluded that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.
AHRQ-funded; HS018665.
Citation: Salloum A, Johnco C, Lewin AB .
Barriers to access and participation in community mental health treatment for anxious children.
J Affect Disord 2016 May 15;196:54-61. doi: 10.1016/j.jad.2016.02.026.
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Keywords: Access to Care, Anxiety, Children/Adolescents, Community-Based Practice, Behavioral Health
Snyder ME, Frail CK, Gernant SA
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
The researchers described common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships. They found that common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Gernant SA .
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
J Am Pharm Assoc 2016 May-Jun;56(3):316-22. doi: 10.1016/j.japh.2015.11.015.
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Keywords: Community-Based Practice, Education: Continuing Medical Education, Provider: Pharmacist
Hernandez SE, Taylor L, Grembowski D
A first look at PCMH implementation for minority veterans: room for improvement.
The researchers sought to determine if the degree of Patient Aligned Care Teams (a patient-centered medical home model), implementation at Veterans Health Administration hospital-based and community-based primary care facilities varied with the percentage of minority veteran patients at each facility. They found that overall implementation of the care teams varied with respect to the racial/ethnic composition of a facility, with medium and high minority facilities having lower implementation scores.
AHRQ-funded; HS013853; HS023376.
Citation: Hernandez SE, Taylor L, Grembowski D .
A first look at PCMH implementation for minority veterans: room for improvement.
Med Care 2016 Mar;54(3):253-61. doi: 10.1097/mlr.0000000000000512.
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Keywords: Patient-Centered Healthcare, Racial and Ethnic Minorities, Community-Based Practice, Primary Care
Liss DT, French DD, Buchanan DR
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
This budget impact analysis investigated benefits and costs of fecal immunochemical testing (FIT) outreach-with FIT kits mailed to patients, followed by reminders and phone calls-compared with point-of-care (POC) strategies. Cost per patient screened was $20.60 for POC and $71.84 for outreach ($51.24 difference). Outreach costs decreased by approximately one fourth under optimized workflows.
AHRQ-funded; HS021141.
Citation: Liss DT, French DD, Buchanan DR .
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
Am J Prev Med 2016 Feb;50(2):e54-61. doi: 10.1016/j.amepre.2015.07.003.
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Keywords: Cancer: Colorectal Cancer, Community-Based Practice, Health Promotion, Prevention, Screening
Marino M, Bailey SR, Gold R
Receipt of preventive services after Oregon's randomized Medicaid experiment.
This study examined the three-year impact of Oregon's 2008 randomized Medicaid expansion (the "Oregon Experiment") on receipt of 12 preventive care services in community health centers using electronic health record data. They found that Medicaid coverage significantly increased the odds of receipt of most preventive services. They concluded that rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. They recommended continued effort to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations.
AHRQ-funded; HS021522.
Citation: Marino M, Bailey SR, Gold R .
Receipt of preventive services after Oregon's randomized Medicaid experiment.
Am J Prev Med 2016 Feb;50(2):161-70. doi: 10.1016/j.amepre.2015.07.032.
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Keywords: Access to Care, Community-Based Practice, Health Insurance, Medicaid, Prevention
Hoopes MJ, Angier H, Gold R
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
Using electronic health record data, the researchers examined longitudinal changes in community health center (CHC) visit rates from 2013 through 2014 in Medicaid expansion versus nonexpansion states. Rates increased in expansion state CHCs for new patient, preventive, and limited-service visits (14 percent, 41percent, and 23 percent, respectively), whereas these rates remained unchanged in nonexpansion states.
AHRQ-funded; HS024270.
Citation: Hoopes MJ, Angier H, Gold R .
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
J Ambul Care Manage 2016 Jan 13;39(4):290-8. doi: 10.1097/jac.0000000000000123.
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Keywords: Electronic Health Records (EHRs), Community-Based Practice, Healthcare Utilization, Medicaid, Uninsured
Wittie M, Ngo-Metzger Q, Lebrun-Harris L
AHRQ Author: Ngo-Metzger Q
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
This study analyzed cross-sectional data from all 1,128 health centers in 2011, which served over 20 million patients during that year. As of 2011, 80 percent of health centers reported using an electronic health record (EHR), and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic composition, physician staffing, or health center funding.
AHRQ-authored.
Citation: Wittie M, Ngo-Metzger Q, Lebrun-Harris L .
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
J Healthc Qual 2016 Jan-Feb;38(1):42-51. doi: 10.1111/jhq.12067.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Health Services Research (HSR)
Unertl KM, Schaefbauer CL, Campbell TR
Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.
The authors compared 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. They identified benefits and challenges, and created several principles that extended an existing CBPR framework to specifically address health informatics research requirements.
AHRQ-funded; HS019853; HS022961.
Citation: Unertl KM, Schaefbauer CL, Campbell TR .
Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.
J Am Med Inform Assoc 2016 Jan;23(1):60-73. doi: 10.1093/jamia/ocv094.
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Keywords: Community-Based Practice, Health Information Technology (HIT), Patient and Family Engagement, Patient-Centered Healthcare
Stucky BD, Hays RD, Edelen MO
Possibilities for shortening the CAHPS Clinician and Group Survey.
This paper explores the impact on reliability and validity of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) domain scores of reducing the numbers of items used to assess the 3 core Clinician and Group adult survey CAHPS domains (Provider Communication, Access to Care, and Courteous and Helpful Office Staff).
AHRQ-funded; HS016980.
Citation: Stucky BD, Hays RD, Edelen MO .
Possibilities for shortening the CAHPS Clinician and Group Survey.
Med Care 2016 Jan;54(1):32-7. doi: 10.1097/mlr.0000000000000452..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Ambulatory Care and Surgery, Community-Based Practice
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
Storch EA, Salloum A, King MA
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
This study aimed to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. It found that relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, King MA .
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
Depress Anxiety 2015 Nov;32(11):843-52. doi: 10.1002/da.22399.
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Keywords: Anxiety, Children/Adolescents, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Patel P, Hemmeger H, Kozak MA
Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).
The researchers described the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation.
AHRQ-funded; HS022119.
Citation: Patel P, Hemmeger H, Kozak MA .
Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).
J Am Pharm Assoc (2003) 2015 Nov-Dec;55(6):649-55. doi: 10.1331/JAPhA.2015.14244.
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Keywords: Community-Based Practice, Medication: Safety, Practice-Based Research Network (PBRN), Provider: Pharmacist
Taveras EM, Marshall R, Sharifi M
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
The Connect for Health study is designed to assess whether a novel approach to care delivery that leverages clinical and community resources and addresses socio-contextual factors will improve body mass index and family-centered, obesity-related outcomes of interest to parents and children. The intervention is informed by clinical, community, parent, and youth stakeholders and incorporates successful strategies and best practices learned from 'positive outlier' families.
AHRQ-funded; HS022986.
Citation: Taveras EM, Marshall R, Sharifi M .
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
Contemp Clin Trials 2015 Nov;45(Pt B):287-95. doi: 10.1016/j.cct.2015.09.022.
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Keywords: Children/Adolescents, Obesity, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Persell SD, Brown T, Lee JY
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
The researchers conducted a randomized trial to determine if mailed outreach containing patients’ individualized CVD risk and uncontrolled risk factors followed by telephone discussion with trained lay health workers would improve statin use for primary prevention among community health center patients with moderately high cardiovascular risk. They found that the intervention, led to more cholesterol treatment discussions with primary care clinicians but had little impact on statin prescribing.
AHRQ-funded; HS021141.
Citation: Persell SD, Brown T, Lee JY .
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. doi: 10.1161/circoutcomes.115.001723..
Keywords: Cardiovascular Conditions, Prevention, Community-Based Practice, Clinician-Patient Communication, Risk
Davis MM, Balasubramanian BA, Cifuentes M
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
This study examined the interrelationship among behavioral health clinician staffing, scheduling, and a primary care practice's approach to delivering integrated care. It concluded that practices' approaches to staffing by primary care clinicians and behavioral health clinicians, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context.
AHRQ-funded; HS022981.
Citation: Davis MM, Balasubramanian BA, Cifuentes M .
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S32-40. doi: 10.3122/jabfm.2015.S1.150087.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Community-Based Practice
Cohen DJ, Davis M, Balasubramanian BA
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. It concluded that primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Davis M, Balasubramanian BA .
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042.
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Keywords: Healthcare Delivery, Community-Based Practice, Shared Decision Making, Behavioral Health, Primary Care
Hall J, Cohen DJ, Davis M
Preparing the workforce for behavioral health and primary care integration.
The researchers sought to identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. They concluded that insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. Until the training capacity grows to meet the demand, practices must put forth considerable effort and resources to train their own employees.
AHRQ-funded; HS022981.
Citation: Hall J, Cohen DJ, Davis M .
Preparing the workforce for behavioral health and primary care integration.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S41-51. doi: 10.3122/jabfm.2015.S1.150054.
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Keywords: Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Behavioral Health, Training, Community-Based Practice
Balasubramanian BA, Fernald D, Dickinson LM
REACH of interventions integrating primary care and behavioral health.
This study reports REACH (the extent to which an intervention or program was delivered to the identified target population) of interventions integrating primary care and behavioral health implemented by real-world practices. Practices that implemented systematic protocols to identify patients needing integrated care had a significantly higher screening REACH compared with practices that used clinicians' discretion.
AHRQ-funded; HS022981.
Citation: Balasubramanian BA, Fernald D, Dickinson LM .
REACH of interventions integrating primary care and behavioral health.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S73-85. doi: 10.3122/jabfm.2015.S1.150055.
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Keywords: Behavioral Health, Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Community-Based Practice, Implementation, Community-Based Practice, Implementation
Okumura MJ, Saunders M, Rehm RS
The role of health advocacy in transitions from pediatric to adult care for children with special health care needs: bridging families, provider and community services.
The aim of this study was to develop a theoretical understanding of how family, healthcare providers, and community supports can assist youth and young adults with special healthcare needs (YASHCN) during the transition from pediatric to adult healthcare and services. Transition Advocacy consists of the presence of, or need for, a healthcare advocate who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. If advocates were identified, youth were more likely to obtain needed services.
AHRQ-funded; HS017716.
Citation: Okumura MJ, Saunders M, Rehm RS .
The role of health advocacy in transitions from pediatric to adult care for children with special health care needs: bridging families, provider and community services.
J Pediatr Nurs 2015 Sep-Oct;30(5):714-23. doi: 10.1016/j.pedn.2015.05.015.
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Keywords: Children/Adolescents, Community-Based Practice, Disabilities, Health Services Research (HSR), Young Adults
Cohen DJ, Balasubramanian BA, Davis M
Understanding care integration from the ground up: five organizing constructs that shape integrated practices.
The authors identified 5 key organizing constructs influencing integration of primary care and behavioral health. They concluded that the interaction among 5 organizing constructs and practice context produces diverse expressions of integrated care. These constructs provide a framework for understanding how primary care and behavioral health services can be integrated in routine practice.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Balasubramanian BA, Davis M .
Understanding care integration from the ground up: five organizing constructs that shape integrated practices.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S7-20. doi: 10.3122/jabfm.2015.S1.150050.
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Keywords: Behavioral Health, Healthcare Delivery, Community-Based Practice, Primary Care
Goldman SN, Liss DT, Brown T
Comparative effectiveness of multifaceted outreach to initiate colorectal cancer screening in community health centers: a randomized controlled trial.
The researchers sought to determine whether outreach increases fecal immune-chemical test (FIT) uptake among patients with no CRC screening history compared to usual care. They found that patients who received outreach were more likely to complete FIT than those in usual care (36.7 percent vs. 14.8 percent).
AHRQ-funded; HS021141.
Citation: Goldman SN, Liss DT, Brown T .
Comparative effectiveness of multifaceted outreach to initiate colorectal cancer screening in community health centers: a randomized controlled trial.
J Gen Intern Med 2015 Aug;30(8):1178-84. doi: 10.1007/s11606-015-3234-5..
Keywords: Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention, Screening
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
DeVoe JE, Marino M, Gold R
Community health center use after Oregon's randomized medicaid experiment.
To better understand the effect of new Medicaid coverage on community health center (CHC)use over time, the researchers studied Oregon’s 2008 randomized Medicaid expansion (the “Oregon Experiment”). Their results suggest that use of many different types of CHC services will increase as patients gain Medicaid through Affordable Care Act expansions.
AHRQ-funded; HS021522.
Citation: DeVoe JE, Marino M, Gold R .
Community health center use after Oregon's randomized medicaid experiment.
Ann Fam Med 2015 Jul;13(4):312-20. doi: 10.1370/afm.1812..
Keywords: Community-Based Practice, Healthcare Utilization, Medicaid, Primary Care
Albright K, Krantz MJ, Backlund JP
Health promotion text messaging preferences and acceptability among the medically underserved.
Preimplementation focus groups with participants informed the development of text messages that were used in a 6-week pilot program. Postimplementation focus groups and interviews then evaluated the pilot program. The results of the pilot study indicates support among participants for health promotion text messaging embedded into an existing community-based cardiovascular disease risk reduction program.
AHRQ-funded; HS021138.
Citation: Albright K, Krantz MJ, Backlund JP .
Health promotion text messaging preferences and acceptability among the medically underserved.
Health Promot Pract 2015 Jul;16(4):523-32. doi: 10.1177/1524839914566850..
Keywords: Community-Based Practice, Health Promotion, Prevention, Cardiovascular Conditions, Vulnerable Populations