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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
126 to 150 of 289 Research Studies DisplayedGance-Cleveland B, Leiferman J, Aldrich H
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
The purpose of this study was to develop StartSmart, a mobile health (mHealth) intervention to support evidence-based prenatal screening, brief intervention, and referral to treatment for risk and protective factors in pregnancy. Expert clinicians provided guidance on the screening instruments, resources, and practice guidelines. Clinicians suggested identifying specific prenatal visits for the screening. Patients reported that the tablet-based screening was useful to promote adherence to guidelines and provided suggestions for improvement.
AHRQ-funded; HS024738.
Citation: Gance-Cleveland B, Leiferman J, Aldrich H .
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
J Midwifery Womens Health 2019 Sep;64(5):630-40. doi: 10.1111/jmwh.13009..
Keywords: Health Information Technology (HIT), Domestic Violence, Clinical Decision Support (CDS), Shared Decision Making, Pregnancy, Women, Evidence-Based Practice, Screening, Prevention
Knox CA, Hampp C, Palmsten K
Validation of mother-infant linkage using Medicaid Case ID variable within the Medicaid Analytic eXtract (MAX) database.
The authors established and validated an algorithm within the Medicaid Analytic eXtract (MAX) that links mothers to infants and to identify factors influencing successful mother-infant linkage. They found that their algorithm can correctly link liveborn infants to their mothers, with linkage performance being associated with certain characteristics that may affect representativeness of successfully linked pairs.
AHRQ-funded; HS022384.
Citation: Knox CA, Hampp C, Palmsten K .
Validation of mother-infant linkage using Medicaid Case ID variable within the Medicaid Analytic eXtract (MAX) database.
Pharmacoepidemiol Drug Saf 2019 Sep;28(9):1222-30. doi: 10.1002/pds.4843..
Keywords: Caregiving, Medicaid, Newborns/Infants, Patient Safety, Pregnancy
Fabiyi CA, Reid LD, Mistry KB
AHRQ Author: Fabiyi CA, Mistry KB
Postpartum health care use after gestational diabetes and hypertensive disorders of pregnancy.
The objective of this study was to examine postpartum health care utilization after a pregnancy complicated by gestational diabetes (GD) and hypertensive disorders of pregnancy (HDP) using nationally representative data. The investigators found that women with GD/HDP did not differ from women with neither complication on postpartum utilization outcomes. Less educated women with GD/HDP were more likely to miss an office visit within 1 year postpartum than less educated women with neither complication. Certain subgroups of women were more likely to forego timely and appropriate postpartum care.
AHRQ-authored.
Citation: Fabiyi CA, Reid LD, Mistry KB .
Postpartum health care use after gestational diabetes and hypertensive disorders of pregnancy.
J Womens Health 2019 Aug;28(8):1116-23. doi: 10.1089/jwh.2018.7198..
Keywords: Medical Expenditure Panel Survey (MEPS), Maternal Care, Pregnancy, Diabetes, Blood Pressure, Women, Healthcare Utilization
Henderson JT, Webber EM, Bean SI
Screening for hepatitis B infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
In this research letter, the authors described their evidence update conducted to inform the USPSTF in updating its 2009 recommendation. They found that targeted resources are needed to ensure that case management is effectively implemented through health care that reaches vulnerable populations most at risk of perinatal transmission of hepatitis B virus (HBV), including women born in countries where HBV is endemic. They concluded that improving access to prenatal care, screening, and case management are among the strategies to help eliminate perinatal HBV infection in the United States.
AHRQ-funded; 290201500007I.
Citation: Henderson JT, Webber EM, Bean SI .
Screening for hepatitis B infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
AHRQ-funded; 290201500007I..
Keywords: Evidence-Based Practice, Hepatitis, Pregnancy, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF), Women
Brenes-Monge A, Saavedra-Avendano B, Alcalde-Rabanal J
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition.
Researchers conducted a cross-sectional study to test the association between overweight and obesity and cesarean delivery in Mexico using data from the 2012 National Survey of Health and Nutrition (ENSANUT). They found that multiparous women with obesity are at higher risk of cesarean delivery in Mexico than multiparous women with normal body mass index. They recommend that efforts to reduce the cesarean deliveries rate take the obesity epidemic into account.
AHRQ-funded; HS022981.
Citation: Brenes-Monge A, Saavedra-Avendano B, Alcalde-Rabanal J .
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition.
BMC Pregnancy Childbirth 2019 Jul 11;19(1):239. doi: 10.1186/s12884-019-2393-5..
Keywords: Labor and Delivery, Obesity, Pregnancy, Risk, Women
Brown SD, Fotuhi O, Grijalva CS
A randomized study of values affirmation to promote interest in diabetes prevention among women with a history of gestational diabetes.
The purpose of this study was to test whether two interventions promote interest in diabetes prevention among women with a history of gestational diabetes mellitus. The researchers designed an email outreach message incorporating ‘values affirmation,’ a theory-based intervention, and promoting an existing preventive lifestyle program. Selected patients were randomized to read an outreach message containing either no affirmation (control) or 1 of 2 affirmations. Results showed that participants randomized to the values affirmation more frequently demonstrated interest in the lifestyle program and sought information about diabetes prevention, while the parenting affirmation yielded no significant differences in either outcome.
AHRQ-funded; HS019367.
Citation: Brown SD, Fotuhi O, Grijalva CS .
A randomized study of values affirmation to promote interest in diabetes prevention among women with a history of gestational diabetes.
Med Care 2019 Jul;57(7):528-35. doi: 10.1097/mlr.0000000000001133..
Keywords: Diabetes, Chronic Conditions, Pregnancy, Women, Health Promotion, Prevention, Lifestyle Changes
Simpson KR, Lyndon A, Spetz J
Adaptation of the MISSCARE Survey to the maternity care setting.
This paper examines the feasibility of using the Missed Nursing Care (MISSCARE) Survey to study missed nursing care during labor and delivery. This survey has not been used to examine childbirth care although it is the most common reason for hospitalization in the United States. A modified version called the Perinatal Missed Care Survey appears to be the most feasible and promising instrument to evaluate missed nursing care during labor and delivery.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adaptation of the MISSCARE Survey to the maternity care setting.
J Obstet Gynecol Neonatal Nurs 2019 Jul;48(4):456-67. doi: 10.1016/j.jogn.2019.05.005..
Keywords: Labor and Delivery, Maternal Care, Nursing, Pregnancy, Women
Danilack VA, Brousseau EC, Paulo BA
Characteristics of women without a postpartum checkup among PRAMS participants, 2009-2011.
The authors studied whether sociodemographic characteristics and pregnancy and delivery factors were related to the likelihood of missing a postpartum checkup. They found that, compared to women who attended a postpartum checkup, women who missed the visit were younger, unmarried, less educated, with lower income, without insurance, and smokers. Also, women with intermediate or inadequate prenatal care were more likely to miss the checkup. Additionally, women were more likely to miss this checkup if their infant was born at a residence compared to a hospital and were less likely to miss the checkup if their newborn had a one-week well visit.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Paulo BA .
Characteristics of women without a postpartum checkup among PRAMS participants, 2009-2011.
Matern Child Health J 2019 Jul;23(7):903-09. doi: 10.1007/s10995-018-02716-x..
Keywords: Healthcare Utilization, Maternal Care, Patient Adherence/Compliance, Pregnancy, Social Determinants of Health, Women
Triebwasser JE, Kamdar NS, Langen ES
Hospital contribution to variation in rates of vaginal birth after cesarean.
The purpose of this retrospective cohort study was to determine the influence of delivery hospital on the rate of vaginal birth after cesarean (VBAC). Claims data were obtained from Blue Cross and Blue Shield of Michigan and included women with a prior cesarean and a singleton live birth. Hospital-specific risk-standardized VBAC rates and the median odds ratio as a measure of variation were calculated. From their results, the authors conclude that the individual delivery hospital contributes to the significant variation in rates of VBAC, after adjustment for patient and hospital characteristics.
AHRQ-funded; HS025465.
Citation: Triebwasser JE, Kamdar NS, Langen ES .
Hospital contribution to variation in rates of vaginal birth after cesarean.
J Perinatol 2019 Jul;39(7):904-10. doi: 10.1038/s41372-019-0373-2..
Keywords: Hospitals, Labor and Delivery, Maternal Care, Pregnancy, Women
Selph SS, Bougatsos C, Dana T
Screening for HIV Infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
Prenatal screening for HIV can inform use of interventions to reduce the risk of mother-to-child transmission. The US Preventive Services Task Force (USPSTF) previously found strong evidence that prenatal HIV screening reduced risk of mother-to-child transmission. The previous evidence review was conducted in 2012. The objective of this study was to update the 2012 review on prenatal HIV screening to inform the USPSTF.
AHRQ-funded; 290201500009I.
Citation: Selph SS, Bougatsos C, Dana T .
Screening for HIV Infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Jun 18;321(23):2349-60. doi: 10.1001/jama.2019.2593..
Keywords: U.S. Preventive Services Task Force (USPSTF), Human Immunodeficiency Virus (HIV), Screening, Pregnancy, Women, Evidence-Based Practice
Guglielminotti J, Landau R, Li. G
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. The investigators concluded that compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Landau R, Li. G .
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Anesthesiology 2019 Jun;130(6):912-22. doi: 10.1097/aln.0000000000002629..
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Surgery, Pregnancy, Adverse Drug Events (ADE), Adverse Events, Women, Medication, Medication: Safety, Patient Safety, Maternal Care
Masho SW, Ihongbe TO, Wan W
Effectiveness of shortened time interval to postpartum visit in improving postpartum attendance: design and rationale for a randomized controlled trial.
Recent evidence suggests that there are numerous benefits to scheduling postpartum visits as early as 3 weeks post-delivery. However, findings are not conclusive due to methodological limitations. This report discussed the unique aspects of a randomized controlled trial's (RCT) design, intervention, and strategies to maintain participant retention. The study design offered unique features which ensured excellent participant completion and adherence rates, despite the presence of hard-to-track women who typically do not return for their postpartum visits.
AHRQ-funded; HS021504.
Citation: Masho SW, Ihongbe TO, Wan W .
Effectiveness of shortened time interval to postpartum visit in improving postpartum attendance: design and rationale for a randomized controlled trial.
Contemp Clin Trials 2019 Jun;81:40-43. doi: 10.1016/j.cct.2019.04.012..
Keywords: Maternal Care, Pregnancy, Women, Patient Adherence/Compliance, Research Methodologies
Simpson KR, Lyndon A, Spetz J
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Labor and delivery nurses were surveyed to determine if their units adhere to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Labor nurses in selected hospitals in California, Michigan and New Jersey were invited via email to participate in the study. Their nurse leaders facilitated the invitations. A total of 615 labor nurses from 67 hospitals participated. Most nurses did report that staffing guidelines were adhered to. The hospitals with smaller annual birth volumes (500-999 range) were significantly more like to be perceived as compliant than hospitals with 2,500 or more annual births.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Nurs Womens Health 2019 Jun;23(3):217-23. doi: 10.1016/j.nwh.2019.03.003..
Keywords: Care Management, Guidelines, Labor and Delivery, Maternal Care, Patient Safety, Pregnancy, Provider, Provider: Nurse, Women
Campbell KH, Illuzzi JL, Lee HC
Optimal maternal and neonatal outcomes and associated hospital characteristics.
The goal of this study was to examine hospital variation in both maternal and neonatal morbidities and to identify institutional characteristics associated with hospital performance in a combined measure of maternal and neonatal outcomes. The authors found that hospitals with low maternal morbidity rates may not have low neonatal morbidity rates and vice versa, highlighting the importance of assessing joint maternal-newborn outcomes in order to fully characterize a hospital's obstetrical performance.
AHRQ-funded; HS023801.
Citation: Campbell KH, Illuzzi JL, Lee HC .
Optimal maternal and neonatal outcomes and associated hospital characteristics.
Birth 2019 Jun;46(2):289-99. doi: 10.1111/birt.12400.
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Keywords: Hospitals, Newborns/Infants, Outcomes, Pregnancy, Provider Performance, Quality of Care, Women
Dorst MT, Anders SH, Chennupati S
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
This study’s objective was to determine the number and nature of the components of the support systems of pregnant women and their caregivers (family members) and the role of health information technologies (HIT) in these support systems. Pregnant women and their caregivers were enrolled from advanced maternal-fetal and group prenatal care clinics. Participants filled out surveys which addressed stress levels, socioeconomic status, health literacy, and they drew a diagram of their support systems. Pregnant women overall had a larger support system than their caregivers. Their source of medical information was more likely to be specific medical information websites, while caregivers used more general internet search engines. No association was found between stress, support system size, and support system components.
AHRQ-funded; HS021496.
Citation: Dorst MT, Anders SH, Chennupati S .
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
J Med Internet Res 2019 May 9;21(5):e10865. doi: 10.2196/10865..
Keywords: Health Information Technology (HIT), Pregnancy, Caregiving, Women, Social Media
Vanderlaan J, Rochat R, Williams B
Associations between hospital maternal service level and delivery outcomes.
This study explored the associations between delivery hospital self-reported level of maternal service, as defined by the American Hospital Association, and both maternal and neonatal outcomes among women at high maternal risk, as defined by the Obstetric Comorbidity Index. The investigators concluded that for the group of pregnant women in need of maternal transfer, delivery hospital self-reported level of maternal care was not associated with the odds of poor maternal or neonatal outcomes.
AHRQ-funded; HS024655.
Citation: Vanderlaan J, Rochat R, Williams B .
Associations between hospital maternal service level and delivery outcomes.
Womens Health Issues 2019 May - Jun;29(3):252-58. doi: 10.1016/j.whi.2019.02.004..
Keywords: Maternal Care, Labor and Delivery, Pregnancy, Women, Outcomes, Hospitals, Quality of Care, Newborns/Infants, Mortality
Cantor AG, Hendrickson R, Blazina I
Screening for elevated blood lead levels in childhood and pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to synthesize evidence on the effects of screening, testing, and treatment for elevated blood lead level in pregnant women and children aged 5 years and younger in the primary care setting to inform the US Preventive Services Task Force. The investigators found that screening questionnaires were not accurate for identifying children with elevated blood lead levels. Additionally, chelating agents in children were not significantly associated with sustained effects on blood level levels but were associated with harms.
AHRQ-funded; 290201500009I.
Citation: Cantor AG, Hendrickson R, Blazina I .
Screening for elevated blood lead levels in childhood and pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Apr 16;321(15):1510-26. doi: 10.1001/jama.2019.1004..
Keywords: Children/Adolescents, Evidence-Based Practice, Pregnancy, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF), Women
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Maurer M, Carman KL, Yang M
Increasing the use of comparative quality information in maternity care: results from a randomized controlled trial.
The authors tested an intervention to increase uptake of hospital-level maternity care quality reports among 245 pregnant women in North Carolina. They found that intervention participants were significantly more likely to report adopting behaviors to inform care, such as thinking through preferences, talking with their doctor, or creating a birth plan. They concluded that reports designed to put quality information into the larger context of what consumers want and need to know, along with targeted and timely communications, can increase consumer use of quality information and prompt them to talk with providers about care preferences and evidence-based practices.
AHRQ-funded; HS021873.
Citation: Maurer M, Carman KL, Yang M .
Increasing the use of comparative quality information in maternity care: results from a randomized controlled trial.
Med Care Res Rev 2019 Apr;76(2):208-28. doi: 10.1177/1077558717712290.
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Keywords: Maternal Care, Patient and Family Engagement, Quality Improvement, Women, Pregnancy
Milla C, Guo M, Chang A
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Childbirth is a national priority area for healthcare quality improvement. Patient perspectives are increasingly valued in healthcare, yet Asian American and Pacific Islander (AAPI) perspectives of healthcare quality are often understudied, particularly from individuals with limited English proficiency (LEP). In this study, the goal was to understand factors that consumers in Hawai'i, including AAPI and those with LEP, used to compare patient care in hospitals, especially for childbirth.
AHRQ-funded; HS021903.
Citation: Milla C, Guo M, Chang A .
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Hawaii J Med Public Health 2019 Mar;78(3):89-97..
Keywords: Labor and Delivery, Pregnancy, Hospitals, Quality Improvement, Quality of Care, Cultural Competence, Women
Horner-Johnson W, Biel FM, Caughey AB
Differences in prenatal care by presence and type of maternal disability.
This study examined timing and frequency of prenatal care of women with disabilities by disability type. A retrospective cohort study was done of all births in California from 2000-2012. Women with intellectual/developmental disabilities, or limited hearing had the most significant risk of receiving less prenatal care compared to women with physical disabilities. However women with intellectual/developmental or physical disabilities may have a higher than normal number of prenatal visits. Delays in prenatal care may result in poorer birth outcomes.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Biel FM, Caughey AB .
Differences in prenatal care by presence and type of maternal disability.
Am J Prev Med 2019 Mar;56(3):376-82. doi: 10.1016/j.amepre.2018.10.021..
Keywords: Disabilities, Healthcare Utilization, Pregnancy, Vulnerable Populations, Women
Mehra R, Shebi FM, Cunningham SD
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
This research studied the association between area-level deprivation and preterm birth. A retrospective cohort study was conducted using data obtained from the Health Care Cost Institute that uses national, commercial health claims data from 2011. The highest quartile of area-level deprivation experienced the highest number of preterm birth (24.9%) as opposed to the lowest quarter (9.6%). This was true even among commercially-insured women.
AHRQ-funded; HS017589; HS022242.
Citation: Mehra R, Shebi FM, Cunningham SD .
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
BMC Public Health 2019 Feb 27;19(1):236. doi: 10.1186/s12889-019-6533-7..
Keywords: Health Insurance, Newborns/Infants, Pregnancy, Social Determinants of Health, Women
O'Connor E, Senger CA, Henninger ML
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
This evidence review, funded by the U.S. Preventive Services Task Force examined if interventions to prevent perinatal depression was effective. A large number of studies were identified, and 50 were included in the review. There was an absolute difference in the risk of perinatal depression from 1.3% reduction in the control group to 31.8% greater reduction in the intervention group. Most of the studies were limited to women at increased risk for perinatal depression. Counseling interventions seemed to be the most effective.
AHRQ-funded; 290201500017I.
Citation: O'Connor E, Senger CA, Henninger ML .
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Feb 12;321(6):588-601. doi: 10.1001/jama.2018.20865.
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Keywords: Depression, Evidence-Based Practice, Pregnancy, U.S. Preventive Services Task Force (USPSTF), Women, Behavioral Health, Maternal Care
Herrick CJ, Keller MR, Trolard AM
Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010-2015.
This study looked at postpartum screening for type 2 diabetes among low-income women who were previously diagnosed with gestational diabetes. Gestational diabetes increases risk for developing type 2 diabetes 7-fold so it is recommended that screening is done within months after delivery. Results in a Missouri population found that almost 20% were screened within the first year of delivery.
AHRQ-funded; HS019455.
Citation: Herrick CJ, Keller MR, Trolard AM .
Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010-2015.
BMC Public Health 2019 Feb 4;19(1):148. doi: 10.1186/s12889-019-6475-0..
Keywords: Diabetes, Low-Income, Pregnancy, Screening, Women
Gadgil MD, Ehrlich SF, Zhu Y
Dietary quality and glycemic control among women with gestational diabetes mellitus.
Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with GDM. The authors concluded that clinicians should be aware that even a small improvement in diet quality may be beneficial for the achievement of improved glycemic control in women with GDM.
AHRQ-funded; HS019367.
Citation: Gadgil MD, Ehrlich SF, Zhu Y .
Dietary quality and glycemic control among women with gestational diabetes mellitus.
J Womens Health 2019 Feb;28(2):178-84. doi: 10.1089/jwh.2017.6788..
Keywords: Pregnancy, Diabetes, Nutrition, Women, Risk, Prevention