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Topics
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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
26 to 50 of 74 Research Studies DisplayedKrist AH, Baumann LJ, Holtrop JS
Evaluating feasible and referable behavioral counseling interventions.
The U.S. Preventive Services Task Force (USPSTF) convened an expert forum in 2013 to inform the evaluation of behavioral counseling intervention (BCI) feasibility. This manuscript reports on findings from the forum and proposes that researchers use several frameworks to help clinicians and the USPSTF evaluate which BCIs work under usual conditions. A key recommendation for BCI researchers is to use frameworks whose components can support dissemination and implementation efforts.
AHRQ-funded; 290201000004I.
Citation: Krist AH, Baumann LJ, Holtrop JS .
Evaluating feasible and referable behavioral counseling interventions.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S138-49. doi: 10.1016/j.amepre.2015.05.009.
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Keywords: Behavioral Health, Primary Care, Evidence-Based Practice, U.S. Preventive Services Task Force (USPSTF)
Zanocco K, Butt Z, Kaltman D
Improvement in patient-reported physical and mental health after parathyroidectomy for primary hyperparathyroidism.
The objective of this study was to evaluate the feasibility of Patient-Reported Outcomes Measurement Information System (PROMIS) assessment in the clinical setting to measure changes in patient-reported health before and after parathyroidectomy. It found that PROMIS is an efficient clinical assessment platform for measuring patient-reported outcomes in primary hyperparathyroidism via computer-adaptive testing.
AHRQ-funded; HS000078.
Citation: Zanocco K, Butt Z, Kaltman D .
Improvement in patient-reported physical and mental health after parathyroidectomy for primary hyperparathyroidism.
Surgery 2015 Sep;158(3):837-45. doi: 10.1016/j.surg.2015.03.054..
Keywords: Health Status, Surgery, Behavioral Health, Patient-Centered Outcomes Research, Outcomes
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
Ludman EJ, Curry SJ
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
This study, Options Regarding Consumption of Alcohol (ORCA), was designed to test whether a primary care-based intervention would reduce alcohol misuse among patients who screened positive for risky or hazardous drinking. This paper assesses the study features using the Pragmatic-Explanatory Continuum Indicator Summary Model domains. As a randomized trial, the study included some explanatory features (e.g., standardized follow-up surveys administered by study personnel); however, several aspects of the study were highly pragmatic.
AHRQ-funded; 290201000004I.
Citation: Ludman EJ, Curry SJ .
Perspectives in implementing a primary care-based intervention to reduce alcohol misuse.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S194-9. doi: 10.1016/j.amepre.2015.05.016.
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Keywords: Alcohol Use, Behavioral Health, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
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
McNellis RJ, Ory MG, Lin JS
AHRQ Author: McNellis RJ
Standards of evidence for behavioral counseling recommendations.
This paper summarizes and expands upon an extensive discussion held at the U.S. Preventive Services Task Force’s Expert Forum on behavioral counseling interventions held in November 2013. The paper describes the foundational challenges for using behavioral outcomes as evidence to support a Task Force recommendation.
AHRQ-authored
Citation: McNellis RJ, Ory MG, Lin JS .
Standards of evidence for behavioral counseling recommendations.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S150-7. doi: 10.1016/j.amepre.2015.06.002..
Keywords: Behavioral Health, Evidence-Based Practice, Health Promotion, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
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
Kurth AE, Miller TL, Woo M
AHRQ Author: Miller TL
Understanding research gaps and priorities for improving behavioral counseling interventions: lessons learned from the U.S. Preventive Services Task Force.
This paper describes the types of gaps that the USPSTF encounters across its behavioral counseling intervention topics and provides suggestions for opportunities to address these gaps to enhance the evidence base for primary care–based behavioral counseling recommendations. To accomplish this, it draws from both the USPSTF experience and issues identified by researchers and clinicians during the USPSTF-sponsored Behavioral Counseling Intervention Forum.
AHRQ-authored
Citation: Kurth AE, Miller TL, Woo M .
Understanding research gaps and priorities for improving behavioral counseling interventions: lessons learned from the U.S. Preventive Services Task Force.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S158-65. doi: 10.1016/j.amepre.2015.06.007..
Keywords: Behavioral Health, Evidence-Based Practice, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Earnshaw VA, Smith LR, Cunningham CO
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
The researchers examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. They found that participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Smith LR, Cunningham CO .
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
J Health Psychol 2015 Aug;20(8):1083-9. doi: 10.1177/1359105313507964..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Behavioral Health, Social Stigma, Substance Abuse
Jolles MP, Haynes-Maslow L, Roberts MC
Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
This study examines (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. It found that most patient office visits (70 percent) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded.
AHRQ-funded; HS000032.
Citation: Jolles MP, Haynes-Maslow L, Roberts MC .
Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.
Med Care 2015 Aug;53(8):708-12. doi: 10.1097/mlr.0000000000000389..
Keywords: Depression, Behavioral Health, Chronic Conditions, Primary Care
Wielen LM, Gilchrist EC, Nowels MA
Not near enough: racial and ethnic disparities in access to nearby behavioral health care and primary care.
The authors addressed disparities associated with integrated behavioral health and primary care services. They found that primary care providers practicing in neighborhoods with higher percentages of African Americans and Hispanics were less likely to have geographically proximate behavioral health professionals; this also applied to rural areas. They concluded that additional behavioral health professionals are needed in racial/ethnic minority neighborhoods and rural areas to provide access to behavioral health services, and to progress toward more integrated primary care.
AHRQ-funded; HS022444.
Citation: Wielen LM, Gilchrist EC, Nowels MA .
Not near enough: racial and ethnic disparities in access to nearby behavioral health care and primary care.
J Health Care Poor Underserved 2015 Aug;26(3):1032-47. doi: 10.1353/hpu.2015.0083.
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Keywords: Behavioral Health, Disparities, Primary Care, Racial and Ethnic Minorities
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
Gerhard T, Devanand DP, Huang C
Lithium treatment and risk for dementia in adults with bipolar disorder: population-based cohort study.
This study examined the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder. It found that compared with non-use, 301–365 days of lithium exposure was associated with significantly reduced dementia risk. No corresponding association was observed for shorter lithium exposures.
AHRQ-funded; HS021112.
Citation: Gerhard T, Devanand DP, Huang C .
Lithium treatment and risk for dementia in adults with bipolar disorder: population-based cohort study.
Br J Psychiatry 2015 Jul;207(1):46-51. doi: 10.1192/bjp.bp.114.154047..
Keywords: Dementia, Risk, Behavioral Health, Medication
Zuvekas SH
AHRQ Author: Zuvekas SH
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
This study used data from the 2004-2008 Medical Expenditure Panel Survey to examine differences in offers and take-up of employer-sponsored health insurance (ESI) coverage among adults aged 27-54 by mental health status. It found little difference in the take-up of offers of ESI coverage between those with and without mental disorders.
AHRQ-authored
Citation: Zuvekas SH .
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
J of Behav Health Serv and Res. 2015 Jul;42(3):279-91. doi: 10.1007/s11414-015-9459-6..
Keywords: Behavioral Health, Medical Expenditure Panel Survey (MEPS), Health Insurance
Fan T, Rossi C
AHRQ Author: Fan T
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
This case study involves a 16-year-old white female nonsmoker who presents for a sports clearance physical. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Fan T, Rossi C .
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
Am Fam Physician 2015 Jun 15;91(12):865-6.
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Keywords: Children/Adolescents, Primary Care, Behavioral Health, U.S. Preventive Services Task Force (USPSTF), Substance Abuse
Lu CY, Zhang F, Lakoma MD
Asthma treatments and mental health visits after a Food and Drug Administration label change for leukotriene inhibitors.
This study investigated how a label change to include neuropsychiatric adverse events (e.g., depression and suicidality) affected the use of leukotriene inhibitors (LTIs) and other asthma controller medications, mental health visits, and suicide attempts. The label change was associated with abrupt reductions in LTI use among all age groups.
AHRQ-funded; HS019669.
Citation: Lu CY, Zhang F, Lakoma MD .
Asthma treatments and mental health visits after a Food and Drug Administration label change for leukotriene inhibitors.
Clin Ther 2015 Jun;37(6):1280-91. doi: 10.1016/j.clinthera.2015.03.027..
Keywords: Adverse Drug Events (ADE), Asthma, Children/Adolescents, Medication, Behavioral Health
Aschbrenner KA, Brunette MF, McElvery R
Cigarette smoking and interest in quitting among overweight and obese adults with serious mental illness enrolled in a fitness intervention.
The authors explored cigarette smoking, health status, and interest in quitting among overweight and obese adults with serious mental illness enrolled in a fitness intervention. Using the In SHAPE fitness intervention data, the researchers found that 84% of smokers were interested in quitting. Smokers in the intervention had lower high-density lipoprotein cholesterol and were less ready to reduce dietary fat.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Brunette MF, McElvery R .
Cigarette smoking and interest in quitting among overweight and obese adults with serious mental illness enrolled in a fitness intervention.
J Nerv Ment Dis 2015 Jun;203(6):473-6. doi: 10.1097/nmd.0000000000000309.
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Keywords: Health Status, Lifestyle Changes, Behavioral Health, Obesity, Tobacco Use
Gibbons MB, Thompson SM, Mack RA
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
The researchers explored the role of baseline skills deficits in compensatory skills and self-understanding across both cognitive and dynamic treatment modalities. Their results support a capitalization model for cognitive therapy but failed to support either a compensation model or a capitalization model for the short-term dynamic model.
AHRQ-funded; HS022124.
Citation: Gibbons MB, Thompson SM, Mack RA .
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
J Clin Psychol 2015 Jun;71(6):491-9. doi: 10.1002/jclp.22165..
Keywords: Comparative Effectiveness, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Weiss SM, Tobin JN, Lopez M
Translating an evidence-based behavioral intervention for women living with HIV into clinical practice: the SMART/EST Women's Program.
The researchers explored the pathways to effectively transfer promising research accomplishments into effective and sustainable service programs within the health care delivery system. Their study confirmed (a) the translatability of the Stress Management And Relaxation Training/Emotional Supportive Therapy (SMART/EST) Women's Program, from academic to community health center settings in two geographic regions with high HIV prevalence among women, (b) the ability of local staff to successfully achieve program fidelity and clinical outcomes, and (c) the sustainability the program beyond the auspices of research support, through supportive community health center leadership securing continued program funding.
AHRQ-funded; HS021667.
Citation: Weiss SM, Tobin JN, Lopez M .
Translating an evidence-based behavioral intervention for women living with HIV into clinical practice: the SMART/EST Women's Program.
Int J Behav Med 2015 Jun;22(3):415-24. doi: 10.1007/s12529-014-9399-1.
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Keywords: Behavioral Health, Evidence-Based Practice, Healthcare Delivery, Human Immunodeficiency Virus (HIV), Implementation
Olfson M, Druss BG, Marcus SC
Trends in mental health care among children and adolescents.
This study examined national trends in the use of outpatient mental health services by children and adolescents, focusing on the severity of mental health impairment. It found that outpatient mental health treatment and psychotropic-medication use in children and adolescents increased in the United States between 1996–1998 and 2010–2012. Youths with less severe or no impairment accounting for most of the absolute increase in service use.
AHRQ-funded; HS021112.
Citation: Olfson M, Druss BG, Marcus SC .
Trends in mental health care among children and adolescents.
N Engl J Med 2015 May 21;372(21):2029-38. doi: 10.1056/NEJMsa1413512..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Ambulatory Care and Surgery
Samples H, Mojtabai R
Antidepressant self-discontinuation: results from the collaborative psychiatric epidemiology surveys.
The authors examined the extent and correlates of self-discontinuation of antidepressant medications without physician advice using the Collaborative Psychiatric Epidemiology Surveys. They concluded that physicians prescribing antidepressants need to communicate clearly about the expected benefits of treatment, the minimum duration of use required to experience benefits, and the potential side effects of these medications, particularly to younger patients, those with anxiety disorders, and patients treated in general medical settings, all of whom have increased odds of self-discontinuation.
AHRQ-funded; HS000029.
Citation: Samples H, Mojtabai R .
Antidepressant self-discontinuation: results from the collaborative psychiatric epidemiology surveys.
Psychiatr Serv 2015 May;66(5):455-62. doi: 10.1176/appi.ps.201400021.
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Keywords: Medication, Depression, Medication: Safety, Behavioral Health, Patient Adherence/Compliance
Ghant MS, Sengoba KS, Recht H
Beyond the physical: a qualitative assessment of the burden of symptomatic uterine fibroids on women's emotional and psychosocial health.
This study qualitatively assessed the burden of uterine fibroids on women's emotional health. It found that most participants exhibited a significant emotional response to their fibroids, including fear, anxiety, anger, and depression. Half of the women felt helpless and believed that they had no control over their fibroids.
AHRQ-funded; HS021141.
Citation: Ghant MS, Sengoba KS, Recht H .
Beyond the physical: a qualitative assessment of the burden of symptomatic uterine fibroids on women's emotional and psychosocial health.
J Psychosom Res 2015 May;78(5):499-503. doi: 10.1016/j.jpsychores.2014.12.016..
Keywords: Women, Behavioral Health, Quality of Life
Storzbach D, O'Neil ME, Roost SM
Comparing the neuropsychological test performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress symptoms.
The purpose of this paper was to compare neuropsychological test performance of veterans with and without mild traumatic brain injury (MTBI), blast exposure, and posttraumatic stress disorder (PTSD) symptoms. The authors found that, although some mild neurocognitive effects were associated with blast exposure, these neurocognitive effects might be better explained by PTSD symptom severity rather than blast exposure or MTBI history alone.
AHRQ-funded; HS022981; HS019456.
Citation: Storzbach D, O'Neil ME, Roost SM .
Comparing the neuropsychological test performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress symptoms.
J Int Neuropsychol Soc 2015 May;21(5):353-63. doi: 10.1017/s1355617715000326.
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Keywords: Brain Injury, Behavioral Health, Neurological Disorders
Sylvia LG, Thase ME, Reilly-Harrington NA
Psychotherapy use in bipolar disorder: association with functioning and illness severity.
The researchers examined characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Their data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden.
AHRQ-funded; HS019371.
Citation: Sylvia LG, Thase ME, Reilly-Harrington NA .
Psychotherapy use in bipolar disorder: association with functioning and illness severity.
Aust N Z J Psychiatry 2015 May;49(5):453-61. doi: 10.1177/0004867415569803..
Keywords: Access to Care, Healthcare Utilization, Behavioral Health