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
1 to 25 of 35 Research Studies DisplayedCai L, Wu Y, Cheskin LI
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
This study, the first systematic, quantitative study of childhood obesity prevention programs on blood lipids in high-income countries found that most interventions (70 percent) showed similar significant or no effects on adiposity- and lipid outcomes; 15 percent of interventions improved both adiposity- and lipids outcomes; 55 percent had no significant effects on either. These programs had a significant desirable effect on LDL-C and HDL-C.
AHRQ-funded; 290200710061I
Citation: Cai L, Wu Y, Cheskin LI .
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
Obes Rev. 2014 Dec;15(12):933-44. doi: 10.1111/obr.12227..
Keywords: Children/Adolescents, Obesity, Prevention, Outcomes, Social Determinants of Health
Rokicki S, Montana L, Fink G
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
The researchers used detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. They found that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated.
AHRQ-funded; HS000055.
Citation: Rokicki S, Montana L, Fink G .
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
Demography 2014 Dec;51(6):2229-54. doi: 10.1007/s13524-014-0339-0..
Keywords: Pregnancy, Urban Health, Social Determinants of Health, Labor and Delivery
Pignone MP, Crutchfield TM, Brown PM
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
This study used a discrete choice experiment (DCE) to learn about how vulnerable individuals in North Carolina value different aspects of CRC screening programs. It found that follow-up cost coverage was most frequently found to be the most important attribute from the DCE (47 percent); followed by test reward/copayment (33 percent).
AHRQ-funded; HS019468.
Citation: Pignone MP, Crutchfield TM, Brown PM .
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
BMC Health Serv Res 2014 Nov 30;14:611. doi: 10.1186/s12913-014-0611-4..
Keywords: Cancer: Colorectal Cancer, Health Promotion, Rural Health, Screening, Social Determinants of Health
Angier H, Gregg J, Gold R
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
The researchers explored low-income parents’ perspectives on accessing health care. Interviews with 29 Oregon parents revealed that affordability and limited availability were seen as barriers to care; while a continuous relationship with a health care provider helped them overcome these barriers. Parents also described the difficult decisions they made between affordability and acceptability in order to get the best care they could for their children.
AHRQ-funded; HS018569.
Citation: Angier H, Gregg J, Gold R .
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
BMC Health Serv Res 2014 Nov 19;14:585. doi: 10.1186/s12913-014-0585-2..
Keywords: Access to Care, Children/Adolescents, Low-Income, Social Determinants of Health, Healthcare Costs
Heisler M, Choi H, Palmisano G
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
This study compared outcomes between community health worker (CHW) use of a tailored, interactive, Web-based, tablet computer-delivered tool specifically developed for the study and use of printed educational materials. In a population of low-income Latino and African American adults with diabetes and relatively low levels of formal education, participants in both CHW-led interventions reported mostly similar improvements in outcomes over 3 months.
AHRQ-funded; HS019256
Citation: Heisler M, Choi H, Palmisano G .
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22. doi: 10.7326/m13-3012..
Keywords: Health Information Technology (HIT), Diabetes, Shared Decision Making, Outcomes, Social Determinants of Health
Malhotra K, Baltrus P P, Zhang S
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
Using 2007 Medicaid claims data from 556 counties in 14 southern states, the researchers described the local area variation in 1-year asthma prevalence rates, emergency department visit rates, and racial disparity rate ratios. They found much local area variation in asthma prevalence and asthma ED visit rates among Medicaid-enrolled children. Between black and white children, more counties had higher prevalence of asthma and higher ED visit rates among blacks.
AHRQ-funded; HS022444; HS019470
Citation: Malhotra K, Baltrus P P, Zhang S .
Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states.
J Asthma. 2014 Nov;51(9):913-21. doi: 10.3109/02770903.2014.930479..
Keywords: Asthma, Medicaid, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Lyles CR, Schafer AL, Seligman HK
Income, food insecurity, and osteoporosis among older adults in the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
The researchers investigated osteoporosis and low socioeconomic status (SES). They concluded that income and food insecurity may have significant implications not just for immediate nutritional outcomes, but also for conditions such as osteoporosis that develop over the lifespan.
AHRQ-funded; HS022408.
Citation: Lyles CR, Schafer AL, Seligman HK .
Income, food insecurity, and osteoporosis among older adults in the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
J Health Care Poor Underserved 2014 Nov;25(4):1530-41. doi: 10.1353/hpu.2014.0174.
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Keywords: Elderly, Nutrition, Osteoporosis, Social Determinants of Health, Low-Income
Kaiboriboon K, Schiltz NK, Bakaki PM
Premature mortality in poor health and low income adults with epilepsy.
This research study’s objective was to examine mortality and causes of death in socioeconomically disadvantaged persons with epilepsy in the United States. While death from epilepsy-related causes was about 10%, comorbidities like cardiovascular disease, cancer, and unintentional injuries caused 18.4% of deaths. Socioeconomically deprived and Medicaid-insured patients died 17 years prematurely.
Epilepsia. 2014 Nov;55(11):1781-8. doi: 10.1111/epi.12789.
Citation: Kaiboriboon K, Schiltz NK, Bakaki PM .
Premature mortality in poor health and low income adults with epilepsy.
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Keywords: Low-Income, Mortality, Neurological Disorders, Social Determinants of Health
Diaz OV, Guendelman S, Kuppermann M
Subjective social status and depression symptoms: a prospective study of women with noncancerous pelvic problems.
The investigators sought to examine the effect of community and national subjective social status (SSS) on symptoms of depression in a racially/ethnically diverse sample of adult women with noncancerous uterine conditions. They found that low perceived community social status is predictive of symptoms suggestive of major or other depressive disorder among women with noncancerous uterine conditions.
AHRQ-funded; HS011657.
Citation: Diaz OV, Guendelman S, Kuppermann M .
Subjective social status and depression symptoms: a prospective study of women with noncancerous pelvic problems.
Womens Health Issues 2014 Nov-Dec;24(6):649-55. doi: 10.1016/j.whi.2014.07.003.
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Keywords: Depression, Health Status, Pain, Social Determinants of Health, Women
McCormick EV, Dickinson LM, Haemer MA
What can providers learn from childhood body mass index trajectories: a study of a large, safety-net clinical population.
The investigators described childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identified among gender- and race/ethnicity-specific groups any trends for increased risk. They found that all gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood, with Hispanic boys and black girls showing the most significant increase during this observation period. They further found that many obese children were already overweight by age 3, and persistence of obesity after 3 years of age was high. They concluded that intervention before age 3 may be essential to curbing unhealthy weight trajectories.
AHRQ-funded; HS021138.
Citation: McCormick EV, Dickinson LM, Haemer MA .
What can providers learn from childhood body mass index trajectories: a study of a large, safety-net clinical population.
Acad Pediatr 2014 Nov-Dec;14(6):639-45. doi: 10.1016/j.acap.2014.06.009.
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Keywords: Children/Adolescents, Obesity, Racial and Ethnic Minorities, Social Determinants of Health, Obesity: Weight Management
Goldman LE, Sarkar U, Kessell E
Support from hospital to home for elders: a randomized trial.
The researchers studied a peridischarge, nurse-led intervention combined with telephone follow-up designed to reduce readmissions among patients who were 55 or older. They found that the nurse-led, in-hospital discharge support intervention did not show a reduction in readmissions or ED visits among 700 diverse, low-income older adults at a safety-net hospital.
AHRQ-funded; HS018090.
Citation: Goldman LE, Sarkar U, Kessell E .
Support from hospital to home for elders: a randomized trial.
Ann Intern Med 2014 Oct 7;161(7):472-81. doi: 10.7326/m14-0094..
Keywords: Hospital Discharge, Hospital Readmissions, Emergency Department, Elderly, Social Determinants of Health, Nursing
Richards MR, Marti J
Heterogeneity in the smoking response to health shocks by out-of-pocket spending risk.
Using longitudinal data from 11 European countries, the researchers investigated the impact of a new cardiovascular (CV) health shock on smoking decisions among older adults and examine whether personal exposure to medical spending risk influences the smoking response. They found that CV shocks impact the propensity to smoke, with relatively more impact among individuals with high financial risk exposure to medical spending.
AHRQ-funded; HS017589.
Citation: Richards MR, Marti J .
Heterogeneity in the smoking response to health shocks by out-of-pocket spending risk.
Health Econ Policy Law 2014 Oct;9(4):343-57. doi: 10.1017/s1744133114000152..
Keywords: Cardiovascular Conditions, Tobacco Use, Lifestyle Changes, Health Insurance, Social Determinants of Health
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health
Holzer J, Canavan M, Bradley E
County-level correlation between adult obesity rates and prevalence of dentists.
The researchers conducted a study to examine the association between the prevalence of dentists and the rates of adult obesity. They found that having one additional dentist per 10,000 population was associated significantly with a 1-percentage point reduction in the rate of obesity. This effect was significantly larger in counties in which 25 percent of children or more (versus less than 25 percent of children) lived in poverty and in counties that had more primary care physicians per 10,000 population.
AHRQ-funded; HS017589.
Citation: Holzer J, Canavan M, Bradley E .
County-level correlation between adult obesity rates and prevalence of dentists.
J Am Dent Assoc 2014 Sep;145(9):932-9. doi: 10.14219/jada.2014.48.
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Keywords: Dental and Oral Health, Obesity, Risk, Social Determinants of Health
Wheeler SB, Kuo TM, Goyal RK
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
The researchers examined colorectal cancer (CRC) testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. They found that fewer than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kuo TM, Goyal RK .
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
Health Place 2014 Sep;29:114-23. doi: 10.1016/j.healthplace.2014.07.001.
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Keywords: Access to Care, Cancer: Colorectal Cancer, Disparities, Screening, Social Determinants of Health
Kenik J, Jean-Jacques M, Feinglass J
Explaining racial and ethnic disparities in cholesterol screening.
This study examining the impact of low socioeconomic status, access to care, and language on racial and ethnic disparities in cholesterol screening found that these factors explained most of those disparities. After adjusting for these factors, disparities between whites and Blacks and Hispanics but not Asians and Pacific Islanders were eliminated.
AHRQ-funded; HS021141
Citation: Kenik J, Jean-Jacques M, Feinglass J .
Explaining racial and ethnic disparities in cholesterol screening.
Prev Med. 2014 Aug;65:65-9. doi: 10.1016/j.ypmed.2014.04.026..
Keywords: Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Screening, Access to Care
Gomez SL, Lichtensztajn DY, Parikh P
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
The authors reported on a sruvey of general acute care hospitals in California to elucidate practices regarding collection and auditing of patient race, ethnicity, and primary spoken language (REL). They found that the majority of hospitals used standardized forms for collection, and 75% audited patient information for completeness. They concluded that California hospitals are collecting information on patient REL as mandated, but variation in data collection exists, and hospitals may benefit from standardized data collection and auditing practices.
AHRQ-funded; HS019963.
Citation: Gomez SL, Lichtensztajn DY, Parikh P .
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
J Health Care Poor Underserved 2014 Aug;25(3):1384-96. doi: 10.1353/hpu.2014.0126.
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Keywords: Data, Hospitals, Racial and Ethnic Minorities, Social Determinants of Health
Chambers C, Chiu S, Scott AN
Factors associated with poor mental health status among homeless women with and without dependent children.
The researchers estimated the prevalence of mental health problems among homeless women as well as the effects of risk factors on those problems. They found that, in a group of 522 homeless women in Toronto, Canada, poor mental health was associated with low perceived access to social support, physical/sexual assault in the past 12 months, presence of a chronic health condition, and presence of a drug use problem.
AHRQ-funded; HS014129
Citation: Chambers C, Chiu S, Scott AN .
Factors associated with poor mental health status among homeless women with and without dependent children.
Community Ment Health J. 2014 Jul;50(5):553-9. doi: 10.1007/s10597-013-9605-7..
Keywords: Behavioral Health, Chronic Conditions, Social Determinants of Health, Risk
Singh JA
The impact of gout on patient's lives: a study of African-American and Caucasian men and women with gout.
The objectives of this study were to assess the impact of gout on patients’ quality of life (QOL) and explore gender and race differences in the impact of gout on patients’ QOL. Some frequently cited high-ranked concerns among the ten nominal race- and sex-stratified groups were: (1) effect of gout flare on daily activities (n = 10 groups); (2) work disability (n = 8 groups);and (3) severe pain (n = 8 groups).
AHRQ-funded; HS021110.
Citation: Singh JA .
The impact of gout on patient's lives: a study of African-American and Caucasian men and women with gout.
Arthritis Res Ther 2014 Jun 24;16(3):R132. doi: 10.1186/ar4589..
Keywords: Quality of Life, Social Determinants of Health, Racial and Ethnic Minorities
Bettger JP, Zhao X, Bushnell C
The association between socioeconomic status and disability after stroke: findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry.
The authors examined the association of three indicators of SES--educational attainment, working status, and perceived adequacy of household income--with disability 3-months following an acute ischemic stroke. They found that 58% of the Adherence eValuation After Ischemic stroke--Longitudinal study patients had a high school or less education, 61% were not working, and 27% perceived their household income as inadequate prior to their stroke. Thirty five percent of patients were disabled at 3-months. They concluded that, in this cohort of stroke survivors, socioeconomic status was associated with disability following acute ischemic stroke.
AHRQ-funded; HS019479; HS016964.
Citation: Bettger JP, Zhao X, Bushnell C .
The association between socioeconomic status and disability after stroke: findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry.
BMC Public Health 2014 Mar 26;14:281. doi: 10.1186/1471-2458-14-281.
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Keywords: Disabilities, Patient-Centered Outcomes Research, Social Determinants of Health, Stroke
Bushnell CD, Reeves MJ, Zhao X
Sex differences in quality of life after ischemic stroke.
This study compared quality of life (QOL) in men and women at 3 and 12 months after stroke, and the change in QOL over time between men and women. It found that women have worse QOL than men up to 12 months after stroke, even after adjusting for important sociodemographic variables and stroke severity.
AHRQ-funded; HS016964.
Citation: Bushnell CD, Reeves MJ, Zhao X .
Sex differences in quality of life after ischemic stroke.
Neurology 2014 Mar 18;82(11):922-31. doi: 10.1212/wnl.0000000000000208..
Keywords: Stroke, Disparities, Women, Social Determinants of Health
Moy E, Freeman W
AHRQ Author: Moy E, Freeman W
Federal investments to eliminate racial/ethnic health-care disparities.
The authors presented a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. They proposed that increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication.
AHRQ-authored.
Citation: Moy E, Freeman W .
Federal investments to eliminate racial/ethnic health-care disparities.
Public Health Rep 2014 Jan-Feb;129 Suppl 2:62-70. doi: 10.1177/00333549141291s212.
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Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Vulnerable Populations
Hwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Chambers C, Chiu S, Katic M
High utilizers of emergency health services in a population-based cohort of homeless adults.
This study identified predictors of frequent emergency department (ED) use among a population-based sample of homeless adults in Toronto, Ontario. It found that among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
AHRQ-funded; HS014129.
Citation: Chambers C, Chiu S, Katic M .
High utilizers of emergency health services in a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S302-10. doi: 10.2105/ajph.2013.301397..
Keywords: Emergency Department, Social Determinants of Health, Health Insurance, Healthcare Utilization
John DA, de Castro AB, Duran B
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
The researchers examined how nativity and occupational class among Asian Americans may explain disparities in uninsurance and use of routine preventive healthcare services such as routine physical checkup and dental/eye exams. They found that 35 to 40 percent of workers in blue-collar and service occupations reported no physical checkup or dental/eye exams in the past year.
AHRQ-funded; HS013853
Citation: John DA, de Castro AB, Duran B .
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
J Immigr Minor Health. 2013 Dec;15(6):1011-22. doi: 10.1007/s10903-013-9851-3..
Keywords: Disparities, Uninsured, Racial and Ethnic Minorities, Social Determinants of Health, Prevention