National Healthcare Quality and Disparities Report
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- Chronic Conditions (5)
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- (-) Social Determinants of Health (14)
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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 14 of 14 Research Studies DisplayedMehta S, Lyles CR, Rubinsky AD
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
It is not clear how accurately Electronic health records (HER) data reflect patients' lived experience of social determinants of health (SDOH). The process of manually reviewing clinical notes to retrieve SDOH information is not feasible. The purpose of this study was to apply two tools, PatientExploreR and Electronic Medical Record Search Engine (EMERSE), to identify SDOH mappings for structured and unstructured patient data. The researchers included 4,283 adult patients receiving primary care for diabetes at UCSF. The study results revealed that SDOH may be more significant in the lives of patients with diabetes than is evident from structured data recorded on EHRs. When researchers applied EMERSE NLP rules, additional information was uncovered from patient clinical notes on problems related to social connections isolation, employment, financial insecurity, housing insecurity, food insecurity, education, and stress.
AHRQ-funded; HS026383.
Citation: Mehta S, Lyles CR, Rubinsky AD .
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
JMIR Med Inform 2023 Aug 22; 11:e46159. doi: 10.2196/46159..
Keywords: Social Determinants of Health, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Field C, Lynch CD, Fareed N
Association of community walkability and glycemic control among pregnant individuals with pregestational diabetes mellitus.
The role of community walkability in influencing glycemic regulation in expectant individuals with pre-existing diabetes is yet to be established. The purpose of this study was to explore the relationship between the walkability of a neighborhood at the community level and glycemic control, as indicated by hemoglobin A1c (A1C), in pregnant individuals with pregestational diabetes. The researchers conducted a retrospective examination of expectant individuals with pregestational diabetes who participated in a combined prenatal and diabetic care program from 2012 to 2016. The determinant of interest was community walkability, determined by the US Environmental Protection Agency National Walkability Index (score range 1-20), which includes intersection concentration (design), closeness to transit stops (distance), and a combination of job and household varieties (diversity). Participants from the most walkable neighborhoods were contrasted with those from less walkable neighborhoods as per the National Environmental Protection Agency's definition. The outcomes were glycemic control, including A1C, measured both in early and late pregnancy, and the average change in A1C throughout pregnancy. The study found that out of 417 expectant individuals, 10% resided in the most walkable areas. All 417 participants had an A1C assessment in early pregnancy, and 376 had another A1C assessment in late pregnancy. Pregnant individuals living in the most walkable areas were more likely to have an A1C <6.0% in early pregnancy, and an A1C <6.5% in late pregnancy compared with those in less walkable areas. The change in A1C across pregnancy was not related to walkability. The study concluded that individuals with pre-existing diabetes residing in more walkable areas demonstrated better glycemic control during both early and late pregnancy.
AHRQ-funded; HS028822.
Citation: Field C, Lynch CD, Fareed N .
Association of community walkability and glycemic control among pregnant individuals with pregestational diabetes mellitus.
Am J Obstet Gynecol MFM 2023 May; 5(5):100898. doi: 10.1016/j.ajogmf.2023.100898..
Keywords: Diabetes, Maternal Care, Social Determinants of Health, Women
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
AHRQ-funded; HS019455.
Citation: McQueen A, Kreuter MW, Herrick CJ .
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords: Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Chambers EC, McAuliff KE, Heller CG
Toward understanding social needs among primary care patients with uncontrolled diabetes.
This study examined the relationship between unmet social needs and diabetes among a predominantly Black and Hispanic patient population in a large urban hospital system in Bronx, New York. A total of 5846 patients with diabetes seen at a primary care visit between April 2018 and December 2019 were included and completed a social needs screener. Twenty-two percent of the patient sample had at least 1 unmet social need, with the most prevalent unmet needs being housing issues, food insecurity, and lack of healthcare transportation. Patients with more unmet needs had a greater likelihood of uncontrolled diabetes, with lack of healthcare transportation and food insecurity having the greatest likelihood.
AHRQ-funded; HS026396.
Citation: Chambers EC, McAuliff KE, Heller CG .
Toward understanding social needs among primary care patients with uncontrolled diabetes.
J Prim Care Community Health 2021 Jan-Dec;12:2150132720985044. doi: 10.1177/2150132720985044..
Keywords: Diabetes, Chronic Conditions, Primary Care, Vulnerable Populations, Social Determinants of Health
Ke C, Kim SJ, Shah BR
AHRQ Author: Bierman AS
Impact of socioeconomic status on incidence of end-stage renal disease and mortality after dialysis in adults with diabetes.
The purpose of this study was to determine whether low socioeconomic status (SES), with or without universal drug coverage, predicts end-stage renal disease (ESRD) and survival after dialysis in patients with diabetes. Results showed that low SES was inversely associated with ESRD outcomes in individuals with diabetes, and this disparity was reduced in those age 65 and older who universally received prescription drug coverage. Low SES was associated with a higher mortality after dialysis, largely explained by lower kidney transplantation rates in poorer populations.
AHRQ-authored.
Citation: Ke C, Kim SJ, Shah BR .
Impact of socioeconomic status on incidence of end-stage renal disease and mortality after dialysis in adults with diabetes.
Can J Diabetes 2019 Oct;43(7):483-89.e4. doi: 10.1016/j.jcjd.2019.04.006..
Keywords: Diabetes, Kidney Disease and Health, Mortality, Social Determinants of Health
Phillips AZ, Rodriguez HP
Adults with diabetes residing in "food swamps" have higher hospitalization rates.
This study examined the relationship between ‘food swamps’ and hospitalization rates among adults with diabetes. Food Swamps are defined and measured by a ratio of fast food outlets to grocery stores within a given area. Data resources for this study included the Blue Cross Blue Shield Association Community Health Management Hub(R), AHRQ’s Health Care Cost and Utilization Project State Inpatient Databases, and HHS’s Area Health Resources File. The study concludes that higher hospitalization rates among adults with diabetes are significantly associated with food swamps, more so in rural than urban communities, and that improvements to local food environments may help to reduce this disparity.
AHRQ-funded; HS022241.
Citation: Phillips AZ, Rodriguez HP .
Adults with diabetes residing in "food swamps" have higher hospitalization rates.
Health Serv Res 2019 Feb;54(Suppl 1):217-25. doi: 10.1111/1475-6773.13102..
Keywords: Chronic Conditions, Diabetes, Disparities, Nutrition, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Social Determinants of Health
Lobo JM, Anderson R, Stukenborg GJ
Disparities in the use of diabetes screening in Appalachia.
This study examines disparities in the use of diabetes screening in Appalachia. Results showed that at-risk counties had significantly lower screening rates than competitive counties. Recommendations include introducing social policies that improve socioeconomic status and educational attainment, and health policies that reduce barriers to access to care in order to reduce disparities in diabetes screening rates in the less affluent Appalachian counties.
AHRQ-funded; HS018542.
Citation: Lobo JM, Anderson R, Stukenborg GJ .
Disparities in the use of diabetes screening in Appalachia.
J Rural Health 2018 Mar;34(2):173-81. doi: 10.1111/jrh.12247..
Keywords: Diabetes, Rural Health, Disparities, Social Determinants of Health, Screening, Prevention
Graetz I, Huang J, Brand RJ
Bridging the digital divide: mobile access to personal health records among patients with diabetes.
The authors examined personal health record (PHR) use through a computer-based Web browser or mobile device. They found that mobile-ready PHRs may increase access among patients facing a digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower socioeconomic status patients. They recommend continued efforts to increase equitable access to PHRs among patients with chronic conditions.
AHRQ-funded; HS015280.
Citation: Graetz I, Huang J, Brand RJ .
Bridging the digital divide: mobile access to personal health records among patients with diabetes.
Am J Manag Care 2018 Jan;24(1):43-48..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Racial and Ethnic Minorities, Social Determinants of Health
Sohn MW, Kang H, Park JS
Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region.
This study examined disparities in the receipt of preventive care recommended by the American Diabetes Association (ADA) between Appalachian and non-Appalachian counties and within Appalachian counties. It concluded that there are significant disparities in the uptake of many recommended preventive services between less and more affluent counties in the Appalachian region.
AHRQ-funded; HS018542.
Citation: Sohn MW, Kang H, Park JS .
Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region.
BMJ Open Diabetes Res Care 2016 Dec;4(1):e000284. doi: 10.1136/bmjdrc-2016-000284.
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Keywords: Diabetes, Disparities, Prevention, Chronic Conditions, Social Determinants of Health
Mayberry LS, Harper KJ, Osborn CY
Family behaviors and type 2 diabetes: what to target and how to address in interventions for adults with low socioeconomic status.
The researchers studied adults with type 2 diabetes at a Federally Qualified Health Center to better understand experiences with diabetes-specific family behaviors and willingness to engage family members in diabetes interventions. They found that some participants (40 percent) said engaging family in interventions would positively affect all members; others (27 percent) did not want to involve family.
AHRQ-funded; HS022990.
Citation: Mayberry LS, Harper KJ, Osborn CY .
Family behaviors and type 2 diabetes: what to target and how to address in interventions for adults with low socioeconomic status.
Chronic Illn 2016 Sep;12(3):199-215. doi: 10.1177/1742395316644303.
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Keywords: Diabetes, Patient Self-Management, Social Determinants of Health, Lifestyle Changes, Education: Patient and Caregiver
Steve SL, Tung EL, Schlichtman JJ
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
The authors reported on their narrative review of the literature that explores the associations between social disorder and diabetes-related health outcomes within vulnerable communities. They also proposed a multilevel ecosocial model for conceptualizing social disorder, specifically focusing on its role in racial disparities and its pathways to mediating diabetes outcomes.
AHRQ-funded; HS000078.
Citation: Steve SL, Tung EL, Schlichtman JJ .
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
Curr Diab Rep 2016 Aug;16(8):72. doi: 10.1007/s11892-016-0760-4.
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Keywords: Diabetes, Low-Income, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Sorkin DH, Billimek J, August KJ
AHRQ Author: Ngo-Metzger Q
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
The aim of this paper was to examine the relative contribution of glycaemic control (HbA1C) and depressive symptoms on diabetes-related symptom burden (hypoglycaemia and hyperglycaemia) in order to guide medication modification. The authors found that mental health symptoms are associated with higher levels of patient-reported diabetes-related symptoms, but the association between diabetes-related symptoms and subsequent regimen modifications is diminished in patients with greater depressive symptoms.
AHRQ-authored.
Citation: Sorkin DH, Billimek J, August KJ .
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
Fam Pract 2015 Jun;32(3):317-22. doi: 10.1093/fampra/cmv014.
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Keywords: Depression, Diabetes, Medication, Practice Patterns, Social Determinants of Health
Nichols GA, Schroeder EB, Karter AJ
Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
This study of diabetes trends found that among 7 million insured adults there was no significant increase between 2006 and 2010. The small increase that occurred from 2010 to 2011 coincided with a shift from fasting plasma glucose testing to use of the HbA1c assay. The increase in diabetes incidence rates was significant only among racial and ethnic minority groups and among very obese persons.
AHRQ-funded; HS019859
Citation: Nichols GA, Schroeder EB, Karter AJ .
Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project.
Am J Epidemiol. 2015 Jan;181(1):32-9. doi: 10.1093/aje/kwu255..
Keywords: Diabetes, Health Insurance, Social Determinants of Health, Obesity
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