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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 18 of 18 Research Studies DisplayedDanielson EC, Li W, Suleiman L
Social risk and patient-reported outcomes after total knee replacement: implications for Medicare policy.
The objective of this study was to determine if county- or patient-level social risk factors are associated with patient-reported outcomes after total knee replacement when added to the comprehensive joint replacement risk-adjustment model. Patient and outcomes data from the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement cohort were merged with the CDC Social Vulnerability Index. The findings indicated that patient-reported race, education, and income were associated with patient-reported pain or functional scores; pain improvement was negatively associated with Black race and positively associated with higher annual incomes. The authors concluded that these findings suggested that patient-level social factors warrant further investigation to promote health equity in patient-reported outcomes after total knee replacement.
Citation: Danielson EC, Li W, Suleiman L .
Social risk and patient-reported outcomes after total knee replacement: implications for Medicare policy.
Health Serv Res 2024 Feb; 59(1):e14215. doi: 10.1111/1475-6773.14215.
Keywords: Surgery, Orthopedics, Medicare, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Bell N, Wilkerson R, Mayfield-Smith K
Community social determinants and health outcomes drive availability of patient-centered medical homes.
This study assessed the geographic distribution of patient-centered medical homes and the community social determinants and health outcomes that drive availability. The authors assessed spatial clusters of mental and physical health surveys; health behaviors; as well as premature mortality with clusters of medical home saturation and community socioeconomic characteristics. Counties having lower uninsured rates and lower poverty rates were more likely to have medical homes.
AHRQ-funded; HS026263.
Citation: Bell N, Wilkerson R, Mayfield-Smith K .
Community social determinants and health outcomes drive availability of patient-centered medical homes.
Health Place 2021 Jan;67:102439. doi: 10.1016/j.healthplace.2020.102439..
Keywords: Social Determinants of Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes
Kostelanetz S, Di Gravio C, Schildcrout JS
Should we implement geographic or patient-reported social determinants of health measures in cardiovascular patients.
The authors compared patient-reported social determinants of health (SDOH) to the Brokamp Area Deprivation Index (ADI) and then evaluated the association of patient-reported SDOH and ADI with mortality in patients with cardiovascular disease (CVD). They found that the Brokamp ADI is associated with mortality in hospitalized patients with CVD. They recommended that, in the absence of available patient-reported data, hospitals implement the Brokamp ADI as an approximation for patient-reported data to enhance risk stratification of patients with CVD.
AHRQ-funded; HS026122.
Citation: Kostelanetz S, Di Gravio C, Schildcrout JS .
Should we implement geographic or patient-reported social determinants of health measures in cardiovascular patients.
Ethn Dis 2021 Winter;31(1):9-22. doi: 10.18865/ed.31.1.9..
Keywords: Social Determinants of Health, Cardiovascular Conditions, Mortality, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Fichtenberg CM, Alley DE, Mistry KB
AHRQ Author: Mistry KB
Improving social needs intervention research: key questions for advancing the field.
This paper summarizes emerging evidence and identifies key areas where more research is needed to advance implementation and policy development. Gaps exist in terms of comparative effectiveness and cost effectiveness of social needs intervention approaches. Increased understanding of mechanisms of action to maximize practitioners' ability to tailor interventions would be a benefit. More research is recommended to guard against unintended consequences and ensure these interventions reduce health inequities. Implementation science research should identify supports and incentives for adoption of effective interventions. Focusing both public and private research efforts on these evidence gaps can help advance identification of interventions that maximize both health equity and healthcare value.
AHRQ-authored; AHRQ-funded; HS026664.
Citation: Fichtenberg CM, Alley DE, Mistry KB .
Improving social needs intervention research: key questions for advancing the field.
Am J Prev Med 2019 Dec;57(6s1):S47-s54. doi: 10.1016/j.amepre.2019.07.018..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Social Determinants of Health
Smith NA, Voisin DR, Yang JP
Keeping your guard up: hypervigilance among urban residents affected by community and police violence.
This study’s aim was to quantify the effects of hypervigilance among urban residents affected by community and police violence. A survey of 504 adults in Chicago in 2018 was done in a neighborhood affected by high levels of violence. It was found that exposure to police violence was associated with a 9.8% increase in hypervigilance while exposure to community violence caused a 5.5% increase. Among participants who had a police stop, it was associated with 20% increase in hypervigilance. Overall, the highest quartile of hypervigilance was associated with higher systolic blood pressure.
AHRQ-funded; HS023007.
Citation: Smith NA, Voisin DR, Yang JP .
Keeping your guard up: hypervigilance among urban residents affected by community and police violence.
Health Aff 2019 Oct;38(10):1662-69. doi: 10.1377/hlthaff.2019.00560..
Keywords: Urban Health, Social Determinants of Health, Behavioral Health, Patient-Centered Outcomes Research, Evidence-Based Practice
Mehta B, Szymonifka J, Dey S
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
The objective of this study was to assess the relationship of neighborhood immigrant proportion (IP) to preoperative and 2-year postoperative pain and function after elective total knee arthroplasty (TKA) using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients in a high-volume institutional TKA registry were analyzed retrospectively, and demographics, pre-op and 2-year post-op WOMAC pain and function scores, and addresses obtained. Patient-level variables were linked to Census Bureau tract data. Researchers conclude that patients living in high IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in lower IP neighborhoods.
AHRQ-funded; HS016075.
Citation: Mehta B, Szymonifka J, Dey S .
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
BMC Musculoskelet Disord 2019 Feb 9;20(1):67. doi: 10.1186/s12891-019-2446-y..
Keywords: Arthritis, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health, Surgery
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Cardet JC, Louisias M, King TS
Income is an independent risk factor for worse asthma outcomes.
The authors investigated whether low income, low education, and high perceived stress were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. They found that participants with lower income were more likely to experience adverse asthma outcomes independent of education, perceived stress, race, and medication adherence.
AHRQ-funded; HS022986.
Citation: Cardet JC, Louisias M, King TS .
Income is an independent risk factor for worse asthma outcomes.
J Allergy Clin Immunol 2018 Feb;141(2):754-60.e3. doi: 10.1016/j.jaci.2017.04.036..
Keywords: Asthma, Chronic Conditions, Low-Income, Outcomes, Patient-Centered Outcomes Research, Risk, Social Determinants of Health
Heerman WJ, Jackson N, Roumie CL
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
The objective of this study was to report survey response rates and demographic characteristics of eight recruitment approaches to determine acceptability and effectiveness of large-scale patient recruitment among various populations. The study concluded that technology-enabled recruitment approaches such as registries and emails are effective for recruiting but may yield less racial/ethnic diversity compared to traditional, more time-intensive approaches.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Jackson N, Roumie CL .
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
Contemp Clin Trials 2017 Nov;62:50-55. doi: 10.1016/j.cct.2017.08.006..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Racial and Ethnic Minorities, Social Determinants of Health
Bachmann JM, Huang S, Gupta DK
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
This study investigated the association of neighborhood socioeconomic context with Cardiac Rehabilitation (CR) participation in the Southern Community Cohort Study- a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims. The study found that lower neighborhood socioeconomic context was associated with decreased CR participation independent of individual socioeconomic status. These data invite research on interventions to increase CR access in deprived communities.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Huang S, Gupta DK .
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
J Am Heart Assoc 2017 Oct 11;6(10). doi: 10.1161/jaha.117.006260..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Patient-Centered Outcomes Research, Rehabilitation, Social Determinants of Health
Goodman SM, Mandl LA, Parks ML
Disparities in TKA outcomes: census tract data show interactions between race and poverty.
Race is an important predictor of total knee arthroplasty (TKA) outcomes in the United States; however, analyses of race can be confounded by socioeconomic factors, which can result in difficulty determining the root cause of disparate outcomes after TKA. This study found that blacks and whites living in communities with little poverty have similar patient-reported TKA outcomes, whereas in communities with high levels of poverty, there are important racial disparities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandl LA, Parks ML .
Disparities in TKA outcomes: census tract data show interactions between race and poverty.
Clin Orthop Relat Res 2016 Sep;474(9):1986-95. doi: 10.1007/s11999-016-4919-8.
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Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Patient-Centered Outcomes Research, Surgery
Peek ME, Lopez FY, Williams HS
Development of a conceptual framework for understanding shared decision making among African-American LGBT patients and their clinicians.
The purpose of this review was to understand how race, sexual orientation and gender identity can simultaneously influence shared decision making (SDM) among African-American LGBT persons. It also presents a conceptual model for understanding SDM in African-American LGBT persons, wherein multiple systems of social stratification (e.g., race, gender, sexual orientation) influence patient and provider perceptions, behaviors, and shared decision making.
AHRQ-funded; HS023050.
Citation: Peek ME, Lopez FY, Williams HS .
Development of a conceptual framework for understanding shared decision making among African-American LGBT patients and their clinicians.
J Gen Intern Med 2016 Jun;31(6):677-87. doi: 10.1007/s11606-016-3616-3.
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Keywords: Shared Decision Making, Social Determinants of Health, Racial and Ethnic Minorities, Patient-Centered Outcomes Research
Spatz ES, Jiang X, Lu J
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
The Qingdao Port Cardiovascular Health Study was designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Early findings reveal a significant increase in cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, and body mass index) from 2000 to 2010.
AHRQ-funded; HS023000.
Citation: Spatz ES, Jiang X, Lu J .
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
BMJ Open 2015 Dec 9;5(12):e008403. doi: 10.1136/bmjopen-2015-008403.
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Keywords: Cardiovascular Conditions, Risk, Social Determinants of Health, Patient-Centered Outcomes Research, Prevention
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Eapen ZJ, McCoy LA, Fonarow CG
Utility of socioeconomic status in predicting 30-day outcomes after heart failure hospitalization.
The researchers investigated whether accounting for socioeconomic status (SES) can improve risk-adjusted models for 30-day outcomes among CMS beneficiaries hospitalized with heart failure. They found that county-level SES data are modestly associated with 30-day outcomes but do not improve risk adjustment models based on patient characteristics alone.
AHRQ-funded; HS021092.
Citation: Eapen ZJ, McCoy LA, Fonarow CG .
Utility of socioeconomic status in predicting 30-day outcomes after heart failure hospitalization.
Circ Heart Fail 2015 May;8(3):473-80. doi: 10.1161/circheartfailure.114.001879.
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Keywords: Shared Decision Making, Heart Disease and Health, Hospitalization, Patient-Centered Outcomes Research, Social Determinants of Health
Okuda M, Picazo J, Olfson M
Prevalence and correlates of anger in the community: results from a national survey.
This study assessed the prevalence, as well as the sociodemographic and clinical correlates of anger, in the general population and characterize adults that report inappropriate, intense, or poorly controlled anger. It found the overall prevalence of inappropriate, intense, or poorly controlled anger in the U.S. population was 7.8 percent. Anger was especially common among men and younger adults, and was associated with decreased psychosocial functioning.
AHRQ-funded; HS021112.
Citation: Okuda M, Picazo J, Olfson M .
Prevalence and correlates of anger in the community: results from a national survey.
CNS Spectr 2015 Apr;20(2):130-9. doi: 10.1017/s1092852914000182..
Keywords: Patient-Centered Outcomes Research, Behavioral Health, Substance Abuse, Social Determinants of Health
Brody H, Croisant SA, Crowder JW
Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.
Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group or a higher income White group. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups.
AHRQ-funded; HS022134.
Citation: Brody H, Croisant SA, Crowder JW .
Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.
J Empir Res Hum Res Ethics 2015 Feb;10(1):22-30. doi: 10.1177/1556264614568426..
Keywords: Communication, Comparative Effectiveness, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health
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