National Healthcare Quality and Disparities Report
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Topics
- Access to Care (14)
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- Electronic Prescribing (E-Prescribing) (1)
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- Quality Indicators (QIs) (1)
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- Quality of Life (1)
- Racial and Ethnic Minorities (12)
- Research Methodologies (1)
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- Screening (6)
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- Shared Decision Making (6)
- Social Determinants of Health (13)
- Social Stigma (3)
- Stress (2)
- Substance Abuse (5)
- Telehealth (2)
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- (-) Vulnerable Populations (81)
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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 81 Research Studies DisplayedWisk LE, Levy S, Weitzman ER
Parental views on state cannabis laws and marijuana use for their medically vulnerable children.
Given a rapidly changing policy landscape, the investigators sought to characterize the effects of state marijuana laws on parents' views of marijuana use by their teenage children. The investigators found that among parents of medically vulnerable children, perceiving state marijuana policies as more permissive was strongly associated with lower perceived riskiness of marijuana use for their children.
AHRQ-funded; HS022986.
Citation: Wisk LE, Levy S, Weitzman ER .
Parental views on state cannabis laws and marijuana use for their medically vulnerable children.
Drug Alcohol Depend 2019 Jun 1;199:59-67. doi: 10.1016/j.drugalcdep.2018.12.027..
Keywords: Children/Adolescents, Policy, Vulnerable Populations, Chronic Conditions, Substance Abuse
Kalkhoran S, Thorndike AN, Rigotti NA
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
This study compared current smoking and quitting-related characteristics of low-income US adults with and without serious mental illness (SMI) who received healthcare at federally funded health centers. Using data from the Health Center Patient Survey, researchers concluded that the lower quit ratio in the SMI population suggests that advice alone is unlikely to be sufficient. They recommend augmented strategies to promote smoking cessation and to reduce the excess burden of tobacco-related disease in patients with SMI.
AHRQ-funded; HS025378.
Citation: Kalkhoran S, Thorndike AN, Rigotti NA .
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
J Gen Intern Med 2019 Jun;34(6):986-91. doi: 10.1007/s11606-019-04857-3..
Keywords: Behavioral Health, Lifestyle Changes, Low-Income, Tobacco Use, Vulnerable Populations
Borsky AE, Zhang E
AHRQ Author: Borsky AE
Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults.
This Putting Prevention into Practice case study demonstrates how a U.S. Preventive Services Task Force (USPSTF) recommendation can used by clinicians. This case study uses the Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults recommendation as an example. Three quiz questions are given which directly link to the recommendations. The questions involve screening guidelines, screening instruments, and follow-up if there is a positive screening and detailed answers are provided.
AHRQ-authored.
Citation: Borsky AE, Zhang E .
Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults.
Am Fam Physician 2019 May 15;99(10):649-50..
Keywords: Case Study, Domestic Violence, Elderly, Evidence-Based Practice, Screening, U.S. Preventive Services Task Force (USPSTF), Vulnerable Populations
Jarpe M, Mosley JE, Smith BT
Understanding the collaborative planning process in homeless services: networking, advocacy, and local government support may reduce service gaps.
The Continuum of Care (CoC) process-a nationwide system of regional collaborative planning networks addressing homelessness-is the chief administrative method utilized by the US Department of Housing and Urban Development to prevent and reduce homelessness in the United States. The objective of this study was to provide a benchmark comprehensive picture of the structure and practices of CoC networks, as well as information about which of those factors were associated with lower service gaps, a key goal of the initiative.
AHRQ-funded; HS000084.
Citation: Jarpe M, Mosley JE, Smith BT .
Understanding the collaborative planning process in homeless services: networking, advocacy, and local government support may reduce service gaps.
J Public Health Manag Pract 2019 May/Jun;25(3):262-69. doi: 10.1097/phh.0000000000000812..
Keywords: Vulnerable Populations, Access to Care, Healthcare Delivery
Wu J, Braunschweig Y, Harris LH
Looking back while moving forward: a justice-based, intersectional approach to research on contraception and disability.
This paper discusses the higher use of female sterilization than long-acting reversible contraception use among women with disabilities compared to women without disabilities. The reasons for that were discussed and the authors advocate for a justice-based intersectional approach to research on contraception and disability.
AHRQ-funded; HS022981.
Citation: Wu J, Braunschweig Y, Harris LH .
Looking back while moving forward: a justice-based, intersectional approach to research on contraception and disability.
Contraception 2019 May;99(5):267-71. doi: 10.1016/j.contraception.2019.01.006..
Keywords: Disabilities, Sexual Health, Vulnerable Populations, Women
Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al.
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
This study compared the health status and healthcare experiences of Cambodian American refugees and immigrants, using data were collected via questionnaires and medical records from two community clinics in Southern California. Minimal differences in self-reported health behaviors occurred between the two groups. Refugees reported lower levels of health-related quality of life overall and self-rated health, but similar or more positive healthcare experiences than the immigrants. Refugees had higher rates of diabetes and cardiovascular disease risk, in adjusted analyses. The authors conclude that there is a need for more health promotion efforts to improve health outcomes and perceived wellbeing of Cambodian American refugees and immigrants.
AHRQ-authored.
Citation: Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al..
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
J Immigr Minor Health 2019 Apr;21(2):346-55. doi: 10.1007/s10903-018-0736-3..
Keywords: Disparities, Health Status, Patient Experience, Quality of Life, Racial and Ethnic Minorities, Vulnerable Populations
Lindau ST
CommunityRx, an e-prescribing system connecting people to community resources.
CommunityRx is an e-prescribing system that make it easier for patients in communities to connect with health resources. NowPow, LLC is an information technology enterprise that is part of CommunityRx. NowPow participated in AHRQ’s EvidenceNow grants program and worked with hundreds of small Midwestern primary care practices in the Healthy Hearts in the Heartland study. By 2018, over 1600 youths had been employed (many for the first-time) and generated annual asset census for Chicago, New York, and two rural areas of North Carolina. CommunityRx has been successful in providing health resource information to lower-income communities such as Chicago’s South Side. They also found that half of people who received a HealtheRx e-prescription use the information to help others.
AHRQ-funded; HS023921.
Citation: Lindau ST .
CommunityRx, an e-prescribing system connecting people to community resources.
Am J Public Health 2019 Apr;109(4):546-47. doi: 10.2105/ajph.2019.304986..
Keywords: Access to Care, Community-Based Practice, Electronic Prescribing (E-Prescribing), Evidence-Based Practice, Health Information Technology (HIT), Medication, Vulnerable Populations
Kemmick Pintor J, Mitchell DC, Schenker MB
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
This study explored if depression affects treatment for obesity among Latino immigrant farmworkers. The workplace pilot study called Pasos Saludables,was successful, but the participants at risk for depression had lower weight loss than the participants with no indication of depression.
AHRQ-funded; HS022236.
Citation: Kemmick Pintor J, Mitchell DC, Schenker MB .
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
J Immigr Minor Health 2019 Apr;21(2):383-92. doi: 10.1007/s10903-018-0743-4..
Keywords: Depression, Behavioral Health, Obesity, Racial and Ethnic Minorities, Vulnerable Populations
Lyles CR, Tieu L, Sarkar U
A randomized trial to train vulnerable primary care patients to use a patient portal.
This study examined the use of patient care portals in primary care practices with vulnerable patients such as those with lower socioeconomic status or limited health literacy (LHL). A randomized control trial was created with 93 English-speaking patients with 1+ chronic diseases. The patients were provided with either an 1) in-person tutorial with a research assistant, or 2) a link to view the videos on their own. A third arm of the trial were control patients with just normal access to get to the portal. There was a higher rate of access (21%) after the trial was over with the two intervention groups as compared with 9% for the usual care patients.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Lyles CR, Tieu L, Sarkar U .
A randomized trial to train vulnerable primary care patients to use a patient portal.
J Am Board Fam Med 2019 Mar-Apr;32(2):248-58. doi: 10.3122/jabfm.2019.02.180263..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Vulnerable Populations
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
Sun CJ, Anderson KM, Toevs K
"Little tablets of gold": an examination of the psychological and social dimensions of PrEP among LGBTQ communities.
There are significant psychological, social, and cultural dimensions to the HIV epidemic in the United States, especially among lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. Biomedical HIV treatment has been shown to impact these dimensions. However, there is little understanding of the real-world psychosocial and sociocultural effects of the latest biomedical HIV prevention strategy, HIV pre-exposure prophylaxis (PrEP). This study explored the psychosocial and sociocultural dimensions of PrEP use among LGBTQ adults.
AHRQ-funded; HS022981.
Citation: Sun CJ, Anderson KM, Toevs K .
"Little tablets of gold": an examination of the psychological and social dimensions of PrEP among LGBTQ communities.
AIDS Educ Prev 2019 Feb;31(1):51-62. doi: 10.1521/aeap.2019.31.1.51..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Vulnerable Populations, Social Stigma
Elm JHL, Walls ML, Aronson BD
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Investigators analyzed focus group transcripts of American Indian adults with type 2 diabetes from five tribal communities and classified stressors using an inductive/deductive analytical approach. They identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for American Indians and concluded that stressors are generally experienced as chronic, regardless of the duration of the stressor.
AHRQ-funded; HS024180.
Citation: Elm JHL, Walls ML, Aronson BD .
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Am Indian Alsk Native Ment Health Res 2019;26(1):33-62. doi: 10.5820/aian.2601.2019.33..
Keywords: Diabetes, Chronic Conditions, Stress, Racial and Ethnic Minorities, Vulnerable Populations
Zuckerman RB, Wu S, Chen LM
The five-star skilled nursing facility rating system and care of disadvantaged populations.
AHRQ-funded; HS000029.
Citation: Zuckerman RB, Wu S, Chen LM .
The five-star skilled nursing facility rating system and care of disadvantaged populations.
J Am Geriatr Soc 2019 Jan;67(1):108-14. doi: 10.1111/jgs.15629..
Keywords: Nursing Homes, Vulnerable Populations, Medicare, Elderly, Provider Performance, Quality of Care, Hospital Discharge, Disparities
Werner RM, Kanter GP, Polsky D
Association of physician group participation in Accountable Care Organizations with patient social and clinical characteristics.
The goal of this retrospective cohort study was to estimate the association between the patient characteristics of a physician group and the group's participation in a newly formed accountable care organization (ACOs). A random sample of Medicare fee-for-service beneficiaries attributed to physician groups were identified by Medicare claims made before ACO participation. Physician groups that participated and did not participate in the Medicare Shared Savings Program (MSSP) were then identified. ACO-participating physician groups were compared with non-participating groups for reference, and estimates were made at both the physician and patient level. The study found that physician groups that participated in the MSSP ACO program cared for more vulnerable patients than non-participating groups did; ACO-participating physician groups cared for an equally large number of vulnerable patients compared with non-participating groups. The authors conclude that ACOs may be an effective approach to target care among high-risk patients.
AHRQ-funded; HS025184.
Citation: Werner RM, Kanter GP, Polsky D .
Association of physician group participation in Accountable Care Organizations with patient social and clinical characteristics.
JAMA Netw Open 2019 Jan 4;2(1):e187220. doi: 10.1001/jamanetworkopen.2018.7220..
Keywords: Health Services Research (HSR), Medicare, Vulnerable Populations
Kim DH, Bassett SM, So S
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
This study assessed whether future orientation and self-esteem affected the relationship between family stress and mental health problems among African American youth in predominantly low-income neighborhoods. Youths (mainly female, average age 15.83 years old) were sampled for family stress, self-esteem, future orientation, mental health and other covariates such as gender and sexual orientation. A correlation was found between future orientation and self-esteem levels and family stress and mental health problems.
AHRQ-funded; HS000078.
Citation: Kim DH, Bassett SM, So S .
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
Am J Orthopsychiatry 2019;89(2):125-33. doi: 10.1037/ort0000371..
Keywords: Children/Adolescents, Family Health and History, Low-Income, Behavioral Health, Racial and Ethnic Minorities, Stress, Vulnerable Populations
Anderson VR, Ouyang F, Tu W
Medicaid coverage and continuity for juvenile justice-involved youth.
This retrospective cohort study examined Medicaid coverage and continuity for youth with varying levels of justice system involvement and the impact of a policy change allowing Medicaid suspension, rather than termination. The study highlighted the importance of maximizing opportunities to keep youth enrolled, as gaps in coverage likely affect juveniles' access to physical, mental, and behavioral health care.
AHRQ-funded; HS022681.
Citation: Anderson VR, Ouyang F, Tu W .
Medicaid coverage and continuity for juvenile justice-involved youth.
J Correct Health Care 2019 Jan;25(1):45-54. doi: 10.1177/1078345818820043..
Keywords: Access to Care, Children/Adolescents, Medicaid, Policy, Vulnerable Populations
Banks DE, Hershberger AR, Pemberton T
Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology.
Juvenile offenders engage in both cannabis use and polysubstance use at higher rates than the general adolescent population. Yet, limited research has examined the relationship between cannabis poly-use (e.g., cannabis and alcohol use) and functional or psychological problems among juvenile offenders. The current study addresses this gap by examining the association of polysubstance use of cannabis compared to cannabis only use with cognitive functioning, psychological distress, and substance-related problems among juvenile detainees.
AHRQ-funded; HS024296.
Citation: Banks DE, Hershberger AR, Pemberton T .
Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology.
Am J Drug Alcohol Abuse 2019;45(3):313-22. doi: 10.1080/00952990.2018.1558450..
Keywords: Children/Adolescents, Behavioral Health, Substance Abuse, Vulnerable Populations
Castaneda-Guarderas A, Glassbereg J, Grudzen CR
Shared decision making with vulnerable populations in the emergency department.
The authors introduce a research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses to address questions of shared decision making (SDM) among vulnerable groups at a disadvantage in the healthcare system, as well as changes that are needed, and how to cultivate and teach these competencies.
AHRQ-funded; HS024172.
Citation: Castaneda-Guarderas A, Glassbereg J, Grudzen CR .
Shared decision making with vulnerable populations in the emergency department.
Acad Emerg Med 2016 Dec;23(12):1410-16. doi: 10.1111/acem.13134.
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Keywords: Cultural Competence, Shared Decision Making, Emergency Department, Patient and Family Engagement, Vulnerable Populations
Sarkar U, Gourley GI, Lyles CR
Usability of commercially available mobile applications for diverse patients.
The objective of this study was to investigate the usability of existing mobile health applications ("apps") for diabetes, depression, and caregiving, in order to facilitate development and tailoring of patient-facing apps for diverse populations. Participants completed 43 percent of tasks across 11 apps without assistance. Three themes emerged from participant comments: lack of confidence with technology, frustration with design features and navigation, and interest in having technology to support their self-management.
AHRQ-funded; HS022408.
Citation: Sarkar U, Gourley GI, Lyles CR .
Usability of commercially available mobile applications for diverse patients.
J Gen Intern Med 2016 Dec;31(12):1417-26. doi: 10.1007/s11606-016-3771-6.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Self-Management, Telehealth, Vulnerable Populations
Heerman WJ, Mitchell SJ, Thompson J
Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.
The researchers examined the association of perceived availability, condition, and safety of the built environment with its self-reported use for physical activity among underserved families with children at risk for obesity. In their sample of underserved families, perceived availability and condition of built environment structures were associated with use rather than perceived safety.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Mitchell SJ, Thompson J .
Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.
BMC Public Health 2016 Nov 22;16(1):1180. doi: 10.1186/s12889-016-3854-7.
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Keywords: Obesity, Social Determinants of Health, Children/Adolescents, Racial and Ethnic Minorities, Vulnerable Populations
Sobotka SA, Msall ME
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
This article discusses two articles in the same issue, one involving kindergarten readiness after prematurity, and the other examining medical and surgical factors impacting children with congenital heart disease (CHD) and their later school age achievement test performance. The authors state that these two articles provide evidence for longitudinal support of infants who survive critical illness.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Msall ME .
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
J Pediatr 2016 Nov;178:12-14. doi: 10.1016/j.jpeds.2016.07.037.
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Keywords: Children/Adolescents, Newborns/Infants, Patient-Centered Outcomes Research, Children/Adolescents, Vulnerable Populations
Beckman AL, Bilinski A, Boyko R
New hepatitis C drugs are very costly and unavailable to many state prisoners.
This study found that in the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively).
AHRQ-funded; HS000055.
Citation: Beckman AL, Bilinski A, Boyko R .
New hepatitis C drugs are very costly and unavailable to many state prisoners.
Health Aff 2016 Oct;35(10):1893-901. doi: 10.1377/hlthaff.2016.0296.
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Keywords: Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Goff SL, Mazor KM, Pekow PS
Patient navigators and parent use of quality data: a randomized trial.
The authors explored the effectiveness of strategies to overcome barriers in vulnerable populations. They found that an intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice, suggesting that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Pekow PS .
Patient navigators and parent use of quality data: a randomized trial.
Pediatrics 2016 Oct;138(4). doi: 10.1542/peds.2016-1140.
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Keywords: Shared Decision Making, Quality of Care, Public Reporting, Quality Indicators (QIs), Vulnerable Populations
Gao Y, Nocon RS, Gunter KE
AHRQ Author: Ngo-Metzger Q
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
The patient-centered medical home (PCMH) model is being implemented in health centers (HCs) that provide comprehensive primary care to vulnerable populations. The researchers identified characteristics associated with HCs' PCMH capability. EHR adoption likely played a role in HCs' improvement in PCMH capability. Other factors include a greater number of types of financial performance incentives, more types of hospital-HC affiliations, and state-level support and payment for PCMH activities.
AHRQ-authored; AHRQ-funded; HS000084.
Citation: Gao Y, Nocon RS, Gunter KE .
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
J Gen Intern Med 2016 Sep;31(9):1041-51. doi: 10.1007/s11606-016-3729-8.
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Keywords: Patient-Centered Healthcare, Electronic Health Records (EHRs), Primary Care, Community-Based Practice, Vulnerable Populations
Saab D, Nisenbaum R, Dhalla I
Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study.
The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group experiencing homelessness. It concluded that homeless patients had nearly four times the odds of being readmitted within 30-days as compared to low-income controls matched on age, sex and primary reason for admission to hospital.
AHRQ-funded; HS014129.
Citation: Saab D, Nisenbaum R, Dhalla I .
Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study.
J Gen Intern Med 2016 Sep;31(9):1011-8. doi: 10.1007/s11606-016-3680-8.
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Keywords: Low-Income, Hospital Readmissions, Vulnerable Populations