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 368 Research Studies DisplayedCox ED, Hansen K, Rajamanickam VP
Are parents who feel the need to watch over their children's care better patient safety partners?
In this study, the investigators assessed whether needing to watch over care predicted parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections. The researchers concluded that parents who reported the need to watch over care were more likely to perform behaviors specific to safe medication use (but not hand hygiene) compared with those not reporting this need.
AHRQ-funded; HS018680.
Citation: Cox ED, Hansen K, Rajamanickam VP .
Are parents who feel the need to watch over their children's care better patient safety partners?
Hosp Pediatr 2017 Dec;7(12):716-22. doi: 10.1542/hpeds.2017-0036..
Keywords: Adverse Drug Events (ADE), Adverse Events, Caregiving, Children/Adolescents, Healthcare-Associated Infections (HAIs), Medical Errors, Medication, Patient Safety
Carson NJ, Progovac AM, Wang Y
A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
The Food and Drug Administration's 2004 antidepressant warning was followed by decreases in antidepressant prescribing for youth. Little is known about how antidepressant prescribing patterns varied by race/ethnicity. This study analyzed Medicaid claims data from four U.S. states (2002-2009) for youth ages 5-17. The authors found that antidepressant prescription fills declined most post-warning for White youth, suggesting that risk information may have diffused less rapidly to prescribers or caregivers of minorities.
AHRQ-funded; HS021486.
Citation: Carson NJ, Progovac AM, Wang Y .
A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
Depress Anxiety 2017 Dec;34(12):1147-56. doi: 10.1002/da.22681..
Keywords: Medication, Children/Adolescents, Depression, Guidelines, Racial and Ethnic Minorities
Mistry KB, Forrest CB
AHRQ Author: Mistry KB
Applying evidence from clinical trials: need for pediatric learning health system research.
The authors argue that to fill the many gaps in the understanding of major depressive disorder management (and more generally, the pediatric knowledge base), a new approach for augmenting the conventional randomized controlled trial is needed. They believe that the emerging field of learning health system research addresses this need.
AHRQ-authored.
Citation: Mistry KB, Forrest CB .
Applying evidence from clinical trials: need for pediatric learning health system research.
Pediatrics 2017 Dec;140(6). doi: 10.1542/peds.2017-3098.
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Keywords: Depression, Evidence-Based Practice, Health Systems, Children/Adolescents
Berge JM, Truesdale KP, Sherwood NE
Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
This study examined the frequency of eating breakfast, lunch or dinner family meals and associations with pre-school children's overall diet quality and BMI percentile. The authors concluded that breakfast family meal frequency and total weekly family meal frequency were associated with healthier diet quality in non-Hispanic pre-school children but not in Hispanic children. Longitudinal research is needed to clarify the association between family meal type and child diet quality and BMI percentile.
AHRQ-funded; HS022990.
Citation: Berge JM, Truesdale KP, Sherwood NE .
Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
Public Health Nutr 2017 Dec;20(18):3275-84. doi: 10.1017/s1368980017002348..
Keywords: Children/Adolescents, Family Health and History, Nutrition, Obesity: Weight Management, Racial and Ethnic Minorities
Kwa L, Kwa MC, Silverberg JI
Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States.
This study sought to determine if there is an association between pediatric psoriasis and cardiovascular comorbidities. It found that in multivariate survey logistic regression models adjusting for age, sex, and race/ethnicity, pediatric psoriasis was significantly associated with 5 of 10 cardiovascular comorbidities.
AHRQ-funded; HS023011.
Citation: Kwa L, Kwa MC, Silverberg JI .
Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States.
J Am Acad Dermatol 2017 Dec;77(6):1023-29. doi: 10.1016/j.jaad.2017.08.034.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Skin Conditions
Raffo JE, Lloyd C, Collier M
Defining the role of the community health worker within a federal healthy start care coordination team.
The Strong Beginnings program worked to define community health worker (CHW) interventions, a core service of the program to improve maternal and child health. The workgroup identified seven core functions and 28 maternal and child health risk topics to be addressed by the CHW. The process resulted in a detailed document of program interventions that the CHWs use to guide care.
AHRQ-funded; HS020208.
Citation: Raffo JE, Lloyd C, Collier M .
Defining the role of the community health worker within a federal healthy start care coordination team.
Matern Child Health J 2017 Dec;21(Suppl 1):93-100. doi: 10.1007/s10995-017-2379-8.
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Keywords: Care Coordination, Children/Adolescents, Health Promotion, Health Services Research (HSR), Maternal Care
Goff SL, Mazor KM, Guhn-Knight H
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
The authors sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. They found that pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Guhn-Knight H .
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
J Racial Ethn Health Disparities 2017 Dec;4(6):1051-60. doi: 10.1007/s40615-016-0309-x.
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Keywords: Access to Care, Quality of Care, Low-Income, Children/Adolescents, Racial and Ethnic Minorities
Kemper AR, Fan T, Grossman DC
AHRQ Author: Fan T
Gaps in evidence regarding iron deficiency anemia in pregnant women and young children: summary of US Preventive Services Task Force recommendations.
The USPSTF found insufficient evidence to recommend routine iron supplementation for pregnant women or routine screening for iron deficiency anemia in pregnant women or young children. The USPSTF identified a critical evidence gap that is related to whether changing hematologic indexes in otherwise asymptomatic pregnant women or in infants within populations who are reflective of the United States leads to an improvement in maternal or child health outcomes.
AHRQ-authored.
Citation: Kemper AR, Fan T, Grossman DC .
Gaps in evidence regarding iron deficiency anemia in pregnant women and young children: summary of US Preventive Services Task Force recommendations.
Am J Clin Nutr 2017 Dec;106(Suppl 6):1555s-58s. doi: 10.3945/ajcn.117.155788.
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Keywords: Children/Adolescents, Evidence-Based Practice, Maternal Care, U.S. Preventive Services Task Force (USPSTF)
Gao TY, Howe CJ, Zullo AR
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. The study’s findings suggested that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians.
AHRQ-funded; HS022998.
Citation: Gao TY, Howe CJ, Zullo AR .
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
Vulnerable Child Youth Stud 2017;12(4):277-91. doi: 10.1080/17450128.2016.1268741..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Lifestyle Changes, Screening, Urban Health
Joyce NR, Huskamp HA, Hadland SE
The alternative quality contract: impact on service use and spending for children with ADHD.
The authors used Blue Cross-Blue Shield of Massachusetts (BCBSMA) claims for 2006-2011 to compare youths enrolled in provider organizations participating in the alternative quality contract (AQC) with those not participating. They found that the AQC was associated with small increases in the probability of any outpatient visits and in the probability and number of medication management visits among children with attention-deficit hyperactivity disorder (ADHD). Further, spending did not change, and there was no evidence of reductions in service utilization or spending for children with ADHD in the first three years of AQC implementation.
AHRQ-funded; HS022998.
Citation: Joyce NR, Huskamp HA, Hadland SE .
The alternative quality contract: impact on service use and spending for children with ADHD.
Psychiatr Serv 2017 Dec;68(12):1210-12. doi: 10.1176/appi.ps.201700143.
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Keywords: Children/Adolescents, Behavioral Health, Payment, Quality of Care, Healthcare Costs
Magnusson DM, Minkovitz CS, Kuhlthau KA
AHRQ Author: Mistry KB
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
This study sought to understand the role of health beliefs in shaping maternal decisions regarding help-seeking for children with developmental delay (DD) and explore differences between African American and Hispanic mothers. Five major themes emerged describing the role of maternal health beliefs in shaping key stages of the help-seeking pathway for children with DD. Differences between African American and Hispanic mothers are also described.
AHRQ-authored.
Citation: Magnusson DM, Minkovitz CS, Kuhlthau KA .
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
Pediatrics 2017 Nov;140(5):pii: e20172059. doi: 10.1542/peds.2017-2059.
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Keywords: Children/Adolescents, Shared Decision Making, Disabilities, Low-Income, Racial and Ethnic Minorities
Wang Z, Whiteside SPH, Sim L
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
This review evaluated the comparative effectiveness and adverse events of cognitive behavioral therapy (CBT) and pharmacotherapy for childhood anxiety disorders. Evidence supports the effectiveness of CBT and selective serotonin reuptake inhibitors (SSRIs) for reducing childhood anxiety symptoms. Serotonin-norepinephrine reuptake inhibitors also appear to be effective based on less consistent evidence.
AHRQ-funded; 290201500013I.
Citation: Wang Z, Whiteside SPH, Sim L .
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
JAMA Pediatr 2017 Nov;171(11):1049-56. doi: 10.1001/jamapediatrics.2017.3036.
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Keywords: Anxiety, Behavioral Health, Children/Adolescents, Comparative Effectiveness, Medication
Hessels AJ, Darby SW, Simpser E
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
The purpose of this study is to test the Nursing-Kids Intensity of Care, a measure of the intensity of nursing care needs, defined as the quantity and type of direct and indirect care activities performed by caregivers in a national sample. The authors concluded that additional testing to further establish psychometric sufficiency and expanded use to quantify the intensity of nursing care needs of children with complex medical conditions in pediatric long-term care settings is recommended.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
Citation: Hessels AJ, Darby SW, Simpser E .
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
J Pediatr Nurs 2017 Nov/Dec;37:86-90. doi: 10.1016/j.pedn.2017.08.026..
Keywords: Children/Adolescents, Health Services Research (HSR), Long-Term Care, Nursing, Children/Adolescents
Aalsma MC, Anderson VR, Schwartz K
Preventive care use among justice-involved and non-justice-involved youth.
The objective of this study was to determine how rates of well-child (WC) and emergency department visits, as well as public insurance enrollment continuity, differed between youth involved in the justice system (JIY) and youth who have never been in the system (NJIY). It found that JIY had lower use rates of WC visits and higher use rates of emergency services in comparison with NJIY. JIY had more and longer gaps in Medicaid coverage compared with NJIY.
AHRQ-funded; HS023318.
Citation: Aalsma MC, Anderson VR, Schwartz K .
Preventive care use among justice-involved and non-justice-involved youth.
Pediatrics 2017 Nov;140(5):pii: e20171107. doi: 10.1542/peds.2017-1107.
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Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization, Medicaid
Fairbrother G, Dougherty D, Pradhananga R
AHRQ Author: Dougherty D
Road to the future: priorities for child health services research.
The researchers sought to develop and disseminate a robust, domestically focused, policy-oriented health services research agenda. Among the six priority domains identified for future research, including both enduring and emerging emphases were: 1) framing children's health issues so that they are compelling to policy-makers; 2) addressing poverty and other social determinants of child health and wellbeing; and 3) promoting equity in population health and health care.
AHRQ-authored; AHRQ-funded.
Citation: Fairbrother G, Dougherty D, Pradhananga R .
Road to the future: priorities for child health services research.
Acad Pediatr 2017 Nov - Dec;17(8):814-24. doi: 10.1016/j.acap.2017.04.015.
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Keywords: Children/Adolescents, Health Services Research (HSR), Health Services Research (HSR), Policy
Richards JR, Smith NE, Moulin AK
Unintentional cannabis ingestion in children: a systematic review.
The purpose of this study was to analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. The investigators assert that unintentional cannabis ingestion by children is a serious public health concern and is well-documented in numerous studies and case reports; and that clinicians should consider cannabis toxicity in any child with sudden onset of lethargy or ataxia.
AHRQ-funded; HS022236.
Citation: Richards JR, Smith NE, Moulin AK .
Unintentional cannabis ingestion in children: a systematic review.
J Pediatr 2017 Nov;190:142-52. doi: 10.1016/j.jpeds.2017.07.005..
Keywords: Adverse Events, Children/Adolescents, Adverse Drug Events (ADE)
Mabry-Hernandez I, Gottfredson R
AHRQ Author: Mabry-Hernandez I
Screening for lipid disorders in children and adolescents.
This case study concerns a healthy 12-year-old boy presenting for a school physical and well visit. His family history reveals that his maternal grandfather had a heart attack and that his father has started taking a medication for elevated cholesterol levels. His mother is concerned about his genetic risk of a cholesterol disorder and asks if he should be screened. The article poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Mabry-Hernandez I, Gottfredson R .
Screening for lipid disorders in children and adolescents.
Am Fam Physician 2017 Oct 15;96(8):529-30.
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Keywords: Children/Adolescents, Family Health and History, Screening, U.S. Preventive Services Task Force (USPSTF)
Baiocchi M, Omondi B, Langat N
A behavior-based intervention that prevents sexual assault: the results of a matched-pairs, cluster-randomized study in Nairobi, Kenya.
This study was a cluster-randomized, matched-pairs, parallel trial of a behavior-based sexual assault prevention intervention in the informal settlements in Nairobi, Kenya. The study intervention combined parallel training for young adolescent girls and boys in school settings and showed significant reduction in the rate of sexual assault among girls in this population.
AHRQ-funded; HS022192.
Citation: Baiocchi M, Omondi B, Langat N .
A behavior-based intervention that prevents sexual assault: the results of a matched-pairs, cluster-randomized study in Nairobi, Kenya.
Prev Sci 2017 Oct;18(7):818-27. doi: 10.1007/s11121-016-0701-0..
Keywords: Children/Adolescents, Education, Prevention, Women
Erves JC, Mayo-Gamble TL, Hull PC
Adolescent participation in HPV vaccine clinical trials: are parents willing?
This study examined factors influencing parental willingness to consent to their adolescents' participation in HPV vaccine clinical trials and tested for possible racial differences. The authors assert that educating parents about the advantages of HPV vaccines for younger adolescents using low-literacy educational materials and building trust between parents and researchers may increase parental willingness to consent to adolescent participation in HPV vaccine clinical trials.
AHRQ-funded; HS022990.
Citation: Erves JC, Mayo-Gamble TL, Hull PC .
Adolescent participation in HPV vaccine clinical trials: are parents willing?
J Community Health 2017 Oct;42(5):894-901. doi: 10.1007/s10900-017-0331-x..
Keywords: Children/Adolescents, Research Methodologies, Vaccination
Letourneau LR, Carmody D, Wroblewski K
Diabetes presentation in infancy: high risk of diabetic ketoacidosis.
In this study, the largest of its kind, diabetic ketoacidosis (DKA) was more frequent than in other early-onset U.S. studies or other cohorts of patients with neonatal diabetes. The authors argue that continuing to educate pediatric providers about the many ways that infants can present with diabetes may help to diagnose cases more efficiently and ultimately decrease the frequency of DKA at diagnosis.
AHRQ-funded; HS023007.
Citation: Letourneau LR, Carmody D, Wroblewski K .
Diabetes presentation in infancy: high risk of diabetic ketoacidosis.
Diabetes Care 2017 Oct;40(10):e147-e48. doi: 10.2337/dc17-1145.
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Keywords: Diabetes, Diagnostic Safety and Quality, Newborns/Infants, Children/Adolescents
Allen CD, McNeely CA
Do restrictive omnibus immigration laws reduce enrollment in public health insurance by Latino citizen children? A comparative interrupted time series study.
This study uses nationally-representative data from the National Health Interview Survey (2005-2014) and comparative interrupted time series methods to assess whether passage of state omnibus immigration laws reduced access to Medicaid/CHIP for US citizen Latino children. The authors found that law passage did not reduce enrollment for children with noncitizen parents and actually resulted in temporary increases in coverage among Latino children with at least one citizen parent.
AHRQ-funded; HS024248.
Citation: Allen CD, McNeely CA .
Do restrictive omnibus immigration laws reduce enrollment in public health insurance by Latino citizen children? A comparative interrupted time series study.
Soc Sci Med 2017 Oct;191:19-29. doi: 10.1016/j.socscimed.2017.08.039..
Keywords: Access to Care, Children/Adolescents, Children's Health Insurance Program (CHIP), Policy, Racial and Ethnic Minorities
Burgette JM, Preisser JS, Weinberger M
Early head start, pediatric dental use, and oral health-related quality of life.
The objective of the study was to examine the mediating effect of child dental use on the effectiveness of North Carolina Early Head Start (EHS) in improving oral health-related quality of life (OHRQoL). It concluded that EHS increases child dental use, which worsens family OHRQoL. However, EHS is associated with improved OHRQoL overall.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Early head start, pediatric dental use, and oral health-related quality of life.
JDR Clin Trans Res 2017 Oct;2(4):353-62. doi: 10.1177/2380084417709758.
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Keywords: Children/Adolescents, Dental and Oral Health, Quality of Life, Children/Adolescents
Burgette JM, Preisser JS, Weinberger M
Enrollment in early head start and oral health-related quality of life.
Researchers examined the effect of enrollment in North Carolina Early Head Start (EHS) - a federally funded early education program for children under three years of age and their families - on oral health-related quality of life (OHRQoL). Their study is the first to demonstrate that families of young children enrolled in EHS report improved OHRQoL compared to their non-enrolled peers.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Weinberger M .
Enrollment in early head start and oral health-related quality of life.
Qual Life Res 2017 Oct;26(10):2607-18. doi: 10.1007/s11136-017-1584-7.
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Keywords: Children/Adolescents, Dental and Oral Health, Quality of Life
Wisk LE, Weitzman ER
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
This study sought to investigate educational aspirations, expectations, and attainment among youth with and without chronic conditions and to determine if these relationships mediated subsequent disparities in health and well-being. Findings suggest an important risk mechanism through which youth with chronic medical conditions may acquire socioeconomic disadvantage as they develop and progress through educational settings.
AHRQ-funded; HS022986; HS000063.
Citation: Wisk LE, Weitzman ER .
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
J Adolesc Health 2017 Oct;61(4):461-70. doi: 10.1016/j.jadohealth.2017.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Disparities, Education, Health Status
Ray KN, Ashcraft LE, Mehrotra A
Family perspectives on telemedicine for pediatric subspecialty care.
The researchers sought to understand how subspecialty telemedicine is perceived and to identify design elements with the potential to improve telemedicine uptake and impact. They found that although informants saw the potential value of using telemedicine to replace in-person subspecialty visits, they were more enthusiastic about using telemedicine to complement rather than replace in-person visits.
AHRQ-funded; HS022989.
Citation: Ray KN, Ashcraft LE, Mehrotra A .
Family perspectives on telemedicine for pediatric subspecialty care.
Telemed J E Health 2017 Oct;23(10):852-62. doi: 10.1089/tmj.2016.0236.
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Keywords: Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Children/Adolescents, Telehealth