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
101 to 125 of 270 Research Studies DisplayedCrews DC, Purnell TS
COVID-19, racism, and racial disparities in kidney disease: galvanizing the kidney community response.
This article and associated podcast discussed racial disparities in kidney disease and COVID-19, including Geronimus’ weathering hypothesis, structural racism, and the role of nephrologists.
AHRQ-funded; HS024600.
Citation: Crews DC, Purnell TS .
COVID-19, racism, and racial disparities in kidney disease: galvanizing the kidney community response.
J Am Soc Nephrol 2020 Aug;31(8):1-3. doi: 10.1681/asn.2020060809..
Keywords: COVID-19, Disparities, Racial and Ethnic Minorities, Kidney Disease and Health
Swietek KE, Gaynes BN, Jackson GL
Effect of the patient-centered medical home on racial disparities in quality of care.
Research demonstrates that the patient-centered medical home (PCMH) is associated with improved clinical outcomes and quality of care, and the populations that can most benefit from this model require long-term management, e.g., persons with chronic illness and behavioral health conditions. The objective of this study was to estimate the association between enrollment in National Committee for Quality Assurance (NCQA)-recognized PCMHs and racial disparities in quality of care for adults with major depressive disorder (MDD) and comorbid medical conditions.
AHRQ-funded; HS025562.
Citation: Swietek KE, Gaynes BN, Jackson GL .
Effect of the patient-centered medical home on racial disparities in quality of care.
J Gen Intern Med 2020 Aug;35(8):2304-13. doi: 10.1007/s11606-020-05729-x.
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Keywords: Patient-Centered Healthcare, Disparities, Racial and Ethnic Minorities, Quality of Care, Chronic Conditions
Purnell TS, Bae S, Luo X
National trends in the association of race and ethnicity with predialysis nephrology care in the United States From 2005 to 2015.
Predialysis nephrology care is associated with better survival among patients with end-stage kidney disease. The purpose of this study was to examine national trends in racial/ethnic disparities in receipt of predialysis nephrology care at least 1 year before dialysis initiation in the United States from 2005 to 2015. The study findings suggested that national strategies to address racial/ethnic disparities in predialysis nephrology care are needed.
AHRQ-funded; HS024600.
Citation: Purnell TS, Bae S, Luo X .
National trends in the association of race and ethnicity with predialysis nephrology care in the United States From 2005 to 2015.
JAMA Netw Open 2020 Aug;3(8):e2015003. doi: 10.1001/jamanetworkopen.2020.15003..
Keywords: Kidney Disease and Health, Dialysis, Racial and Ethnic Minorities, Chronic Conditions, Disparities
Payán DD, Maggard-Gibbons M, Flórez KR
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. In this study, the investigators formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years) and conducted a randomized controlled trial of a health communication intervention for Latinas.
AHRQ-funded; HS019264.
Citation: Payán DD, Maggard-Gibbons M, Flórez KR .
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Cultural Competence, Health Promotion, Communication, Women, Community-Based Practice
Heintzman J, Marino M, Clark K
Using electronic health record data to study Latino immigrant populations in health services research.
The purpose of this study was to validate an electronic health record (EHR)-based algorithm that could serve as a safe proxy for self-reported immigration status for health services researchers. Researchers developed an EHR algorithm to classify a population of patients as likely undocumented or recent Latino immigrants and validated this algorithm by conducting semi-structured interviews of staff. They concluded that the EHR has potential for studying immigration status in health services research, although more study is needed to determine the accuracy and utility of EHRs for this purpose.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Clark K .
Using electronic health record data to study Latino immigrant populations in health services research.
J Immigr Minor Health 2020 Aug;22(4):754-61. doi: 10.1007/s10903-019-00925-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Health Services Research (HSR)
Bi S, Vela MB, Nathan AG
Teaching intersectionality of sexual orientation, gender identity, and race/ethnicity in a health disparities course.
Intersectionality considers how different identities simultaneously affect an individual's experiences. Those of multiple minority statuses may experience effects of intersecting systems of oppression. Most health disparities curricula do not focus on intersectionality. The investigators studied the impact of an innovative module teaching intersectionality of sexual orientation, gender identity, and race/ethnicity issues in the required Pritzker School of Medicine course Health Care Disparities: Equity and Advocacy.
AHRQ-funded; HS023050.
Citation: Bi S, Vela MB, Nathan AG .
Teaching intersectionality of sexual orientation, gender identity, and race/ethnicity in a health disparities course.
MedEdPORTAL 2020 Jul 31;16:10970. doi: 10.15766/mep_2374-8265.10970..
Keywords: Racial and Ethnic Minorities, Disparities, Education: Curriculum
Payán DD, Derose KP, Flórez KR
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
The authors developed a mapping component as part of a multilevel church-based intervention that used community-based participatory research to prevent obesity in African American and Latino churches in South Los Angeles. They developed neighborhood maps of local food environments and provided churches with standardized information on food access, availability, quality, and marketing practices. Including several tables as well as discussion, they stated that local food environment maps that are paired with data can inform community-based strategies to prevent obesity and food insecurity.
AHRQ-funded; HS000046.
Citation: Payán DD, Derose KP, Flórez KR .
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
Prev Chronic Dis 2020 Jul 16;17:E61. doi: 10.5888/pcd17.200028.
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Keywords: Obesity, Racial and Ethnic Minorities, Prevention, Prevention, Community Partnerships, Community-Based Practice, Nutrition
Pollack LM, Olsen MA, Gehlert SJ
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
The objective of the study was to evaluate racial/ethnic variation in hysterectomy surgical route in women likely eligible for minimally invasive hysterectomy. The investigators concluded that African American, Hispanic, and Asian/PI women eligible for minimally invasive hysterectomy were more likely than White women to receive abdominal hysterectomy. In addition, the proportion of all women undergoing abdominal hysterectomy was highest at hospitals serving higher proportions of African American persons.
AHRQ-funded; HS019455; HS022330.
Citation: Pollack LM, Olsen MA, Gehlert SJ .
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
J Minim Invasive Gynecol 2020 Jul-Aug;27(5):1167-77. doi: 10.1016/j.jmig.2019.09.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Women, Surgery
Kubi B, Enumah ZO, Lee KT
Theory-based development of an implementation intervention using community health workers to increase palliative care use.
This study used the Behavior Change Wheel and Theoretical Domains Framework models to help design an implementation intervention using community health workers (CHWs) to increase palliative care use in African American communities. There were two phases to the study. In Phase 1, focus group sessions were conducted to identify barriers and facilitators of palliative care use. Phase 2 consisted of a stakeholder meeting to select intervention content and prioritize modes of delivery after applying the framework. There were 15 stakeholders total that participated in the study. Interventions identified were designed to improve patient capability and motivation, physician capability and motivation, and increase patient opportunities to use palliative care services. The strategies were all facilitated by CHWs and included creation and dissemination of brochures, empowerment and activation of patients to initiate goals-of-care discussions, outreach to community churches, and expanding patient social support.
AHRQ-funded; HS024736.
Citation: Kubi B, Enumah ZO, Lee KT .
Theory-based development of an implementation intervention using community health workers to increase palliative care use.
J Pain Symptom Manage 2020 Jul;60(1):10-19. doi: 10.1016/j.jpainsymman.2020.02.009..
Keywords: Community-Based Practice, Palliative Care, Healthcare Utilization, Racial and Ethnic Minorities, Implementation, Disparities, Healthcare Delivery
Cunningham-Erves J, Barajas C, Mayo-Gamble TL
Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities.
This study’s goal was to address knowledge deficiencies about cancer clinical trials and biospecimen donation that can potentially improve participation among racial and ethnic minorities. The researchers included community-based organization (CBO) leaders as research team members, conducted focus groups and cognitive interviews with community members as reviewers/consultants, and interacted with two community advisory groups. Five focus group themes were identified. A final program consisted of two versions (English and Spanish) of a culturally-appropriate slide presentation with speaker notes and videos that represent community member and researcher testimonials. It is hoped these findings will help promote cancer clinical trial participation among African Americans and Latinos.
AHRQ-funded; HS026122.
Citation: Cunningham-Erves J, Barajas C, Mayo-Gamble TL .
Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities.
BMC Public Health 2020 Jun 3;20(1):840. doi: 10.1186/s12889-020-08939-4..
Keywords: Cancer, Racial and Ethnic Minorities, Cultural Competence, Research Methodologies, Disparities
Jannat-Khah DP, Khodneva Y, Bryant K
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
This study examined whether time-varying depressive symptoms (TVDS) predict mortality and if racial and income differences moderate the association in a large cohort. The cohort from the REGARDS study was used to look at that determination. The REGARDS study used community-dwelling U.S. adults aged 45 years or older. They found that there was similar and statistically significant differences with white, black, and low-income ($35,000 or less) participants for the association between TVDS and mortality. High-income participants were found to have a lower hazard.
AHRQ-funded; HS025198.
Citation: Jannat-Khah DP, Khodneva Y, Bryant K .
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
Ann Epidemiol 2020 Jun;46:31-40.e2. doi: 10.1016/j.annepidem.2020.04.004..
Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Cardiovascular Conditions, Cancer, Low-Income, Social Determinants of Health, Mortality
Cuffee YL, Rosal M, Hargraves JL
Does home remedy use contribute to medication nonadherence among Blacks with hypertension?
The objective of this study was to examine home remedy (HR) use among Blacks with hypertension and to determine if home remedy use is correlated with blood pressure and medication adherence. Data was obtained from the TRUST study conducted 2006-2008. Findings showed that the use of HR and the number of HRs used may be associated with medication nonadherence and with higher systolic and diastolic blood pressure among Blacks with hypertension. Recommendations included that health care providers need to be aware of health behaviors that may serve as barriers to medication adherence, such as the use of home remedies.
AHRQ-funded; HS020755.
Citation: Cuffee YL, Rosal M, Hargraves JL .
Does home remedy use contribute to medication nonadherence among Blacks with hypertension?
Ethn Dis 2020 Summer;30(3):451-58. doi: 10.18865/ed.30.3.451..
Keywords: Patient Adherence/Compliance, Medication, Blood Pressure, Racial and Ethnic Minorities, Cardiovascular Conditions
Whitley MD, Payán DD, Flórez KR
Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
Church-based programs can act on multiple levels to improve dietary and physical activity behaviors among African Americans and Latinos. However, the effectiveness of these interventions may be limited due to challenges in reaching all congregants or influencing behavior outside of the church setting. This study examined the feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
AHRQ-funded; HS000046.
Citation: Whitley MD, Payán DD, Flórez KR .
Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
Health Informatics J 2020 Jun;26(2):880-96. doi: 10.1177/1460458219853408..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Health Information Technology (HIT), Health Promotion
Murosko D, Passerella M, Lorch S
Racial segregation and intraventricular hemorrhage in preterm infants.
Intraventricular hemorrhage (IVH) disproportionately affects black neonates. Other conditions that are more common in black neonates, including low birth weight and preterm delivery, have been linked with residential racial segregation (RRS). In this study, the authors investigated the association between RRS and IVH. The investigators concluded that RRS was associated with an increased risk of IVH in preterm neonates, but the effect size varied by race. They indicated that this association persisted after balancing for community factors and birth weight, representing a novel risk factor for IVH.
AHRQ-funded; HS018661.
Citation: Murosko D, Passerella M, Lorch S .
Racial segregation and intraventricular hemorrhage in preterm infants.
Pediatrics 2020 Jun;145(6):e20191508. doi: 10.1542/peds.2019-1508..
Keywords: Newborns/Infants, Racial and Ethnic Minorities, Adverse Events
Dos Santos Marques IC, Herbey II, Theiss LM
Understanding the surgical experience for African-Americans and Caucasians with enhanced recovery.
The purpose of this study was to use qualitative methods to better understand the surgical experience for African-American and Caucasian patients in the setting of an enhanced recovery program (ERP). Findings showed that African-American and Caucasian surgical patients have varied surgical experiences even under an ERP. All patients, however, valued the ability to obtain, process, and understand health information during the surgical process. These elements define "health literacy" and suggest the importance of providing health literacy-sensitive care in surgery.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Herbey II, Theiss LM .
Understanding the surgical experience for African-Americans and Caucasians with enhanced recovery.
J Surg Res 2020 Jun;250:12-22. doi: //10.1016/j.jss.2019.12.034..
Keywords: Surgery, Racial and Ethnic Minorities, Patient Experience, Disparities, Health Literacy, Education: Patient and Caregiver
Toledo P, Lewis CR, Lange EMS
Women and underrepresented minorities in academic anesthesiology.
The demographics of the United States is changing with 51% of the population being female, and 32% of the population identifying as an underrepresented minority (URM, ie, African American/black, Hispanic/Latino, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). This article provides an overview of the current status of women and URM faculty in academic anesthesiology and provides a framework for academic advancement.
AHRQ-funded; HS025267; HS026169.
Citation: Toledo P, Lewis CR, Lange EMS .
Women and underrepresented minorities in academic anesthesiology.
Anesthesiol Clin 2020 Jun;38(2):449-57. doi: 10.1016/j.anclin.2020.01.004..
Keywords: Provider: Physician, Provider, Workforce, Women, Racial and Ethnic Minorities, Education: Academic
Canedo JR, Wilkins CH, Senft N
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
This study examined barriers to dissemination and adoption of precision medicine among the Hispanic/Latino population. Six focus groups and a demographic survey in English and Spanish was developed. Forty-one self-identified Hispanics/Latinos from diverse countries participated in the study. The participants had never heard of precision medicine and barriers to adoption and dissemination included lack of health insurance, distrust of government, immigration status, financial burden, limited English proficiency, low literacy levels, lack of information and lack of transportation. Facilitators included family support, information provided in Spanish, use of plain language and graphics and trust in healthcare providers and institutions. The authors recommend culturally- and linguistically-tailored, low-literacy educational material about precision medicine in English and Spanish.
AHRQ-funded; HS026122.
Citation: Canedo JR, Wilkins CH, Senft N .
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
BMC Public Health 2020 May 1;20(1):603. doi: 10.1186/s12889-020-08718-1..
Keywords: Racial and Ethnic Minorities, Cultural Competence, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication
Walker DM, Hefner JL, Fareed N
Exploring the digital divide: age and race disparities in use of an inpatient portal.
Age and race disparities in the use of new technologies-the digital divide-may be limiting the potential of patient-facing health information technology to improve health and health care. The objective of this study was to investigate whether disparities exist in the use of patient portals designed specifically for the inpatient environment. The investigators identified lower use of the inpatient portal among African American and older patients, relative to White and younger patients, respectively.
AHRQ-funded; HS024379; HS024091; HS024349.
Citation: Walker DM, Hefner JL, Fareed N .
Exploring the digital divide: age and race disparities in use of an inpatient portal.
Telemed J E Health 2020 May;26(5):603-13. doi: 10.1089/tmj.2019.0065..
Keywords: Racial and Ethnic Minorities, Disparities, Health Information Technology (HIT), Inpatient Care, Hospitalization
Gaskin DJ, Karmarkar TD, Maurer A
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
This study examined whether using a decision-making tool would aid Latina and African-American women over age 45 years with arthritic knee pain in making more informed treatment decisions. The researchers conducted 4 focus groups of Latina and African-American women and 2 focus groups with primary care providers who treated them for knee pain. They found that minority women and primary care providers all endorsed the use of a decision-making tool that provided information on the impact of treatment on quality of life, medical care costs, and work productivity.
AHRQ-funded; HS000029.
Citation: Gaskin DJ, Karmarkar TD, Maurer A .
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
Arthritis Care Res 2020 May;72(5):692-98. doi: 10.1002/acr.23903..
Keywords: Arthritis, Orthopedics, Pain, Quality of Life, Healthcare Costs, Shared Decision Making, Racial and Ethnic Minorities, Women
Lee JT, Polsky D, Fitzsimmons R
Proportion of racial minority patients and patients with low socioeconomic status cared for by physician groups after joining accountable care organizations.
The purpose of this study was to test for changes in the percentage of racial minority patients and patients with low socioeconomic status cared for by physician groups after joining an accountable care organization (ACO). This cohort study’s subjects consisted of a 15% random sample of Medicare fee-for-service beneficiaries attributed to physician groups. ACO file were used to determine Medicare Shared Savings Program (MSSP) participation. No changes were found in the proportions of vulnerable patients cared for by ACO-participating physician groups after joining an ACO compared with changes among nonparticipating groups.
AHRQ-funded; HS025184.
Citation: Lee JT, Polsky D, Fitzsimmons R .
Proportion of racial minority patients and patients with low socioeconomic status cared for by physician groups after joining accountable care organizations.
JAMA Netw Open 2020 May;3():e204439. doi: 10.1001/jamanetworkopen.2020.4439.
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Keywords: Social Determinants of Health, Racial and Ethnic Minorities, Medicare
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in emergency department pain management of children with fractures.
Researchers tested the hypotheses that minority children with long-bone fractures are less likely to receive analgesics, to receive opioid analgesics, and to achieve pain reduction. Using data from the Pediatric Emergency Care Applied Research Network Registry, they found that there are differences in process and outcome measures by race and ethnicity in the emergency department management of pain among children with long-bone fractures. Although minority children are more likely to receive analgesics and achieve reduction in pain, they are less likely to receive opioids and achieve optimal pain reduction.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in emergency department pain management of children with fractures.
Pediatrics 2020 May;145(5):e20193370. doi: 10.1542/peds.2019-3370..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Emergency Department, Pain, Injuries and Wounds, Medication, Opioids, Disparities
Mefford MT, Goyal P, Howard G
The association of hypertension, hypertension duration, and control with incident heart failure in black and white adults.
Associations between hypertension and some cardiovascular diseases are stronger in black vs white adults. In this study, the investigators examined associations of hypertension, hypertension duration, and control with incident heart failure (HF) in black and white REasons for Geographic And Racial Differences in Stroke study participants (n = 25 770) who were followed for incident HF hospitalization (n = 947) from enrollment in 2003-2007 through 2015.
AHRQ-funded; HS013852.
Citation: Mefford MT, Goyal P, Howard G .
The association of hypertension, hypertension duration, and control with incident heart failure in black and white adults.
J Clin Hypertens 2020 May;22(5):857-66. doi: 10.1111/jch.13856..
Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities
Ornelas IJ, Yamanis TJ, Ruiz RA
The health of undocumented Latinx immigrants: what we know and future directions.
This review article summarizes the limited but growing literature on the health of undocumented Latinx immigrations and how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect their mental and physical health. The authors discuss how policies and social ties can promote their health. They focus on areas of concern and recommend how future research should be conducted.
AHRQ-funded; HS013853.
Citation: Ornelas IJ, Yamanis TJ, Ruiz RA .
The health of undocumented Latinx immigrants: what we know and future directions.
Annu Rev Public Health 2020 Apr 2;41:289-308. doi: 10.1146/annurev-publhealth-040119-094211..
Keywords: Racial and Ethnic Minorities, Vulnerable Populations, Social Determinants of Health, Policy
Flórez KR, Payán DD, Palar K
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
This systematic literature review examined the impact of multilevel church-based interventions to address racial/ethnic disparities in obesity in the US. The review identified 43 relevant articles using systematic review methods developed by the CDC’s Task Force on Community Preventive Services. Although 81% of the studies reported significant results, effective size was reported or could only be calculated in 56% of the cases. A lack of diversity among the samples was also found with few studies involving Latinos, men, young adults, or children. Few interventions were actually multilevel in nature or incorporated strategies at the church or community. Greater diversity is needed in future church-based interventions.
AHRQ-funded; HS000046.
Citation: Flórez KR, Payán DD, Palar K .
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
Nutr Rev 2020 Apr;78(4):304-22. doi: 10.1093/nutrit/nuz046..
Keywords: Racial and Ethnic Minorities, Obesity, Obesity: Weight Management, Disparities, Health Promotion, Prevention
Chen DW, Reyes-Gastelum D, Wallner LP
Disparities in risk perception of thyroid cancer recurrence and death.
The authors studied risk perception among survivors of thyroid cancer. Patients diagnosed with differentiated thyroid cancer from the Surveillance, Epidemiology, and End Results registries were surveyed and an analytic cohort defined by a 5% or greater risk of disease recurrence and mortality. The authors found that less educated patients and Hispanic patients were more likely to report inaccurate risk perceptions, which were associated with worry and a decreased quality of life.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Wallner LP .
Disparities in risk perception of thyroid cancer recurrence and death.
Cancer 2020 Apr 1;126(7):1512-21. doi: 10.1002/cncr.32670..
Keywords: Disparities, Cancer, Risk, Quality of Life, Social Determinants of Health, Racial and Ethnic Minorities