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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
76 to 100 of 229 Research Studies DisplayedShaikh U, Romano P, Paterniti DA
Organizing for quality improvement in health care: An example from childhood obesity prevention.
The researchers evaluated how the quality improvement (QI) intervention, Healthy Eating Active Living TeleHealth Community of Practice, at 7 rural California clinics addressed the challenges. of preventing and managing obesity and translation of evidence into practice. Key challenges were clinician and staff buy-in, changing ingrained clinical practices, and motivating patient and families. Facilitators included top-down organizational requirements for QI, linkages to local QI resources, and involvement of clinical champions.
AHRQ-funded; HS018567.
Citation: Shaikh U, Romano P, Paterniti DA .
Organizing for quality improvement in health care: An example from childhood obesity prevention.
Qual Manag Health Care 2015 Jul-Sep;24(3):121-8. doi: 10.1097/qmh.0000000000000066.
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Keywords: Quality Improvement, Children/Adolescents, Obesity, Prevention, Primary Care
Feemster KA
Remembering the benefits of vaccination.
This commentary discussed the issue of vaccination and tightening exemptions for school entry. The author pointed out that events show that the success of vaccines can be fragile, as the measles cases associated with Disneyland were preceded by 644 cases in 2014. And 2012 saw more than 40,000 cases of pertussis, the largest number since 1960. These events provided a dramatic reminder that vaccines remain an important and necessary public health tool.
AHRQ-funded; HS020939.
Citation: Feemster KA .
Remembering the benefits of vaccination.
JAMA Pediatr 2015 Jul;169(7):624-6. doi: 10.1001/jamapediatrics.2015.0647.
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Keywords: Children/Adolescents, Infectious Diseases, Patient Safety, Policy, Vaccination
Carter EJ, Cohen B, Murray MT
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
The aim of the study was to engage staff in the development of workflow diagrams, which highlighted hand hygiene (HH) practices during commonly performed patient-care activities. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene.
AHRQ-funded; HS021470.
Citation: Carter EJ, Cohen B, Murray MT .
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
J Pediatr Nurs 2015 Jul-Aug;30(4):e17-21. doi: 10.1016/j.pedn.2014.12.002..
Keywords: Patient Safety, Quality of Care, Children/Adolescents, Long-Term Care
Wang Y, Cai L, Wu Y
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
The researchers systematically evaluated the effectiveness of childhood obesity prevention programs conducted in high-income countries and implemented in various settings. Their review found at least moderately strong evidence supporting the effectiveness of school-based interventions involving physical activity, diet or combined diet and physical activity for preventing childhood obesity.
AHRQ-funded; 290200710061I.
Citation: Wang Y, Cai L, Wu Y .
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
Obes Rev 2015 Jul;16(7):547-65. doi: 10.1111/obr.12277..
Keywords: Children/Adolescents, Comparative Effectiveness, Obesity, Prevention
Norman BA, Rajgopal J, Lim J
Modular vaccine packaging increases packing efficiency.
The researchers developed a spreadsheet model that evaluated the impact of different packing schemes for the Benin routine regimen plus the introduction of the Rotarix vaccine. Their analysis suggests that modular packaging systems could offer significant advantages over conventional vaccine packaging systems with respect to space efficiency and potential numbers of fully-immunized children, when they are stored in standard vaccine carrying devices.
AHRQ-funded; HS023317.
Citation: Norman BA, Rajgopal J, Lim J .
Modular vaccine packaging increases packing efficiency.
Vaccine 2015 Jun 17;33(27):3135-41. doi: 10.1016/j.vaccine.2015.04.091..
Keywords: Vaccination, Medication, Children/Adolescents
Fan T, Rossi C
AHRQ Author: Fan T
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
This case study involves a 16-year-old white female nonsmoker who presents for a sports clearance physical. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Fan T, Rossi C .
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
Am Fam Physician 2015 Jun 15;91(12):865-6.
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Keywords: Children/Adolescents, Primary Care, Behavioral Health, U.S. Preventive Services Task Force (USPSTF), Substance Abuse
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
Because laboratory testing and coding for rotavirus are not routinely performed for patients with diarrhea, the researchers examined both all-cause acute gastroenteritis and rotavirus-coded hospitalizations among children younger than 5 years from 2000 through 2012. They found that, in 2012, when vaccine coverage was highest, the greatest reductions were observed for all-cause acute gastroenteritis (55 percent) and rotavirus-coded (94 percent) hospitalizations.
AHRQ-authored.
Citation: Leshem E, Tate JE, Steiner CA .
Acute gastroenteritis hospitalizations among US children following implementation of the rotavirus vaccine.
JAMA 2015 Jun 9;313(22):2282-4. doi: 10.1001/jama.2015.5571..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination, Children/Adolescents, Adverse Events
Stockwell DC, Bisarya H, Classen DC
A trigger tool to detect harm in pediatric inpatient settings.
The researchers developed and pilot tested a trigger tool that would identify the most common causes of harm in pediatric inpatient environments. After reviewing review 100 randomly selected inpatient records from each of 6 academic children’s hospitals, they found that the most common patient harms were intravenous catheter infiltrations/burns, respiratory distress, constipation, pain, and surgical complications.
AHRQ-funded; HS020513.
Citation: Stockwell DC, Bisarya H, Classen DC .
A trigger tool to detect harm in pediatric inpatient settings.
Pediatrics 2015 Jun;135(6):1036-42. doi: 10.1542/peds.2014-2152..
Keywords: Children/Adolescents, Patient Safety, Inpatient Care, Children/Adolescents, Adverse Events
Carmody D, Lindauer KL, Naylor RN
Adolescent non-adherence reveals a genetic cause for diabetes.
Glucokinase related maturity-onset diabetes of the young (GCK-MODY) is frequently unrecognized or misdiagnosed as Type 1 or Type 2 diabetes, resulting in unnecessary pharmacologic therapy. The authors recommend considering a genetic cause when evaluating every person with new-onset hyperglycaemia or those with atypical diabetes. Testing costs for the most common MODY causing genes may be offset by savings made in therapeutic costs. They suggest that it is important that all clinicians supervising diabetes care recognize the cardinal features that distinguish GCK-MODY from other forms of diabetes.
AHRQ-funded; HS023007.
Citation: Carmody D, Lindauer KL, Naylor RN .
Adolescent non-adherence reveals a genetic cause for diabetes.
Diabet Med 2015 Jun;32(6):e20-3. doi: 10.1111/dme.12669.
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Keywords: Children/Adolescents, Diabetes, Diagnostic Safety and Quality, Genetics, Medication
Lu CY, Zhang F, Lakoma MD
Asthma treatments and mental health visits after a Food and Drug Administration label change for leukotriene inhibitors.
This study investigated how a label change to include neuropsychiatric adverse events (e.g., depression and suicidality) affected the use of leukotriene inhibitors (LTIs) and other asthma controller medications, mental health visits, and suicide attempts. The label change was associated with abrupt reductions in LTI use among all age groups.
AHRQ-funded; HS019669.
Citation: Lu CY, Zhang F, Lakoma MD .
Asthma treatments and mental health visits after a Food and Drug Administration label change for leukotriene inhibitors.
Clin Ther 2015 Jun;37(6):1280-91. doi: 10.1016/j.clinthera.2015.03.027..
Keywords: Adverse Drug Events (ADE), Asthma, Children/Adolescents, Medication, Behavioral Health
Iroh Tam PY, Bernstein E, Ma X
Blood culture in evaluation of pediatric community-acquired pneumonia: a systematic review and meta-analysis.
The researchers systematically reviewed the international pediatric literature to evaluate how often blood cultures (BCs) are positive in hospitalized children with CAP, identify the most commonly isolated pathogens, and determine the impact of positive BCs on clinical management. They found that BCs in pediatric CAP identified organisms in only a small percentage of patients, predominantly S. pneumoniae. False-positive BC rates can be substantial.
AHRQ-funded; HS020666.
Citation: Iroh Tam PY, Bernstein E, Ma X .
Blood culture in evaluation of pediatric community-acquired pneumonia: a systematic review and meta-analysis.
Hosp Pediatr 2015 Jun;5(6):324-36. doi: 10.1542/hpeds.2014-0138..
Keywords: Children/Adolescents, Hospitalization, Children/Adolescents, Comparative Effectiveness
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
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Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Wisk LE, Finkelstein JA, Sawicki GS
Predictors of timing of transfer from pediatric- to adult-focused primary care.
The researchers examined the timing of transfer to adult-focused primary care providers (PCPs), the time between last pediatric-focused and first adult-focused PCP visits, and the predictors of transfer timing. They found that most youths are transferring care later than recommended and with gaps of more than a year. They further noted that while youths with chronic conditions have shorter gaps, they may need even shorter transfer intervals to ensure continuous access to care.
AHRQ-funded; HS000063; HS020513.
Citation: Wisk LE, Finkelstein JA, Sawicki GS .
Predictors of timing of transfer from pediatric- to adult-focused primary care.
JAMA Pediatr 2015 Jun;169(6):e150951. doi: 10.1001/jamapediatrics.2015.0951.
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Keywords: Children/Adolescents, Chronic Conditions, Primary Care, Transitions of Care, Young Adults
Chinnadurai S, Francis DO, Epstein RA
Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review.
The researchers systematically reviewed literature on feeding, speech, and social outcomes of treatments for infants and children with ankyloglossia. After analyzing two randomized controlled trials, 2 cohort studies, and 11 case series assessing the effects of frenotomy on feeding, speech, and social outcomes, they determined that data are currently insufficient for assessing the effects of frenotomy on nonbreastfeeding outcomes that may be associated with ankyloglossia.
AHRQ-funded; 290201200009I.
Citation: Chinnadurai S, Francis DO, Epstein RA .
Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review.
Pediatrics 2015 Jun;135(6):e1467-74. doi: 10.1542/peds.2015-0660..
Keywords: Breast Feeding, Children/Adolescents, Outcomes, Comparative Effectiveness
Olfson M, Druss BG, Marcus SC
Trends in mental health care among children and adolescents.
This study examined national trends in the use of outpatient mental health services by children and adolescents, focusing on the severity of mental health impairment. It found that outpatient mental health treatment and psychotropic-medication use in children and adolescents increased in the United States between 1996–1998 and 2010–2012. Youths with less severe or no impairment accounting for most of the absolute increase in service use.
AHRQ-funded; HS021112.
Citation: Olfson M, Druss BG, Marcus SC .
Trends in mental health care among children and adolescents.
N Engl J Med 2015 May 21;372(21):2029-38. doi: 10.1056/NEJMsa1413512..
Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Behavioral Health, Ambulatory Care and Surgery
Snider C, Jiang D, Logsetty S
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
In Winnipeg, Canada, 20% of youth who visit an emergency department with an injury due to violence have a second visit for a subsequent violent injury within 1 year. This study protocol describes a wraparound care model delivered by a support worker with experience with violence, supported by social workers and links to multiple community partners. It has been developed using an integrated knowledge translation approach.
AHRQ-funded; HS016444.
Citation: Snider C, Jiang D, Logsetty S .
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
BMJ Open 2015 May 19;5(5):e008088. doi: 10.1136/bmjopen-2015-008088.
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Keywords: Children/Adolescents, Emergency Department, Injuries and Wounds
Kelly MS, Smieja M, Luinstra K
Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.
The authors examined whether detection of respiratory viruses predicts acute lower respiratory tract infection (ALRI) outcomes in low- and middle-income countries. They found that respiratory viruses were detected from most children hospitalized with ALRI in Botswana, but only respiratory syncytial virus (RSV) and human metapneumovirus were more frequent than among children without ALRI. Further, detection of RSV from children with ALRI predicted a protracted illness course but lower mortality compared with non-RSV viruses.
AHRQ-funded; HS020939.
Citation: Kelly MS, Smieja M, Luinstra K .
Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.
PLoS One 2015 May 14;10(5):e0126593. doi: 10.1371/journal.pone.0126593.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Pneumonia, Respiratory Conditions
Yun L, Boles RE, Haemer MA
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
This paper delineates the study protocol for the Community Outreach Obesity Prevention Trial. COOPT is an ongoing, 4-year (October 2011-September 2015) randomized controlled trial that tests the effectiveness of a home-based patient navigator program delivered to preschoolers of a large urban safety-net health care system. The researchers believe that its home-based intervention venue will provide rich data characterizing barriers and facilitators to healthy behavior change within the home.
AHRQ-funded; HS021138.
Citation: Yun L, Boles RE, Haemer MA .
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
BMC Public Health 2015 May;15:506. doi: 10.1186/s12889-015-1833-z..
Keywords: Children/Adolescents, Community-Based Practice, Obesity, Prevention, Racial and Ethnic Minorities
Christensen AL, Zickafoose JS, Natzke B
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
This study assessed the relationship between having a patient-centered medical home and use of health services by children enrolled in Medicaid in three States. The researchers found that medical homeness was not associated with the likelihood of receiving well-child care. Association of medical homeness with non-urgent, preventable, or avoidable emergency department visits varied.
AHRQ-funded; 290200900019I
Citation: Christensen AL, Zickafoose JS, Natzke B .
Associations between practice-reported medical homeness and health care utilization among publicly insured children.
Acad Pediatr. 2015 May-Jun;15(3):267-74. doi: 10.1016/j.acap.2014.12.001..
Keywords: Children/Adolescents, Medicaid, Patient-Centered Healthcare, Children's Health Insurance Program (CHIP), Healthcare Utilization
Raghavan R, Brown DS, Allaire BT
Challenges in using Medicaid claims to ascertain child maltreatment.
Using data from the first National Survey of Child and Adolescent Well-Being and Medicaid claims, this study assessed the validity of Medicaid codes in identifying maltreatment. Medicaid claims identify maltreatment in only 15 percent of all children identified by the child’s investigating child welfare worker as having been maltreated.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Challenges in using Medicaid claims to ascertain child maltreatment.
Challenges in using Medicaid claims to ascertain child maltreatment..
Keywords: Domestic Violence, Children/Adolescents, Medicaid
Finnell SM, Rosenman MB, Christenson JC
Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
The researchers sought to determine whether decolonization following incision and drainage (I&D) for methicillin-resistant Staphylococcus aureus (MRSA) abscess decreases repeat I&D and MRSA-positive cultures in children. They found that no statistically significant association between referral to the Pediatric Infectious Disease Service for decolonization and the outcomes.
AHRQ-funded; HS020014.
Citation: Finnell SM, Rosenman MB, Christenson JC .
Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
Clin Pediatr 2015 May;54(5):445-50. doi: 10.1177/0009922814556059..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Treatments
Butz AM, Ogborn J, Mudd S
Factors associated with high short-acting beta2-agonist use in urban children with asthma.
The investigators examined factors associated with high short-acting β₂ agonist (SABA) use in inner-city children with asthma. They found that high SABA users were more than 5 times more likely to have an asthma hospitalization, almost 3 times more likely to have an asthma intensive care unit admission, and more than 3 times more likely to have prior specialty asthma care or positive cockroach sensitization than low to moderate SABA users.
AHRQ-funded; HS000029.
Citation: Butz AM, Ogborn J, Mudd S .
Factors associated with high short-acting beta2-agonist use in urban children with asthma.
Ann Allergy Asthma Immunol 2015 May;114(5):385-92. doi: 10.1016/j.anai.2015.03.002.
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Keywords: Asthma, Children/Adolescents, Medication, Urban Health
Hudson JL, Hill SC, Selden TM
AHRQ Author: Hudson JL, Hill SC, Selden TM
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
This study investigated the potential health insurance options available to low-income children if federal CHIP funding ends in 2017 or if federal requirements change in 2019, allowing states to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels. It found that the percentage of low-income children ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children).
Citation: Hudson JL, Hill SC, Selden TM .
If rollbacks go forward, up to 14 million children could become ineligible for public or subsidized coverage by 2019.
Health Aff 2015 May;34(5):864-70. doi: 10.1377/hlthaff.2015.0004..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Health Insurance, Low-Income
Pati S, Wong AT, Calixte RE
Medicaid and CHIP retention among children in 12 states.
The authors sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level. They found that all 3 metrics demonstrated reproducible estimates at the state level. Reproducibility of relative rankings for child health insurance retention of counties within states were sensitive to county child population size and the amount of variability in retention rates within the county and at the state level.
AHRQ-funded; HS020508.
Citation: Pati S, Wong AT, Calixte RE .
Medicaid and CHIP retention among children in 12 states.
Acad Pediatr 2015 May-Jun;15(3):249-57. doi: 10.1016/j.acap.2014.09.012.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Health Insurance, Policy, Medicaid
Thorpe CT, Johnson H, Dopp AL
Medication oversupply in patients with diabetes.
This article describes the development of Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which included a national field test with 69 hospitals in 34 States, psychometric analysis, and end-user testing of the final survey. The final Child HCAHPS instrument has 62 items, including 39 patient experience items, 10 screeners, 12 demographic/descriptive items and 1 open-ended item.
AHRQ-funded; HS000083; HS018368; HS017646.
Citation: Thorpe CT, Johnson H, Dopp AL .
Medication oversupply in patients with diabetes.
Res Social Adm Pharm 2015 May-Jun;11(3):382-400. doi: 10.1016/j.sapharm.2014.09.002..
Keywords: Medication, Diabetes, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Children/Adolescents, Hospitals