National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (4)
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (1)
- Anxiety (1)
- Behavioral Health (9)
- Cancer (1)
- Cancer: Colorectal Cancer (2)
- Cardiovascular Conditions (1)
- Care Coordination (2)
- Caregiving (1)
- Care Management (2)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Colonoscopy (1)
- Communication (1)
- (-) Community-Based Practice (42)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Cultural Competence (1)
- Decision Making (1)
- Depression (1)
- Diabetes (5)
- Disparities (2)
- Education: Continuing Medical Education (1)
- Electronic Health Records (EHRs) (5)
- Healthcare Costs (1)
- Healthcare Delivery (5)
- Healthcare Utilization (5)
- Health Information Technology (HIT) (4)
- Health Insurance (2)
- Health Promotion (3)
- Health Services Research (HSR) (3)
- Heart Disease and Health (1)
- Home Healthcare (2)
- Learning Health Systems (1)
- Lifestyle Changes (1)
- Low-Income (1)
- Medicaid (5)
- Medical Expenditure Panel Survey (MEPS) (1)
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- Patient-Centered Outcomes Research (1)
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- Patient Experience (2)
- Practice Improvement (1)
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- Provider (1)
- Provider: Health Personnel (1)
- Provider: Pharmacist (2)
- Quality Improvement (4)
- Quality of Care (5)
- Racial and Ethnic Minorities (5)
- Rural Health (2)
- Screening (2)
- Social Media (2)
- Substance Abuse (2)
- Teams (2)
- Tobacco Use (1)
- Training (2)
- Uninsured (2)
- Urban Health (1)
- Vulnerable Populations (3)
- Workflow (1)
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 42 Research Studies DisplayedRodriguez HP, Friedberg MW, Vargas-Bustamante A
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
The purpose of this study was to compare the impact of implementing team-based diabetes care management involving community health workers (CHWs) vs. medical assistants (MA) in community health centers (CHCs) on diabetes care processes, intermediate outcomes, and patients' experiences of chronic care. The investigators found that diabetes care improved in CHCs integrating CHWs and MAs onto primary care teams, but the improvements were no different than improvements observed among matched control group patients.
AHRQ-funded; HS02012001.
Citation: Rodriguez HP, Friedberg MW, Vargas-Bustamante A .
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
BMC Health Serv Res 2018 Nov 20;18(1):875. doi: 10.1186/s12913-018-3710-9..
Keywords: Community-Based Practice, Diabetes, Healthcare Delivery, Teams
Tung EL, Gunter KE, Bergeron NQ
Cross-sector collaboration in the high-poverty setting: qualitative results from a community-based diabetes intervention.
The purpose of this study was to characterize the motivations of stakeholders from diverse sectors who engaged in cross-sector collaboration with an academic medical center. The investigators identified several factors that motivated collaboration across diverse sectors with health care systems to promote health in a high-poverty, urban setting.
AHRQ-funded; HS023007.
Citation: Tung EL, Gunter KE, Bergeron NQ .
Cross-sector collaboration in the high-poverty setting: qualitative results from a community-based diabetes intervention.
Health Serv Res 2018 Oct;53(5):3416-36. doi: 10.1111/1475-6773.12824..
Keywords: Community-Based Practice, Diabetes, Health Promotion
Davis MM, Gunn R, Gowen LK
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
In this study, the authors examined, using qualitative methods, patients' experiences of care in integrated settings. The study included 24 patients receiving care across five practices participating in Advancing Care Together (ACT)-a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. The investigators found that patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Gowen LK .
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
Transl Behav Med 2018 Sep 8;8(5):649-59. doi: 10.1093/tbm/ibx001..
Keywords: Community-Based Practice, Healthcare Delivery, Behavioral Health, Patient Experience, Primary Care
Andreae SJ, Andreae LJ, Cherrington AL
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
The investigators presented an iterative developmental approach to cognitive behavioral therapy (CBT) that combined program adaptation, pretesting, and community health workers (CHW) training processes for a CBT-based diabetes self-care program for individuals living with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Cherrington AL .
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
Fam Community Health 2018 Jul/Sep;41(3):178-84. doi: 10.1097/fch.0000000000000197.
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Keywords: Behavioral Health, Chronic Conditions, Community-Based Practice, Diabetes, Rural Health
Mullins CD, Wingate LT, Edwards HA
Transitioning from learning healthcare systems to learning health care communities.
The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. This paper discusses transitioning from learning healthcare systems to learning healthcare communities.
AHRQ-funded; HS022135.
Citation: Mullins CD, Wingate LT, Edwards HA .
Transitioning from learning healthcare systems to learning health care communities.
J Comp Eff Res 2018 Jun;7(6):603-14. doi: 10.2217/cer-2017-0105..
Keywords: Community-Based Practice, Healthcare Delivery, Learning Health Systems, Patient-Centered Healthcare
Harrison KL, Taylor HA, Merritt MW
Action guide for addressing ethical challenges of resource allocation within community-based healthcare organizations.
This article proposes an action guide to making decisions regarding the ethical allocation of resources that affect access to healthcare services offered by community-based healthcare organizations. The authors suggest that the action guide provides community-based healthcare organizations with a conceptually grounded, empirically informed framework for ethical decision making.
AHRQ-funded; HS000029.
Citation: Harrison KL, Taylor HA, Merritt MW .
Action guide for addressing ethical challenges of resource allocation within community-based healthcare organizations.
J Clin Ethics 2018 Summer;29(2):124-38..
Keywords: Community-Based Practice, Decision Making, Health Services Research (HSR)
Cole MB, Wright B, Wilson IB
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
The purpose of this study was to evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. The authors found that within- and between-center racial/ethnic disparities in quality were evident and although quality outcomes in health centers continued to compare favorably to other care settings, there was no evidence of improved quality or reduced disparities in diabetes control, hypertension control, or birthweight from 2009 to 2014.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
J Gen Intern Med 2018 Jun;33(6):906-13. doi: 10.1007/s11606-018-4305-1..
Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Cole MB, Wright B, Wilson IB
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Investigators studied the impact of Medicaid expansion in rural areas. Data from 2011-2015 found that there was an 11.4% decline in uninsured patients and a 13.5% increase in Medicaid patients at community health centers (CHCs). Relative improvements were shown in patients with chronic conditions such as asthma and hypertension; and an increase in visits for mammograms and substance abuse disorders.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Medicaid expansion and community health centers: care quality and service use increased for rural patients.
Health Aff 2018 Jun;37(6):900-07. doi: 10.1377/hlthaff.2017.1542..
Keywords: Medicaid, Community-Based Practice, Rural Health, Access to Care, Quality of Care, Healthcare Utilization, Primary Care
Baggett TP, Berkowitz SA, Fung V
Prevalence of housing problems among community health center patients.
This study used data from a national survey to assess the prevalence and health-related correlates of housing problems among community health center patients. It found that, compared with those without housing problems, participants with housing problems were more likely to report health problems, emergency department use, and delays in care.
AHRQ-funded; HS025378.
Citation: Baggett TP, Berkowitz SA, Fung V .
Prevalence of housing problems among community health center patients.
JAMA 2018 Feb 20;319(7):717-19. doi: 10.1001/jama.2017.19869.
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Keywords: Community-Based Practice, Health Services Research (HSR), Vulnerable Populations
Leung LB, Vargas-Bustamante A, Martinez AE
Disparities in diabetes care quality by English language preference in community health centers.
Researchers conducted a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. There were no significant differences in glycemic control by language for either Latino or Asian patients.
AHRQ-funded; HS020120.
Citation: Leung LB, Vargas-Bustamante A, Martinez AE .
Disparities in diabetes care quality by English language preference in community health centers.
Health Serv Res 2018 Feb;53(1):509-31. doi: 10.1111/1475-6773.12590.
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Keywords: Community-Based Practice, Cultural Competence, Diabetes, Disparities, Racial and Ethnic Minorities
Martsolf GR, Ashwood S, Friedberg MW
Linking structural capabilities and workplace climate in community health centers.
This study examined the relationship between workplace climate and structural capabilities. Twenty-five community health centers (CHCs) were surveyed to determine workplace climate. CHC directors and adult primary care clinicians and staff were surveyed. Positive attributes included a manageable workload, staff relationships, a quality improvement orientation, and manager readiness. Lower electronic record functionality did not seem to improve workplace climates.
AHRQ-funded; HS020120.
Citation: Martsolf GR, Ashwood S, Friedberg MW .
Linking structural capabilities and workplace climate in community health centers.
Inquiry 2018 Jan-Dec;55:46958018794542. doi: 10.1177/0046958018794542..
Keywords: Community-Based Practice, Organizational Change, Quality Improvement, Quality of Care
Sherry M, Wolff JL, Ballreich J
Bridging the silos of service delivery for high-need, high-cost individuals.
This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration.
AHRQ-funded; HS000029.
Citation: Sherry M, Wolff JL, Ballreich J .
Bridging the silos of service delivery for high-need, high-cost individuals.
Popul Health Manag 2016 Dec;19(6):421-28. doi: 10.1089/pop.2015.0147.
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Keywords: Community-Based Practice, Healthcare Costs, Healthcare Delivery, Care Coordination
Naslund JA, Aschbrenner KA, Bartels SJ
How people with serious mental illness use smartphones, mobile apps, and social media.
The researchers surveyed individuals with serious mental illness to explore their use of mobile devices or whether they access social media. Among respondents (n = 70), 93 percent owned cellphones, 78 percent used text messaging, 50 percent owned smartphones, and 71 percent used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media.
AHRQ-funded; HS021695.
Citation: Naslund JA, Aschbrenner KA, Bartels SJ .
How people with serious mental illness use smartphones, mobile apps, and social media.
Psychiatr Rehabil J 2016 Dec;39(4):364-67. doi: 10.1037/prj0000207.
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Keywords: Communication, Community-Based Practice, Health Promotion, Behavioral Health, Social Media
Thomas KS, Allen SM
Interagency partnership to deliver veteran-directed home and community-based services: interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership.
AHRQ-funded; HS000011.
Citation: Thomas KS, Allen SM .
Interagency partnership to deliver veteran-directed home and community-based services: interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
J Rehabil Res Dev 2016;53(5):611-18. doi: 10.1682/jrrd.2015.02.0019.
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Keywords: Community-Based Practice, Provider: Health Personnel, Home Healthcare, Training
Komaromy M, Duhigg D, Metcalf A
Project ECHO (Extension for Community Healthcare Outcomes): a new model for educating primary care providers about treatment of substance use disorders.
ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning. This article describes a teleECHO clinic that is focused on treatment of substance use disorders (SUDs) and behavioral health disorders. It concluded that the ECHO model can promote expansion of access to treatment for opioid use disorder and other SUDs, particularly in underserved areas.
AHRQ-funded; HS016510.
Citation: Komaromy M, Duhigg D, Metcalf A .
Project ECHO (Extension for Community Healthcare Outcomes): a new model for educating primary care providers about treatment of substance use disorders.
Subst Abus 2016;37(1):20-4. doi: 10.1080/08897077.2015.1129388.
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Keywords: Community-Based Practice, Primary Care, Substance Abuse, Training, Health Information Technology (HIT)
Valdez RS, Holden RJ
Health care human factors/ergonomics fieldwork in home and community settings.
The researchers offered several strategies that human factors and ergonomics professionals can use before, during, and after home and community site visits to optimize fieldwork and mitigate challenges in these settings.
AHRQ-funded; HS022930; HS018809.
Citation: Valdez RS, Holden RJ .
Health care human factors/ergonomics fieldwork in home and community settings.
Ergon Des 2016 Oct;24(4):4-9. doi: 10.1177/1064804615622111.
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Keywords: Caregiving, Community-Based Practice, Home Healthcare, Workflow
Bailey SR, Hoopes MJ, Marino M
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
This study aimed to determine if uninsured community health center (CHC) patients who gain Medicaid coverage experience greater primary care utilization, receive more cessation medication orders, and achieve higher quit rates, compared to continuously uninsured smokers. It found that newly insured patients had increased odds of quit smoking status over 24 months of follow-up than those who remained uninsured.
AHRQ-funded; HS021522; HS024270.
Citation: Bailey SR, Hoopes MJ, Marino M .
Effect of gaining insurance coverage on smoking cessation in community health centers: a cohort study.
J Gen Intern Med 2016 Oct;31(10):1198-205. doi: 10.1007/s11606-016-3781-4.
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Keywords: Tobacco Use, Health Insurance, Community-Based Practice, Medicaid, Healthcare Utilization
Fulford D, Tuot DS, Mangurian C
Electronic psychiatric consultation in primary care in the safety net.
The authors examined the feasibility and acceptability of implementing a psychiatric eReferral program in a publicly funded, community-based primary care clinic in San Francisco staffed by eight primary care practitioners (PCPs). They found feasibility and acceptability of implementing an integrated electronic psychiatry consultation and referral service in a community-based primary care clinic and recommended future trials designed to examine the impact of this type of service on the delivery of high-quality mental health care and its cost-effectiveness in a safety-net health care system.
AHRQ-funded; HS021700.
Citation: Fulford D, Tuot DS, Mangurian C .
Electronic psychiatric consultation in primary care in the safety net.
Psychiatr Serv 2016 Oct;67(10):1160-61. doi: 10.1176/appi.ps.671003.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Behavioral Health, Primary Care, Health Information Technology (HIT)
Friedberg MW, Rodriguez HP, Martsolf GR
Measuring workplace climate in community clinics and health centers.
The authors assessed the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and generated a shorter instrument for future use. They concluded that survey instruments designed to measure workplace climate have substantial overlap, and the set they identified might help target and tailor clinics' quality improvement efforts.
AHRQ-funded; HS020120.
Citation: Friedberg MW, Rodriguez HP, Martsolf GR .
Measuring workplace climate in community clinics and health centers.
Med Care 2016 Oct;54(10):944-9. doi: 10.1097/mlr.0000000000000585.
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Keywords: Community-Based Practice, Provider, Organizational Change, Quality Improvement, Quality of Care, Practice Improvement
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
Connolly Gibbons MB, Gallop R, Thompson D
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
The authors sought to determine whether dynamic psychotherapy (DT) is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Connolly Gibbons MB, Gallop R, Thompson D .
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
JAMA Psychiatry 2016 Sep;73(9):904-11. doi: 10.1001/jamapsychiatry.2016.1720.
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Keywords: Comparative Effectiveness, Community-Based Practice, Depression, Behavioral Health, Patient-Centered Outcomes Research
Liss DT, Brown T, Lee JY
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Fecal occult blood testing (FOBT) is a pragmatic screening option for many community health centers (CHCs), but FOBT screening programs will not reduce mortality if patients with positive results do not undergo diagnostic colonoscopy (DC). This study was conducted to investigate DC completion among CHC patients. It found that DC completion was low overall, which raises concerns about whether FOBT can reduce CRC mortality in practice.
AHRQ-funded; HS021141.
Citation: Liss DT, Brown T, Lee JY .
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Cancer Causes Control 2016 Jul;27(7):881-7. doi: 10.1007/s10552-016-0763-0.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Community-Based Practice, Screening
Karmali KN, Lee JY, Brown T
Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.
The authors aimed to identify factors associated with a cholesterol treatment discussion and statin prescribing in a high-risk population. They found that single risk factor management strongly influences cholesterol treatment discussions and statin prescribing patterns, and they recommended interventions that promote risk-based statin use.
AHRQ-funded; HS021141.
Citation: Karmali KN, Lee JY, Brown T .
Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.
Prev Med 2016 Jul;88:176-81. doi: 10.1016/j.ypmed.2016.04.011.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Community-Based Practice, Medication, Prevention
Aschbrenner KA, Naslund JA, Shevenell M
A pilot study of a peer-group lifestyle intervention enhanced with mHealth technology and social media for adults with serious mental illness.
This pilot study of 32 participants examined the preliminary effectiveness of a peer-group lifestyle intervention enhanced with mobile health technology and social media for obese individuals with serious mental illness. Most participants (72%) lost weight, and 17% showed clinically significant improvements in cardiovascular fitness. This study demonstrated the preliminary effectiveness of peer-group lifestyle intervention in a community mental health setting.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Naslund JA, Shevenell M .
A pilot study of a peer-group lifestyle intervention enhanced with mHealth technology and social media for adults with serious mental illness.
J Nerv Ment Dis 2016 Jun;204(6):483-6. doi: 10.1097/nmd.0000000000000530.
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Keywords: Behavioral Health, Social Media, Lifestyle Changes, Obesity, Community-Based Practice
Salloum A, Johnco C, Lewin AB
Barriers to access and participation in community mental health treatment for anxious children.
The authors examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. They found that the most common access barrier was parents not knowing where or from whom to seek services. They concluded that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.
AHRQ-funded; HS018665.
Citation: Salloum A, Johnco C, Lewin AB .
Barriers to access and participation in community mental health treatment for anxious children.
J Affect Disord 2016 May 15;196:54-61. doi: 10.1016/j.jad.2016.02.026.
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Keywords: Access to Care, Anxiety, Children/Adolescents, Community-Based Practice, Behavioral Health