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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 31 Research Studies DisplayedSherry 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
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
Snyder ME, Frail CK, Gernant SA
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
The researchers described common facilitators, challenges, and lessons learned in 5 schools and colleges of pharmacy in establishing community pharmacy research fellowships. They found that common characteristics across the programs include length of training, prerequisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position.
AHRQ-funded; HS022119.
Citation: Snyder ME, Frail CK, Gernant SA .
Fellowships in community pharmacy research: experiences of five schools and colleges of pharmacy.
J Am Pharm Assoc 2016 May-Jun;56(3):316-22. doi: 10.1016/j.japh.2015.11.015.
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Keywords: Community-Based Practice, Education: Continuing Medical Education, Provider: Pharmacist
Hernandez SE, Taylor L, Grembowski D
A first look at PCMH implementation for minority veterans: room for improvement.
The researchers sought to determine if the degree of Patient Aligned Care Teams (a patient-centered medical home model), implementation at Veterans Health Administration hospital-based and community-based primary care facilities varied with the percentage of minority veteran patients at each facility. They found that overall implementation of the care teams varied with respect to the racial/ethnic composition of a facility, with medium and high minority facilities having lower implementation scores.
AHRQ-funded; HS013853; HS023376.
Citation: Hernandez SE, Taylor L, Grembowski D .
A first look at PCMH implementation for minority veterans: room for improvement.
Med Care 2016 Mar;54(3):253-61. doi: 10.1097/mlr.0000000000000512.
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Keywords: Patient-Centered Healthcare, Racial and Ethnic Minorities, Community-Based Practice, Primary Care
Liss DT, French DD, Buchanan DR
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
This budget impact analysis investigated benefits and costs of fecal immunochemical testing (FIT) outreach-with FIT kits mailed to patients, followed by reminders and phone calls-compared with point-of-care (POC) strategies. Cost per patient screened was $20.60 for POC and $71.84 for outreach ($51.24 difference). Outreach costs decreased by approximately one fourth under optimized workflows.
AHRQ-funded; HS021141.
Citation: Liss DT, French DD, Buchanan DR .
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
Am J Prev Med 2016 Feb;50(2):e54-61. doi: 10.1016/j.amepre.2015.07.003.
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Keywords: Cancer: Colorectal Cancer, Community-Based Practice, Health Promotion, Prevention, Screening
Marino M, Bailey SR, Gold R
Receipt of preventive services after Oregon's randomized Medicaid experiment.
This study examined the three-year impact of Oregon's 2008 randomized Medicaid expansion (the "Oregon Experiment") on receipt of 12 preventive care services in community health centers using electronic health record data. They found that Medicaid coverage significantly increased the odds of receipt of most preventive services. They concluded that rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. They recommended continued effort to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations.
AHRQ-funded; HS021522.
Citation: Marino M, Bailey SR, Gold R .
Receipt of preventive services after Oregon's randomized Medicaid experiment.
Am J Prev Med 2016 Feb;50(2):161-70. doi: 10.1016/j.amepre.2015.07.032.
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Keywords: Access to Care, Community-Based Practice, Health Insurance, Medicaid, Prevention
Hoopes MJ, Angier H, Gold R
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
Using electronic health record data, the researchers examined longitudinal changes in community health center (CHC) visit rates from 2013 through 2014 in Medicaid expansion versus nonexpansion states. Rates increased in expansion state CHCs for new patient, preventive, and limited-service visits (14 percent, 41percent, and 23 percent, respectively), whereas these rates remained unchanged in nonexpansion states.
AHRQ-funded; HS024270.
Citation: Hoopes MJ, Angier H, Gold R .
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
J Ambul Care Manage 2016 Jan 13;39(4):290-8. doi: 10.1097/jac.0000000000000123.
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Keywords: Electronic Health Records (EHRs), Community-Based Practice, Healthcare Utilization, Medicaid, Uninsured
Wittie M, Ngo-Metzger Q, Lebrun-Harris L
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
This study analyzed cross-sectional data from all 1,128 health centers in 2011, which served over 20 million patients during that year. As of 2011, 80 percent of health centers reported using an electronic health record (EHR), and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic composition, physician staffing, or health center funding.
AHRQ-authored.
Citation: Wittie M, Ngo-Metzger Q, Lebrun-Harris L .
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
J Healthc Qual 2016 Jan-Feb;38(1):42-51. doi: 10.1111/jhq.12067.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Health Services Research (HSR)
Unertl KM, Schaefbauer CL, Campbell TR
Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.
The authors compared 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. They identified benefits and challenges, and created several principles that extended an existing CBPR framework to specifically address health informatics research requirements.
AHRQ-funded; HS019853; HS022961.
Citation: Unertl KM, Schaefbauer CL, Campbell TR .
Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.
J Am Med Inform Assoc 2016 Jan;23(1):60-73. doi: 10.1093/jamia/ocv094.
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Keywords: Community-Based Practice, Health Information Technology (HIT), Patient and Family Engagement, Patient-Centered Healthcare
Stucky BD, Hays RD, Edelen MO
Possibilities for shortening the CAHPS Clinician and Group Survey.
This paper explores the impact on reliability and validity of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) domain scores of reducing the numbers of items used to assess the 3 core Clinician and Group adult survey CAHPS domains (Provider Communication, Access to Care, and Courteous and Helpful Office Staff).
AHRQ-funded; HS016980.
Citation: Stucky BD, Hays RD, Edelen MO .
Possibilities for shortening the CAHPS Clinician and Group Survey.
Med Care 2016 Jan;54(1):32-7. doi: 10.1097/mlr.0000000000000452..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Ambulatory Care and Surgery, Community-Based Practice
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
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Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement
Van der Wees PJ, Friedberg MW, Guzman EA
Comparing the implementation of team approaches for improving diabetes care in community health centers.
The researchers sought to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. They found that CHW and MA responsibilities converged over time to focus on health coaching of diabetic patients, with the MA health coaches experiencing difficulty in allocating dedicated time due to other responsibilities. Time constraints also limited the personal introduction of patients to health coaches by clinicians. Participants highlighted the importance of a supportive team climate and proactive leadership as important enablers for MAs and CHWs to implement their health coaching responsibilities. This study suggests that a flexible approach to implementing health coaching is more important than fidelity to rigid models that do not allow for variable allocation of responsibilities across team members.
AHRQ-funded; HS020120.
Citation: Van der Wees PJ, Friedberg MW, Guzman EA .
Comparing the implementation of team approaches for improving diabetes care in community health centers.
BMC Health Serv Res 2014 Dec 3;14:608. doi: 10.1186/s12913-014-0608-z.
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Keywords: Community-Based Practice, Diabetes, Patient-Centered Healthcare, Quality Improvement, Teams
Davidson AJ, McCormick EV, Dickinson LM
Population-level obesity surveillance: monitoring childhood body mass index z-score in a safety-net system.
The objective of this study was to determine the utility of repeated patient-level body mass index (BMI) measurements among higher-risk patients seen at safety-net clinics as a community-level monitoring tool for overweight and obesity population trends. The researchers found that childhood obesity prevalence was high, with substantial progression to overweight and obesity from first to last visit and concluded that clinically derived BMI z-score per person-year measures can effectively show population trends not observed using standard weight status categories.
AHRQ-funded; HS021138.
Citation: Davidson AJ, McCormick EV, Dickinson LM .
Population-level obesity surveillance: monitoring childhood body mass index z-score in a safety-net system.
Acad Pediatr 2014 Nov-Dec;14(6):632-8. doi: 10.1016/j.acap.2014.06.007.
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Keywords: Children/Adolescents, Community-Based Practice, Obesity
