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
76 to 100 of 137 Research Studies DisplayedLee SC, Marks EG, Sanders JM
Elucidating patient-perceived role in "decision-making" among African Americans receiving lung cancer care through a county safety-net system.
The researchers explored patient-perceived role in "decision-making" related to active treatment and palliation among African Americans receiving lung cancer care through a county safety-net system. They found that caregivers and patients expressed a concurrent lack of understanding of their prognosis and outcomes of treatment. Dyads did not discuss their lung cancer experience in terms of decision-making; rather, most articulated their role as following physician guidance.
AHRQ-funded; HS022418.
Citation: Lee SC, Marks EG, Sanders JM .
Elucidating patient-perceived role in "decision-making" among African Americans receiving lung cancer care through a county safety-net system.
J Cancer Surviv 2016 Feb;10(1):153-63. doi: 10.1007/s11764-015-0461-z.
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Keywords: Cancer: Lung Cancer, Cancer, Racial and Ethnic Minorities, Decision Making, Clinician-Patient Communication
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
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Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Lafata JE, Karter AJ, O'Connor PJ
Medication adherence does not explain black-white differences in cardiometabolic risk factor control among insured patients with diabetes.
The researchers examined whether medication adherence, controlling for treatment intensification, could explain differences in risk factor control between black and white patients with diabetes. They found poorer medication adherence among black patients than white patients. They concluded that medication adherence failed to explain observed racial differences in the achievement of HbA1c, LDL-C, and SBP control among insured patients with diabetes.
AHRQ-funded; HS019859.
Citation: Lafata JE, Karter AJ, O'Connor PJ .
Medication adherence does not explain black-white differences in cardiometabolic risk factor control among insured patients with diabetes.
J Gen Intern Med 2016 Feb;31(2):188-95. doi: 10.1007/s11606-015-3486-0.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Yang HY, Chen HJ, Marsteller JA
AHRQ Author: Liang L
Patient-health care professional gender or race/ethnicity concordance and its association with weight-related advice in the United States.
This study examined association between adult patients' and health care providers' (HCPs) gender or race/ethnicity concordance and patients' reported receiving weight-related advice from HCP's in USA. It found that patient/HCP gender or race/ethnicity concordance was not positively associated with HCPs providing weight-related advice. Patients with female HCPs or with racial/ethnic discordant HCPs (especially black or Asian HCPs) were more likely to receive advice.
AHRQ-authored.
Citation: Yang HY, Chen HJ, Marsteller JA .
Patient-health care professional gender or race/ethnicity concordance and its association with weight-related advice in the United States.
Patient Educ Couns 2016 Feb;99(2):271-8. doi: 10.1016/j.pec.2015.08.030.
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Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Obesity, Obesity: Weight Management, Clinician-Patient Communication
Chen J, Mullins CD, Novak P
Personalized strategies to activate and empower patients in health care and reduce health disparities.
The authors proposed a patient-centered, multilevel activation and empowerment framework to inform the development of culturally informed personalized patient activation and empowerment (P-PAE) interventions to improve population health and reduce racial and ethnic disparities. They believe the P-PAE model is timely and sustainable and will be critical to engaging patients in their treatment, developing patients' abilities to manage their health, helping patients express concerns and preferences regarding treatment, empowering patients to ask questions about treatment options, and building up strategic patient-provider partnerships through shared decision making.
AHRQ-funded; HS022135.
Citation: Chen J, Mullins CD, Novak P .
Personalized strategies to activate and empower patients in health care and reduce health disparities.
Health Educ Behav 2016 Feb;43(1):25-34. doi: 10.1177/1090198115579415.
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Keywords: Decision Making, Disparities, Patient and Family Engagement, Patient-Centered Healthcare, Racial and Ethnic Minorities
Lipworth L, Morgans AK, Edwards TL
Renal cell cancer histological subtype distribution differs by race and sex.
The researchers examined racial differences in the distribution of histological subtypes of renal cell carcinoma (RCC) and associations with established RCC risk factors by subtype. They observed marked racial differences in the proportional subtype distribution of RCCs diagnosed at a large tertiary care academic centre. To their knowledge, no previous study has examined racial differences in the distribution of RCC histologies while adjusting for ESRD.
AHRQ-funded; HS022990.
Citation: Lipworth L, Morgans AK, Edwards TL .
Renal cell cancer histological subtype distribution differs by race and sex.
BJU Int 2016 Feb;117(2):260-5. doi: 10.1111/bju.12950.
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Keywords: Cancer, Kidney Disease and Health, Racial and Ethnic Minorities
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
Oncotype DX (ODX) has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in cancer care quality may persist or worsen. The researchers examined racial disparities in ODX testing uptake. They did not find racial disparities in ODX testing for node-negative patients for whom ODX testing is guideline recommended and widely covered by insurers.
HS019468; HS022189
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
J Clin Oncol 2016 Jan 10;34(2):130-8. doi: 10.1200/jco.2015.63.2489..
Keywords: Cancer: Breast Cancer, Healthcare Delivery, Treatments, Disparities, Racial and Ethnic Minorities
Albright KC, Boehme AK, Tanner RM
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
The authors examined racial differences in risk factors being addressed among stroke survivors and those at risk for stroke. They found that addressed hypertension and hyperlipidemia in stroke-naïve participants were significantly lower in blacks than in whites. They concluded that a better understanding of this information is critical to preventing stroke and other vascular diseases.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Boehme AK, Tanner RM .
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
Ethn Dis 2016 Jan 21;26(1):9-16. doi: 10.18865/ed.26.1.9.
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Keywords: Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Prevention, Stroke
Booth JN, 3rd, Redmond N, Sims M
The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study.
The reseaerchers evaluated the association between percent predicted lung-function and 24-hour blood pressure variability (BPV) in 1008 African Americans enrolled in the Jackson Heart Study who underwent ambulatory blood pressure (BP) monitoring. They found that lung-function was not associated with increased 24-hour BPV.
AHRQ-funded; HS023009.
Citation: Booth JN, 3rd, Redmond N, Sims M .
The association of reduced lung function with blood pressure variability in African Americans: data from the Jackson Heart Study.
BMC Cardiovasc Disord 2016 Jan 12;16:6. doi: 10.1186/s12872-015-0182-2.
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Keywords: Cardiovascular Conditions, Blood Pressure, Racial and Ethnic Minorities, Risk, Respiratory Conditions
Newhall K, Spangler E, Dzebisashvili N
Amputation rates for patients with diabetes and peripheral arterial disease: the effects of race and region.
The authors examined national trends in care of patients with both peripheral artery disease (PAD) and diabetes. They found that the prevalence of concurrent PAD and diabetes is increasing, but amputation rates and amputation-free survival vary significantly by both race and hospital referral region.
AHRQ-funded; HS021581.
Citation: Newhall K, Spangler E, Dzebisashvili N .
Amputation rates for patients with diabetes and peripheral arterial disease: the effects of race and region.
Ann Vasc Surg 2016 Jan;30:292-8.e1. doi: 10.1016/j.avsg.2015.07.040.
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Keywords: Cardiovascular Conditions, Diabetes, Elderly, Racial and Ethnic Minorities, Outcomes
Speck AL, Hess M, Baptist AP
An electronic asthma self-management intervention for young African American adults.
The objective of this study was to develop and assess the feasibility of an electronic asthma self-management program for young African American adults. The researchers found that all subjects completing the 2-week postprogram survey reported that the program was helpful, and 97% would recommend it to others. Asthma control as measured by the Asthma Control Test improved, and asthma quality of life as measured by the Mini Asthma Quality of Life Questionnaire also improved. They concluded that the Breathe Michigan program is feasible for recruitment and retention, and demonstrated an improvement in asthma control and quality of life for young African American adults.
AHRQ-funded; HS020977.
Citation: Speck AL, Hess M, Baptist AP .
An electronic asthma self-management intervention for young African American adults.
J Allergy Clin Immunol Pract 2016 Jan-Feb;4(1):89-95.e2. doi: 10.1016/j.jaip.2015.08.007.
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Keywords: Asthma, Health Information Technology (HIT), Racial and Ethnic Minorities, Patient Self-Management, Young Adults
Earnshaw VA, Rosenthal L, Cunningham SD
Exploring group composition among young, urban women of color in prenatal care: implications for satisfaction, engagement, and group attendance.
The current investigation aimed to explore associations between prenatal care group composition with patient satisfaction, engagement, and group attendance among young, urban women of color. It found that women in groups with others more diverse in age reported greater patient engagement and, in turn, attended more group sessions.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Rosenthal L, Cunningham SD .
Exploring group composition among young, urban women of color in prenatal care: implications for satisfaction, engagement, and group attendance.
Womens Health Issues 2016 Jan-Feb;26(1):110-5. doi: 10.1016/j.whi.2015.09.011.
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Keywords: Racial and Ethnic Minorities, Pregnancy, Patient Experience, Women, Urban Health
Mayer LA, Elliott MN, Haas A
Less use of extreme response options by asians to standardized care scenarios may explain some racial/ethnic differences in CAHPS scores.
The researchers explored whether lower extreme response tendency ( ERT) is observed for Asians than whites in response to standardized vignettes depicting patient experiences of care and whether ERT might in part explain Asians reporting worse care than whites. They concluded that lower ERT in Asians may partially explain observations of lower observed mean CAHPS scores for Asians in real-world settings.
AHRQ-funded; HS016980.
Citation: Mayer LA, Elliott MN, Haas A .
Less use of extreme response options by asians to standardized care scenarios may explain some racial/ethnic differences in CAHPS scores.
Med Care 2016 Jan;54(1):38-44. doi: 10.1097/mlr.0000000000000453..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Disparities, Racial and Ethnic Minorities, Patient Experience, Patient Experience
Zamora-Kapoor A, Nelson L, Buchwald D
Maternal correlates of body mass index in American Indian/Alaska Native and white adolescents: differences between mother/son and mother/daughter pairs.
This study sough to determine the influence of maternal correlates on adolescent body mass index (BMI), and the extent to which the size and significance of these correlates vary by adolescent sex and race. Its findings suggest that maternal factors are critical in the transmission of obesogenic behaviors from one generation to the next, and their effects vary between mother/son and mother/daughter pairs, and are similar for AI/ANs and Whites.
AHRQ-funded; HS021686.
Citation: Zamora-Kapoor A, Nelson L, Buchwald D .
Maternal correlates of body mass index in American Indian/Alaska Native and white adolescents: differences between mother/son and mother/daughter pairs.
Eat Behav 2016 Jan;20:43-7. doi: 10.1016/j.eatbeh.2015.11.002..
Keywords: Children/Adolescents, Obesity, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Thienprayoon R, Marks E, Funes M
Perceptions of the pediatric hospice experience among English- and Spanish-speaking families.
The objective of this study was to explore parental perspectives of the hospice experience in children with cancer, and to explore how race/ethnicity impacts this experience. Both English and Spanish speakers described the importance of honest, direct communication by medical providers, and anxieties surrounding the expectation of the moment of death. English-speaking families were more likely to return to the hospital because of unsatisfactory symptom management.
AHRQ-funded; HS022418.
Citation: Thienprayoon R, Marks E, Funes M .
Perceptions of the pediatric hospice experience among English- and Spanish-speaking families.
J Palliat Med 2016 Jan;19(1):30-41. doi: 10.1089/jpm.2015.0137.
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Keywords: Children/Adolescents, Palliative Care, Long-Term Care, Racial and Ethnic Minorities, Cancer
Khanna AS, Michaels S, Skaathun B
Preexposure prophylaxis awareness and use in a population-based sample of young black men who have sex with men.
The researchers studied relevant characteristics of diverse young black men who have sex with men and their corresponding preexposure prophylaxis (PrEP) engagement. Their population-based cohort study illustrated that real-world PrEP use by those with the highest HIV incidence faces major implementation challenges that require purposeful and sustained engagement with black communities inclusive of their health care providers.
AHRQ-funded; HS000084.
Citation: Khanna AS, Michaels S, Skaathun B .
Preexposure prophylaxis awareness and use in a population-based sample of young black men who have sex with men.
JAMA Intern Med 2016 Jan;176(1):136-8. doi: 10.1001/jamainternmed.2015.6536..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities, Education: Patient and Caregiver
Toledo P, Eosakul ST, Grobman WA
Primary spoken language and neuraxial labor analgesia use among Hispanic Medicaid recipients.
The researchers investigated whether there is a disparity in anticipated or actual use of neuraxial labor analgesia among Hispanic women based on primary language (English versus Spanish). A language-based disparity was found in neuraxial labor analgesia use. It is possible that there are communication barriers in knowledge or understanding of analgesic options.
AHRQ-funded; HS020122.
Citation: Toledo P, Eosakul ST, Grobman WA .
Primary spoken language and neuraxial labor analgesia use among Hispanic Medicaid recipients.
Anesth Analg 2016 Jan;122(1):204-9. doi: 10.1213/ane.0000000000001079.
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Keywords: Racial and Ethnic Minorities, Disparities, Clinician-Patient Communication, Pain, Medicaid
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
Sentell TL, Juarez DT, Ahn HJ
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Elderly (65+) Native Hawaiian, Filipino, and Japanese men and Filipino women have a higher risk of diabetes-related potentially preventable hospitalizations than whites. The authors sought to determine if similar disparities are seen among the non-elderly (< 65). They found that preventable hospitalizations rates were significantly higher for Native Hawaiians males compared to whites, but significantly lower for Chinese men and women, Japanese men and women, and Filipino men and women. Rates for Native Hawaiian females did not differ significantly from Whites. Disparities in diabetes-related preventable hospitalizations were seen for working-age (18-64) Native Hawaiian men even when their higher population-level diabetes prevalence was considered.
AHRQ-funded; HS019990.
Citation: Sentell TL, Juarez DT, Ahn HJ .
Disparities in diabetes-related preventable hospitalizations among working-age Native Hawaiians and Asians in Hawai'i.
Hawaii J Med Public Health 2014 Dec;73(12 Suppl 3):8-13.
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Keywords: Diabetes, Disparities, Hospitalization, Quality Indicators (QIs), Racial and Ethnic Minorities
Hines AL, Andrews RM, Moy E
AHRQ Author: Andrews RM, Moy E
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
The authors investigated inpatient mortality rates and obstetric trauma for self-reported speakers of English, Spanish, and languages of Asia and the Pacific Islands (API) and compared quality of care by language with patterns by race/ethnicity. They found that speaking a non-English principal language and having a non-White race/ethnicity did not place patients at higher risk for inpatient mortality, except for a higher stroke mortality for Japanese-speaking patients. Patients who spoke API languages or had API race/ethnicity had higher risk for obstetric trauma than English-speaking White patients, while Spanish-speaking Hispanic patients had more obstetric trauma than English-speaking Hispanic patients.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Hines AL, Andrews RM, Moy E .
Disparities in rates of inpatient mortality and adverse events: race/ethnicity and language as independent contributors.
Int J Environ Res Public Health 2014 Dec;11(12):13017-34. doi: 10.3390/ijerph111213017.
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Keywords: Communication, Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities
Wen KY, Hu A, Ma GX
Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning.
The researchers conducted a qualitative study to examine the information and communication needs as well as survivorship care preferences of Chinese American breast cancer survivors. The main themes identified through analysis of interview transcripts were: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for care plan elements and format.
AHRQ-funded; HS019001.
Citation: Wen KY, Hu A, Ma GX .
Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning.
J Community Support Oncol 2014 Dec;12(12):439-45. doi: 10.12788/jcso.0095..
Keywords: Cancer: Breast Cancer, Cultural Competence, Clinician-Patient Communication, Racial and Ethnic Minorities
McGarry BE, Temkin-Greener H, Li Y
Role of race and ethnicity in private long-term care insurance ownership.
The authors sought to determine if racial/ethnic disparities exist in the ownership of private long-term care insurance (LTCI) among current Medicare beneficiaries. They found that 12.3% of Blacks and 5.8% of Hispanics, compared with 20.2% of Whites, reported having LTCI coverage and that Hispanics were 48% less likely to have LTCI compared with Whites. Hispanic women were 81% less likely to be insured compared with White women.
AHRQ-funded; HS000044.
Citation: McGarry BE, Temkin-Greener H, Li Y .
Role of race and ethnicity in private long-term care insurance ownership.
Gerontologist 2014 Dec;54(6):1001-12. doi: 10.1093/geront/gnt102.
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Keywords: Disparities, Elderly, Health Insurance, Long-Term Care, Racial and Ethnic Minorities
Rodrigue JR, Fleishman A, Fitzpatrick S
Organ donation knowledge, willingness, and beliefs of motor vehicle clerks.
This study assessed the donation knowledge, willingness, and beliefs of MV clerks and their association with demographic characteristics. It found that most clerks believed that people should register as organ donors. Whites and already registered donors were more likely than minorities and nonregistered clerks to believe others should register as donors.
AHRQ-funded; HS022061; HS024204.
Citation: Rodrigue JR, Fleishman A, Fitzpatrick S .
Organ donation knowledge, willingness, and beliefs of motor vehicle clerks.
Transplantation 2014 Nov 27;98(10):1025-8. doi: 10.1097/tp.0000000000000424..
Keywords: Racial and Ethnic Minorities, Registries, Education: Patient and Caregiver
Qato DM, Daviglus ML, Wilder J
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
The authors examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions and whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. They found that in 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. These findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability.
AHRQ-funded; HS021093.
Citation: Qato DM, Daviglus ML, Wilder J .
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
Health Aff 2014 Nov;33(11):1958-65. doi: 10.1377/hlthaff.2013.1397.
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Keywords: Access to Care, Medication, Provider: Pharmacist, Racial and Ethnic Minorities, Urban Health
Fritz SA, Hogan PG, Singh LN
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
This study of the households of 50 children with active or recent culture-positive community-associated methicillin-resistant staphylococcus aureus (MRSA) infection found MRSA-contaminated surfaces in 23 of the 50 households, most frequently form the bed linens (18 percent), television remote control (16 percent), and bathroom hand towel (15 percent).
AHRQ-funded; HS021736
Citation: Fritz SA, Hogan PG, Singh LN .
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
JAMA Pediatr. 2014 Nov;168(11):1030-8. doi: 10.1001/jamapediatrics.2014.1218..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents, Racial and Ethnic Minorities