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
1 to 25 of 134 Research Studies DisplayedCarson NJ, Progovac AM, Wang Y
A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
The Food and Drug Administration's 2004 antidepressant warning was followed by decreases in antidepressant prescribing for youth. Little is known about how antidepressant prescribing patterns varied by race/ethnicity. This study analyzed Medicaid claims data from four U.S. states (2002-2009) for youth ages 5-17. The authors found that antidepressant prescription fills declined most post-warning for White youth, suggesting that risk information may have diffused less rapidly to prescribers or caregivers of minorities.
AHRQ-funded; HS021486.
Citation: Carson NJ, Progovac AM, Wang Y .
A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
Depress Anxiety 2017 Dec;34(12):1147-56. doi: 10.1002/da.22681..
Keywords: Medication, Children/Adolescents, Depression, Guidelines, Racial and Ethnic Minorities
Berge JM, Truesdale KP, Sherwood NE
Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
This study examined the frequency of eating breakfast, lunch or dinner family meals and associations with pre-school children's overall diet quality and BMI percentile. The authors concluded that breakfast family meal frequency and total weekly family meal frequency were associated with healthier diet quality in non-Hispanic pre-school children but not in Hispanic children. Longitudinal research is needed to clarify the association between family meal type and child diet quality and BMI percentile.
AHRQ-funded; HS022990.
Citation: Berge JM, Truesdale KP, Sherwood NE .
Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children?.
Public Health Nutr 2017 Dec;20(18):3275-84. doi: 10.1017/s1368980017002348..
Keywords: Children/Adolescents, Family Health and History, Nutrition, Obesity: Weight Management, Racial and Ethnic Minorities
Crawford J, Beaton D, Almad F
AHRQ Author: Bierman AS
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
The objective of this work was to develop a survey that considered cultural relevance and diversity of South Asian populations, with the aim of describing or predicting factors that influence colorectal cancer screening intention and adherence. The initial development of the Colon Cancer Screening Behaviours Survey for South Asian populations was completed using a number of steps. This initial survey was later cross-culturally translated and adapted into the Urdu language.
AHRQ-authored.
Citation: Crawford J, Beaton D, Almad F .
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
BMC Res Notes 2017 Dec 28;10(1):770. doi: 10.1186/s13104-017-3098-3.
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Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Patient Adherence/Compliance, Racial and Ethnic Minorities, Screening
Adams AS, Madden JM, Zhang F
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
This study evaluated the impact of transitioning from Medicaid to Medicare Part D drug coverage on the use of noncancer treatments among dual enrollees with cancer. Its findings suggest that the removal of drug caps under Part D had a modest impact on the treatment of hypercholesterolemia overall and may have reduced white-black gaps in the use of lipid-lowering and antidepressant therapies.
AHRQ-funded; HS018577.
Citation: Adams AS, Madden JM, Zhang F .
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
Value Health 2017 Dec;20(10):1345-54. doi: 10.1016/j.jval.2017.05.023.
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Keywords: Access to Care, Cancer, Medicare, Medication, Racial and Ethnic Minorities
Taira DA, Seto BK, Davis JW
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
This study examined racial/ethnic and regional differences in medication adherence in patients with diabetes taking oral anti-diabetic, anti-hypertensive, and cholesterol lowering medications and to identify the pharmacies and prescribers who serve these communities. After adjustment for other factors, Filipinos, Native Hawaiians, and people of other race were significantly less adherent to anti-diabetic and anti-hypertensive medications than Japanese.
AHRQ-funded; HS023185.
Citation: Taira DA, Seto BK, Davis JW .
Examining factors associated with nonadherence and identifying providers caring for nonadherent subgroups.
J Pharm Health Serv Res 2017 Dec;8(4):247-53. doi: 10.1111/jphs.12193.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Racial and Ethnic Minorities
Goff SL, Mazor KM, Guhn-Knight H
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
The authors sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. They found that pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Guhn-Knight H .
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
J Racial Ethn Health Disparities 2017 Dec;4(6):1051-60. doi: 10.1007/s40615-016-0309-x.
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Keywords: Access to Care, Quality of Care, Low-Income, Children/Adolescents, Racial and Ethnic Minorities
Kumar K, Holscher CM, Luo X
Persistent regional and racial disparities in nondirected living kidney donation.
Nondirected living donors (NDLDs) are an important and growing source of kidneys to help reduce the organ shortage. The authors of this study hypothesized that the initial geographic clustering and racial disparities may have improved due to an increase in NDLDs. The authors found that despite the increased number of NDLDs, racial disparities have worsened and the center-level distribution of NDLD transplants has narrowed in recent years.
AHRQ-funded; HS024600.
Citation: Kumar K, Holscher CM, Luo X .
Persistent regional and racial disparities in nondirected living kidney donation.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13135..
Keywords: Disparities, Health Services Research (HSR), Policy, Transplantation, Racial and Ethnic Minorities
Attanasio LB, Hardeman RR, Kozhimannil KB
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
This study examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. The study concluded that there are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Findings also suggested that white and high-socioeconomic status women may be more able to realize their preferences in childbirth.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Hardeman RR, Kozhimannil KB .
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
Birth 2017 Dec;44(4):306-14. doi: 10.1111/birt.12305..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Acker WW, Plasek JM, Blumenthal KG
Prevalence of food allergies and intolerances documented in electronic health records.
The researchers sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. Among 2.7 million patients, they identified 97,482 patients (3.6 percent) with 1 or more food allergies or intolerances. The prevalence of food allergy and intolerance was higher in females (4.2 percent vs 2.9 percent) and Asians (4.3 percent vs 3.6 percent).
AHRQ-funded; HS022728.
Citation: Acker WW, Plasek JM, Blumenthal KG .
Prevalence of food allergies and intolerances documented in electronic health records.
J Allergy Clin Immunol 2017 Dec;140(6):1587-91.e1. doi: 10.1016/j.jaci.2017.04.006.
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Keywords: Electronic Health Records (EHRs), Patient Safety, Racial and Ethnic Minorities, Sex Factors
Jones JM, Fingar KR, Miller MA
AHRQ Author: Miller MA; Heslin KC
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
The objective of this study was to use a broad method of capturing sepsis cases to estimate 2004-2013 trends in in-hospital sepsis mortality rates by race/ethnicity. Mortality rates adjusted for patient characteristics were higher for all minority groups than for white patients. After adjusting for hospital characteristics, sepsis mortality rates in 2013 were similar for white, black, and Hispanic patients.
AHRQ-authored.
Citation: Jones JM, Fingar KR, Miller MA .
Racial disparities in sepsis-related in-hospital mortality: using a broad case capture method and multivariate controls for clinical and hospital variables, 2004-2013.
Crit Care Med 2017 Dec;45(12):e1209-e17. doi: 10.1097/ccm.0000000000002699.
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Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Mortality, Racial and Ethnic Minorities, Sepsis
Lee AK, Lee CJ, Huang ES
Risk factors for severe hypoglycemia in black and white adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
Severe hypoglycemia is a rare but important complication of type 2 diabetes. Few studies have examined the epidemiology of hypoglycemia in a community-based population. This study concluded that poor glycemic control, glycemic variability as captured by 1,5-anhydroglucitol, kidney damage, and measures of cognitive and functional impairments were strongly associated with increased risk of severe hypoglycemia.
AHRQ-funded; HS018542.
Citation: Lee AK, Lee CJ, Huang ES .
Risk factors for severe hypoglycemia in black and white adults with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
Diabetes Care 2017 Dec;40(12):1661-67. doi: 10.2337/dc17-0819.
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Keywords: Cardiovascular Conditions, Elderly, Diabetes, Racial and Ethnic Minorities, Risk
Powell-Wiley TM, Wong MS, Adu-Brimpong J
Simulating the impact of crime on African American women's physical activity and obesity.
The objective of this study was to quantify the impact of crime on physical activity location accessibility, leisure-time physical activity (LTPA), and obesity among African American women. The study’s simulations showed that crime may serve as a barrier to LTPA. Reducing crime and increasing propensity to exercise through multilevel interventions may promote greater than linear declines in obesity prevalence.
AHRQ-funded; HS023317.
Citation: Powell-Wiley TM, Wong MS, Adu-Brimpong J .
Simulating the impact of crime on African American women's physical activity and obesity.
Obesity 2017 Dec;25(12):2149-55. doi: 10.1002/oby.22040.
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Keywords: Health Status, Lifestyle Changes, Obesity, Racial and Ethnic Minorities
Oates GR, Hamby BW, Stepanikova I
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. This study aimed to identify social determinants of adherence to PR. The findings showed that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Stepanikova I .
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Copd 2017 Dec;14(6):610-17. doi: 10.1080/15412555.2017.1379070..
Keywords: Respiratory Conditions, Racial and Ethnic Minorities, Patient Adherence/Compliance, Social Determinants of Health
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Cole MB, Wilson IB, Trivedi AN
State variation in quality outcomes and disparities in outcomes in community health centers.
The researchers estimated between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. They found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers..
AHRQ-funded; HS024652.
Citation: Cole MB, Wilson IB, Trivedi AN .
State variation in quality outcomes and disparities in outcomes in community health centers.
Med Care 2017 Dec;55(12):1001-07. doi: 10.1097/mlr.0000000000000818.
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Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Hong S, Burnett-Zeigler I
The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study.
This report examined the frequency of a post-traumatic stress disorder (PTSD) diagnosis and subthreshold PTSD among 72 female participants with depressive symptoms in a mindfulness-based intervention for depression at an urban federally qualified health center. The authors reported the high frequency of PTSD diagnosis and subthreshold PTSD among underserved women with depressive symptoms.
AHRQ-funded; HS023011.
Citation: Hong S, Burnett-Zeigler I .
The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study.
J Racial Ethn Health Disparities 2017 Dec;4(6):1069-73. doi: 10.1007/s40615-016-0311-3.
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Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Urban Health, Vulnerable Populations
Roman LA, Raffo JE, Dertz K
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
The purpose of this study was to explore the perspectives of Medicaid-insured women about their experiences of perinatal care across a continuum of clinical and community-based services. It found that many women experienced difficulties engaging in early care, getting more help, and understanding and communicating with their providers, with some reporting socio-economic and racial bias in care.
AHRQ-funded; HS020208.
Citation: Roman LA, Raffo JE, Dertz K .
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
Matern Child Health J 2017 Dec;21(Suppl 1):81-92. doi: 10.1007/s10995-017-2372-2.
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Keywords: Access to Care, Maternal Care, Medicaid, Pregnancy, Racial and Ethnic Minorities
Taira DA, Shen C, King M
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. The purpose of this study was to examine medication access by race/ethnicity among Medicare beneficiaries. The authors found that possible interventions for non-Hispanic blacks might include assisting them in finding the best drug plan to meeting their needs, connecting them to medication assistance programs, and discussing convenience of pharmacy with patients.
AHRQ-funded; HS023185.
Citation: Taira DA, Shen C, King M .
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Res Social Adm Pharm 2017 Nov;13(6):1208-13. doi: 10.1016/j.sapharm.2016.10.021..
Keywords: Access to Care, Medicare, Medication, Racial and Ethnic Minorities, Social Determinants of Health
Magnusson DM, Minkovitz CS, Kuhlthau KA
AHRQ Author: Mistry KB
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
This study sought to understand the role of health beliefs in shaping maternal decisions regarding help-seeking for children with developmental delay (DD) and explore differences between African American and Hispanic mothers. Five major themes emerged describing the role of maternal health beliefs in shaping key stages of the help-seeking pathway for children with DD. Differences between African American and Hispanic mothers are also described.
AHRQ-authored.
Citation: Magnusson DM, Minkovitz CS, Kuhlthau KA .
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
Pediatrics 2017 Nov;140(5):pii: e20172059. doi: 10.1542/peds.2017-2059.
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Keywords: Children/Adolescents, Decision Making, Disabilities, Low-Income, Racial and Ethnic Minorities
Hefele JG, Ritter GA, Bishop CE
Examining racial and ethnic differences in nursing home quality.
The authors measured within-facility differences for a range of publicly reported nursing home quality measures. They found that, on average, care is delivered equally across all racial/ethnic groups in the same nursing home. They concluded that nursing home providers should attempt to identify racial/ethnic within-facility differences in care.
AHRQ-funded; HS021891.
Citation: Hefele JG, Ritter GA, Bishop CE .
Examining racial and ethnic differences in nursing home quality.
Jt Comm J Qual Patient Saf 2017 Nov;43(11):554-64. doi: 10.1016/j.jcjq.2017.06.003.
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Keywords: Disparities, Quality of Care, Nursing Homes, Racial and Ethnic Minorities, Public Reporting
Heerman WJ, Jackson N, Roumie CL
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
The objective of this study was to report survey response rates and demographic characteristics of eight recruitment approaches to determine acceptability and effectiveness of large-scale patient recruitment among various populations. The study concluded that technology-enabled recruitment approaches such as registries and emails are effective for recruiting but may yield less racial/ethnic diversity compared to traditional, more time-intensive approaches.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Jackson N, Roumie CL .
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
Contemp Clin Trials 2017 Nov;62:50-55. doi: 10.1016/j.cct.2017.08.006..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Racial and Ethnic Minorities, Social Determinants of Health
Hiratsuka VY, Beans JA, Robinson RF
Self-determination in health research: an Alaska native example of tribal ownership and research regulation.
Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and the tribal community by making trust and accountability required features of health research in Alaska Native (AN) and American Indian (AI) communities. This review evaluates research through the lens of tribal principles, practices, and priorities. The SCF example provides a framework for other tribes and organizations seeking to reshape the future of health research in AN/AI communities.
AHRQ-funded; HS000079.
Citation: Hiratsuka VY, Beans JA, Robinson RF .
Self-determination in health research: an Alaska native example of tribal ownership and research regulation.
Int J Environ Res Public Health 2017 Oct 31;14(11). doi: 10.3390/ijerph14111324.
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Keywords: Health Services Research (HSR), Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Policy, Racial and Ethnic Minorities
Rauscher GH, Dabbous F, Dolecek TA
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
The researchers sought to estimate the extent of an anticipated racial disparity in interval breast cancer (IBC) within a single, large health care organization. Contrary to expectation, in patient-adjusted models, there was no IBC racial disparity. The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated disparity in IBC.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Dabbous F, Dolecek TA .
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
Ann Epidemiol 2017 Oct;27(10):654-58. doi: 10.1016/j.annepidem.2017.09.002.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Racial and Ethnic Minorities, Women, Screening, Screening, Imaging
Allen CD, McNeely CA
Do restrictive omnibus immigration laws reduce enrollment in public health insurance by Latino citizen children? A comparative interrupted time series study.
This study uses nationally-representative data from the National Health Interview Survey (2005-2014) and comparative interrupted time series methods to assess whether passage of state omnibus immigration laws reduced access to Medicaid/CHIP for US citizen Latino children. The authors found that law passage did not reduce enrollment for children with noncitizen parents and actually resulted in temporary increases in coverage among Latino children with at least one citizen parent.
AHRQ-funded; HS024248.
Citation: Allen CD, McNeely CA .
Do restrictive omnibus immigration laws reduce enrollment in public health insurance by Latino citizen children? A comparative interrupted time series study.
Soc Sci Med 2017 Oct;191:19-29. doi: 10.1016/j.socscimed.2017.08.039..
Keywords: Access to Care, Children/Adolescents, Children's Health Insurance Program (CHIP), Policy, Racial and Ethnic Minorities
Davis CM, Guo M, Miyamura J
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency.
Understanding (1) how expectant mothers gather information to decide where to give birth, and (2) who helps make that decision, provides critical health communication and decision-making insights. This survey found that the top three health decision-makers for both those Asian American and Pacific Islanders (AAPIs) with limited English proficiency and English-proficient AAPIs were themselves, their obstetrician, and their spouse, which did not differ significantly by language proficiency.
AHRQ-funded; HS021903.
Citation: Davis CM, Guo M, Miyamura J .
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency.
Hawaii J Med Public Health 2017 Oct;76(10):279-86.
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Keywords: Healthcare Delivery, Cultural Competence, Decision Making, Pregnancy, Racial and Ethnic Minorities