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 22 of 22 Research Studies DisplayedMayberry LS, Lyles CR, Oldenburg B
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
The authors evaluate the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes. They found evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research to substantiate these early findings is recommended; the authors suggest that many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.
AHRQ-funded; HS022408; HS025429.
Citation: Mayberry LS, Lyles CR, Oldenburg B .
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
Curr Diab Rep 2019 Nov 25;19(12):148. doi: 10.1007/s11892-019-1280-9.
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Keywords: Diabetes, Vulnerable Populations, Patient Self-Management, Telehealth, Health Information Technology (HIT), Patient-Centered Healthcare, Low-Income, Chronic Conditions
Goins RT, Jones J, Schure M
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
This study’s purpose was to examine beliefs, attitudes, and practices of older Native Americans regarding type 2 diabetes mellitus (T2DM) management. This disease is one the leading causes of morbidity and mortality among Native Americans, and they are twice as likely to have T2DM, and over three times the mortality rate from T2DM as Whites. Semi-structured in-depth qualitative interviews were conducted with 28 participants with a mean age of 73 years, with 57% female. Participants’ mean confidence score of their T2DM management was 8.0 on a scale of 1 to 10 and their mean Hb1Ac was 7.3.%. Overall 5 themes were discussed: sociocultural factors, causes and consequences, cognitive and affective assessment, diet and exercise, and medical management.
AHRQ-funded; HS000078.
Citation: Goins RT, Jones J, Schure M .
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
Ethn Health 2020 Nov;25(8):1055-71. doi: 10.1080/13557858.2018.1493092..
Keywords: Diabetes, Chronic Conditions, Elderly, Racial and Ethnic Minorities, Patient Self-Management, Care Management
Volerman A, Fierstein J, Boon K
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Guidelines recommend that children and families receive education about and demonstration of effective inhaler technique as part of asthma self-management education. For youth, improved inhaler technique is associated with better quality of life and decreased health care use, yet technique remains suboptimal. To understand potential reasons for differences in inhaler skills, this study examined individual- and health care-level factors associated with effective inhaler technique among children.
AHRQ-funded; HS026385.
Citation: Volerman A, Fierstein J, Boon K .
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Ann Allergy Asthma Immunol 2019 Nov;123(5):511-12.e1. doi: 10.1016/j.anai.2019.08.017.
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Keywords: Children/Adolescents, Asthma, Chronic Conditions, Patient Self-Management, Education: Patient and Caregiver, Medication, Quality of Life
Keller SC, Cosgrove SE, Arbaje AI
Roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy.
This study examined roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy (OPAT). A qualitative study of patients and caregivers was conducted using 40 semistructured telephone interviews and 20 contextual inquiries for patients and caregivers. The participants had been discharged from two academic medical centers and put on OPAT. Four main roles were identified: communicator, advocate, learner-trainer, and lay health care worker. There was ambiguity shown among health care workers as well as patients and caregivers. Clearer delineation of roles as to who performs which tasks was indicated in the study.
AHRQ-funded; HS025782.
Citation: Keller SC, Cosgrove SE, Arbaje AI .
Roles and role ambiguity in patient- and caregiver-performed outpatient parenteral antimicrobial therapy.
Jt Comm J Qual Patient Saf 2019 Nov;45(11):763-71. doi: 10.1016/j.jcjq.2019.07.003..
Keywords: Patient-Centered Healthcare, Quality Improvement, Healthcare Delivery, Patient Self-Management, Care Management, Caregiving, Quality of Care, Patient Safety
Cho H, Flynn G, Saylor M
Use of the FITT framework to understand patients' experiences using a real-time medication monitoring pill bottle linked to a mobile-based HIV self-management app: a qualitative study.
This study examined the usefulness of a mobile app linked to a real-time medication monitoring pill bottle that reminds HIV patients to take their medication. Thirty-eight randomized patients living with HIV who were aged 18 and older, owned a smartphone and were mostly medication-compliant were selected. The majority were African-American, had a high school education or less, and had a median income of less than $20,000. The Fit between Individuals, Task and Technology (FITT) framework was used to determine the fit between the individuals and the technology. Hindrances to the technology included: ease of use, HIV-related stigma and disclosure of HIV status, customized alert of medication time windows, and preference for device design.
AHRQ-funded; HS025071.
Citation: Cho H, Flynn G, Saylor M .
Use of the FITT framework to understand patients' experiences using a real-time medication monitoring pill bottle linked to a mobile-based HIV self-management app: a qualitative study.
Int J Med Inform 2019 Nov;131:103949. doi: 10.1016/j.ijmedinf.2019.08.009..
Keywords: Patient Experience, Patient Adherence/Compliance, Medication, Patient Self-Management, Health Information Technology (HIT)
Schure M, Goins RT, Jones J
Dietary beliefs and management of older American Indians with type 2 diabetes.
This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM). The investigators concluded that American Indian older adults face a variety of challenges to dietary management of T2DM. The investigators suggested that future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM.
AHRQ-funded; HS000078.
Citation: Schure M, Goins RT, Jones J .
Dietary beliefs and management of older American Indians with type 2 diabetes.
J Nutr Educ Behav 2019 Jul-Aug;51(7):826-33. doi: 10.1016/j.jneb.2018.11.007..
Keywords: Elderly, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Nutrition, Patient Self-Management
Befus DR, Hull S
Nonpharmacological self-management of migraine across social locations: an equity-oriented, qualitative analysis.
The authors conducted focus groups to explore patients’ desires and recommendations for migraine clinicians and researchers. They identified 4 themes: a more holistic, collaborative, long-term treatment approach; medication as a short-term solution; high personal and economic costs of medication; and desire for more information about and access to natural approaches. The authors concluded that holistic and integrative approaches were preferred over medication as long-term migraine management strategies; however, people in marginalized social locations, while disproportionately disabled by migraine, did not feel as comfortable accessing integrative approaches through currently available channels.
AHRQ-funded; HS0224430.
Citation: Befus DR, Hull S .
Nonpharmacological self-management of migraine across social locations: an equity-oriented, qualitative analysis.
Glob Adv Health Med 2019 Jun 13;8:2164956119858034. doi: 10.1177/2164956119858034..
Keywords: Care Management, Chronic Conditions, Complementary and Alternative Medicine, Neurological Disorders, Patient Self-Management
Vizer LM, Eschler j, KOO BM
"It's not just technology, it's people": constructing a conceptual model of shared health informatics for tracking in chronic illness management.
To inform development of effective technologies that aid tracking of health indicators to support chronic illness management, this study aimed to construct a health informatics model that accurately describes the work and social context of that tracking work. The investigators concluded that the resulting CoMSHI yielded a more detailed and nuanced viewpoint of tracking in support of chronic illness management and could inform technology design to improve tracking tools to support people in more confident and capable chronic illness management.
AHRQ-funded; HS021590.
Citation: Vizer LM, Eschler j, KOO BM .
"It's not just technology, it's people": constructing a conceptual model of shared health informatics for tracking in chronic illness management.
J Med Internet Res 2019 Apr 29;21(4):e10830. doi: 10.2196/10830..
Keywords: Care Management, Chronic Conditions, Health Information Technology (HIT), Patient Self-Management
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Beauchemin M, Gradilla M, Baik D
A multi-step usability evaluation of a self-management app to support medication adherence in persons living with HIV.
The authors developed a mHealth app (WiseApp) for HIV self-management to help persons living with HIV (PLWH) self-manage their health. The purpose of this study was to evaluate the usability of the WiseApp. The results of the cognitive walkthrough with both experts and end-users informed iterative refinements to the WiseApp and finalization of a mHealth app for PLWH to better self-manage their health.
AHRQ-funded; HS025071.
Citation: Beauchemin M, Gradilla M, Baik D .
A multi-step usability evaluation of a self-management app to support medication adherence in persons living with HIV.
Int J Med Inform 2019 Feb;122:37-44. doi: 10.1016/j.ijmedinf.2018.11.012..
Keywords: Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient Self-Management
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Nundy S, Mishra A, Hogan P
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. It found that the intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating).
AHRQ-funded; HS015054.
Citation: Nundy S, Mishra A, Hogan P .
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
Diabetes Educ 2014 Nov-Dec;40(6):806-19. doi: 10.1177/0145721714551992..
Keywords: Diabetes, Health Information Technology (HIT), Patient Self-Management, Telehealth
Mitchell SE, Mako M, Sadikova E
The comparative experiences of women in control: diabetes self-management education in a virtual world.
The investigators characterized participants' experiences of a diabetes self-management (DSM) education program delivered via a virtual world (VW) versus a face-to-face (F2F) format. They found that VW and F2F groups both reported mastery of DSM knowledge, attitudes, and skills, and there were no differences in peer-derived social support between groups. The technological aspects of VW participation afforded VW participants a unique sense of personal agency and diabetes self-efficacy not reported by F2F participants. They concluded that DSM education in a VW is feasible and educational outcomes are similar to a F2F classroom experience.
AHRQ-funded; HS019771.
Citation: Mitchell SE, Mako M, Sadikova E .
The comparative experiences of women in control: diabetes self-management education in a virtual world.
J Diabetes Sci Technol 2014 Nov;8(6):1185-92. doi: 10.1177/1932296814549829.
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Keywords: Education: Patient and Caregiver, Diabetes, Health Promotion, Patient Self-Management
Chen R, Cheadle A, Johnson D
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
The purpose of this study was to examine trends in the receipt of 8 recommended diabetes clinical and self-care indicators from 2001 to 2010 and assess racial/ethnic disparities in care. There were significant increases from 2001 to 2010 in A1C tests, annual foot exams, flu shots, diabetes self-management education and self management of blood glucose but declines in eye and self feet exams.
AHRQ-funded; HS013853.
Citation: Chen R, Cheadle A, Johnson D .
US trends in receipt of appropriate diabetes clinical and self-care from 2001 to 2010 and racial/ethnic disparities in care.
Diabetes Educ 2014 Nov-Dec;40(6):756-66. doi: 10.1177/0145721714546721..
Keywords: Diabetes, Patient Self-Management, Disparities, Racial and Ethnic Minorities, Racial and Ethnic Minorities
Cohen MJ, Morton S, Scholle SH
Self-management support activities in patient-centered medical home practices.
This study is a survey of small practices of fewer than 5 physicians with National Committee for Quality Assurance recognition. Practices reported a high proportion of self-management support activities, while practices that perform more of these activities have more nonindependent health care providers.
AHRQ-funded; HS019162.
Citation: Cohen MJ, Morton S, Scholle SH .
Self-management support activities in patient-centered medical home practices.
J Ambul Care Manage 2014 Oct-Dec;37(4):349-58. doi: 10.1097/jac.0000000000000040.
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Keywords: Patient-Centered Healthcare, Patient Self-Management, Primary Care
Leung LA, Swaminathan S, Trivedi AN
Diabetes diagnosis and exercise initiation among older Americans.
The investigators sought to determine whether exercise participation increased following a new diagnosis of diabetes using a sample of U.S. individuals aged 50 and over who did not report exercise prior to diagnosis. They found that over 35% of persons with a new diagnosis of diabetes initiated moderate or vigorous exercise in the year following their diagnosis.
AHRQ-funded; HS000011.
Citation: Leung LA, Swaminathan S, Trivedi AN .
Diabetes diagnosis and exercise initiation among older Americans.
Prev Med 2014 Aug;65:128-32. doi: 10.1016/j.ypmed.2014.05.001.
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Keywords: Diabetes, Diagnostic Safety and Quality, Elderly, Lifestyle Changes, Patient Self-Management
Chrischilles EA, Hourcade JP, Doucette W
Personal health records: a randomized trial of effects on elder medication safety.
The purpose of this study was to compare patient-reported medication self-management behaviors and safety indicators among older adult participants invited to use an electronic personal health record (PHR). Among the 16.1 percent of participants who used the PHR frequently, there were significantly more changes in medication use, improved medication reconciliation behaviors, and more recognition of side effects.
AHRQ-funded; HS017034
Citation: Chrischilles EA, Hourcade JP, Doucette W .
Personal health records: a randomized trial of effects on elder medication safety.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):679-86. doi: 10.1136/amiajnl-2013-002284..
Keywords: Elderly, Medication, Medication: Safety, Health Information Technology (HIT), Patient Safety, Patient Self-Management
Voils CI, Gierisch JM, Yancy WS, Jr.
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
The authors posited that health behavior initiation and maintenance require separate psychological processes and skills. They found evidence of improvement in dietary intake and of maintenance of physical activity and low-density lipoprotein cholesterol during the 4-month maintenance study. Participants found it helpful to plan for relapses, self-monitor, and obtain social support, but they had mixed reactions about reflecting on satisfaction with outcomes.
AHRQ-funded; HS000079.
Citation: Voils CI, Gierisch JM, Yancy WS, Jr. .
Differentiating behavior initiation and maintenance: theoretical framework and proof of concept.
Health Educ Behav 2014 Jun;41(3):325-36. doi: 10.1177/1090198113515242.
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Keywords: Nutrition, Patient Adherence/Compliance, Patient Self-Management, Lifestyle Changes
Nundy S, Dick JJ, Chou CH
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. The researchers examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes. In addition to pre-post improvements in glycemic control and patients’ satisfaction with overall care, they observed a net cost savings of 8.8 percent.
AHRQ-funded; HS000084.
Citation: Nundy S, Dick JJ, Chou CH .
Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.
Health Aff 2014 Feb;33(2):265-72. doi: 10.1377/hlthaff.2013.0589..
Keywords: Diabetes, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Telehealth
Fuji KT, Abbott AA, Galt KA
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Few studies have examined the barriers to personal health record (PHR) use resulting from design issues identified by actual users. The researchers conducted interviews with 59 patients who had received training in using Microsoft Health Vault for PHRs to manage their diabetes-related health information. Three barriers to use (difficulty of use, lack of value, life got in the way) could be traced back to PHR design considerations.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Diabetes Care 2014;37(1):e13-4. doi: 10.2337/dc13-1630..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Self-Management