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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
26 to 50 of 182 Research Studies DisplayedMcCoy RG, Van Houten HK, Dunlay SM
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
The authors examined the differences in the use of three glucose-lowering medications as a function of both sex and race. They found that, compared to white men, GLP-1RA were 43% more likely to be started by White women, 12% more likely to be started by non-White men, and 21% less likely to be started by non-White women. SGLT2i were at least 10% less likely to be started by all groups compared to White men, and DPP4i were used more often by non-White than White patients of both sexes.
AHRQ-funded; HS024075.
Citation: McCoy RG, Van Houten HK, Dunlay SM .
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
Race and sex differences in the initiation of diabetes drugs by privately insured US adults..
Keywords: Diabetes, Chronic Conditions, Medication, Sex Factors, Racial and Ethnic Minorities
Dixon BE, Grannis SJ, Lembcke LR
The synchronicity of COVID-19 disparities: statewide epidemiologic trends in SARS-CoV-2 morbidity, hospitalization, and mortality among racial minorities and in rural America.
Researchers sought to examine trends in COVID-19 morbidity, hospitalization, and mortality over time for minority and rural populations, especially during the U.S. fall surge. Data were taken from a statewide cohort of adult residents in Indiana tested for SARS-CoV-2 infection. The researchers found that, by the fall of 2020, hospitalization and mortality rates in rural areas surpassed those of urban areas, and gaps between black/brown and white populations narrowed. Cumulative morbidity and mortality were highest among minority groups and in rural communities. They concluded that the synchronicity of disparities in COVID-19 by race and geography suggested that health officials explicitly measure disparities and adjust mitigation as well as vaccination strategies to protect those sub-populations with greater disease burden.
AHRQ-funded; HS025502.
Citation: Dixon BE, Grannis SJ, Lembcke LR .
The synchronicity of COVID-19 disparities: statewide epidemiologic trends in SARS-CoV-2 morbidity, hospitalization, and mortality among racial minorities and in rural America.
PLoS One 2021 Jul 23;16(7):e0255063. doi: 10.1371/journal.pone.0255063..
Keywords: COVID-19, Disparities, Racial and Ethnic Minorities, Hospitalization, Mortality, Rural Health
Morden NE, Chyn D, Wood A
Racial inequality in prescription opioid receipt - role of individual health systems.
The purpose of this study was to explore the contribution of individual health systems in the receipt of prescription opioids among racial groups in the United States. Medicare claims data for 2016-2017 was used to obtain a random 40% national sample of fee-for-service, Black and White beneficiaries 18 to 64 years of age and identify 310 racially diverse systems. Findings showed that, within individual health systems, Black and White patients received markedly different opioid doses. These system-specific findings could facilitate exploration of the causes and consequences of these differences.
AHRQ-funded; HS024075.
Citation: Morden NE, Chyn D, Wood A .
Racial inequality in prescription opioid receipt - role of individual health systems.
N Engl J Med 2021 Jul 22;385(4):342-51. doi: 10.1056/NEJMsa2034159..
Keywords: Opioids, Medication, Racial and Ethnic Minorities, Disparities, Practice Patterns
Cunningham-Erves J, Campbell L, Barlow C
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
AHRQ-funded; HS022990.
Citation: Cunningham-Erves J, Campbell L, Barlow C .
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614..
Keywords: Sexual Health, Infectious Diseases, Cancer, Disparities, Racial and Ethnic Minorities, Men's Health, Prevention, Health Promotion, Education: Patient and Caregiver
Tremblay ES, Ruiz J, Dykeman B
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
It is widely recognized that Type 1 Diabetes (T1D) outcomes are worse among Hispanic children; however, little is published about the perspectives of these patients and their caregivers. The intent of this study was to characterize the lived experience of Hispanic caregivers of children with T1D, focusing on the role of language and culture and their perspectives on current medical care and alternative care models.
AHRQ-funded; HS000063.
Citation: Tremblay ES, Ruiz J, Dykeman B .
Hispanic caregivers' experience of pediatric type 1 diabetes: a qualitative study.
Pediatr Diabetes 2021 Jul 7;22(7):1040-50. doi: 10.1111/pedi.13247..
Keywords: Children/Adolescents, Diabetes, Caregiving, Chronic Conditions, Racial and Ethnic Minorities, Cultural Competence
Burris HH, Passarella M, Handley SC
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
This study’s objective was to determine whether black-white disparities in maternal in-hospital mortality during delivery vary across hospital types (black-serving vs non-black and teaching vs non-teaching) and whether overall maternal mortality differs across hospital types. The authors performed a population-based, retrospective cohort study of 5,679,044 deliveries among black (14.2%) and white patients (85.8%) in 3 states (California, Missouri, and Pennsylvania) from 1995 to 2009. Examination of black-white disparities found that after risk adjustment, black patients had significantly greater risk of death and that the disparity was similar within each of the hospital types. At teaching hospitals, mortality was similar in black-serving and nonblack-serving hospitals. Among non-teaching hospitals, mortality was significantly higher in black-serving vs nonblack-serving hospitals. Over half (53%) of black patients delivered in nonteaching black-serving hospitals compared with just 19% of white patients.
AHRQ-funded; HS018661.
Citation: Burris HH, Passarella M, Handley SC .
Black-white disparities in maternal in-hospital mortality according to teaching and black-serving hospital status.
Am J Obstet Gynecol 2021 Jul;225(1):83.e1-83.e9. doi: 10.1016/j.ajog.2021.01.004..
Keywords: Maternal Care, Pregnancy, Mortality, Women, Racial and Ethnic Minorities, Disparities, Hospitals
Lillie KM, Shaw J, Jansen KJ
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). The investigators concluded that younger patients and those with co-occurring substance use remained at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people.
AHRQ-funded; HS023207.
Citation: Lillie KM, Shaw J, Jansen KJ .
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
J Addict Med 2021 Jul-Aug 01;15(4):297-302. doi: 10.1097/adm.0000000000000757..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Racial and Ethnic Minorities, Vulnerable Populations
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation: Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Lange EMS, Toledo P
Peripartum racial/ethnic disparities.
Addressing disparities has been a focus of the US Department of Health and Human Services Healthy People initiative for decades, with the most recent Healthy People 2020 establishing a need for health equity in the United States. In this article, the investigators presented an overview of peripartum racial/ethnic disparities and address potential structural solutions to improve maternal health equity.
AHRQ-funded; HS025267.
Citation: Lange EMS, Toledo P .
Peripartum racial/ethnic disparities.
Int Anesthesiol Clin 2021 Jul 1;59(3):1-7. doi: 10.1097/aia.0000000000000326..
Keywords: Maternal Care, Pregnancy, Disparities, Racial and Ethnic Minorities, Women
Thomas TW, Golin C, Samuel-Hodge CD
Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: a mixed-methods assessment.
The projected three-fold increase in diabetes burden by 2060 in the United States will affect certain race and gender groups disproportionately. The objective of this mixed-methods study was to assess differences in prediabetes screening and clinician response to prediabetes by patient race and gender. The investigators found that qualitatively, physicians reported a non-systematic approach to prediabetes screening and follow-up care related to: 1) System-level barriers to screening and treatment; 2) Implicit bias; 3) Patient factors; and 4) Physician preferences for prediabetes treatment.
AHRQ-funded; HS025561; HS000032.
Citation: Thomas TW, Golin C, Samuel-Hodge CD .
Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: a mixed-methods assessment.
Prev Med 2021 Jul;148:106587. doi: 10.1016/j.ypmed.2021.106587..
Keywords: Diabetes, Racial and Ethnic Minorities, Screening, Diagnostic Safety and Quality
Coley RY, Johnson E, Simon GE
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
This study looked at racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visit. The main outcome measured was the suicide rate within 90 days after a mental health visit. The study used a 50% sample of visits from a random set of outpatients at 7 large integrated health care systems by patients 13 years and older (6,984,184 visits). Suicide rates were highest for visits by patients with no race/ethnicity recorded, followed by Asian, White, American Indian/Alaskan Native, Hispanic, and Black. Sensitivity of both models used were high for White, Hispanic, and Asian patients and poor for Black and American Indian/Alaskan Native patients and patients with no race/ethnicity recorded.
AHRQ-funded; HS026369.
Citation: Coley RY, Johnson E, Simon GE .
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
JAMA Psychiatry 2021 Jul;78(7):726-34. doi: 10.1001/jamapsychiatry.2021.0493..
Keywords: Disparities, Racial and Ethnic Minorities, Behavioral Health, Mortality, Risk
Adams LB, Baxter SLK, Lightfoot AF
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
This study’s goal was to look at why prevalence of depression is lower for Black males despite cumulative socioeconomic disadvantage and risk factors. For Black men, emotional vulnerability is often seen as a sign of weakness which may potentially mask the timely identification of mental health needs in this population. The authors use concept mapping, which is a structured mixed methods approach to determine how stakeholders of Black men’s health conceptualize their depressive symptoms. Thirty-six stakeholders comprised of Black men, Black women, and primary care providers participated in separate stakeholder groups in 2018. Participants generated 68 characteristics of Black men’s depression reflected in six conceptual clusters: 1) physical states; 2) emotional states; 3) diminished drive; 4) internal conflicts; 5) communication with others; and 6) social pressures. Using a content analysis approach, they found that items comprising the “social pressures” cluster were not reflected in any common depression scales.
AHRQ-funded; HS000032.
Citation: Adams LB, Baxter SLK, Lightfoot AF .
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
BMC Public Health 2021 Jun 22;21(1):1194. doi: 10.1186/s12889-021-11137-5..
Keywords: Men's Health, Racial and Ethnic Minorities, Depression, Behavioral Health, Diagnostic Safety and Quality
Chen DW, Reyes-Gastelum D, Hawley ST
Unmet information needs among Hispanic women with thyroid cancer.
The authors sought to determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer. They assessed acculturation with the Short Acculturation Scale for Hispanics. They found that low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Hawley ST .
Unmet information needs among Hispanic women with thyroid cancer.
J Clin Endocrinol Metab 2021 Jun 16;106(7):e2680-e87. doi: 10.1210/clinem/dgab128..
Keywords: Cancer, Women, Racial and Ethnic Minorities, Education: Patient and Caregiver, Cultural Competence
Meyers DJ, Rahman M, Mor V
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
This cross-sectional study looked at racial/ethnic minority and socioeconomic disparities in ratings for Medicare Advantage (MA) plans, which disproportionately enroll these populations. A total of 1,578,564 enrollees were included in this analysis that used 22 measures of quality and satisfaction at the individual enrollee level, aggregated into simulated star ratings from 2-5 stratified by socioeconomic status (SES) and race/ethnicity. Low SES enrollees had simulated stratified star ratings 0.5 stars lower than individuals with high SES in the same contract. Black enrollees had simulated star ratings that were 0.3 stars lower and Hispanic enrollees had 0.1 lower simulated star ratings than White enrollees in the same contract. There was a larger difference in ratings with 4.5 to 5-star contracts with Black and Hispanic enrollees with Whites, and no statistical difference in 2.0 to 2.5 star-rated contracts. There was only low correlation between simulated ratings for enrollees of low SES and high SES.
AHRQ-funded; HS02705101.
Citation: Meyers DJ, Rahman M, Mor V .
Association of Medicare Advantage Star Ratings with racial, ethnic, and socioeconomic disparities in quality of care.
JAMA Health Forum 2021 Jun;2(6):e210793..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Medicare, Patient Experience, Disparities, Quality Measures, Provider Performance, Quality of Care, Racial and Ethnic Minorities
Lee K, Gani F, Canner JK
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
The primary objective of this study was to describe racial differences in the use of inpatient palliative care consultations (IPCC) for patients with advanced cancer who are admitted to a hospital in the United States. Hospital admissions of patients with advanced cancers were identified through the National Inpatient Dataset. Findings showed that death during hospitalization was a significant modifier of the relationship between race and receipt of palliative care consultation. There were significant racial disparities in the utilization of IPCC for patients with advanced cancer.
AHRQ-funded; HS024736.
Citation: Lee K, Gani F, Canner JK .
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
Am J Hosp Palliat Care 2021 Jun;38(6):539-46. doi: 10.1177/1049909120922779..
Keywords: Healthcare Cost and Utilization Project (HCUP), Palliative Care, Cancer, Disparities, Racial and Ethnic Minorities, Healthcare Utilization, Inpatient Care, Chronic Conditions
Smith JM, Lin H, Thomas-Hawkins C
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015.
AHRQ-funded; HS022406.
Citation: Smith JM, Lin H, Thomas-Hawkins C .
Timing of home health care initiation and 30-day rehospitalizations among Medicare beneficiaries with diabetes by race and ethnicity.
Int J Environ Res Public Health 2021 May 25;18(11). doi: 10.3390/ijerph18115623..
Keywords: Elderly, Home Healthcare, Hospital Readmissions, Medicare, Diabetes, Chronic Conditions, Racial and Ethnic Minorities
Lacson R, Shi J, Kapoor N
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
Researchers assessed diagnostic radiology examination utilization and associated social determinants of health during the early stages of reopening after state-mandated shutdown of nonurgent services because of COVID-19. They found that, despite resumption of nonurgent services, a marked decrease in radiology examination utilization persisted in all care settings post-shutdown, with more significantly decreased odds ratios for having examinations in inpatient and outpatient settings versus in the emergency department. Inequities worsened, with patients from communities with high rates of poverty, unemployment, and chronic disease having significantly lower odds of undergoing radiology examinations post-shutdown. Patients of Asian race and Hispanic ethnicity had significantly lower odds ratios for having examinations post-shutdown compared with White and non-Hispanic patients, respectively.
AHRQ-funded; HS024722.
Citation: Lacson R, Shi J, Kapoor N .
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
J Am Coll Radiol 2021 May;18(5):696-703. doi: 10.1016/j.jacr.2020.12.009..
Keywords: COVID-19, Disparities, Diagnostic Safety and Quality, Racial and Ethnic Minorities, Social Determinants of Health
Hollingsworth JM, Yu X, Yan PL
Provider care team segregation and operative mortality following coronary artery bypass grafting.
The purpose of this study was to examine whether provider care team segregation within hospitals contributes to the higher mortality rate of Black patients following coronary artery bypass grafting compared to their White counterparts. Using national Medicare data, findings showed that Black patients who undergo coronary artery bypass grafting at a hospital with a higher level of provider care team segregation die more frequently after surgery than Black patients treated at a hospital with a lower level.
AHRQ-funded; HS026908.
Citation: Hollingsworth JM, Yu X, Yan PL .
Provider care team segregation and operative mortality following coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2021 May;14(5):e007778. doi: 10.1161/circoutcomes.120.007778..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Mortality, Teams, Healthcare Delivery, Racial and Ethnic Minorities
Kim D, Lee Y, Thorsness R
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
This national study estimated excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. Findings showed that, among the US kidney failure population, the number of excess deaths was 16% higher than expected, similar to reports for the general population. However, results showed that the relative increase in deaths among Black and Hispanic patients was more than 4-fold higher than that observed among White patients. The magnitude of these disparities was larger than corresponding relative ratios reported among COVID-19–associated deaths in the general population.
AHRQ-funded; HS028285.
Citation: Kim D, Lee Y, Thorsness R .
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
Am J Kidney Dis 2021 May;77(5):827-29. doi: 10.1053/j.ajkd.2021.02.003..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Mortality, Kidney Disease and Health, Chronic Conditions, Social Determinants of Health
Pollack LM, Lowder JL, Keller M
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
The objective of this retrospective cohort study was to evaluate whether 30- and 90-day surgical complication and postoperative hospitalization rates after hysterectomy for benign conditions differed by race/ethnicity and whether the differences remained after controlling for patient, hospital, and surgical characteristics. The investigators concluded that Black and Asian/Pacific Islander women had higher risk of some 30- and 90-day surgical complications after hysterectomy than white women. Black and Hispanic women had higher risk of posthysterectomy hospitalization.
AHRQ-funded; HS019455.
Citation: Pollack LM, Lowder JL, Keller M .
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
J Minim Invasive Gynecol 2021 May;28(5):1022-32.e12. doi: 10.1016/j.jmig.2020.12.032..
Keywords: Surgery, Risk, Racial and Ethnic Minorities, Adverse Events, Hospitalization, Women
Danan ER, White KM, Wilt TJ
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
This study looked at differences in attitudes about recommendations and evidence on prostate cancer screening among White and Black male veterans. The authors provided a draft educational pamphlet about the benefits and harms of Prostate Specific Antigen (PSA) screening to 44 men, ages 55-81 at a midwestern VA medical center in 2013 and 2015. The groups were divided into four White and two Black focus groups. Three universal themes were low baseline familiarity with prostate cancer, surprise and resistance to the guidelines not to test routinely, and negative emotions in response to ambiguity. Discussions in the White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Discussions in Black groups devoted almost no time to benefits, considered harms significant, and emphasized personal and collective responsibility for cancer prevention through diet, exercise, and alternative medicine. Discussion in Black groups also emphasized the history of racism and discrimination in healthcare and medical research.
AHRQ-funded; HS026379.
Citation: Danan ER, White KM, Wilt TJ .
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
Am J Mens Health 2021 May-Jun;15(3):15579883211022110. doi: 10.1177/15579883211022110..
Keywords: Cancer: Prostate Cancer, Cancer, Screening, Prevention, Racial and Ethnic Minorities, Evidence-Based Practice, Health Promotion, Education: Patient and Caregiver
Javalkar K, Robson VK, Gaffney L
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Researchers characterized the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C). They found that lower socioeconomic status or higher social vulnerability index, Hispanic ethnicity, and Black race independently increased risk for MIS-C. They recommended additional studies to target interventions to improve health equity for children.
AHRQ-funded; HS000063.
Citation: Javalkar K, Robson VK, Gaffney L .
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-039933..
Keywords: Children/Adolescents, Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Risk
Alcántara C, Giorgio Cosenzo L, McCullough E
Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: a systematic review of randomized controlled trials in the United States.
This systematic review examined behavioral randomized controlled trials (RCTs) on prevalent sleep-wake disorders and sleep disturbances to determine if these studies targeted underserved populations or addressed contextual and cultural factors. The authors examined sociodemographic characteristics of behavioral RCTs that targeted underserved adults, identified types of cultural adaptations (surface-level or deep-level), and described intervention effectiveness on primary sleep outcomes. Overall out of 56 studies, 6.97% targeted underserved groups (veterans, women, racial/ethnic minorities, low socioeconomic status, disability status); and 64.9% made surface-level or deep-level cultural adaptations. Most cultural adaptions were made to behavioral therapies, and cognitive behavioral therapy for insomnia (CBT-I). Surface-level cultural adaptions made were mostly to the delivery modality and setting. Deep-level cultural adaptations to the content and core intervention components were the most typical. Intervention effectiveness varied by type of adapted intervention and the participant population. RCTs including adapted CBT-I interventions among participants showed consistent significant reductions in adverse sleep outcomes versus control.
AHRQ-funded; HS024274.
Citation: Alcántara C, Giorgio Cosenzo L, McCullough E .
Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: a systematic review of randomized controlled trials in the United States.
Sleep Med Rev 2021 Apr;56:101455. doi: 10.1016/j.smrv.2021.101455..
Keywords: Sleep Problems, Cultural Competence, Behavioral Health, Racial and Ethnic Minorities, Vulnerable Populations
Kirby JB, Berdahl TA, Stone RA
AHRQ Author: Kirby JB, Berdahl TA
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
Investigators sought to estimate racial/ethnic differences in perceptions of provider communication among the six largest Asian subgroups. Using MEPS data, they found that negative views of provider communication are not pervasive among all Asians but, rather, primarily reflect the perceptions of Chinese and, possibly, Vietnamese patients. They recommended that researchers, policymakers, health plan executives, and others who produce or use data on patients' experiences with health care avoid categorizing all Asians into a single group.
AHRQ-authored.
Citation: Kirby JB, Berdahl TA, Stone RA .
Perceptions of patient-provider communication across the six largest Asian subgroups in the USA.
J Gen Intern Med 2021 Apr;36(4):888-93. doi: 10.1007/s11606-020-06391-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Clinician-Patient Communication, Communication, Patient Experience, Racial and Ethnic Minorities, Cultural Competence
Costello WG, Zhang L, Schnipper J
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
This study compared post-discharge adverse events (AEs) among African American and Caucasian patients at an urban community hospital. This prospective cohort study was conducted from December 2011 to October 2012. The cohort included 589 English-speaking patients who were discharged home and could be contacted after discharge for evaluation. Two nurses performed 30-day post-discharge telephone interviews, and two physicians reviewed health records to determine AEs using a previous methodology. African Americans had a slightly higher incidence of post-discharge AEs than Caucasian patients (30.6 vs. 29.9%) but it was not statistically significant.
AHRQ-funded; HS018694.
Citation: Costello WG, Zhang L, Schnipper J .
Post-discharge adverse events among African American and Caucasian patients of an urban community hospital.
J Racial Ethn Health Disparities 2021 Apr;8(2):439-47. doi: 10.1007/s40615-020-00800-z..
Keywords: Adverse Events, Racial and Ethnic Minorities, Urban Health, Disparities, Hospital Discharge