National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Anxiety (1)
- Asthma (2)
- Behavioral Health (5)
- Caregiving (1)
- Care Management (1)
- Case Study (2)
- (-) Children/Adolescents (22)
- Clinical Decision Support (CDS) (3)
- Clinician-Patient Communication (2)
- Community-Based Practice (1)
- Decision Making (2)
- Dental and Oral Health (1)
- Depression (2)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (2)
- Evidence-Based Practice (4)
- Guidelines (4)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (5)
- Health Services Research (HSR) (1)
- Implementation (2)
- Low-Income (1)
- Medication (2)
- Obesity (1)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Practice Patterns (4)
- Prevention (5)
- (-) Primary Care (22)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (2)
- Research Methodologies (1)
- Screening (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Substance Abuse (4)
- Tobacco Use (2)
- Tobacco Use: Smoking Cessation (2)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Vulnerable Populations (1)
- Young Adults (2)
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 DisplayedRadovic A, Odenthal K, Flores AT
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
Supporting Our Valued Adolescents (SOVA) is a web-based technology intervention designed to increase depression and anxiety treatment uptake by adolescents in the context of an anonymous peer community with an accompanying website for parents. With a goal of informing the design of a hybrid effectiveness-implementation randomized controlled trial, we conducted a pre-implementation study in two primary care practices to guide implementation strategy development. We conducted focus groups with primary care providers (PCPs) at three different timepoints with PCPs (14 total) from two community practices.
AHRQ-funded; HS022989.
Citation: Radovic A, Odenthal K, Flores AT .
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
J Clin Psychol Med Settings 2020 Dec;27(4):766-82. doi: 10.1007/s10880-019-09669-5.
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Keywords: Children/Adolescents, Depression, Anxiety, Behavioral Health, Primary Care, Health Information Technology (HIT), Implementation
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Mills J, Wonoprabowo L
AHRQ Author: Mills J
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
This case study concerns a 14-year-old patient who presents for a well-child visit. The patient eats a healthy diet, is part of a local soccer league, is an overall good student, and just started high school in the fall. The patient denies trying any illicit substances but reports trying to “get high” from cough syrup. Three questions are presented, and answers provided.
AHRQ-authored.
Citation: Mills J, Wonoprabowo L .
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
Am Fam Physician 2020 Oct 15;102(8):493-94..
Keywords: Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study, Guidelines, Evidence-Based Practice
Callejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Fan T, Smith HJ
AHRQ Author: Fan T
Primary care interventions for prevention and cessation of tobacco use in children and adolescents.
In this case study, three questions are posed concerning a 13-year-old girl presenting for a routine well-child visit who reports that she has never used tobacco products in any form.
AHRQ-authored.
Citation: Fan T, Smith HJ .
Primary care interventions for prevention and cessation of tobacco use in children and adolescents.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Case Study, Children/Adolescents, Tobacco Use: Smoking Cessation, Tobacco Use, Primary Care, Prevention, Substance Abuse
Riley AR, Walker BL, Hall TA
Development and initial validation of a measure of parents' preferences for behavioral counseling in primary care.
There is a significant need to understand the factors that contribute to parents' consumer preferences for behavioral health services in pediatric primary care; however, no validated measure of such preferences exists. In this article, the investigators discuss the development of the BIPS (Behavioral Information Preferences Scale), a measure of parents' preferences for delivery of behavioral guidance in pediatric primary care and assessed its psychometric properties.
AHRQ-funded; HS022981.
Citation: Riley AR, Walker BL, Hall TA .
Development and initial validation of a measure of parents' preferences for behavioral counseling in primary care.
Fam Syst Health 2020 Jun;38(2):139-50. doi: 10.1037/fsh0000481..
Keywords: Children/Adolescents, Behavioral Health, Primary Care, Caregiving
Fiori KP, Rehm CD, Sanderson D
Integrating social needs screening and community health workers in primary care: the community linkage to care program.
This study used logistic regression to identify factors associated with successful social service uptake in an urban pediatric practice. Out of 4948 households screened for social needs from December 2017 to November 2018, 20% self-reported at least one factor. Only 43% of the 287 households with unmet needs reported social service uptake. Greater than 4 outreach encounters were significantly associated with successful referrals. This study suggests the need for additional research and an opportunity for further program optimization.
AHRQ-funded; HS026396.
Citation: Fiori KP, Rehm CD, Sanderson D .
Integrating social needs screening and community health workers in primary care: the community linkage to care program.
Clin Pediatr 2020 Jun;59(6):547-56. doi: 10.1177/0009922820908589..
Keywords: Children/Adolescents, Community-Based Practice, Primary Care, Social Determinants of Health, Implementation, Low-Income
Fishbein AB, Hamideh N, Lor J
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
The authors characterized primary care providers' (PCPs) practice patterns for atopic dermatitis (AD) in children under 2 years of age and determined the need for AD guidelines for PCPs focused on this age group. They found that PCP management of AD in children under 2 years of age is different from that of older children, with possible underuse of medium/high-potency topical corticosteroids. They recommended clear guidelines for this age group.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Hamideh N, Lor J .
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
J Pediatr 2020 Jun;221:138-44.e3. doi: 10.1016/j.jpeds.2020.02.015..
Keywords: Children/Adolescents, Skin Conditions, Provider: Physician, Practice Patterns, Primary Care, Medication, Care Management
Luk JW, Parker EO, Richardson LP
Sexual attraction and experiences in the primary care setting: examining disparities in satisfaction with provider and health self-efficacy.
This study examines whether sexual minority adolescents report lower satisfaction with primary care providers and lower health self-efficacy compared to heterosexual males and females. Data from 535 adolescents who participated in one of two randomized clinical trials were analyzed. Both sets of adolescents reported high satisfaction with providers. Relative to heterosexual males, sexual minority males reported lower self-efficacy in reaching health goals. Sexual minority females reported lower confidence in positively impacting their own health and lower self-efficacy in setting health goals compared to heterosexual females.
AHRQ-funded; HS023383.
Citation: Luk JW, Parker EO, Richardson LP .
Sexual attraction and experiences in the primary care setting: examining disparities in satisfaction with provider and health self-efficacy.
J Adolesc 2020 Jun;81:96-100. doi: 10.1016/j.adolescence.2020.04.009..
Keywords: Children/Adolescents, Patient Experience, Primary Care, Clinician-Patient Communication, Vulnerable Populations, Disparities
O'Connor E, Thomas R, Senger CA
Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors reviewed the benefits and harms of interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults to inform the US Preventive Services Task Force. They found that the evidence for behavioral counseling interventions to prevent initiation of illicit and nonmedical drug use among adolescents and young adults was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use. Health, social, and legal outcomes were sparsely reported, and few showed improvements.
AHRQ-funded; 2902015000017I.
Citation: O'Connor E, Thomas R, Senger CA .
Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 May 26;323(20):2067-79. doi: 10.1001/jama.2020.1432..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, Guidelines, Evidence-Based Practice
Kuhns LM, Carlino B, Greeley K
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
This study looked at rates of substance use screening and related documentation among adolescents aged 12-17 in outpatient pediatric clinics in a large academic medical center. The authors abstracted a random sample of 127 records and coded clinical notes to describe screening cases and related characteristics. They then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and identify related factors. Rates of screening by providers was 72% for each common substance and a total of 6% of patients reported substance use during screening.
AHRQ-funded; HS026385.
Citation: Kuhns LM, Carlino B, Greeley K .
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
Subst Abuse Treat Prev Policy 2020 May 25;15(1):36. doi: 10.1186/s13011-020-00276-4..
Keywords: Children/Adolescents, Substance Abuse, Screening, Ambulatory Care and Surgery, Alcohol Use, Practice Patterns, Primary Care
Kovalerchik O, Powers E, Holland ML
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
The purpose of this retrospective study was to examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. The authors concluded that the children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations.
AHRQ-funded; HS024332.
Citation: Kovalerchik O, Powers E, Holland ML .
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
Acad Pediatr 2020 May-Jun;20(4):532-39. doi: 10.1016/j.acap.2019.12.011..
Keywords: Children/Adolescents, Primary Care, Emergency Department, Obesity, Healthcare Utilization
Selph S, Patnode C, Bailey SR
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
Interventions to discourage the use of tobacco products (including electronic nicotine delivery systems or e-cigarettes) among children and adolescents may help decrease tobacco-related illness and injury. The objective of this study was to update the 2013 review on primary care-relevant interventions for tobacco use prevention and cessation in children and adolescents to inform the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation: Selph S, Patnode C, Bailey SR .
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 28;323(16):1599-608. doi: 10.1001/jama.2020.3332..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Prevention, Primary Care, Evidence-Based Practice, Guidelines
Peterson EL, Ndumele CD, Busch SH
National referral and treatment patterns among mental health pediatric primary care visits.
The current study explored factors that predict referral from pediatric primary care to mental health specialty care among a nationally representative sample of visits. Results indicated that patient visits that included rarer/serious diagnoses (e.g., bipolar disorder) were more likely to receive a referral in comparison to those with ADHD.
AHRQ-funded; HS017589.
Citation: Peterson EL, Ndumele CD, Busch SH .
National referral and treatment patterns among mental health pediatric primary care visits.
Adm Policy Ment Health 2020 Jan;47(1):86-93. doi: 10.1007/s10488-019-00972-9..
Keywords: Children/Adolescents, Behavioral Health, Primary Care, Practice Patterns
Stafford AM, Garbuz T, Etter DJ
The natural course of adolescent depression treatment in the primary care setting.
Little is known about how adolescents receive depression follow-up in primary care. The purpose of this study was to describe the rates of symptom assessment and depression treatment over time in a group of adolescents screening positive for moderate or severe depression in the primary care setting. Retrospective chart reviews were conducted to gather information related to symptom reassessments, antidepressant prescriptions, psychotherapy referrals, and treatment discontinuation.
AHRQ-funded; HS022681.
Citation: Stafford AM, Garbuz T, Etter DJ .
The natural course of adolescent depression treatment in the primary care setting.
J Pediatr Health Care 2020 Jan-Feb;34(1):38-46. doi: 10.1016/j.pedhc.2019.07.002..
Keywords: Children/Adolescents, Depression, Behavioral Health, Primary Care
Fierro JL, Prasad PA, Localio AR
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
The researchers compared practice patterns regarding the diagnosis and management of streptococcal pharyngitis across 25 pediatric primary care practices sharing an electronic health record. They found that only 18 of 222 clinicians wrote 50 percent of all broad-spectrum antibiotic prescriptions for children with group a streptococcus pharyngitis. They suggested targeted interventions to improve adherence to prescribing guidelines.
AHRQ-funded; 290200710013
Citation: Fierro JL, Prasad PA, Localio AR .
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S79-85. doi: 10.1086/677820..
Keywords: Antibiotics, Children/Adolescents, Diagnostic Safety and Quality, Primary Care, Practice Patterns
Adams WG, Phillips BD, Bacic JD
Automated conversation system before pediatric primary care visits: a randomized trial.
The purpose of this study was to determine whether use of an interactive voice response system, the Personal Health Partner (PHP), before routine health care maintenance visits could improve the quality of primary care visits and be well accepted by parents and clinicians. It found that the PHP was able to identify and counsel in multiple areas. All clinicians reported that PHP improved the quality of their care.
AHRQ-funded; HS017248
Citation: Adams WG, Phillips BD, Bacic JD .
Automated conversation system before pediatric primary care visits: a randomized trial.
Pediatrics. 2014 Sep;134(3):e691-9. doi: 10.1542/peds.2013-3759..
Keywords: Primary Care, Quality of Care, Children/Adolescents, Health Information Technology (HIT)
Carroll AE, Bauer NS, Dugan TM
Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial.
A study to determine whether a computerized clinical decision support system is an effective approach to improve standardized developmental surveillance and screening (DSS) within primary care practices found that use of such a system significantly increased the number of children screened at 9, 18, and 30 months of age. It also increased the number of children who ultimately were diagnosed as having a developmental delay.
AHRQ-funded; HS017939
Citation: Carroll AE, Bauer NS, Dugan TM .
Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial.
JAMA Pediatr. 2014 Sep;168(9):815-21. doi: 10.1001/jamapediatrics.2014.464..
Keywords: Health Information Technology (HIT), Clinical Decision Support (CDS), Primary Care, Children/Adolescents
Gillette C, Blalock SJ, Rao JK
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
The objectives of the study were to: (1) describe the extent to which primary care pediatric providers discuss risks associated with asthma control medications with families and (2) examine the relationship between child, caregiver, provider, and clinic visit characteristics and discussions about risks associated with asthma control medications. It found that providers discussed asthma control medication risks during 23% of visits.
AHRQ-funded; HS020534.
Citation: Gillette C, Blalock SJ, Rao JK .
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.
Pediatr Pulmonol 2014 Aug;49(8):727-33. doi: 10.1002/ppul.22892..
Keywords: Medication, Asthma, Children/Adolescents, Clinician-Patient Communication, Primary Care
Kranz AM, Rozier RG, Preisser JS
Preventive services by medical and dental providers and treatment outcomes.
The researchers compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. They concluded that, due to children's increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Preventive services by medical and dental providers and treatment outcomes.
J Dent Res 2014 Jul;93(7):633-8. doi: 10.1177/0022034514536731.
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Keywords: Children/Adolescents, Dental and Oral Health, Patient-Centered Outcomes Research, Prevention, Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care