National Healthcare Quality and Disparities Report
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- Adverse Events (1)
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- Comparative Effectiveness (1)
- Decision Making (1)
- Diabetes (11)
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- Elderly (2)
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- Home Healthcare (1)
- Hospital Discharge (1)
- Human Immunodeficiency Virus (HIV) (3)
- Implementation (2)
- Injuries and Wounds (1)
- Lifestyle Changes (3)
- Medication (4)
- Medication: Safety (1)
- Nutrition (1)
- Outcomes (1)
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- Quality of Life (1)
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- Risk (1)
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- Sickle Cell Disease (1)
- Skin Conditions (1)
- Surgery (1)
- Telehealth (6)
- Vulnerable Populations (1)
- Women (1)
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 26 Research Studies DisplayedFlynn G, Jia H, Reynolds NR
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
This paper outlines the protocol for the WiseApp randomized control trial. The WiseApp contains real-time medication monitoring linking an electronic pill bottle and fitness tracker to the app, helping persons living with HIV (PLWH) self-manage their medication adherence and improve their overall quality of life. The primary objective of the trial is to test the effect of the WiseApp's medication adherence features on antiretroviral adherence in underserved PLWH in New York City. The real-time monitoring of the WiseApp has the potential to help providers initiate interventions to help patients resume treatment before drug resistance begins.
AHRQ-funded; HS025071.
Citation: Flynn G, Jia H, Reynolds NR .
Protocol of the randomized control trial: the WiseApp trial for improving health outcomes in PLWH (WiseApp).
BMC Public Health 2020 Nov 25;20(1):1775. doi: 10.1186/s12889-020-09688-0..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Chronic Conditions, Care Management, Healthcare Delivery
Abramsohn E, DePumpo M, Boyd K
Implementation of community-based resource referrals for cardiovascular disease self-management.
Investigators described primary care practices' implementation of CommunityRx-H3. They found that practice facilitators were increasingly being utilized by primary care practices to support quality improvement interventions and could also play an important role in implementation science. Their study yielded insights to improve implementation of community resource referral solutions to support primary care cardiovascular disease prevention efforts.
AHRQ-funded; HS023921.
Citation: Abramsohn E, DePumpo M, Boyd K .
Implementation of community-based resource referrals for cardiovascular disease self-management.
Ann Fam Med 2020 Nov;18(6):486-95. doi: 10.1370/afm.2583..
Keywords: Cardiovascular Conditions, Patient Self-Management, Primary Care, Quality Improvement, Quality of Care, Implementation
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Makelarski JA, DePumpo M, Boyd K
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
The purpose of this study was to describe outcomes from implementation of a community resource referral system into small clinical practices to reduce cardiovascular disease risk. HealtheRx-H3, a printed list of resources for patients, was created. It was feasible to create practice-specific HealtheRx-H3s; however, systematic distribution of HealtheRx-H3s using digital electronic health record integration was found to be infeasible. Successful implementation of quality improvement strategies to systematize community resource referral solutions was feasible at small practices, but more research was recommended in order to understand what motivates small practices to participate in implementation of these solutions.
AHRQ-funded; HS023921.
Citation: Makelarski JA, DePumpo M, Boyd K .
Implementation of systematic community resource referrals at small primary care practices to promote cardiovascular disease self-management.
J Healthc Qual 2020 Sep/Oct;42(5):278-86. doi: 10.1097/jhq.0000000000000234..
Keywords: Cardiovascular Conditions, Risk, Community-Based Practice, Patient Self-Management, Education: Patient and Caregiver, Primary Care, Implementation, Lifestyle Changes
Despins LA, Wakefield BJ
Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: a qualitative study.
The purpose of this study was to describe individuals' with type 2 diabetes mellitus sense-making of blood glucose data and other influences impacting self-management behavior. One-on-one interviews with adults diagnosed with type 2 diabetes mellitus were used. Results showed that individuals used self-monitored glucose values and/or HbA1C values to evaluate glucose control. Recommendations included having nurses assess sense-making processes in self-management decisions and providing periodic refresher diabetes education for individuals with type 2 diabetes mellitus.
AHRQ-funded; HS022140.
Citation: Despins LA, Wakefield BJ .
Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: a qualitative study.
J Clin Nurs 2020 Jul;29(13-14):2572-88. doi: 10.1111/jocn.15280..
Keywords: Patient Self-Management, Diabetes, Chronic Conditions, Patient Adherence/Compliance, Decision Making
Alberts NM, Badawy SM, Hodges J
Development of the incharge health mobile app to improve adherence to hydroxyurea in patients with sickle cell disease: user-centered design approach.
This study looked at how use of a newly developed mobile app called InCharge Health can help sickle cell disease (SCD) patients adhere to their prescribed medication use of hydroxyurea. Four phases were used to develop the mobile app with substantial input from users and by mapping the Health Belief Model (HBM) as the framework that guided the choice for its components. More than half of the patients reported potentially low health literacy. Preferred patient app features included 7 key components: medication reminders and tracker, disease education, communication, personalization, motivation, support during pain episodes, and social support. This information was translated into features within the app.
AHRQ-funded; HS023011.
Citation: Alberts NM, Badawy SM, Hodges J .
Development of the incharge health mobile app to improve adherence to hydroxyurea in patients with sickle cell disease: user-centered design approach.
JMIR Mhealth Uhealth 2020 May 8;8(5):e14884. doi: 10.2196/14884..
Keywords: Sickle Cell Disease, Health Information Technology (HIT), Patient Adherence/Compliance, Patient Self-Management, Medication
Munson SA, Schroeder J, Karkar R SA, Schroeder J, Karkar R
The importance of starting with goals in N-of-1 studies.
N-of-1 tools offer the potential to support people in monitoring health and identifying individualized health management strategies. The authors argue that elicitation of individualized goals and customization of tracking to support those goals are a critical yet under-studied and under-supported aspect of self-tracking. In this paper, they reviewed examples of self-tracking from across a range of chronic conditions and self-tracking designs (e.g., self-monitoring, correlation analyses, self-experimentation).
AHRQ-funded; HS023654.
Citation: Munson SA, Schroeder J, Karkar R SA, Schroeder J, Karkar R .
The importance of starting with goals in N-of-1 studies.
Front Digit Health 2020 May;2:3. doi: 10.3389/fdgth.2020.00003..
Keywords: Chronic Conditions, Patient Self-Management, Care Management, Primary Care
Tung EL, Abramsohn EM, Boyd K
Impact of a low-intensity resource referral intervention on patients' knowledge, beliefs, and use of community resources: results from the CommunityRx trial.
Connecting patients to community-based resources is now a cornerstone of modern healthcare that supports self-management of health. The mechanisms that link resource information to behavior change, however, remain poorly understood. The objective of this study was to evaluate the impact of CommunityRx, an automated, low-intensity resource referral intervention, on patients' knowledge, beliefs, and use of community resources.
AHRQ-funded; HS023007.
Citation: Tung EL, Abramsohn EM, Boyd K .
Impact of a low-intensity resource referral intervention on patients' knowledge, beliefs, and use of community resources: results from the CommunityRx trial.
J Gen Intern Med 2020 Mar;35(3):815-23. doi: 10.1007/s11606-019-05530-5..
Keywords: Patient Self-Management, Medication, Patient-Centered Healthcare, Patient Self-Management
Giguere R, Lopez-Rios J, Frasca T
Use of HIV self-testing kits to screen clients among transgender female sex workers in New York and Puerto Rico.
This research focused on the use of HIV self-testing (HIVST) kits given to transgender female sex workers (TFSW) to screen sexual partners. Ten TFSWs were given ten HIVST kits each and they complete an online questionnaire 3 months later or underwent an interview. Eight of them reported using the test kit with potential clients or partners. The majority who were asked to test were clients (84%). Out of those 50 potential partners or clients, 34 out of 50 accepted and 16 refused. Participants felt empowered but the market cost of these kits is prohibitive and could only be implemented if the costs were lowered or subsidized.
AHRQ-funded; HS026383.
Citation: Giguere R, Lopez-Rios J, Frasca T .
Use of HIV self-testing kits to screen clients among transgender female sex workers in New York and Puerto Rico.
AIDS Behav 2020 Feb;24(2):506-15. doi: 10.1007/s10461-019-02730-2..
Keywords: Human Immunodeficiency Virus (HIV), Vulnerable Populations, Diagnostic Safety and Quality, Sexual Health, Patient Self-Management, Women
Barry-Menkhaus SA, Wagner DV, Riley AR
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
In this article, the authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions among youth with type 1 diabetes.
AHRQ-funded; HS022981.
Citation: Barry-Menkhaus SA, Wagner DV, Riley AR .
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
Curr Diab Rep 2020 Jan 30;20(1):3. doi: 10.1007/s11892-020-1290-7..
Keywords: Diabetes, Patient-Centered Healthcare, Patient Self-Management, Patient Adherence/Compliance, Care Management, Patient-Centered Outcomes Research, Healthcare Delivery, Children/Adolescents
Bilgrami Z, Abutaleb A, Chudy-Onwugaje K
Effect of TELEmedicine for inflammatory bowel disease on patient activation and self-efficacy.
This study examined the use of a web-based monitoring system called TELEmedicine to remotely monitor changes in patient activation and self-efficacy for inflammatory bowel disease (IBD) patients. This multicenter, randomized controlled trial enrolled 222 adults with IBD who had experienced an IBD flare within 2 years prior to the trial. Changes in self-efficacy were not significantly different between the two groups although patient activation scores were.
AHRQ-funded; HS018975.
Citation: Bilgrami Z, Abutaleb A, Chudy-Onwugaje K .
Effect of TELEmedicine for inflammatory bowel disease on patient activation and self-efficacy.
Dig Dis Sci 2020 Jan;65(1):96-103. doi: 10.1007/s10620-018-5433-5..
Keywords: Telehealth, Digestive Disease and Health, Patient Self-Management, Care Management, Health Information Technology (HIT), Patient and Family Engagement
Pembroke M, Nemeth LS
Instruments to evaluate self-management of radiation dermatitis in patients with breast cancer.
Radiation dermatitis (RD) is a side effect of radiation to the breast and chest wall. Healthcare providers routinely grade the severity of RD without assessing its impact on quality of life. This study investigates instruments to identify a patient's ability and confidence to self-manage RD. Findings showed that using a validated instrument to assess patients' needs and ability to self-manage RD will promote personalized care plans tailored to each patient. These findings can be used to implement a patient-reported outcome measure into clinical practice, to develop educational programs for RD management, and to create personalized care plans.
AHRQ-funded.
Citation: Pembroke M, Nemeth LS .
Instruments to evaluate self-management of radiation dermatitis in patients with breast cancer.
Oncol Nurs Forum 2020 Jan;47(1):101-11. doi: 10.1188/20.Onf.101-111..
Keywords: Patient Self-Management, Cancer: Breast Cancer, Cancer, Skin Conditions
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
Cognitive behavioral therapy (CBT)-based programs delivered by trained community members could improve functioning and pain in individuals who lack access to such programs. In this study, the investigators tested the effectiveness of a peer-delivered diabetes self-management program integrating CBT principles in improving physical activity, functional status, pain, quality of life (QOL), and health outcomes in individuals with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
Ann Fam Med 2020 Jan;18(1):15-23. doi: 10.1370/afm.2469..
Keywords: Diabetes, Chronic Conditions, Pain, Patient Self-Management, Quality of Life
Jolliff AF, Hoonakker P, Ponto K
The desktop, or the top of the desk? The relative usefulness of household features for personal health information management.
This study examined how members of the diabetic population use features of the home environment to support personal health information management (PHIM). Using a simulated home environment (VR CAVE), participants identified the most useful features for performing three examples of PHIM tasks. The computer was perceived as the most useful feature, but perceived usefulness varied based on the PHIM task performed and the rooms in which features appeared. A detailed study of the affordances of features may be needed to ease the burden of managing chronic illness, particularly diabetes mellitus, in the sociotechnical system of the home.
AHRQ-funded; HS022548.
Citation: Jolliff AF, Hoonakker P, Ponto K .
The desktop, or the top of the desk? The relative usefulness of household features for personal health information management.
Appl Ergon 2020 Jan;82:102912. doi: 10.1016/j.apergo.2019.102912..
Keywords: Diabetes, Chronic Conditions, 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