Search All Research Studies
AHRQ Research Studies Date
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 41 Research Studies Displayed
Fisher KA, Bloomstone SJ, Walder J
Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults.
The authors assessed the intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identified predictors of and reasons for vaccine hesitancy. They found that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. They recommended targeted and multipronged efforts to increase acceptance of a COVID-19 vaccine.
Citation: Fisher KA, Bloomstone SJ, Walder J . Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults. Ann Intern Med 2020 Dec 15;173(12):964-73. doi: 10.7326/m20-3569..
Keywords: COVID-19, Vaccination, Public Health, Patient Adherence/Compliance
Byrnes ME, Varlamos CJ, Rivard SJ
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
This viewpoint article reflects the narratives of 58 colorectal surgeons who engaged in an in-depth qualitative interview during the COVID-19 shutdown of elective surgeries. The goal for reporting these findings is to offer a snapshot of surgeon perspectives on the delays of elective surgeries and to give voice to surgeons who were unable to perform most or all their duties as a surgeon.
AHRQ-funded; HS025365; HS000053.
Citation: Byrnes ME, Varlamos CJ, Rivard SJ . "You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19. Dis Colon Rectum 2020 Dec;63(12):1575-78. doi: 10.1097/dcr.0000000000001818..
Keywords: Surgery, Provider: Physician, Provider, COVID-19, Public Health, Infectious Diseases
Temkin-Greener H, Guo W, Mao Y
COVID-19 pandemic in assisted living communities: results from seven states.
The purpose of this observational study was to describe variations in COVID-19 confirmed cases and deaths among assisted living (AL) residents and examine their associations with key AL characteristics. The investigators concluded that ALs with a higher proportion of minorities had more COVID-19 cases. Many of the previously identified individual risk factors were also present in this vulnerable population.
AHRQ-funded; HS024923; HS026893; HS026893.
Citation: Temkin-Greener H, Guo W, Mao Y . COVID-19 pandemic in assisted living communities: results from seven states. J Am Geriatr Soc 2020 Dec;68(12):2727-34. doi: 10.1111/jgs.16850..
Keywords: Elderly, Public Health, COVID-19, Nursing Homes, Vulnerable Populations, Risk
Sonik RA, Coleman-Jensen A, Parish SL
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
The purpose of this study was to compare exposure to household food insufficiency and the relationship between household food insufficiency and both health status and emergency healthcare utilization among children with and without special healthcare needs (SHCN). The investigators concluded that compared with other children, children with SHCN have an elevated risk of exposure to household food insufficiency and experiencing greater reductions in health status when exposed.
Citation: Sonik RA, Coleman-Jensen A, Parish SL . Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs. Public Health Nutr 2020 Dec;23(17):3204-10. doi: 10.1017/s1368980020000361..
Keywords: Children/Adolescents, Nutrition, Health Status, Emergency Department, Public Health
Barry CL, Han H, Presskreischer R
Public support for social safety-net policies for COVID-19 in the United States, April 2020.
Researchers examined public support for health insurance, income support, and unemployment policies during the initial phase of disease transmission and economic distress following the COVID-19 outbreak and assessed varying public support based on beliefs about the role of government. They fielded a nationally representative survey of US adults from April 7-13, 2020. Their results indicate that, during the initial phase of the COVID-19 pandemic in early April 2020, most US adults favored a range of safety-net policies to ameliorate its negative health and economic consequences, with public support being the highest among those favoring a stronger governmental role in society.
Citation: Barry CL, Han H, Presskreischer R . Public support for social safety-net policies for COVID-19 in the United States, April 2020. Am J Public Health 2020 Dec;110(12):1811-13. doi: 10.2105/ajph.2020.305919..
Keywords: Public Health, Policy, COVID-19
Kang M, Gurbani SS, Kempker JA
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
This article describes a PubMed search done on the published scientific literature on COVID-19 from first reporting of the virus in late December 2019 through Nov. 9, 2020. A total of 57,263 articles were included, with 34% ahead of print, 25.1% e-published, and 40.9% print published at the time of data extraction. There was a peak of 2277 articles the week of May 11. The origin countries of publication were United States (35.7%), followed by England (27%), and the Netherlands (8.7%). Most publications (98%) were in English followed by less than 1% each in Spanish, German, and French.
Citation: Kang M, Gurbani SS, Kempker JA . The published scientific literature on COVID-19: an analysis of PubMed abstracts. J Med Syst 2020 Nov 25;45(1):3. doi: 10.1007/s10916-020-01678-4..
Keywords: COVID-19, Public Health, Research Methodologies, Health Services Research (HSR)
Selden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
Citation: Selden TM, Berdahl TA, Fang Z . The risk of severe COVID-19 within households of school employees and school-age children. Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
Fan T, Palma M
AHRQ Author: Fan T
Behavioral counseling interventions to prevent sexually transmitted infections.
This case study of a 24-year-old cisgender woman presents three questions with answers concerning USPSTF recommendations about sexually transmitted infections and counseling.
Citation: Fan T, Palma M . Behavioral counseling interventions to prevent sexually transmitted infections. Am Fam Physician 2020 Nov 15;102(10):623-24..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Public Health, Prevention, Case Study, Guidelines
Misra-Hebert AD, Ji X, Nowacki AS
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
Researchers assessed healthcare workers (HCW) risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. Participants were individuals who had tested for SARS-CoV-2 infection in a large academic healthcare system. The study found that, in a large healthcare system, HCW had similar odds for testing positive, but lower odds of hospitalization, compared to non-HCW. Patient-facing HCW had higher odds of a positive test.
Citation: Misra-Hebert AD, Ji X, Nowacki AS . Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system. J Gen Intern Med 2020 Nov;35(11):3293-301. doi: 10.1007/s11606-020-06171-9..
Keywords: COVID-19, Risk, Provider: Health Personnel, Public Health, Healthcare Delivery, Infectious Diseases
Chou R, Dana T, Jungbauer R
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
This study examined the effectiveness of N95, surgical, and cloth masks in community and health care settings for preventing respiratory virus infections, including coronavirus. The effects of reuse or extended use of N95 masks was also studied. The authors used multiple electronic databases, including the World Health Organization COVID-19 database and medRxiv preprint server (2003 through 2020), and reference lists. Randomized trials of masks and risks for respiratory virus infection were included. The studies were abstracted and methodological limitations were assessed by one reviewer, with a second reviewer providing verification. Thirty-nine studies with 33,867 participants were included. No studies were found that evaluated reuse or extended use of N95 masks. The studies showed that COVID-19 and MERS probably decreased with use versus nonuse and possibly decreased with N95 versus surgical mask use. Random trials in community settings found not much difference between N95 versus surgical masks. The studies’ findings were not definitive.
Citation: Chou R, Dana T, Jungbauer R . Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review. Ann Intern Med 2020 Oct 6;173(7):542-55. doi: 10.7326/m20-3213..
Keywords: COVID-19, Respiratory Conditions, Infectious Diseases, Prevention, Public Health, Evidence-Based Practice
Bartsch SM, O'Shea KJ, Ferguson MC
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
This study examined the needed efficacy and coverage of a COVID-19 vaccine to prevent or stop the pandemic. Simulation experiments were conducted at 60-80% efficacy rates. At 60% efficacy, vaccination coverage needs to be 100%. If the coverage rate is reduced to 75%, the efficacy needs to be 70% and up to 80% when coverage drops to 60%. These findings show that the vaccine needs to have at least an efficacy rate of 70% to prevent an epidemic and at least 80% to extinguish an epidemic without any other measures such as social distancing.
Citation: Bartsch SM, O'Shea KJ, Ferguson MC . Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention. Am J Prev Med 2020 Oct;59(4):493-503. doi: 10.1016/j.amepre.2020.06.011..
Keywords: Vaccination, COVID-19, Public Health, Prevention, Evidence-Based Practice, Infectious Diseases
White EM, Kosar CM, Feifer RA
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
The objective of this study was to identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). The investigators concluded that larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence were at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.
Citation: White EM, Kosar CM, Feifer RA . Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities. J Am Geriatr Soc 2020 Oct;68(10):2167-73. doi: 10.1111/jgs.16752..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Public Health, Infectious Diseases
Auger KA, Shah SS, Richardson T
Association between statewide school closure and COVID-19 incidence and mortality in the US.
This study examined whether school closures between March and May due to the beginning of the COVID-19 pandemic was associated with decreased COVID-19 incidence and mortality. States were examined in quartiles using the number of cases per 100,000 population. States with the lowest cumulative incidence had the most significant decline (-72%) in cases compared to states with the highest incidence (-49%). States that closed schools earlier had the largest reduction in incidence and mortality.
AHRQ-funded; HS024735, HS026763, HS025138.
Citation: Auger KA, Shah SS, Richardson T . Association between statewide school closure and COVID-19 incidence and mortality in the US. JAMA 2020 Sep;324(9):859-70. doi: 10.1001/jama.2020.14348..
Keywords: COVID-19, Public Health, Children/Adolescents, Policy, Mortality
Buxbaum JD, Chernew ME, Fendrick AM
Contributions of public health, pharmaceuticals, and other medical care to US life expectancy changes, 1990-2015.
This study examined the contributions of public health, pharmaceuticals, and other medical care to increases in US life expectancy by 3.3 years from 1990 to 2015. Vital statistics data and cause-deletion analysis was used to identify the conditions most responsible. They found that 12 conditions most responsible for changing life expectance explained 2.9 years of net improvement. Ischemic heart disease prevention was the largest positive contributor to life expectancy, with accidental poisoning or drug overdose the largest negative contributor. Life expectancy improvement was attributed to public health 45%, 35% to pharmaceuticals, 13% to other medical care, and -7% was attributable to other/unknown factors.
Citation: Buxbaum JD, Chernew ME, Fendrick AM . Contributions of public health, pharmaceuticals, and other medical care to US life expectancy changes, 1990-2015. Health Aff 2020 Sep;39(9):1546-56. doi: 10.1377/hlthaff.2020.00284..
Keywords: Public Health, Medication, Mortality
Rhee C, Baker M, Vaidya V
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
Some patients are avoiding essential care for fear of contracting coronavirus disease 2019 (COVID-19) in hospitals. The purpose of this study was to assess the incidence of COVID-19 among patients hospitalized at a large US academic medical center in the 12 weeks after the first inpatient case was identified. The investigators concluded that in this cohort study of patients in a large academic medical center with rigorous infection control measures, nosocomial COVID-19 was rare during the height of the pandemic in the region.
AHRQ-funded; K08 HS025008.
Citation: Rhee C, Baker M, Vaidya V . Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center. JAMA Netw Open 2020 Sep;3(9):e2020498. doi: 10.1001/jamanetworkopen.2020.20498..
Keywords: COVID-19, Hospitalization, Hospitals, Public Health
Pantell MS, Shields-Zeeman L
Maintaining social connections in the setting of COVID-19 social distancing: a call to action.
The COVID-19 pandemic is an unprecedented public health crisis, with substantial health, social, and economic implications. The devastating direct medical consequences of COVID-19 have been accompanied by far reaching economic and social consequences, including increased risk of social isolation and loneliness. The authors discuss the need to remember that “social distancing” should refer to physical distancing and isolation, but not social isolation as changes to social routines impact the country.
Citation: Pantell MS, Shields-Zeeman L . Maintaining social connections in the setting of COVID-19 social distancing: a call to action. Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: COVID-19, Public Health
Bettencourt AP, Vance AJ, Jun J
Maximizing the academic nursing model in the era of COVID-19 and beyond.
This opinion paper revisits the 2016 American Association of Colleges of Nursing (AACN) position statement on academic nursing. In the age of COVID-19, the statement is reimagined as a means to maximize nursing’s contributions to this global health crises. The 2016 position statement discussed the potentials for nursing schools to work within healthcare systems beyond clinic training. Most academic nurses do not also provide clinical care which is limited by structural barriers that inhibit academic nursing transformation. Many academic nurses who also have a clinical practice have had to do so on their own time. This new vision would capitalize on nursing’s strength in population health. The authors urge nursing schools to transform their model of academic nursing.
Citation: Bettencourt AP, Vance AJ, Jun J . Maximizing the academic nursing model in the era of COVID-19 and beyond. Nurs Outlook 2020 Sep-Oct;68(5):542-44. doi: 10.1016/j.outlook.2020.04.013..
Keywords: COVID-19, Nursing, Provider: Nurse, Public Health, Education: Academic
Bartsch SM, Mitgang EA, Geller G
What if the influenza vaccine did not offer such variable protection?
This study looked at the impact of reducing the variability in responses to the influenza vaccine across the population. Protection from the vaccine can vary significantly from person to person due to differences in immune systems, body types, and other factors. The authors compared the projected cases, direct medical costs, and productivity losses at the 30%, 50%, and 70% efficacy rates.
Citation: Bartsch SM, Mitgang EA, Geller G . What if the influenza vaccine did not offer such variable protection? J Infect Dis 2020 Sep 1;222(7):1138-44. doi: 10.1093/infdis/jiaa240..
Keywords: Influenza, Vaccination, Respiratory Conditions, Public Health
Steele MK, Wikswo ME, Hall AJ
Characterizing norovirus transmission from outbreak data, United States.
Norovirus is the leading cause of acute gastroenteritis outbreaks in the United States. In this study, the investigators estimated the basic (R(0)) and effective (R(e)) reproduction numbers for 7,094 norovirus outbreaks reported to the National Outbreak Reporting System (NORS) during 2009-2017 and used regression models to assess whether transmission varied by outbreak setting.
Citation: Steele MK, Wikswo ME, Hall AJ . Characterizing norovirus transmission from outbreak data, United States. Emerg Infect Dis 2020 Aug;26(8):1818-25. doi: 10.3201/eid2608.191537..
Keywords: Infectious Diseases, Public Health, Digestive Disease and Health
Auerbach A, O'Leary KJ, Greysen SR
Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers.
The authors sought to characterize inpatient adaptations to care for non-ICU COVID-19 patients. They found that the COVID-19 pandemic has required medical wards to rapidly adapt with expanding use of respiratory isolation units and use of technology emerging as critical approaches. Reports of unrecognized or delayed diagnoses highlight how such adaptations may produce potential adverse effects on care.
AHRQ-funded; HS026383; HS026215; HS027369.
Citation: Auerbach A, O'Leary KJ, Greysen SR . Hospital ward adaptation during the COVID-19 pandemic: a national survey of academic medical centers. J Hosp Med 2020 Aug;15(8):483-88. doi: 10.12788/jhm.3476..
Keywords: COVID-19, Emergency Preparedness, Hospitals, Public Health, Healthcare Delivery, Inpatient Care
Khazanie P, Wynia MK, Dickert NW. P, Wynia MK, Dickert NW
Forced choices: ethical challenges in cardiology during the COVID-19 pandemic.
This article discusses the ethical dilemmas that cardiologists may face with cardiac patients due to the COVID-19 pandemic. The influx of patients threatens to exhaust resources in many hospitals and creates many challenges. These include determining the urgency of subacute and chronic cardiovascular diseases. Another challenge is critical care triage in cardiac patients. Protocols were developed during the 2009 H1N1 pandemic which are now adapted for the COVID-19 pandemic. The largest challenge has been interacting with patients and their families. A cardiac patient may not be able to go to an intensive care unit due to severe scarcity of beds and to minimize risks to them and the medical staff.
AHRQ-funded; R01 HS026081.
Citation: Khazanie P, Wynia MK, Dickert NW. P, Wynia MK, Dickert NW . Forced choices: ethical challenges in cardiology during the COVID-19 pandemic. Circulation 2020 Jul 21;142(3):194-96. doi: 10.1161/circulationaha.120.047681..
Keywords: COVID-19, Cardiovascular Conditions, Heart Disease and Health, Public Health, Healthcare Delivery
Vyles D, Antoon JW, Norton A
Children with reported penicillin allergy: public health impact and safety of delabeling.
The objectives of this study were to: 1.) Review the relevant literature related to children with reported penicillin allergy 2.) Highlight the different ways in which children could be delabeled and 3.) Evaluate the public health impact that a penicillin allergy has for children. The investigators concluded that penicillin allergy was overdiagnosed, often incorrectly, and the label was frequently first applied during childhood.
Citation: Vyles D, Antoon JW, Norton A . Children with reported penicillin allergy: public health impact and safety of delabeling. Ann Allergy Asthma Immunol 2020 Jun;124(6):558-65. doi: 10.1016/j.anai.2020.03.012..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Public Health
Cho HJ, Feldman LS, Keller S
Choosing Wisely in the COVID-19 era: preventing harm to healthcare workers.
This paper highlights the 5 top recommendations developed for hospitals in the COVID-19 era as part of the Choosing Wisely® campaign. This top 5 list of overuse practices in hospital medicine can lead to harm of both patients and healthcare workers. The recommendations include: 1) Do not obtain nonurgent labs in separate blood draws if they can be batched together; 2) Do not use bronchodilators unless there is active obstructive airway disease; 3) Do not use posteroanterior and lateral chest X-ray (CXR) as initial imaging, use a portable CXR instead; 4) Avoid in-person evaluations in favor of virtual communication unless necessary; and 5) Do not delay goals of care conversations for hospitalized patients who are unlikely to benefit from life-sustaining treatments.
Citation: Cho HJ, Feldman LS, Keller S . Choosing Wisely in the COVID-19 era: preventing harm to healthcare workers. J Hosp Med 2020 Jun;15(6):360-62. doi: 10.12788/jhm.3457..
Keywords: COVID-19, Infectious Diseases, Hospitals, Prevention, Public Health, Provider: Health Personnel
Abrams EM, Greenhawt M
Risk communication during COVID-19.
This article focuses on ways the healthcare community can best communicate risk of COVID-19 to the public. Poor risk communication results in hoarding behavior which can lead to lack of medications and personal protective equipment. Utilizing social media channels to ensure an ongoing consistent media presence is one potential way to ensure appropriate risk communication. Including all stakeholders in broader public health messaging is also important.
Citation: Abrams EM, Greenhawt M . Risk communication during COVID-19. J Allergy Clin Immunol Pract 2020 Jun;8(6):1791-94. doi: 10.1016/j.jaip.2020.04.012..
Keywords: COVID-19, Communication, Risk, Public Health, Emergency Preparedness
Baker AW, Nehls N, Ilies I
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks.
This study analyzed the use of optimized dual statistical process control (SPC) charts to predict surgical site infection (SSI) outbreaks. The researchers retrospectively applied an optimized pair of moving average (MA) SPC charts to all 30 SSI outbreaks previously identified and investigated from 2007 to 2015 in the Duke Infection Control Outreach Network (DICON), which is a network of more than 50 community hospitals. The dual MA SPC chart approach detected all 30 outbreaks at a median of 16 months prior to traditional surveillance detection.
Citation: Baker AW, Nehls N, Ilies I . Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks. BMJ Qual Saf 2020 Jun;29(6):517-20. doi: 10.1136/bmjqs-2019-010586..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Hospitals, Public Health, Infectious Diseases