National Healthcare Quality and Disparities Report
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Topics
- Access to Care (3)
- Adverse Events (1)
- Alcohol Use (1)
- Ambulatory Care and Surgery (2)
- Anxiety (1)
- Asthma (2)
- Autism (1)
- Behavioral Health (8)
- Caregiving (4)
- Care Management (1)
- Case Study (2)
- (-) Children/Adolescents (32)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (3)
- Communication (1)
- Community-Based Practice (2)
- Depression (3)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Education: Patient and Caregiver (2)
- Emergency Department (2)
- Evidence-Based Practice (4)
- Guidelines (4)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (2)
- Healthcare Delivery (6)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (3)
- Health Services Research (HSR) (4)
- Implementation (3)
- Infectious Diseases (1)
- Influenza (1)
- Low-Income (2)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (1)
- Obesity (2)
- Obesity: Weight Management (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (2)
- Patient Experience (1)
- Policy (1)
- Practice Patterns (3)
- Prevention (6)
- (-) Primary Care (32)
- Primary Care: Models of Care (4)
- Provider: Physician (1)
- Quality Improvement (2)
- Quality of Care (3)
- Research Methodologies (2)
- Respiratory Conditions (1)
- Screening (4)
- Shared Decision Making (2)
- Skin Conditions (1)
- Social Determinants of Health (2)
- Substance Abuse (4)
- Telehealth (1)
- Tobacco Use (2)
- Tobacco Use: Smoking Cessation (2)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Urban Health (1)
- Vulnerable Populations (1)
- Web-Based (1)
- Workflow (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 25 of 32 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
Downs SM, Bauer NS, Saha C
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
This study examined outcomes for implementation of a decision support system called CHICA (Child Health Improvement Through Computer Automation) to improve screening rates for autism in children aged 18 to 24 months. A random sample of 274 children in four urban clinics was used. Two clinics participated in the intervention, and two served as controls. Because participating clinics requested intervention be discontinued for children aged 18 months, only results for those aged 24 months was analyzed. Of the 263 children with reviewed results, 92% were enrolled in Medicaid, 52.5% were African American, and 36.5% were Hispanic. Screening rates increased from 0% at baseline to 100% in 24 months during the study period of November 2010 to November 2012. Screening results were positive for 265 of 980 children screened by CHICA in the time period, with 2 children from the intervention group positively diagnosed in the time frame of the study.
AHRQ-funded; HS018453.
Citation: Downs SM, Bauer NS, Saha C .
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
JAMA Netw Open 2019 Dec 2;2(12):e1917676. doi: 10.1001/jamanetworkopen.2019.17676..
Keywords: Autism, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Primary Care, Children/Adolescents, Screening
Riley AR, Walker BL, Wilson AC
Parents' consumer preferences for early childhood behavioral intervention in primary care.
In this study, the investigators sought to better understand parents' preferences for the content and delivery method of behavioral health guidance in pediatric primary care and to determine the relationship of those preferences with demographic characteristics, child behavior problems, and parenting style. The investigators found that most parents were interested in behavioral guidance as part of primary care, but their preferences for the content and delivery of that guidance varied by known socioeconomic, child, and parenting risk factors.
AHRQ-funded; HS022981.
Citation: Riley AR, Walker BL, Wilson AC .
Parents' consumer preferences for early childhood behavioral intervention in primary care.
J Dev Behav Pediatr 2019 Dec;40(9):669-78. doi: 10.1097/dbp.0000000000000736..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Caregiving, Healthcare Delivery
Breitenstein SM, Laurent S, Pabalan L
Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.
The authors studied implementation of mobile delivery to deliver parent training in order to identify and address barriers and facilitators and inform sustainability efforts. They suggest that implementation fidelity may improve with additional education and training of the interdisciplinary team, clear messaging regarding the purpose and content of the program, defining roles within the care team, identifying practice champions, and use of the electronic health record. Findings from this evaluation, including data from the randomized controlled trial and literature to support intervention effectiveness and implementation, will be used to develop an implementation toolkit to include specific strategies for implementation and ideas for local adaptations.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Laurent S, Pabalan L .
Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.
Fam Syst Health 2019 Dec;37(4):282-90. doi: 10.1037/fsh0000447..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Children/Adolescents, Education: Patient and Caregiver
Drouin O, Sharifi M, Gerber M
Parents' willingness to pay for pediatric weight management programs.
This study examined parents’ interested in continuing and willingness to pay (WTP) for 2 pediatric weight management programs after their childrens’ participation. Participants were parents of 2- to 12-year-old children with a body mass index equal to or greater than the 85th percentile who participated in the Connect for Health trial. One group received enhanced primary care (EPC) and the other group EPC plus individualized coaching (EPC+C). After 1 year, they assessed parents’ self-reported WTP for a similar program and the maximum amount they would pay. Of 638 parents polled, 85% were interested in continuing and 38% of them were willing to pay. The median amount they were willing to pay was $25/month. Parents of Hispanic/Latino children versus white ethnicity and those reporting a higher satisfaction with the program more most likely to endorse WTP. Parents of children getting EPC+C were also more willing to pay.
AHRQ-funded; HS024332; HS022986.
Citation: Drouin O, Sharifi M, Gerber M .
Parents' willingness to pay for pediatric weight management programs.
Acad Pediatr 2019 Sep - Oct;19(7):764-72. doi: 10.1016/j.acap.2019.05.124..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Healthcare Costs, Caregiving, Primary Care, Primary Care: Models of Care
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Shared Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Feemster K, Localio R, Grundmeier R
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
The authors evaluated whether exposure to a pediatric clinic visit was associated with subsequent influenza-like illness (ILI) using electronic health record data. They found that pediatric clinic visits during a respiratory virus season were significantly associated with an increased incidence of subsequent ILI among children aged 2 to 6 years but not among those aged less than 2 years. They concluded that their findings support the hypothesis that respiratory virus transmission in a pediatric clinic can result in healthcare-associated ILI in young children.
AHRQ-funded; HS020939.
Citation: Feemster K, Localio R, Grundmeier R .
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
J Pediatric Infect Dis Soc 2019 Jul 1;8(3):191-96. doi: 10.1093/jpids/piy023..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Infectious Diseases, Influenza, Primary Care, Healthcare Delivery, Ambulatory Care and Surgery, Respiratory Conditions
Riley AR, Paternostro JK, Walker BL
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
This retrospective match-controlled study examined the impact of behavioral health consultations on medical visit duration in pediatric primary care. Patient encounters involving behavioral health consultants were significantly longer (11 plus minutes) than matched controls, and had less time allowed for medical care. The authors of the study recommend that behavioral health consultants work with the clinician to improve time efficiency.
AHRQ-funded; HS022981.
Citation: Riley AR, Paternostro JK, Walker BL .
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
Fam Syst Health 2019 Jun;37(2):162-66. doi: 10.1037/fsh0000406..
Keywords: Behavioral Health, Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care
Rinke ML, German M, Azera B
Effect of mental health screening and integrated mental health on adolescent depression-coded visits.
This article describes a retrospective primary care network natural cohort study to analyze how mental health screening and integrated mental health practitioners affect adolescent depression identification. The percentage of depression-coded adolescent visits were compared between practices with and without mental health screening and with and without integrated mental health practitioners, using difference-in-differences analyses. The authors conclude that adolescent mental health screening and integrated mental health practitioners increase depression-coded visits in primary care.
AHRQ-funded; HS0203608.
Citation: Rinke ML, German M, Azera B .
Effect of mental health screening and integrated mental health on adolescent depression-coded visits.
Clin Pediatr 2019 Apr;58(4):437-45. doi: 10.1177/0009922818821889..
Keywords: Children/Adolescents, Depression, Diagnostic Safety and Quality, Primary Care, Screening
Bundy DG, Singh H, Stein RE
The design and conduct of Project RedDE: a cluster-randomized trial to reduce diagnostic errors in pediatric primary care.
This paper discusses the results of Project RedDE, which was a virtual collaborative quality improvement study to reduce diagnostic errors in pediatric primary care practices. Forty-three practices were initially recruited, with a total of 31 practices left at the end due to practice dropout and two participating practices merging. This study was a randomized controlled trial targeting three common diagnostic errors (missed diagnoses of adolescent depression, abnormal blood pressure, and lack of followup for abnormal laboratory results). Contamination across study groups was a recurring problem, but risk mitigations were used. Electronic health records contributed to teams’ success.
AHRQ-funded; HS203608.
Citation: Bundy DG, Singh H, Stein RE .
The design and conduct of Project RedDE: a cluster-randomized trial to reduce diagnostic errors in pediatric primary care.
Clin Trials 2019 Apr;16(2):154-64. doi: 10.1177/1740774518820522..
Keywords: Adverse Events, Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Prevention, Primary Care, Quality of Care, Quality Improvement
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies