National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (4)
- Alcohol Use (1)
- Behavioral Health (5)
- (-) Children/Adolescents (21)
- Chronic Conditions (3)
- Clinician-Patient Communication (1)
- Disabilities (1)
- Disparities (5)
- Family Health and History (2)
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- Hospitalization (2)
- Human Immunodeficiency Virus (HIV) (1)
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- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Policy (3)
- Prevention (1)
- Primary Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (3)
- Respiratory Conditions (1)
- Rural Health (1)
- Screening (1)
- Social Determinants of Health (2)
- Stress (1)
- Substance Abuse (4)
- Uninsured (1)
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- (-) Vulnerable Populations (21)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedChambers EC, Heller C, Fiori K
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Findings showed that disparities in health conditions among youth in public housing were more common in early adolescence: asthma, obesity, depression/anxiety, and behavioral disorders. Chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing; however, this pattern is not consistent across all chronic conditions.
AHRQ-funded; HS026396.
Citation: Chambers EC, Heller C, Fiori K .
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
Glob Pediatr Health 2020 Nov 11;7:2333794x20971164. doi: 10.1177/2333794x20971164..
Keywords: Children/Adolescents, Vulnerable Populations, Chronic Conditions, Urban Health
Rosenberg J, Rosenthal MS, Cramer LD
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, the authors assessed access to MBH treatment using the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents.
AHRQ-funded; HS024332.
Citation: Rosenberg J, Rosenthal MS, Cramer LD .
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Acad Pediatr 2020 Nov-Dec;20(8):1148-56. doi: 10.1016/j.acap.2020.06.013..
Keywords: Children/Adolescents, Behavioral Health, Disparities, Racial and Ethnic Minorities, Vulnerable Populations, Access to Care
Dir AL, Clifton RL
Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth
This study examined court records of drug screens among youth to explore patterns of substance use as well as rates of court-ordered referral to substance use treatment and treatment completion. Of the studied youth with a positive oral drug screen, 96% tested positive for cannabis and 9.8% for opioids at least once; 48.5% were court-ordered to substance use treatment. Of those referred, 67% had history of completing at least one treatment episode. These results underscore the need to utilize objective measures as well as validated self-reports of substance use history in both research and justice system decision-making to aid in identifying youth in need of services.
AHRQ-funded; HS022681; HS023318.
Citation: Dir AL, Clifton RL .
Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth
J Subst Abuse Treat 2020 Nov;118:108095. doi: 10.1016/j.jsat.2020.108095..
Keywords: Children/Adolescents, Substance Abuse, Screening, Vulnerable Populations
Magee LA, Dir AL, Clifton RL
Patterns of adolescent gun carrying and gun-related crime arrests in Indianapolis, Indiana over an 11-year time period.
This study is a descriptive epidemiology analysis that examines patterns of gun carrying and gun-related crime arrests among justice-involved youth in Marion County, Indiana. Findings indicated that the proportions of juvenile arrests for both gun carrying and gun-related crime have substantially increased compared to ten years ago. The majority of gun-related repeat offenders were first arrested for gun carrying; thus, these gun-carrying arrests may be an opportunity to intervene on an individual level by providing treatment, other needed resources, and discussing safe firearm storage with families and communities.
AHRQ-funded; HS023318; HS022681.
Citation: Magee LA, Dir AL, Clifton RL .
Patterns of adolescent gun carrying and gun-related crime arrests in Indianapolis, Indiana over an 11-year time period.
Prev Med 2020 Oct;139:106199. doi: 10.1016/j.ypmed.2020.106199..
Keywords: Children/Adolescents, Vulnerable Populations, Prevention
Chaiyachati BH, Wood JN, Mitra N
All-cause mortality among children in the US foster care system, 2003-2016.
This letter provides data from a cross-sectional analysis of the Adoption and Foster Care Analysis and Reporting System on mortality rates among children in the US foster care system compared to the general population. The rate was found to be significantly higher for children in foster care (35.4 deaths per 100,000 person-years vs 25.0 for the general population). The highest mortality rates were among African-American children at 43.8 deaths per 100,000 person-years. Older children ages 15-18 had the highest mortality rate per years. Two major limitations of the analysis are that children in foster care are unable to be excluded from the Centers for Disease Control and Prevention data file, and more deaths in foster care were excluded relative to person-years in foster care because of incomplete demographic data.
AHRQ-funded; HS026372.
Citation: Chaiyachati BH, Wood JN, Mitra N .
All-cause mortality among children in the US foster care system, 2003-2016.
JAMA Pediatr 2020 Sep;174(9):896-98. doi: 10.1001/jamapediatrics.2020.0715..
Keywords: Children/Adolescents, Vulnerable Populations, Mortality
Wisk LE, Magane KM, Levy S
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, the investigators sought to identify clusters of RALD and test associations with use behaviors. The investigators concluded that for YCMC, RALD were complex but endorsement of multiple general and health-related RALD was associated with less use, and health concerns are especially prevalent.
AHRQ-funded; HS022986.
Citation: Wisk LE, Magane KM, Levy S .
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
J Addict Med 2020 Jul/Aug;14(4):311-18. doi: 10.1097/adm.0000000000000603..
Keywords: Children/Adolescents, Alcohol Use, Behavioral Health, Vulnerable Populations, Substance Abuse
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
Desai AD, Zhou C, Haaland W
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
This study examined associations between social disadvantage, access to care, and disparities in physical functioning among children hospitalized with acute respiratory illness. The study cohort included children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children’s hospitals for three common respiratory illnesses from July 2014 through June 2016. Surveys were completed within 2 to 8 weeks after discharge. The survey assessed social disadvantage, difficulty/delays accessing care, and baseline and follow-up health-related quality of life (HRQoL), and physical functioning using the Pediatric Quality of Life Inventory (PedsQL). A total of 1,325 patients and/or their caregivers completed both PedsQL surveys. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage (minority race/ethnicity, limited English proficiency, low education, and low income), than for patients with none. There were also disadvantage markers or difficulty/delays accessing care which were associated with lower physical functioning. However, these differences were reduced after hospital discharge.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Haaland W .
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
J Hosp Med 2020 Apr;15(4):211-18. doi: 10.12788/jhm.3359..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization, Access to Care, Disparities, Vulnerable Populations, Quality of Life
Mackie TI, Cook S, Crystal S
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
This study examined a multimodal antipsychotic intervention implemented by a specialized Medicaid managed care organization (MMCO) for youths in foster care with routine mental health screening, health passports, elective psychiatric consultation line, and retrospective drug utilization reviews to determine whether this multimodal intervention significantly reduced antipsychotic dispensing for youths with conditions without US Food and Drug Administration (FDA)-approved indications. Findings showed that MMCO implementation significantly reduced antipsychotic medications without FDA-indicated conditions prescribed to youths, while not significantly affecting antipsychotic medications prescribed to youths with FDA-indicated conditions.
AHRQ-funded; HS026001.
Citation: Mackie TI, Cook S, Crystal S .
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
J Am Acad Child Adolesc Psychiatry 2020 Jan;59(1):166-76.e3. doi: 10.1016/j.jaac.2019.04.022..
Keywords: Children/Adolescents, Behavioral Health, Medication, Vulnerable Populations, Medicaid, Health Insurance
Feinberg E, Stransky ML, Augustyn M
Effect of family navigation on participation in Part C early intervention.
This study investigated whether family navigation (FN) improved Part C Early Intervention (EI) initiation following positive primary care screening for autism compared to conventional care management (CCM). The authors conducted a randomized clinical trial among 339 families of children (ages 15-27 months) who screened as having an increased likelihood for autism at 11 urban primary care sites in 3 cities. Families were randomly assigned to FN or CCM. Families in the FN group received community-based outreach from a navigator trained to support families to overcome structural barriers to autism evaluation and services. The authors obtained EI service records from state or local agencies. The primary outcome of this study was measured as the number of days from randomization to the first EI appointment. They obtained service records for 271 children; 156 (57.6%) children were not engaged with EI at study enrollment. Children were followed for 100 days after diagnostic ascertainment or until age 3, when Part C EI eligibility ends. Families receiving FN were approximately 54% more likely to engage EI than those receiving CCM.
AHRQ-funded; HS022242.
Citation: Feinberg E, Stransky ML, Augustyn M .
Effect of family navigation on participation in Part C early intervention.
Acad Pediatr 2023 Jul; 23(5):904-12. doi: 10.1016/j.acap.2023.03.013..
Keywords: Children/Adolescents, Vulnerable Populations, Patient and Family Engagement
Zullo AR, Adams JW, Gantenberg JR
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. The investigators found that strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. They suggest that researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
AHRQ-funded; HS022998.
Citation: Zullo AR, Adams JW, Gantenberg JR .
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
Ann Epidemiol 2019 Nov;39:8-14.e4. doi: 10.1016/j.annepidem.2019.09.010..
Keywords: Children/Adolescents, Low-Income, Vulnerable Populations, Disparities, Social Determinants of Health, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
Kemmick Pintor J, Call KT
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Investigators sought to measure differences in insurance by mother's documentation status among a nationally representative sample of US-born children in immigrant families and to examine the role of state-level immigrant access to prenatal coverage. They found that, in states with nonrestrictive prenatal coverage for immigrants, there were no differences in children's insurance by mother's documentation status, while large inequities were observed within states with restrictive policies.
AHRQ-funded; HS021973.
Citation: Kemmick Pintor J, Call KT .
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Glob Pediatr Health 2019 Sep 26;6:2333794x19873535. doi: 10.1177/2333794x19873535..
Keywords: Policy, Health Insurance, Children/Adolescents, Access to Care, Vulnerable Populations, Disparities
Wisk LE, Levy S, Weitzman ER
Parental views on state cannabis laws and marijuana use for their medically vulnerable children.
Given a rapidly changing policy landscape, the investigators sought to characterize the effects of state marijuana laws on parents' views of marijuana use by their teenage children. The investigators found that among parents of medically vulnerable children, perceiving state marijuana policies as more permissive was strongly associated with lower perceived riskiness of marijuana use for their children.
AHRQ-funded; HS022986.
Citation: Wisk LE, Levy S, Weitzman ER .
Parental views on state cannabis laws and marijuana use for their medically vulnerable children.
Drug Alcohol Depend 2019 Jun 1;199:59-67. doi: 10.1016/j.drugalcdep.2018.12.027..
Keywords: Children/Adolescents, Policy, Vulnerable Populations, Chronic Conditions, Substance Abuse
Kim DH, Bassett SM, So S
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
This study assessed whether future orientation and self-esteem affected the relationship between family stress and mental health problems among African American youth in predominantly low-income neighborhoods. Youths (mainly female, average age 15.83 years old) were sampled for family stress, self-esteem, future orientation, mental health and other covariates such as gender and sexual orientation. A correlation was found between future orientation and self-esteem levels and family stress and mental health problems.
AHRQ-funded; HS000078.
Citation: Kim DH, Bassett SM, So S .
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
Am J Orthopsychiatry 2019;89(2):125-33. doi: 10.1037/ort0000371..
Keywords: Children/Adolescents, Family Health and History, Low-Income, Behavioral Health, Racial and Ethnic Minorities, Stress, Vulnerable Populations
Anderson VR, Ouyang F, Tu W
Medicaid coverage and continuity for juvenile justice-involved youth.
This retrospective cohort study examined Medicaid coverage and continuity for youth with varying levels of justice system involvement and the impact of a policy change allowing Medicaid suspension, rather than termination. The study highlighted the importance of maximizing opportunities to keep youth enrolled, as gaps in coverage likely affect juveniles' access to physical, mental, and behavioral health care.
AHRQ-funded; HS022681.
Citation: Anderson VR, Ouyang F, Tu W .
Medicaid coverage and continuity for juvenile justice-involved youth.
J Correct Health Care 2019 Jan;25(1):45-54. doi: 10.1177/1078345818820043..
Keywords: Access to Care, Children/Adolescents, Medicaid, Policy, Vulnerable Populations
Banks DE, Hershberger AR, Pemberton T
Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology.
Juvenile offenders engage in both cannabis use and polysubstance use at higher rates than the general adolescent population. Yet, limited research has examined the relationship between cannabis poly-use (e.g., cannabis and alcohol use) and functional or psychological problems among juvenile offenders. The current study addresses this gap by examining the association of polysubstance use of cannabis compared to cannabis only use with cognitive functioning, psychological distress, and substance-related problems among juvenile detainees.
AHRQ-funded; HS024296.
Citation: Banks DE, Hershberger AR, Pemberton T .
Poly-use of cannabis and other substances among juvenile-justice involved youth: variations in psychological and substance-related problems by typology.
Am J Drug Alcohol Abuse 2019;45(3):313-22. doi: 10.1080/00952990.2018.1558450..
Keywords: Children/Adolescents, Behavioral Health, Substance Abuse, Vulnerable Populations
Heerman WJ, Mitchell SJ, Thompson J
Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.
The researchers examined the association of perceived availability, condition, and safety of the built environment with its self-reported use for physical activity among underserved families with children at risk for obesity. In their sample of underserved families, perceived availability and condition of built environment structures were associated with use rather than perceived safety.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Mitchell SJ, Thompson J .
Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.
BMC Public Health 2016 Nov 22;16(1):1180. doi: 10.1186/s12889-016-3854-7.
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Keywords: Obesity, Social Determinants of Health, Children/Adolescents, Racial and Ethnic Minorities, Vulnerable Populations
Sobotka SA, Msall ME
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
This article discusses two articles in the same issue, one involving kindergarten readiness after prematurity, and the other examining medical and surgical factors impacting children with congenital heart disease (CHD) and their later school age achievement test performance. The authors state that these two articles provide evidence for longitudinal support of infants who survive critical illness.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Msall ME .
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
J Pediatr 2016 Nov;178:12-14. doi: 10.1016/j.jpeds.2016.07.037.
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Keywords: Children/Adolescents, Newborns/Infants, Patient-Centered Outcomes Research, Children/Adolescents, Vulnerable Populations
Raghavan R, Allaire BT, Brown DS
Medicaid disenrollment patterns among children coming into contact with child welfare agencies.
The authors examined retention of Medicaid coverage over time for children in the child welfare system. Using Medicaid claims files from 36 states, they found that half retained Medicaid coverage across 4 years of follow up, with most disenrollments happening in year 4. They recommend finding ways to promote entry of child welfare-involved children into health insurance coverage in order to assure services.
AHRQ-funded; HS020269.
Citation: Raghavan R, Allaire BT, Brown DS .
Medicaid disenrollment patterns among children coming into contact with child welfare agencies.
Matern Child Health J 2016 Jun;20(6):1280-7. doi: 10.1007/s10995-016-1929-9.
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Keywords: Children/Adolescents, Family Health and History, Medicaid, Uninsured, Vulnerable Populations
Navarra AM, Schlau R, Murray M
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
The researchers designed and tested the Nursing-Kids Intensity of Care Survey (N-KICS) tool and describe intensity of nursing care for children with complex medical conditions. Their psychometric evaluation confirmed an acceptable standard for reliability and validity and feasibility. Intensity scores were highest for nursing care related to infection control, medication administration, nutrition, diaper changes, hygiene, neurological and respiratory support, and standing program.
AHRQ-funded; HS021470.
Citation: Navarra AM, Schlau R, Murray M .
Assessing nursing care needs of children with complex medical conditions: The Nursing-Kids Intensity of Care Survey (N-KICS).
J Pediatr Nurs 2016 May-Jun;31(3):299-310. doi: 10.1016/j.pedn.2015.11.012.
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Keywords: Children/Adolescents, Chronic Conditions, Disabilities, Long-Term Care, Nursing, Vulnerable Populations
Peltz A, Wu CL, White ML
Characteristics of rural children admitted to pediatric hospitals.
The researchers assessed characteristics and hospitalizations of rural children admitted to US children's hospitals in 2012. They found that rural children more often resided in low-income ZIP codes and Health Professional Shortage Areas; they further noted that rural children had a higher prevalence of complex chronic conditions and medical technology assistance. Rural children also experienced higher inpatient costs and higher odds of 30-day readmission.
AHRQ-funded; HS023092.
Citation: Peltz A, Wu CL, White ML .
Characteristics of rural children admitted to pediatric hospitals.
Pediatrics 2016 May;137(5). doi: 10.1542/peds.2015-3156.
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Keywords: Children/Adolescents, Hospitalization, Children/Adolescents, Rural Health, Vulnerable Populations