National Healthcare Quality and Disparities Report
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- Access to Care (1)
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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 22 of 22 Research Studies DisplayedWebb J, Sorensen A, Sommerness S
AHRQ Author: Mistry K
Advancing perinatal patient safety through application of safety science principles using health IT.
Researchers used semi-structured interviews with Labor and Delivery (L&D) units participating in AHRQ's Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation. Seventy percent of the units reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Webb J, Sorensen A, Sommerness S .
Advancing perinatal patient safety through application of safety science principles using health IT.
BMC Med Inform Decis Mak 2017 Dec 19;17(1):176. doi: 10.1186/s12911-017-0572-8.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Pregnancy, Maternal Care
Attanasio LB, Hardeman RR, Kozhimannil KB
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
This study examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. The study concluded that there are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Findings also suggested that white and high-socioeconomic status women may be more able to realize their preferences in childbirth.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Hardeman RR, Kozhimannil KB .
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
Birth 2017 Dec;44(4):306-14. doi: 10.1111/birt.12305..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Roman LA, Raffo JE, Dertz K
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
The purpose of this study was to explore the perspectives of Medicaid-insured women about their experiences of perinatal care across a continuum of clinical and community-based services. It found that many women experienced difficulties engaging in early care, getting more help, and understanding and communicating with their providers, with some reporting socio-economic and racial bias in care.
AHRQ-funded; HS020208.
Citation: Roman LA, Raffo JE, Dertz K .
Understanding perspectives of African American Medicaid-insured women on the process of perinatal care: an opportunity for systems improvement.
Matern Child Health J 2017 Dec;21(Suppl 1):81-92. doi: 10.1007/s10995-017-2372-2.
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Keywords: Access to Care, Maternal Care, Medicaid, Pregnancy, Racial and Ethnic Minorities
Robinson A, Fiechtner L, Roche B
Association of maternal gestational weight gain with the infant fecal microbiota.
The researchers aimed to examine associations of maternal gestational weight gain with infant fecal microbiota composition, bacterial community richness, and Shannon diversity index. Their prospective cohort study of healthy infants concluded that maternal gestational weight gain was associated with the infant fecal microbiota profiles, bacterial community richness, and Shannon diversity index.
AHRQ-funded; HS022986.
Citation: Robinson A, Fiechtner L, Roche B .
Association of maternal gestational weight gain with the infant fecal microbiota.
J Pediatr Gastroenterol Nutr 2017 Nov;65(5):509-15. doi: 10.1097/mpg.0000000000001566.
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Keywords: Maternal Care, Pregnancy, Obesity: Weight Management
Davis CM, Guo M, Miyamura J
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency.
Understanding (1) how expectant mothers gather information to decide where to give birth, and (2) who helps make that decision, provides critical health communication and decision-making insights. This survey found that the top three health decision-makers for both those Asian American and Pacific Islanders (AAPIs) with limited English proficiency and English-proficient AAPIs were themselves, their obstetrician, and their spouse, which did not differ significantly by language proficiency.
AHRQ-funded; HS021903.
Citation: Davis CM, Guo M, Miyamura J .
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency.
Hawaii J Med Public Health 2017 Oct;76(10):279-86.
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Keywords: Healthcare Delivery, Cultural Competence, Decision Making, Pregnancy, Racial and Ethnic Minorities
Ehrlich SF, Hedderson MM, Brown SD
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.
The aim of the study was to assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). The study concluded that higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control.
AHRQ-funded; HS019367.
Citation: Ehrlich SF, Hedderson MM, Brown SD .
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.
Diabetes Metab 2017 Oct;43(5):416-23. doi: 10.1016/j.diabet.2017.01.006..
Keywords: Diabetes, Lifestyle Changes, Outcomes, Patient-Centered Outcomes Research, Pregnancy, Women
Offorjebe OA, Wynn A, Moshashane N
Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana.
This paper describes a prospective cohort study which was conducted among 300 pregnant women presenting to the antenatal clinic at Princess Marina Hospital in Gaborone, Botswana who enrolled in an STI screening study. The authors specifically examine partner notification and treatment. They conclude that their findings suggest that pregnant women are willing to utilize patient-based partner notification, but actual partner treatment might be lower than intended.
AHRQ-funded; HS000046.
Citation: Offorjebe OA, Wynn A, Moshashane N .
Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana.
Int J STD AIDS 2017 Oct;28(12):1184-89. doi: 10.1177/0956462417692455..
Keywords: Infectious Diseases, Pregnancy, Screening, Women
Markowitz S, Adams EK, Lewitt MJ
Competitive effects of scope of practice restrictions: public health or public harm?
This paper examined the case of scope of practice (SOP) restrictions for certified nurse midwives and evaluated the effects of changes in states' SOP laws on markets for CNMs and on maternal and infant outcomes. The authors found that SOP laws are neither helpful nor harmful in regards to health outcomes but states that have no SOP-based barriers have lower rates of induced labor and Cesarean section births.
AHRQ-funded; HS024530.
Citation: Markowitz S, Adams EK, Lewitt MJ .
Competitive effects of scope of practice restrictions: public health or public harm?
J Health Econ 2017 Sep;55:201-18. doi: 10.1016/j.jhealeco.2017.07.004..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Public Health, Policy
Metz TD, Gonzalez C, Allshouse AA
Influence of patient-level factors on mode of delivery among operative vaginal delivery candidates in modern practice.
This study aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Odds of forceps versus vacuum were higher with induction, nulliparity, epidural, maternal indication, older maternal age, and longer second stage. Odds of cesarean versus operative vaginal delivery were higher with maternal indication, a perinatologist, longer second stage, older gestational age and longer labor.
AHRQ-funded; HS022143.
Citation: Metz TD, Gonzalez C, Allshouse AA .
Influence of patient-level factors on mode of delivery among operative vaginal delivery candidates in modern practice.
Am J Perinatol 2017 Aug;34(10):974-81. doi: 10.1055/s-0037-1601441.
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Keywords: Adverse Events, Healthcare Delivery, Labor and Delivery, Pregnancy, Women
Horner-Johnson W, Kulkarni-Rajasekhara S, Darney BG
Live birth, miscarriage, and abortion among U.S. women with and without disabilities.
Researchers compared proportions of live birth, miscarriage, and abortion among women with basic action difficulties, women with complex activity limitations, and women without disabilities in a nationally representative sample. They found few differences between women with and without disabilities, and good likelihood of live birth among women with disabilities experiencing pregnancy.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Kulkarni-Rajasekhara S, Darney BG .
Live birth, miscarriage, and abortion among U.S. women with and without disabilities.
Disabil Health J 2017 Jul;10(3):382-86. doi: 10.1016/j.dhjo.2017.02.006.
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Keywords: Disabilities, Labor and Delivery, Medical Expenditure Panel Survey (MEPS), Pregnancy
Masinter LM, Dina B, Kjerulff K
Short interpregnancy intervals: results from the first baby study.
Short interpregnancy interval (SIPI), defined as 18 months or fewer between delivery and subsequent conception, has become an independent marker of maternal and child health. The authors of this study performed a secondary analysis of 18 months of data from The First Baby Study, a prospective cohort of women followed from pregnancy through 3 years after their first birth.
AHRQ-funded; HS000078.
Citation: Masinter LM, Dina B, Kjerulff K .
Short interpregnancy intervals: results from the first baby study.
Womens Health Issues 2017 Jul - Aug;27(4):426-33. doi: 10.1016/j.whi.2017.02.011..
Keywords: Pregnancy, Labor and Delivery, Women
Horner-Johnson W, Biel FM, Darney BG
Time trends in births and cesarean deliveries among women with disabilities.
This study assessed time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. Among all women giving birth, the proportion with a disability increased from 0.27 percent in 2000 to 0.80 percent in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Biel FM, Darney BG .
Time trends in births and cesarean deliveries among women with disabilities.
Disabil Health J 2017 Jul;10(3):376-81. doi: 10.1016/j.dhjo.2017.02.009.
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Keywords: Disabilities, Labor and Delivery, Pregnancy
Attanasio LB, Kozhimannil KB, Srinivas SK
Concordance between women's self-reported reasons for cesarean delivery and hospital discharge records.
Researchers compared women's self-reported reasons for cesarean with their hospital discharge records and examined correlates of variability in agreement between sources. Ninety-one percent of women reported a reason for their cesarean that was present in the discharge data. Positive predictive value (PPV), the probability that women's self-reported reasons for cesarean varied by reason for cesarean, with high PPV for dystocia, macrosomia, and cephalopelvic disproportion (91.1 percent), and lower PPV for malposition (81.7 percent).
AHRQ-funded; HS024215.
Citation: Attanasio LB, Kozhimannil KB, Srinivas SK .
Concordance between women's self-reported reasons for cesarean delivery and hospital discharge records.
Womens Health Issues 2017 May - Jun;27(3):329-35. doi: 10.1016/j.whi.2016.12.006.
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Keywords: Hospital Discharge, Labor and Delivery, Pregnancy, Women
Travers CP, Carlo WA
How to save 1 million lives in a year in low- and middle-income countries.
This review focuses on educational programs developed to reduce preventable deaths in newborn infants in low- and middle-income countries, including Essential Newborn Care and Helping Babies Breathe, a simplified version of the Neonatal Resuscitation Program. Innovative pragmatic large-scale trials have evaluated these programs in low-resource settings. The results of these studies and the implications for future programs designed to decrease childhood mortality are reviewed.
AHRQ-funded; HS013852.
Citation: Travers CP, Carlo WA .
How to save 1 million lives in a year in low- and middle-income countries.
Neonatology 2017;111(4):431-36. doi: 10.1159/000460512.
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Keywords: Newborns/Infants, Mortality, Newborns/Infants, Pregnancy, Prevention
Kozhimannil KB, Graves AJ, Jarlenski M
Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.
This study characterized non-medical use (NMU) of prescription opioids among reproductive-age U.S. women, with a focus on pregnancy status. Nearly 1 percent of pregnant women and 2.3 percent of non-pregnant reproductive-age women reported opioid NMU in the past 30 days. Forty-six percent of pregnant women identified a doctor as their source compared with 27.6 percent of non-pregnant women reporting NMU.
AHRQ-funded; HS000029.
Citation: Kozhimannil KB, Graves AJ, Jarlenski M .
Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.
Drug Alcohol Depend 2017 May 1;174:201-08. doi: 10.1016/j.drugalcdep.2017.01.003.
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Keywords: Medication, Opioids, Pregnancy, Substance Abuse, Women
Sjaarda LA, Radin RG, Silver RM
AHRQ Author: Mitchell E
Preconception low-dose aspirin restores diminished pregnancy and live birth rates in women with low grade inflammation: a secondary analysis of a randomized trial.
This study investigated the effect of preconception-initiated low dose aspirin (LDA) on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy. It concluded that in women attempting conception with elevated high sensitivity C-reactive protein (hsCRP) and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates to those of women without inflammation and reduce hsCRP elevation during pregnancy.
AHRQ-authored.
Citation: Sjaarda LA, Radin RG, Silver RM .
Preconception low-dose aspirin restores diminished pregnancy and live birth rates in women with low grade inflammation: a secondary analysis of a randomized trial.
J Clin Endocrinol Metab 2017 May;102(5):1495-504. doi: 10.1210/jc.2016-2917.
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Keywords: Pregnancy, Medication, Outcomes, Labor and Delivery
Darney BG, Biel FM, Quigley BP
Primary cesarean delivery patterns among women with physical, sensory, or intellectual disabilities.
This study sought to determine whether physical, sensory, or intellectual and developmental disabilities are independently associated with primary cesarean delivery. It found that women across disability subgroups have higher odds of cesarean delivery, and there is heterogeneity by disability type.
AHRQ-funded; HS022981.
Citation: Darney BG, Biel FM, Quigley BP .
Primary cesarean delivery patterns among women with physical, sensory, or intellectual disabilities.
Womens Health Issues 2017 May - Jun;27(3):336-44. doi: 10.1016/j.whi.2016.12.007.
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Keywords: Disabilities, Labor and Delivery, Patient-Centered Outcomes Research, Pregnancy, Women
Henderson JT, Thompson JH, Burda BU
Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the benefits and harms of preeclampsia screening and risk assessment for the US Preventive Services Task Force. Their review of 21 studies concluded that evidence to estimate benefits and harms of preeclampsia screening and the test performance of different screening approaches over the course of pregnancy was limited. Externally validated risk prediction models had limited applicability.
AHRQ-funded; 290201200151I.
Citation: Henderson JT, Thompson JH, Burda BU .
Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Apr 25;317(16):1668-83. doi: 10.1001/jama.2016.18315.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Women, Prevention
Holroyd LE, Anders S, Robinson JR
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
AHRQ-funded; HS021496.
Citation: Holroyd LE, Anders S, Robinson JR .
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
AMIA Annu Symp Proc 2017 Apr 16;2017:902-11..
Keywords: Caregiving, Education: Patient and Caregiver, Health Information Technology (HIT), Pregnancy, Web-Based
Kato E, Rajupet S
AHRQ Author: Kato E
Primary interventions to support breastfeeding.
This case study involves a 26-year-old woman, who presents for a routine prenatal visit at 28 weeks’ gestation. Her medical history is significant for poorly controlled asthma, and her family history is significant for breast cancer diagnosed in her mother. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Kato E, Rajupet S .
Primary interventions to support breastfeeding.
Am Fam Physician 2017 Apr 15;95(8):517-18.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Breast Feeding, Primary Care, Pregnancy, Asthma
Rice WS, Turan B, Stringer KL
Norms and stigma regarding pregnancy decisions during an unintended pregnancy: development and predictors of scales among young women in the U.S. South.
The researchers sought to create measures of perceived norms and stigma around pregnancy decisions by developing and pre-testing 97 survey items using a mixed methods approach. Their factor analyses revealed four subscales for each pregnancy decision: conditional acceptability, anticipated reactions, stereotypes/misperceptions, and attitudes. Minority women endorsed more negative norms and stigma around adoption.
AHRQ-funded; HS013852.
Citation: Rice WS, Turan B, Stringer KL .
Norms and stigma regarding pregnancy decisions during an unintended pregnancy: development and predictors of scales among young women in the U.S. South.
PLoS One 2017 Mar 22;12(3):e0174210. doi: 10.1371/journal.pone.0174210.
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Keywords: Children/Adolescents, Decision Making, Pregnancy, Social Stigma, Young Adults
Viswanathan M, Treiman KA, Kish-Doto J
Folic acid supplementation for the prevention of neural tube defects: an updated evidence report and systematic review for the US Preventive Services Task Force.
This report reviewed the evidence on folic acid supplementation for preventing neural tube defects to inform the US Preventive Services Task Force for an updated Recommendation Statement. In studies conducted before the initiation of food fortification in the United States in 1998, folic acid supplementation provided protection against neural tube defects. Newer postfortification studies have not demonstrated a protective association but have the potential for misclassification and recall bias.
AHRQ-funded; 290201200015I.
Citation: Viswanathan M, Treiman KA, Kish-Doto J .
Folic acid supplementation for the prevention of neural tube defects: an updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Jan 10;317(2):190-203. doi: 10.1001/jama.2016.19193.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Prevention, Evidence-Based Practice, Vitamins and Supplements