National Healthcare Quality and Disparities Report
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- Adverse Events (2)
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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 25 of 46 Research Studies DisplayedFiechtner L, Perkins M, Biggs V
Comparative effectiveness of clinical and community-based approaches to healthy weight.
The objective of this study was to evaluate if two pediatric weight management interventions delivered to Hispanic, low-income children (one in a health center, the other in a Young Men's Christian Association) were effective in reducing BMI. The authors hypothesized that both would be equally effective. They were unable to establish noninferiority of the modified Healthy Weight and Your Child program. The healthy weight clinic at the health center improved BMI, offering an effective treatment of those disproportionately affected.
AHRQ-funded; HS024332.
Citation: Fiechtner L, Perkins M, Biggs V .
Comparative effectiveness of clinical and community-based approaches to healthy weight.
Pediatrics 2021 Oct;148(4). doi: 10.1542/peds.2021-050405..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Comparative Effectiveness, Evidence-Based Practice
Tignanelli CJ, Bramante CT, Dutta NT
Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease.
SARS-CoV-2 (COVID-19) disease causes significant morbidity and mortality through increased inflammation and thrombosis. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are states of chronic inflammation and indicate advanced metabolic disease. The purpose of this observational study was to characterize the risk of hospitalization for COVID-19 in patients with NAFLD/NASH and evaluate the mitigating effect of various metabolic treatments.
AHRQ-funded; HS026379.
Citation: Tignanelli CJ, Bramante CT, Dutta NT .
Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease.
Surg Obes Relat Dis 2021 Oct;17(10):1780-86. doi: 10.1016/j.soard.2021.05.029..
Keywords: COVID-19, Surgery, Obesity: Weight Management, Obesity
Montgomery JR, Waits SA, Dimick JB
Perioperative risks of sleeve gastrectomy versus roux-en-Y gastric bypass among patients with chronic kidney disease: a review of the MBSAQIP database.
The purpose of this study was to determine whether patients with chronic kidney disease experienced higher rates of perioperative complications after roux-en-Y gastric bypass (RYGB) compared to sleeve gastrectomy. The investigators concluded that among well-matched cohorts of RYGB and sleeve gastrectomy patients, incidence of primary outcomes were similar. Among secondary outcomes, only acute kidney injury was statistically-significantly higher among RYGB patients; however, the E-value for this difference was small and relatively weak confounder(s) could abrogate the statistical difference.
AHRQ-funded; HS025778.
Citation: Montgomery JR, Waits SA, Dimick JB .
Perioperative risks of sleeve gastrectomy versus roux-en-Y gastric bypass among patients with chronic kidney disease: a review of the MBSAQIP database.
Ann Surg 2021 Oct 1;274(4):e328-e35. doi: 10.1097/sla.0000000000003627..
Keywords: Surgery, Obesity, Kidney Disease and Health, Risk, Chronic Conditions
Luo Z, Gritz M, Connelly L
A survey of primary care practices on their use of the intensive behavioral therapy for obese Medicare patients.
The objective of this study was to fill the gap in knowledge on systematic differences between primary care practices (PCP) that do or do not provide intensive behavioral therapy (IBT) for obese Medicare patients. The investigators concluded that although the Centers for Medicare and Medicaid Services established payment codes for PCPs to deliver IBT for obesity in 2011, very few providers submitted fee-for-service claims for these services after almost 10 years.
AHRQ-funded; HS024843.
Citation: Luo Z, Gritz M, Connelly L .
A survey of primary care practices on their use of the intensive behavioral therapy for obese Medicare patients.
J Gen Intern Med 2021 Sep;36(9):2700-08. doi: 10.1007/s11606-021-06596-w..
Keywords: Primary Care, Obesity, Behavioral Health, Medicare, Elderly
Darling KE, Rancourt D, Evans EW
Adolescent weight management intervention in a nonclinical setting: changes in eating-related cognitions and depressive symptoms.
The present study was a secondary data analysis of a randomized controlled trial (RCT) to examine changes in depressive symptoms and eating-related cognitions in teens who participated in a non-clinic-based adolescent behavioral weight control treatment delivered by YMCA coaches. The results demonstrated some positive and no detrimental effects of a non-clinic-based behavioral weight control intervention on adolescents' eating-related cognitions and depressive symptoms.
AHRQ-funded; HS027071.
Citation: Darling KE, Rancourt D, Evans EW .
Adolescent weight management intervention in a nonclinical setting: changes in eating-related cognitions and depressive symptoms.
J Dev Behav Pediatr 2021 Sep 1;42(7):579-87. doi: 10.1097/dbp.0000000000000929..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Depression, Behavioral Health
Fiechtner L, Castro Cheng, ER
Characteristics of achieving clinically important weight loss in two paediatric weight management interventions.
The purpose of this study was to examine characteristics and lifestyle behaviors associated with achieving clinically important weight loss (CIWL) in two pediatric weight management interventions (PWMIs). Findings showed that, in this analysis of children enrolled in PWMIs, achieving CIWL was associated with younger age, not having severe obesity, and consuming fewer sugary beverages at the end of the intervention.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Castro Cheng, ER .
Characteristics of achieving clinically important weight loss in two paediatric weight management interventions.
Pediatr Obes 2021 Sep;16(9):e12784. doi: 10.1111/ijpo.12784..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Lifestyle Changes
Borgatti AC, Schneider-Worthington CR, Stager LM
The COVID-19 pandemic and weight management: effective behaviors and pandemic-specific risk factors.
This study evaluated weight management efforts among weight loss program participants during the COVID-19 pandemic. Findings showed that most online survey participants reported gaining weight during COVID-19. Further, loneliness and working remotely increased the difficulty of weight management behaviors. However, staying active, planning and tracking food consumption, choosing healthy foods, and reducing emotional eating protected against weight gain during this time.
AHRQ-funded; HS013852.
Citation: Borgatti AC, Schneider-Worthington CR, Stager LM .
The COVID-19 pandemic and weight management: effective behaviors and pandemic-specific risk factors.
Obes Res Clin Pract 2021 Sep-Oct;15(5):518-21. doi: 10.1016/j.orcp.2021.06.007..
Keywords: COVID-19, Obesity, Obesity: Weight Management, Risk
Nederveld A, Phimphasone-Brady P, Connelly L
The joys and challenges of delivering obesity care: a qualitative study of US primary care practices.
The authors sought to explore the experience of providing obesity management among primary care clinicians and their team members involved with weight loss in primary care practices. They identified three primary themes: (1) clinicians and staff involved in obesity management in primary care believe that addressing obesity is an essential part of primary care services, (2) because providing obesity care can be challenging, many practices opt out of treatment, and (3) despite the challenges, many clinicians and others find treating obesity feasible, satisfying, and worthwhile. The authors concluded that, in order to improve the ability of clinicians and practice members to treat obesity, important changes in payment, education, and work processes are necessary.
AHRQ-funded; HS024943.
Citation: Nederveld A, Phimphasone-Brady P, Connelly L .
The joys and challenges of delivering obesity care: a qualitative study of US primary care practices.
J Gen Intern Med 2021 Sep;36(9):2709-16. doi: 10.1007/s11606-020-06548-w..
Keywords: Obesity, Obesity: Weight Management, Primary Care, Medicare
Joseph CLM, Alexander GL, Lu M
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
The authors piloted an electronic medical record-based tailored discussion guide (TDG) and a brief provider training to address weight management in overweight teens with asthma. They observed modest improvements in patient-reported asthma outcomes and health behaviors. They found strong evidence that the TDG supports provider discussion of weight and asthma to create a more patient-centered conversation from the perspective of participating teens. They recommended addressing challenges to recruitment and clinic adaptation prior to advancing to a full-scale trial.
AHRQ-funded; HS022417.
Citation: Joseph CLM, Alexander GL, Lu M .
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
Pilot Feasibility Stud 2021 Aug 30;7(1):167. doi: 10.1186/s40814-021-00848-6..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Asthma, Chronic Conditions, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wang ML, Minyé HM, Egan KA
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
The purpose of this study was to assess the efficacy of a community-based childhood obesity prevention intervention targeting sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers. The investigators found that short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention.
AHRQ-funded; HS022242.
Citation: Wang ML, Minyé HM, Egan KA .
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
Community Dent Oral Epidemiol 2021 Aug;49(4):362-68. doi: 10.1111/cdoe.12610..
Keywords: Children/Adolescents, Obesity, Dental and Oral Health, Prevention
Yuce TK, Holmstrom A, Soper NJ
Complications and readmissions associated with first assistant training level following elective bariatric surgery.
Little is known regarding the variation in training level and potential clinical impact of the first assistant in bariatric surgery. In this study, the investigators described the postoperative 30-day complications and readmissions following elective bariatric procedures by training level of the first assistant. The investigators concluded that variation in training level of the first assist during bariatric surgery had no influence on DSM or readmissions.
AHRQ-funded; HS000078.
Citation: Yuce TK, Holmstrom A, Soper NJ .
Complications and readmissions associated with first assistant training level following elective bariatric surgery.
J Gastrointest Surg 2021 Aug;25(8):1948-54. doi: 10.1007/s11605-020-04787-0..
Keywords: Obesity: Weight Management, Obesity, Surgery, Hospital Readmissions, Adverse Events
Darling KE, Warnick J, Hadley W
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
This study measured reactions by adolescents, parents, and physicians to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity. The guidelines recommended those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behavior. In-depth interviews were conducted with 7 adolescents, 7 parents, and 4 physicians. In general, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs.
AHRQ-funded; HS02707.
Citation: Darling KE, Warnick J, Hadley W .
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
Clin Obes 2021 Aug;11(4):e12451. doi: 10.1111/cob.12451..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Obesity, Guidelines, Evidence-Based Practice
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
AHRQ-funded; HS026379.
Citation: Bramante CT, Buse J, Tamaritz L .
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes
Ehlers AP, Chhabra K, Thumma JR
In the eye of the beholder: surgeon variation in intra-operative perceptions of hiatal hernia and reflux outcomes after sleeve gastrectomy.
Researchers sought to determine whether intra-operative diagnosis of hiatal hernia varies among surgeons or if it affects outcomes of laparoscopic sleeve gastrectomy. They found that surgeons who identified hiatal hernias during video review had a higher rate of concurrent hiatal hernia repairs in their practice. However, this identification was not associated with improved patient-reported reflux symptoms after laparoscopic sleeve gastrectomy. They concluded that standardizing identification and management of hiatal hernias during bariatric surgery may help improve reflux outcomes post-operatively.
AHRQ-funded; HS023597.
Citation: Ehlers AP, Chhabra K, Thumma JR .
In the eye of the beholder: surgeon variation in intra-operative perceptions of hiatal hernia and reflux outcomes after sleeve gastrectomy.
Surg Endosc 2021 Jun;35(6):2537-42. doi: 10.1007/s00464-020-07668-4..
Keywords: Obesity, Surgery, Provider: Physician, Provider
Chhabra KR, Fan Z, Chao GF
The role of commercial health insurance characteristics in bariatric surgery utilization.
The goal of this study was to understand relationships among insurance plan type, out-of-pocket cost sharing, and the utilization of bariatric surgery among commercially insured patients. Over 73,000 commercially insured members of the IBM MarketScan commercial claims database who underwent bariatric surgery from 2014-17 were retroactively reviewed. Findings showed that insurance plan types with higher cost sharing have lower utilization of bariatric surgery.
AHRQ-funded; HS025778; HS000053.
Citation: Chhabra KR, Fan Z, Chao GF .
The role of commercial health insurance characteristics in bariatric surgery utilization.
Ann Surg 2021 Jun;273(6):1150-56. doi: 10.1097/sla.0000000000003569..
Keywords: Health Insurance, Obesity, Obesity: Weight Management, Surgery, Healthcare Costs, Healthcare Utilization
Gurka MJ, Siddiqi SU, Filipp SL
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Investigators estimated the proximal change in BMI associated with start of medication and to assess whether medication-specific departures in BMI varied by age and sex in patients with attention deficit hyperactivity disorder (ADHD). Longitudinal electronic health records from children aged 4-19 years with an ADHD diagnosis at one healthcare system were analyzed. They found that all medications had larger impacts at younger ages; decreased BMI was observed with stimulants, while antidepressants and antipsychotics led to BMI increases as did alpha-agonists, significantly varying by sex and age. They recommended future research to study further the interactions of these medications on long-term impacts on obesity.
AHRQ-funded; HS025298.
Citation: Gurka MJ, Siddiqi SU, Filipp SL .
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Pediatr Obes 2021 Apr;16(4):e12738. doi: 10.1111/ijpo.12738..
Keywords: Children/Adolescents, Behavioral Health, Medication, Obesity
Shipe ME, Beeghly-Fadiel A, Deppen SA
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
In this study, the investigators developed a decision analysis model to evaluate risks and benefits of delaying scheduled bariatric surgery during the novel coronavirus disease (COVID-19) pandemic. Their base case was a 45-year-old female with diabetes and a body mass index of 45 kg/m(2). They compared immediate with delayed surgery after 6 months to allow for COVID-19 prevalence to decrease. The investigators found that immediate and delayed bariatric surgeries after 6 months resulted in similar 20-year overall survival.
AHRQ-funded; HS026122.
Citation: Shipe ME, Beeghly-Fadiel A, Deppen SA .
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
Obes Surg 2021 Mar;31(3):1387-91. doi: 10.1007/s11695-020-05054-6..
Keywords: Obesity: Weight Management, Obesity, COVID-19, Surgery, Shared Decision Making
Chhabra KR, Thumma JR, Varban OA
Associations between video evaluations of surgical technique and outcomes of laparoscopic sleeve gastrectomy.
The authors examined associations between technique and outcomes in laparoscopic sleeve gastrectomy. Technical approaches to five controversial aspects of laparoscopic sleeve gastrectomy were studied: dissection of the proximal stomach, sleeve caliber, sleeve anatomy, staple line reinforcement, and leak testing. The authors found that variations in surgical technique can be measured by video review and are associated with differences in patient outcomes.
AHRQ-funded; HS023597; HS025365.
Citation: Chhabra KR, Thumma JR, Varban OA .
Associations between video evaluations of surgical technique and outcomes of laparoscopic sleeve gastrectomy.
JAMA Surg 2021 Feb;156(2):e205532. doi: 10.1001/jamasurg.2020.5532..
Keywords: Surgery, Obesity, Provider Performance, Provider: Physician, Provider, Quality of Care
Gowey MA, Neumeier WH, Henry S
Executive function in individuals with clinically significant weight loss via behavioral intervention.
Researchers sought to characterize executive function (EF) in individuals who achieved clinically significant weight loss via behavioral intervention and to examine potential differences in EF between those who maintained versus regained lost weight. The study sample consisted primarily of women over age 50 with obesity; approximately half self-identified as African-American. The researchers found that most individuals with obesity who achieved clinically significant weight loss via behavioral intervention had average to above average EF; individuals who maintained their lost weight performed better on tests of decision-making.
AHRQ-funded; HS023009.
Citation: Gowey MA, Neumeier WH, Henry S .
Executive function in individuals with clinically significant weight loss via behavioral intervention.
Obes Sci Pract 2021 Feb;7(1):25-34. doi: 10.1002/osp4.458..
Keywords: Obesity: Weight Management, Obesity, Lifestyle Changes
Conroy MB, McTigue KM, Bryce CL
Effect of electronic health record-based coaching on weight maintenance: a randomized trial.
This study compared long-term weight regain after participation in a weight loss management program using an electronic health record (EHR)-based weight maintenance intervention program. Participants were adult outpatients with a BMI of 25 kg/m2 or higher, had intentional weight loss of at least 5% in the previous 2 years, and had no bariatric procedures in the previous 5 years. The EHR tools included weight, diet and physical activity tracking sheets, standardized surveys and reminders. Patients were randomly assigned to the coaching or non-coaching group. They were tracked for 24 months with 24 scheduled contacts. Results showed patients who used the EHR tools plus coaching had less weight regain than patients using EHR tools alone.
AHRQ-funded; HS021162.
Citation: Conroy MB, McTigue KM, Bryce CL .
Effect of electronic health record-based coaching on weight maintenance: a randomized trial.
Ann Intern Med 2019 Dec 3;171(11):777-84. doi: 10.7326/m18-3337..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Obesity: Weight Management, Obesity, Lifestyle Changes
Dolan PT, Afaneh C, Dakin G
Lessons learned from developing a mobile app to assist in patient recovery after weight loss surgery.
This study examines the outcomes of patients recovering from weight loss surgery using a newly developed mobile app to help them recover successfully. The enrolled patients used the app for 30 days from July 2017 to October 2018. As the app was being used, it was updated. Ten patients were enrolled in the trial period with four using the initial version and six with the updated version. All patients were satisfied with the app and liked the notifications of updates. In the trial version only one patient completed at least 70% of the surveys, but five completed the surveys for the updated version. Next steps for the researchers is to conduct a pilot study with a larger set of patients.
AHRQ-funded; HS000066.
Citation: Dolan PT, Afaneh C, Dakin G .
Lessons learned from developing a mobile app to assist in patient recovery after weight loss surgery.
J Surg Res 2019 Dec;244:402-08. doi: 10.1016/j.jss.2019.06.063..
Keywords: Obesity: Weight Management, Obesity, Surgery, Telehealth, Health Information Technology (HIT)
Fitzsimmons-Craft EE, Eichen DM, Kass AE
Reciprocal longitudinal relations between weight/shape concern and comorbid pathology among women at very high risk for eating disorder onset.
This study examined short-term reciprocal longitudinal relations between weight/shape concern and comorbid symptoms and behaviors over the course of 24 months using cross-lagged panel models. Subjects were women 18-25 years old at high risk for onset of an eating disorder (ED), randomized to an online ED preventive intervention or waitlist control. Results supported focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change.
AHRQ-funded; HS00078.
Citation: Fitzsimmons-Craft EE, Eichen DM, Kass AE .
Reciprocal longitudinal relations between weight/shape concern and comorbid pathology among women at very high risk for eating disorder onset.
Eat Weight Disord 2019 Dec;24(6):1189-98. doi: 10.1007/s40519-017-0469-7..
Keywords: Obesity, Obesity: Weight Management, Women, Risk, Behavioral Health, Young Adults
Montgomery JR, Waits SA, Dimick JB
Risks of bariatric surgery among patients with end-stage renal disease.
Pretransplant morbid obesity among patients with end-stage renal disease (ESRD) is a significant predictor of delayed access to transplant and inferior posttransplant patient and kidney allograft outcomes. In this study, the authors performed an analysis of perioperative safety of bariatric surgery in obese patients with ESRD using a national registry capturing greater than 95% of bariatric operations.
AHRQ-funded; HS025778.
Citation: Montgomery JR, Waits SA, Dimick JB .
Risks of bariatric surgery among patients with end-stage renal disease.
JAMA Surg 2019 Dec;154(12):1160-62. doi: 10.1001/jamasurg.2019.2824..
Keywords: Surgery, Obesity, Obesity: Weight Management, Kidney Disease and Health, Transplantation, Risk, Chronic Conditions
Gibbs BB, Tudorascu D, Bryce CL
Lifestyle habits associated with weight regain after intentional loss in primary care patients participating in a randomized trial.
This study examined lifestyle habits associated with weight regain at 6 and 24 months after intentional loss in primary care patients. This randomized trial used adult primary care patients who had a recent weight loss of at least 5%. Lifestyle habits measured using the Connor Diet Habit Survey included consumption of low-fat foods, fish, desserts, sugary beverages, fruits and vegetables and eating at restaurants; moderate-vigorous physical activity by self-report; steps recorded on a pedometer; and sedentary behavior by self-report. Participants had a mean age of 53.4 years, were 26% male and 88% white. Overall, they maintained weight loss at 6 months, but began to regain weight at 24 months. The habits most attributed to weight regain included more eating at restaurants, less fish consumption, and less physical activity. More sedentary behavior was associated with weight regain at 6 months, and reduced consumption of low-fat foods and more desserts and sugary beverages were associated with weight regain at 24 months.
AHRQ-funded; HS021162.
Citation: Gibbs BB, Tudorascu D, Bryce CL .
Lifestyle habits associated with weight regain after intentional loss in primary care patients participating in a randomized trial.
J Gen Intern Med 2020 Nov;35(11):3227-33. doi: 10.1007/s11606-020-06056-x..
Keywords: Obesity: Weight Management, Obesity, Lifestyle Changes, Primary Care, Nutrition
Turer CB, Barlow SE, Sarwer DB
Association of clinician behaviors and weight change in school-aged children.
This study used clinical practice data to determine whether recommended weight management clinician behaviors were associated with weight status improvement in children aged 6-12 years who are overweight or obese. Electronic health record data (2009-2014) from 52 clinics were used. Weight status was examined from 1 visit to the next as dichotomous improvement (versus worsening or no change) and change in percentage overweight (over sex/age-specific BMI95).
AHRQ-funded; HS022418.
Citation: Turer CB, Barlow SE, Sarwer DB .
Association of clinician behaviors and weight change in school-aged children.
Am J Prev Med 2019 Sep;57(3):384-93. doi: 10.1016/j.amepre.2019.04.029..
Keywords: Children/Adolescents, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research