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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
51 to 75 of 80 Research Studies DisplayedFabius CD, Robison J
Differences in living arrangements among older adults transitioning into the community: examining the impact of race and choice.
The federal Money Follows the Person Rebalancing Demonstration program allows nursing home residents to use Medicaid funds for home and community-based services rather than institutional care. Race, choice in housing, and challenges faced prior to transitioning may impact living arrangements following a discharge into the community. This study examined the influence of these factors on living arrangements for 659 program participants age 65 or older.
AHRQ-funded; HS000011.
Citation: Fabius CD, Robison J .
Differences in living arrangements among older adults transitioning into the community: examining the impact of race and choice.
J Appl Gerontol 2019 Apr;38(4):454-78. doi: 10.1177/0733464816687496..
Keywords: Elderly, Transitions of Care, Racial and Ethnic Minorities, Medicaid, Nursing Homes, Home Healthcare, Healthcare Delivery
Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al.
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
This study compared the health status and healthcare experiences of Cambodian American refugees and immigrants, using data were collected via questionnaires and medical records from two community clinics in Southern California. Minimal differences in self-reported health behaviors occurred between the two groups. Refugees reported lower levels of health-related quality of life overall and self-rated health, but similar or more positive healthcare experiences than the immigrants. Refugees had higher rates of diabetes and cardiovascular disease risk, in adjusted analyses. The authors conclude that there is a need for more health promotion efforts to improve health outcomes and perceived wellbeing of Cambodian American refugees and immigrants.
AHRQ-authored.
Citation: Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al..
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
J Immigr Minor Health 2019 Apr;21(2):346-55. doi: 10.1007/s10903-018-0736-3..
Keywords: Disparities, Health Status, Patient Experience, Quality of Life, Racial and Ethnic Minorities, Vulnerable Populations
Kemmick Pintor J, Mitchell DC, Schenker MB
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
This study explored if depression affects treatment for obesity among Latino immigrant farmworkers. The workplace pilot study called Pasos Saludables,was successful, but the participants at risk for depression had lower weight loss than the participants with no indication of depression.
AHRQ-funded; HS022236.
Citation: Kemmick Pintor J, Mitchell DC, Schenker MB .
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
J Immigr Minor Health 2019 Apr;21(2):383-92. doi: 10.1007/s10903-018-0743-4..
Keywords: Depression, Behavioral Health, Obesity, Racial and Ethnic Minorities, Vulnerable Populations
Mahalingam M, Moore Jx, Donnelly JP
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
This study examined the association between frailty (weakness, exhaustion, and low physical activity) and the risk of sepsis in stroke patients. Data from the cohort study Reasons for Geographic and Racial Differences in Stroke (REGARDS) was used. There was an associated increase in sepsis hospitalizations and 30-day case fatalities from sepsis in stroke patients with more frailty indicators.
AHRQ-funded; HS013852.
Citation: Mahalingam M, Moore Jx, Donnelly JP .
Frailty syndrome and risk of sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
J Intensive Care Med 2019 Apr;34(4):292-300. doi: 10.1177/0885066617715251..
Keywords: Elderly, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Hong M, Casado BL, Lee SE
The intention to discuss advance care planning in the context of Alzheimer's disease among Korean Americans.
The authors examined the intention to discuss advance care planning (ACP) for a family member with Alzheimer's disease among Korean Americans. Path analyses were conducted on a cross-sectional convenience sample; age, gender, education, and knowledge about Alzheimer's disease and ACP were included as covariates. From their findings, the authors recommended promoting ACP among this population and designing educational interventions to address positive attitudes and subjective norms toward ACP.
AHRQ-funded; HS022947.
Citation: Hong M, Casado BL, Lee SE .
The intention to discuss advance care planning in the context of Alzheimer's disease among Korean Americans.
Gerontologist 2019 Mar 14;59(2):347-55. doi: 10.1093/geront/gnx211..
Keywords: Elderly, Dementia, Neurological Disorders, Decision Making, Racial and Ethnic Minorities
Baughman KR, Ludwick R, Jarjoura D
Advance care planning in skilled nursing facilities: a multisite examination of professional judgments.
Lack of advance care planning (ACP) may increase hospitalizations and impact the quality of life for skilled nursing facility (SNF) residents, especially African American residents who may be less likely to receive ACP discussions. In this study, the investigators examined the professional judgments of skilled nursing facility providers to see if race of SNF residents and providers, and risk for hospitalization for residents influenced professional judgments as to when ACP was needed.
AHRQ-funded; HS022162.
Citation: Baughman KR, Ludwick R, Jarjoura D .
Advance care planning in skilled nursing facilities: a multisite examination of professional judgments.
Gerontologist 2019 Mar 14;59(2):338-46. doi: 10.1093/geront/gnx129..
Keywords: Elderly, Hospitalization, Nursing Homes, Quality of Life, Racial and Ethnic Minorities
Angier H, Ezekiel-Herera D, Marino M
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
AHRQ-funded; HS024270.
Citation: Angier H, Ezekiel-Herera D, Marino M .
Racial/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid Expansion.
J Health Care Poor Underserved 2019;30(1):116-30. doi: 10.1353/hpu.2019.0011.
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Keywords: Access to Care, Diabetes, Disparities, Health Insurance, Medicaid, Racial and Ethnic Minorities
Lipira L, Nevin PE, Frey S
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
The purpose of thisstudy was to implement the first three steps (information gathering, preliminary design, preliminary testing) in the development of a culturally-adapted multimedia behavioral intervention to reduce HIV-related stigma among African-immigrant PLWH. The investigators concluded that input from key stakeholders and observed decreases in depressive symptoms post-intervention indicated that a multimedia behavioral intervention such as The Positive Living Program could be an effective way to address poor psychosocial outcomes associated with HIV-related stigma among African-immigrant PLWH.
AHRQ-funded; HS013853.
Citation: Lipira L, Nevin PE, Frey S .
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):224-31. doi: 10.1097/jnc.0000000000000037..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Depression, Behavioral Health, Racial and Ethnic Minorities
Hanchate AD, Dyer KS, Paasche-Orlow MK
Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees.
In this retrospective cohort study, the investigators estimated emergency department (ED) use differences across Medicare enrollees of different race/ethnicity who were residing in the same zip codes. The investigators found that among Medicare enrollees, blacks and Hispanics had higher ED use rates than whites overall and among subgroups by demographics and socioeconomic status.
AHRQ-funded; HS022242.
Citation: Hanchate AD, Dyer KS, Paasche-Orlow MK .
Disparities in emergency department visits among collocated racial/ethnic Medicare enrollees.
Ann Emerg Med 2019 Mar;73(3):225-35. doi: 10.1016/j.annemergmed.2018.09.007..
Keywords: Disparities, Emergency Department, Healthcare Utilization, Medicare, Racial and Ethnic Minorities
Adams LB, Gottfredson N, Lightfoot AF
Factor analysis of the CES-D 12 among a community sample of black men.
The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used measures for assessing depression in population-based research. This study assessed the dimensional structure of the CES-D 12-item scale using exploratory and confirmatory factor analysis in a community-based sample of Black men. Findings suggested that the "effort" item from the CES-D 12 should be interpreted with caution among Black men.
AHRQ-funded; HS000032.
Citation: Adams LB, Gottfredson N, Lightfoot AF .
Factor analysis of the CES-D 12 among a community sample of black men.
Am J Mens Health 2019 Mar-Apr;13(2):1557988319834105. doi: 10.1177/1557988319834105..
Keywords: Depression, Diagnostic Safety and Quality, Men's Health, Behavioral Health, Racial and Ethnic Minorities
Tung EL, Hampton DA, Kolak M
Race/ethnicity and geographic access to urban trauma care.
The goal of this study was to examine racial/ethnic differences in geographic access to trauma care in Chicago, Los Angeles, and New York City using census tract data from the 2015 American Community Survey. The role of residential segregation and neighborhood poverty was also considered. Small-area analyses were conducted to assess trauma desert status; ‘trauma desert’ was defined as a travel distance greater than 8 km to the nearest adult level I or level II trauma center. The results for each city’s census tracts and racial/ethnic categories were compared.
AHRQ-funded; HS023007.
Citation: Tung EL, Hampton DA, Kolak M .
Race/ethnicity and geographic access to urban trauma care.
JAMA Netw Open 2019 Mar;2(3):e190138. doi: 10.1001/jamanetworkopen.2019.0138..
Keywords: Racial and Ethnic Minorities, Urban Health, Access to Care, Trauma, Disparities
Johnston FM, Neiman JH, Parmley LE
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
This study focused on the issue of lack of palliative care for African-Americans with cancer. Stakeholder interviews and focus groups were conducted with cancer patients, caregivers, health care administrators, oncologists, and community health workers (CHWs). Participants felt that CHWs could play a central role in bridging patients with their providers, information and resources. They also felt that CHWs should either come from the community, or be familiar with the history, culture, and norms of the communities from which they operate.
AHRQ-funded; HS024736.
Citation: Johnston FM, Neiman JH, Parmley LE .
Stakeholder perspectives on the use of community health workers to improve palliative care use by African Americans with cancer.
J Palliat Med 2019 Mar;22(3):302-06. doi: 10.1089/jpm.2018.0366..
Keywords: Access to Care, Cancer, Healthcare Delivery, Healthcare Utilization, Cultural Competence, Disparities, Palliative Care, Racial and Ethnic Minorities
Desir FA, Lesko CR, Moore RD
One sIZE fITS (n)one: the influence of sex, age, and sexual human immunodeficiency virus (HIV) acquisition risk on racial/ethnic disparities in the HIV care continuum in the United States.
In this study the investigators examined the impact of sex, age, and sexual HIV acquisition risk (ie, heterosexual vs same-sex contact) on the magnitude of HIV-related racial/ethnic disparities. They found that racial/ethnic differences in HIV care persist in specific populations defined by sex, age, and sexual HIV acquisition risk. They suggest that clinical and public health interventions that jointly target these demographic factors are needed.
AHRQ-funded; 90047713.
Citation: Desir FA, Lesko CR, Moore RD .
One sIZE fITS (n)one: the influence of sex, age, and sexual human immunodeficiency virus (HIV) acquisition risk on racial/ethnic disparities in the HIV care continuum in the United States.
Clin Infect Dis 2019 Feb 15;68(5):795-802. doi: 10.1093/cid/ciy556..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Risk
Xie Z, St Clair P, Goldman DP
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
The purpose of this study was to examine the association between socioeconomic status (SES) and racial and ethnic disparities in medication adherence for three widely prescribed therapeutic classes. The investigators concluded that racial/ethnic disparities in adherence were mitigated, but persisted after controlling for detailed socioeconomic measures. They suggest that interventions should focus more on improving medication adherence of existing users, particularly in treating asymptomatic conditions.
AHRQ-funded; HS013447.
Citation: Xie Z, St Clair P, Goldman DP .
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
PLoS One 2019 Feb 14;14(2):e0212117. doi: 10.1371/journal.pone.0212117..
Keywords: Racial and Ethnic Minorities, Disparities, Patient Adherence/Compliance, Medication, Social Determinants of Health, Health Insurance
Mehta B, Szymonifka J, Dey S
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
The objective of this study was to assess the relationship of neighborhood immigrant proportion (IP) to preoperative and 2-year postoperative pain and function after elective total knee arthroplasty (TKA) using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients in a high-volume institutional TKA registry were analyzed retrospectively, and demographics, pre-op and 2-year post-op WOMAC pain and function scores, and addresses obtained. Patient-level variables were linked to Census Bureau tract data. Researchers conclude that patients living in high IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in lower IP neighborhoods.
AHRQ-funded; HS016075.
Citation: Mehta B, Szymonifka J, Dey S .
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
BMC Musculoskelet Disord 2019 Feb 9;20(1):67. doi: 10.1186/s12891-019-2446-y..
Keywords: Arthritis, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health, Surgery
Schnierle J, Christian-Brathwaite N, Louisias M
Implicit bias: what every pediatrician should know about the effect of bias on health and future directions.
This article discusses the role in implicit bias and its effect on health outcomes. The most highly regarded tool to measure implicit bias is the Implicit Association Test (IAT). While there is limited evidence showing an association between implicit bias and health outcomes, existing publications do show clear associations. The authors discuss the need for future research that relies on pre- and post-IAT measurements to examine the effect of bias training among healthcare providers.
AHRQ-funded; HS022986.
Citation: Schnierle J, Christian-Brathwaite N, Louisias M .
Implicit bias: what every pediatrician should know about the effect of bias on health and future directions.
Curr Probl Pediatr Adolesc Health Care 2019 Feb;49(2):34-44. doi: 10.1016/j.cppeds.2019.01.003..
Keywords: Children/Adolescents, Provider: Physician, Racial and Ethnic Minorities, Cultural Competence
Wingood GM, Lambert D, Renfro T
A multilevel intervention with African American churches to enhance adoption of point-of-care HIV and diabetes testing, 2014-2018.
This article describes a multilevel intervention to enhance the adoption of point-of-care HIV and diabetes testing at church health fairs in Atlanta, GA. Church leaders viewed a video and subsequently conducted social activities that support testing; a third of the churches involved hosted HIV and diabetes health fairs and resulted in an increase in attendees receiving HIV or diabetes testing. The authors conclude that this implementation science approach could reduce HIV and diabetes disparities among African Americans.
AHRQ-funded; HS022059.
Citation: Wingood GM, Lambert D, Renfro T .
A multilevel intervention with African American churches to enhance adoption of point-of-care HIV and diabetes testing, 2014-2018.
Am J Public Health 2019 Feb;109(S2):S141-s44. doi: 10.2105/ajph.2019.304990..
Keywords: Diabetes, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities, Disparities, Screening
Cook BL, Wang Y, Sonik R
Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning.
This study analyzed the rate that providers discontinued antidepressants for youth after a 2004 FDA box warning. It was found that prescriptions decreased for White youth but even increased slightly for Black and Latino youth.
AHRQ-funded; HS021486.
Citation: Cook BL, Wang Y, Sonik R .
Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning.
Health Serv Res 2019 Feb; 54(Suppl 1):255-62. doi: 10.1111/1475-6773.13104..
Keywords: Adverse Drug Events (ADE), Medication, Children/Adolescents, Patient Safety, Racial and Ethnic Minorities, Medication: Safety
Louisias M, Wright L, Phipatanakul W
Asthma in the melting pot.
This article highlights research advances related to asthma health disparities, and offers recommendations regarding innovative approaches to achieve equity and social justice for minority and low-income populations. Since traditional randomized controlled trials may not always be the most appropriate approach to health disparities research interventions, the authors suggest appropriate alternatives, such as the stepped-wedge design; or, because intervention trials are not always feasible, alternative analytic approaches such as mediation analysis or modeling could be used instead. Dissemination and implementation (D&I) research and the use of biomarkers to measure the social disadvantage impact of asthma outcomes are also discussed.
AHRQ-funded; HS022986.
Citation: Louisias M, Wright L, Phipatanakul W .
Asthma in the melting pot.
Ann Allergy Asthma Immunol 2019 Feb;122(2):136-39. doi: 10.1016/j.anai.2018.11.009.
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Keywords: Asthma, Disparities, Respiratory Conditions, Low-Income, Racial and Ethnic Minorities
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in health care use vary with health?
Researchers used Medical Expenditure Panel Survey (MEPS) data from 2010-2014 to evaluate health care use between black-white and Hispanic-white adults. They found that there was the widest disparity in health care use in adults in excellent health between Hispanics and whites but the opposite was true for blacks and whites. Differences are attributed to health insurance coverage and access to health care overall.
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in health care use vary with health?
Health Serv Res 2019 Feb;54(1):64-74. doi: 10.1111/1475-6773.13087..
Keywords: Access to Care, Disparities, Healthcare Utilization, Health Insurance, Health Status, Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities
Lipton BJ, Decker SL, Sommers BD
AHRQ Author: Lipton BJ, Decker SL
The Affordable Care Act appears to have narrowed racial and ethnic disparities in insurance coverage and access to care among young adults.
This study analyzed insurance coverage gains of young adults aged 19 to 25 due to the Affordable Care Act’s 2010 coverage provision and also 2014 Medicaid and Marketplace expansions. There were gains in coverage of 11% for Hispanics, 10.1% for Blacks and 4.6% for Whites.
AHRQ-authored; AHRQ-funded; HS021291.
Citation: Lipton BJ, Decker SL, Sommers BD .
The Affordable Care Act appears to have narrowed racial and ethnic disparities in insurance coverage and access to care among young adults.
Med Care Res Rev 2019 Feb;76(1):1077558717706575. Epub ahead of print. doi: 10.1177/1077558717706575..
Keywords: Access to Care, Disparities, Health Insurance, Racial and Ethnic Minorities, Young Adults
Knierim SD, Moore SL, Raghunath SG
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. The investigators concluded that a home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns.
AHRQ-funded; HS021138; HS022143.
Citation: Knierim SD, Moore SL, Raghunath SG .
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
Matern Child Health J 2018 Nov;22(11):1589-97. doi: 10.1007/s10995-018-2553-7..
Keywords: Children/Adolescents, Home Healthcare, Low-Income, Obesity, Children/Adolescents, Racial and Ethnic Minorities
Elm JHL, Walls ML, Aronson BD
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Investigators analyzed focus group transcripts of American Indian adults with type 2 diabetes from five tribal communities and classified stressors using an inductive/deductive analytical approach. They identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for American Indians and concluded that stressors are generally experienced as chronic, regardless of the duration of the stressor.
AHRQ-funded; HS024180.
Citation: Elm JHL, Walls ML, Aronson BD .
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Am Indian Alsk Native Ment Health Res 2019;26(1):33-62. doi: 10.5820/aian.2601.2019.33..
Keywords: Diabetes, Chronic Conditions, Stress, Racial and Ethnic Minorities, Vulnerable Populations
Singal AG, Tiro JA, Murphy CC
Mailed outreach invitations significantly improve HCC surveillance rates in patients with cirrhosis: a randomized clinical trial.
Mailed outreach invitations significantly improve HCC surveillance rates in patients with cirrhosis: a randomized clinical trial.
Hepatology 2019 Jan;69(1):121-30. doi: 10.1002/hep.30129.
In this study, the investigators compared the effectiveness of mailed outreach and patient navigation strategies to increase hepatocellular carcinoma (HCC) surveillance in a racially diverse cohort of patients with cirrhosis. They conducted a pragmatic randomized clinical trial comparing mailed outreach for screening ultrasound, mailed outreach plus patient navigation, or usual care with visit-based screening. The investigators concluded that mailed outreach invitations and navigation significantly increased HCC surveillance versus usual care in patients with cirrhosis.
Hepatology 2019 Jan;69(1):121-30. doi: 10.1002/hep.30129.
In this study, the investigators compared the effectiveness of mailed outreach and patient navigation strategies to increase hepatocellular carcinoma (HCC) surveillance in a racially diverse cohort of patients with cirrhosis. They conducted a pragmatic randomized clinical trial comparing mailed outreach for screening ultrasound, mailed outreach plus patient navigation, or usual care with visit-based screening. The investigators concluded that mailed outreach invitations and navigation significantly increased HCC surveillance versus usual care in patients with cirrhosis.
AHRQ-funded; HS022418.
Citation: Singal AG, Tiro JA, Murphy CC .
Mailed outreach invitations significantly improve HCC surveillance rates in patients with cirrhosis: a randomized clinical trial.
Hepatology 2019 Jan;69(1):121-30. doi: 10.1002/hep.30129..
Keywords: Cancer, Racial and Ethnic Minorities, Prevention, Comparative Effectiveness, Screening
Sun CJ, Nall JL, Rhodes SD
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice.
AHRQ-funded; HS022981.
Citation: Sun CJ, Nall JL, Rhodes SD .
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Am J Mens Health 2019 Jan-Feb;13(1):1557988318804901. doi: 10.1177/1557988318804901..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Men's Health, Community-Based Practice, Patient Adherence/Compliance