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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 DisplayedRosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Ferguson MC, O'Shea KJ, Hammer LD
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
This study compares guidelines for formula feeding and whether current recommendations still result in infants who are overweight or have obesity. The researchers used their “Virtual Infant” agent-based model representing infant-caregiver pairs that allowed caregivers to feed infants each day according to guidelines from Johns Hopkins Medicine (JHM), Children’s Hospital of Philadelphia (CHOP), Children’s Hospital of the King’s Daughters (CHKD), and Women, Infants, and Children (WIC). The WIC guidelines were found to be the best as opposed to JHM/CHOP/CHKD where infants still became overweight/obese by 6 months. The study recommended the minimum recommended amount of daily formula feeding should be made lower for JHM/CHOP/CHKD guidelines and that WIC guidelines may be a good starting point for caregivers.
AHRQ-funded; HS023317.
Citation: Ferguson MC, O'Shea KJ, Hammer LD .
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
Pediatr Res 2020 Oct;88(4):661-67. doi: 10.1038/s41390-020-0844-3..
Keywords: Newborns/Infants, Obesity: Weight Management, Obesity, Guidelines, Caregiving, Evidence-Based Practice
Pollack LM, Wang M, Leung MYM
Obesity-related multimorbidity and risk of cardiovascular disease in the middle-aged population in the United States.
The purpose of this paper was to investigate the prevalence of obesity-related multimorbidity (co-occurrence of ≥2 obesity-related chronic diseases, ORCDs) and the risk of cardiovascular disease in the presence of multimorbidity in middle-aged adults in the United States. The investigators found that hypertension was most commonly the first diagnosed ORCD for populations with 2-4 ORCDs, followed by diabetes for populations with 2-3 ORCDs.
AHRQ-funded; HS022330.
Citation: Pollack LM, Wang M, Leung MYM .
Obesity-related multimorbidity and risk of cardiovascular disease in the middle-aged population in the United States.
Prev Med 2020 Oct;139:106225. doi: 10.1016/j.ypmed.2020.106225..
Keywords: Obesity, Cardiovascular Conditions, Risk, Chronic Conditions
Varban OA, Thumma JR, Carlin AM
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. In this article, the investigators described their study in which the review of de-identified videos of practicing bariatric surgeons was conducted by a minimum of 10 peer surgeons. The videos were assessed on the technical quality of 9 operative maneuvers (ie mobilization of the fundus, stapler location, and sleeve width).
AHRQ-funded; HS017765.
Citation: Varban OA, Thumma JR, Carlin AM .
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
J Am Coll Surg 2020 Oct;231(4):470-77. doi: 10.1016/j.jamcollsurg.2020.06.016..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Provider: Physician, Provider
Li X, Lewis KH, Callaway K
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
The authors assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy. They found that claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.
AHRQ-funded; HS026214.
Citation: Li X, Lewis KH, Callaway K .
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
BMC Med Res Methodol 2020 Sep 7;20(1):225. doi: 10.1186/s12874-020-01106-8..
Keywords: Obesity: Weight Management, Obesity, Surgery, Health Services Research (HSR), Research Methodologies
Gowey M, Redden D, Lim C
Executive function phenotypes in pediatric obesity.
This study examined the behavioral phenotypes of children with and without executive function (EF) impairments in a clinical sample of youth aged 8-17 years attending a medical clinic for obesity. A caregiver-proxy report of EF was assessed using the Behavior Rating Inventory of Executive Function. Four latent classes of EF impairment were identified: No/Low Impairment, Behavioral Regulation Impairment, Metacognition Impairment, and Global Impairment. Behavioral/emotional impairments tended to increase with EF impairment. Children with obesity and EF impairment were found to have a dysregulated behavioral phenotype ranging from internalizing to externalizing behavioral and weight-related symptoms.
AHRQ-funded; HS023009.
Citation: Gowey M, Redden D, Lim C .
Executive function phenotypes in pediatric obesity.
Pediatr Obes 2020 Sep;15(9):e12655. doi: 10.1111/ijpo.12655..
Keywords: Children/Adolescents, Obesity
Darling KE, Ranzenhofer LM, Hadley W
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
This cross-sectional study examined the association between stressful life events and weight-related outcomes including weight status, disordered eating behaviors, and insulin sensitivity in treatment-seeking adolescents with overweight and obesity. The authors were also looking at the potential mediating role of depression. The study included 170 adolescents (mean age 14.8, 62% female) enrolled in an interdisciplinary weight management program. Findings were that stressful childhood experiences were significantly related to weight status and disordered eating but not insulin sensitivity. Depressive symptoms were related to stressful experiences and disordered eating patterns but not weight status or insulin sensitivity.
AHRQ-funded; HS027071.
Citation: Darling KE, Ranzenhofer LM, Hadley W .
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
Eat Behav 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Stress, Depression, Behavioral Health, Trauma
Payán DD, Derose KP, Flórez KR
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
The authors developed a mapping component as part of a multilevel church-based intervention that used community-based participatory research to prevent obesity in African American and Latino churches in South Los Angeles. They developed neighborhood maps of local food environments and provided churches with standardized information on food access, availability, quality, and marketing practices. Including several tables as well as discussion, they stated that local food environment maps that are paired with data can inform community-based strategies to prevent obesity and food insecurity.
AHRQ-funded; HS000046.
Citation: Payán DD, Derose KP, Flórez KR .
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
Prev Chronic Dis 2020 Jul 16;17:E61. doi: 10.5888/pcd17.200028.
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Keywords: Obesity, Racial and Ethnic Minorities, Prevention, Prevention, Community Partnerships, Community-Based Practice, Nutrition
Haynes SC, Tancredi DJ, Tong K
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
This study examined if heart failure patients who had lower adherence to weight telemonitoring had higher hospitalization and death rates. This study was a post hoc secondary analysis of the Better Effectiveness After Transition-Heart Failure randomized clinical trial which included patients from 6 academic medical centers in California. Criteria for eligibility was if they were hospitalized for decompensated heart failure. Exclusion criteria included if they were discharged to a skilled nursing facility, were expected to improve because of a medical procedure, or did not have the cognitive or physical ability to participate. The trial compared a telemonitoring intervention with usual care for patients with heart failure after hospital discharge from October 12, 2011 to September 30, 2013. The cohort of 538 eligible participants had a mean age of 70.9, was 53.8% male and 50.7% white. Adherence got better from week to week, and they found that every increase in adherence by 1 day was associated with a 19% decrease in the rate of death the following week and an 11% decrease in the rate of hospitalization. However, weight adherence is unlikely to be a result of the telemonitoring intervention.
AHRQ-funded; HS019311.
Citation: Haynes SC, Tancredi DJ, Tong K .
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2020 Jul;3(7):e2010174. doi: 10.1001/jamanetworkopen.2020.10174..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Obesity: Weight Management, Obesity, Heart Disease and Health, Cardiovascular Conditions, Hospitalization
Atkins M, Castro I, Sharifi M
Unmet social needs and adherence to pediatric weight management interventions: Massachusetts, 2017-2019.
This study examined the effects of housing insecurity and unmet social needs on adherence to pediatric weight management intervention (PWMI) programs. The authors used data from children enrolled in a 2017-2019 comparative effectiveness trial for 2 high-intensive PWMIs in Massachusetts. Families with housing security had higher contact hours with the program than families without. Children with 3 to 4 unmet social needs (parental stress, parental depression, food insecurity, and housing insecurity) also attended less hours of the program than those without.
AHRQ-funded; HS024332.
Citation: Atkins M, Castro I, Sharifi M .
Unmet social needs and adherence to pediatric weight management interventions: Massachusetts, 2017-2019.
Am J Public Health 2020 Jul;110(S2):S251-s57. doi: 10.2105/ajph.2020.305772..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Patient Adherence/Compliance, Social Determinants of Health, Family Health and History
Ferguson MC, Morgan MJ, O'Shea KJ
Using simulation modeling to guide the design of the Girl Scouts Fierce & Fit Program.
The goal of this study was to see if computational modeling would help to revise the design of the Girl Scouts Fierce & Fit Program. The Girl Scouts of Central Maryland worked with the researchers to develop a computational simulation model representing the 250 adolescent girls who were participating in the program to determine how their diets and physical activity affected their BMI and subsequent outcomes, including costs. As a result, the program changed from 6 weeks meeting twice a week with 5 minutes of physical activity each session to meeting 12 weeks with 30 minutes of physical activity each session. Cost savings were estimated at an additional $84,828 in lifetime direct medical costs, $81,365 in lifetime productivity losses, and 7.85 quality-adjusted life-years.
AHRQ-funded; HS023317.
Citation: Ferguson MC, Morgan MJ, O'Shea KJ .
Using simulation modeling to guide the design of the Girl Scouts Fierce & Fit Program.
Using simulation modeling to guide the design of the Girl Scouts Fierce & Fit Program.
Obesity 2020 Jul;28(7):1317-24. doi: 10.1002/oby.22827..
Obesity 2020 Jul;28(7):1317-24. doi: 10.1002/oby.22827..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Lifestyle Changes
Simione M, Sharifi M, Gerber MW
Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool.
The purpose of this study was to evaluate the psychometric properties of a modified version of the Family Centered-Care Assessment (mFCCA) tool and to assess the family-centeredness of two clinical-community childhood obesity interventions. Using the mFCCA which demonstrated good psychometric properties for the assessment of family-centered care among parents of children with obesity, the investigators found that individualized health coaching is a family-centered approach to pediatric weight management.
AHRQ-funded; HS024332; HS022986.
Citation: Simione M, Sharifi M, Gerber MW .
Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool.
Health Qual Life Outcomes 2020 Jun 11;18(1):179. doi: 10.1186/s12955-020-01431-y..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Patient-Centered Healthcare, Family Health and History
Kovalerchik O, Powers E, Holland ML
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
The purpose of this retrospective study was to examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions. The authors concluded that the children's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations.
AHRQ-funded; HS024332.
Citation: Kovalerchik O, Powers E, Holland ML .
Differences in frequency of visits to pediatric primary care practices and emergency departments by body mass index.
Acad Pediatr 2020 May-Jun;20(4):532-39. doi: 10.1016/j.acap.2019.12.011..
Keywords: Children/Adolescents, Primary Care, Emergency Department, Obesity, Healthcare Utilization
Flórez KR, Payán DD, Palar K
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
This systematic literature review examined the impact of multilevel church-based interventions to address racial/ethnic disparities in obesity in the US. The review identified 43 relevant articles using systematic review methods developed by the CDC’s Task Force on Community Preventive Services. Although 81% of the studies reported significant results, effective size was reported or could only be calculated in 56% of the cases. A lack of diversity among the samples was also found with few studies involving Latinos, men, young adults, or children. Few interventions were actually multilevel in nature or incorporated strategies at the church or community. Greater diversity is needed in future church-based interventions.
AHRQ-funded; HS000046.
Citation: Flórez KR, Payán DD, Palar K .
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
Nutr Rev 2020 Apr;78(4):304-22. doi: 10.1093/nutrit/nuz046..
Keywords: Racial and Ethnic Minorities, Obesity, Obesity: Weight Management, Disparities, Health Promotion, Prevention
Yaramala SR, McElroy SL, Geske J
The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study.
Lithium and quetiapine can cause weight gain, but their comparative longer term anthropometric effects are unknown, as are the potential moderating effects of baseline binge-eating (BE) behavior. In this research, the investigators assessed 6 month changes in body weight, body mass index (BMI) and waist circumference in 482 adults with DSM-IV bipolar disorders who participated in a comparative effectiveness study of lithium and quetiapine with evidence-based adjunctive treatment (Bipolar CHOICE).
AHRQ-funded; HS019371.
Citation: Yaramala SR, McElroy SL, Geske J .
The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study.
months of treatment: Findings from the bipolar CHOICE study.
J Affect Disord 2020 Apr 1;266:772-81. doi: 10.1016/j.jad.2018.09.025.
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J Affect Disord 2020 Apr 1;266:772-81. doi: 10.1016/j.jad.2018.09.025.
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Keywords: Behavioral Health, Medication, Obesity, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Bourgi K, Jenkins CA, Rebeiro PF
Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.
This study compared weight gain among persons with HIV (PWH) following different antiretroviral therapy (ART) drug classes. The cohort was part of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). The 22,972 participants were 87% male and 41% white. Twenty percent started strand transfer inhibitor (INSTI), 31% started protease inhibitor (PI), and 49% started non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based ART. Average weight gain was higher with INSTI-based regimens compared to NNRTI-based regimens or PI-based regimens.
AHRQ-funded; 90047713.
Citation: Bourgi K, Jenkins CA, Rebeiro PF .
Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.
J Int AIDS Soc 2020 Apr;23(4):e25484. doi: 10.1002/jia2.25484.
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Keywords: Human Immunodeficiency Virus (HIV), Obesity: Weight Management, Obesity, Medication
Berdahl T, Biener A, McCormick MC
AHRQ Author: Berdahl T
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
This study examined access to care and utilization patterns across a set of healthcare measures by obesity status and sociodemographic characteristics among children. Data from the Medical Expenditure Panel Survey (MEPS) from 2010-2015 was used to determine obesity status, number of well-child visits, access to a usual source of care, number of preventive dental visits and prescription medication fills in the past year. It was found that uninsured adolescents with obesity were less like to have a usual source of care provider than children without obesity. Among younger children, those living in the Northeast were more than twice as likely to have had a well-child visit than those living in the West. Preventive dental care was less likely to have occurred for children with obesity than non-obese children. More prescription refills were completed for obese adolescents than for younger children.
AHRQ-authored.
Citation: Berdahl T, Biener A, McCormick MC .
Annual report on children's healthcare: healthcare access and utilization by obesity status in the United States.
Acad Pediatr 2020 Mar;20(2):175-87. doi: 10.1016/j.acap.2019.11.020..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Access to Care, Healthcare Utilization, Obesity
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
de Meireles A, Carlin AM, Cain-Nielsen A
Association between surgeon practice knowledge and venous thromboembolism.
Venous thromboembolism (VTE) is the most common cause of mortality following bariatric surgery. This study aimed to determine practice patterns of VTE chemoprophylaxis among bariatric surgeons participating in a large statewide quality collaborative and compare the results of surgeon self-reported chemoprophylaxis prescription practices versus actual data from abstracted charts. They administered a 13-question survey to 66 surgeons to reveal VTE practice patterns such as medication type, dosage, timing, duration, and level of trainee involvement. They also examined the charts of all patients who had developed VTE during the study period and 15 other randomly selected patient charts per site. There was found to be a greater discordance between surgeon self-reported and actual perioperative VTE prophylaxis, but there was no significant discordance postoperatively. Greater perioperative discordance is associated with significantly increased risk of VTE.
AHRQ-funded; HS02362; HS024403.
Citation: de Meireles A, Carlin AM, Cain-Nielsen A .
Association between surgeon practice knowledge and venous thromboembolism.
Obes Surg 2020 Feb 16;30(6):2274-79. doi: 10.1007/s11695-020-04468-6..
Keywords: Surgery, Obesity: Weight Management, Obesity, Blood Clots, Practice Patterns, Provider: Physician, Provider
Glazer KB, Danilack VA, Werner EF
Elucidating the role of overweight and obesity in racial and ethnic disparities in cesarean delivery risk.
This study’s goal was to quantify the extent to which overweight and obesity explain cesarean delivery rates among women of different racial and ethnic backgrounds. Administrative records were used from New York City for 216,481 singleton, nulliparous births from 2008 to 2013. Risk ratios, risk differences, and population attributable fractions for associations between body mass index and cesarean, stratified by race and ethnicity was calculated. Black and Hispanic women had the highest cesarean rates attributable to obesity and overweight (17.4% and 14.6%) respectively.
AHRQ-funded; HS025013.
Citation: Glazer KB, Danilack VA, Werner EF .
Elucidating the role of overweight and obesity in racial and ethnic disparities in cesarean delivery risk.
Ann Epidemiol 2020 Feb;42:4-11.e4. doi: 10.1016/j.annepidem.2019.12.012.
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Keywords: Disparities, Racial and Ethnic Minorities, Pregnancy, Labor and Delivery, Risk, Obesity, Women
Kanters AE, Shubeck SP, Varban OA
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
The goal of this study was to evaluate the rates of use and efficacy of stent placement for postoperative leak following bariatric surgery. Using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, findings showed that the use of stents can be effective; however, such use does not prevent reoperation and is associated with an increased likelihood of readmission. Recommendations included consideration of both technique and resource utilization when choosing a management pathway for leaks.
AHRQ-funded; HS000053; HS023597.
Citation: Kanters AE, Shubeck SP, Varban OA .
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
Ann Surg 2020 Jan;271(1):134-39. doi: 10.1097/sla.0000000000003023..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Patient Safety, Outcomes
Carlson NS, Breman R, Neal JL
Preventing cesarean birth in women with obesity: influence of unit-level midwifery presence on use of cesarean among women in the Consortium on Safe Labor data set.
The primary goal of this study was to examine associations between midwifery unit-level presence and unplanned cesarean birth in women with different body mass index (BMI) ranges. Data from the Consortium on Safe Labor was used to analyze information on low-risk, healthy women who labored and gave birth in medical centers with or without the unit-level presence of midwives. Results indicate that the odds of unplanned cesarean birth among women who gave birth in centers with midwives were 16% lower than the odds of cesarean birth among similar women who gave birth at centers without midwives. However, women whose BMI was above 35.00 kg/m at labor admission had similar odds of cesarean birth, regardless of unit-level midwifery presence. Although integration of midwives into the caregiving environment of medical centers in the United States was associated with overall decrease in the incidence of cesarean birth, increased maternal BMI nevertheless remained positively associated with these outcomes.
AHRQ-funded; HS024733
Citation: Carlson NS, Breman R, Neal JL .
Preventing cesarean birth in women with obesity: influence of unit-level midwifery presence on use of cesarean among women in the Consortium on Safe Labor data set.
J Midwifery Womens Health 2020 Jan;65(1):22-32. doi: 10.1111/jmwh.13022..
Keywords: Labor and Delivery, Pregnancy, Obesity, Women, Prevention, Maternal Care