National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (5)
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Arthritis (2)
- Asthma (2)
- Behavioral Health (10)
- Blood Clots (1)
- Blood Pressure (1)
- Cardiovascular Conditions (2)
- Caregiving (2)
- Care Management (4)
- Case Study (1)
- Children/Adolescents (28)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (4)
- Communication (3)
- Comparative Effectiveness (5)
- COVID-19 (3)
- Cultural Competence (1)
- Decision Making (2)
- Depression (3)
- Diabetes (10)
- Diagnostic Safety and Quality (1)
- Disabilities (2)
- Disparities (4)
- Education (1)
- Education: Patient and Caregiver (4)
- Elderly (2)
- Electronic Health Records (EHRs) (5)
- Evidence-Based Practice (5)
- Family Health and History (9)
- Guidelines (1)
- Healthcare Costs (5)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (8)
- Health Insurance (2)
- Health Literacy (1)
- Health Promotion (2)
- Health Services Research (HSR) (1)
- Health Status (3)
- Heart Disease and Health (3)
- Hospitalization (1)
- Hospital Readmissions (3)
- Human Immunodeficiency Virus (HIV) (3)
- Kidney Disease and Health (2)
- Lifestyle Changes (20)
- Low-Income (1)
- Maternal Care (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (3)
- Medication (7)
- Newborns/Infants (3)
- Nutrition (11)
- Obesity (90)
- (-) Obesity: Weight Management (102)
- Opioids (1)
- Orthopedics (1)
- Outcomes (14)
- Pain (1)
- Patient-Centered Healthcare (6)
- Patient-Centered Outcomes Research (7)
- Patient Adherence/Compliance (4)
- Patient Safety (2)
- Patient Self-Management (3)
- Payment (1)
- Policy (1)
- Practice Patterns (2)
- Pregnancy (4)
- Prevention (3)
- Primary Care (7)
- Primary Care: Models of Care (1)
- Provider (2)
- Provider: Physician (2)
- Provider Performance (1)
- Quality Measures (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (12)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (5)
- Screening (1)
- Sex Factors (1)
- Sleep Problems (1)
- Social Determinants of Health (4)
- Social Media (1)
- Social Stigma (2)
- Stress (2)
- Substance Abuse (1)
- Surgery (29)
- Telehealth (2)
- Tobacco Use (1)
- Transplantation (1)
- Trauma (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vulnerable Populations (1)
- Women (3)
- Workflow (1)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 102 Research Studies DisplayedLucy AT, Rakestraw SL, Stringer C
Readability of patient education materials for bariatric surgery.
This paper examined readability and reading level of online bariatric surgery and standardized perioperative electronic medical record (EMR) patient education materials (PEM). National organizations recommend that PEM not exceed a sixth grade reading level. One institution was used to assess readability of PEM. Text readability was assessed by seven validated instruments and mean readability scores calculated with standard deviations and compared using unpaired t-tests. A total of 32 webpages and seven EMR education documents were assessed. Web pages were overall assessed as "difficult to read" compared to "standard/average" readability EMR materials. All web pages were at or above high school reading levels, with the highest reading levels being pages with nutrition information and the lowest reading level patient testimonials. EMR materials were found to be at sixth to ninth grade reading level.
AHRQ-funded; HS023009.
Citation: Lucy AT, Rakestraw SL, Stringer C .
Readability of patient education materials for bariatric surgery.
Surg Endosc 2023 Aug; 37(8):6519-25. doi: 10.1007/s00464-023-10153-3..
Keywords: Surgery, Education: Patient and Caregiver, Obesity: Weight Management, Obesity, Health Literacy
Zamudio J, Kanji FF, Lusk C
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
The goal of this observational study was to investigate the impact of robotic bariatric surgery (RBS) on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. Twenty-nine RBS procedures were observed at three sites; FDs were recorded in real time and subsequently classified into one of nine work system categories. FDs occurred approximately every 2.4 minutes and happened most frequently during the final patient transfer and robot docking phases of RBS. The coordination challenges that contributed most to these disruptions were associated with waiting for staff/instruments and readjusting equipment.
AHRQ-funded; HS026491.
Citation: Zamudio J, Kanji FF, Lusk C .
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
Obes Surg 2023 Jul; 33(7):2083-89. doi: 10.1007/s11695-023-06620-4..
Keywords: Obesity: Weight Management, Surgery, Workflow, Obesity
Barnett S, Matthews K, DeWindt L
Deaf Weight Wise: a novel randomized clinical trial with Deaf sign language users.
The purpose of this research was to address the lack of scientifically supported weight management programs specifically designed for the Deaf population. The researchers developed the Deaf Weight Wise (DWW) trial and intervention which was informed by community-based participatory research. The primary focus of DWW is promoting a healthy lifestyle and weight management through dietary adjustments and physical activity. A total of 104 Deaf adults aged 40 to 70 years, with a BMI ranging from 25 to 45, were recruited from community settings in Rochester, New York. Participants were randomized into either immediate intervention (n = 48) or a 1-year delayed intervention group (n = 56). The latter group served as a no-intervention control until the trial's midpoint. Data were collected at five time points (every six months) from baseline to 24 months. All DWW intervention leaders and participants were Deaf individuals using American Sign Language (ASL). The study found that at the 6-month mark, the average weight change difference between the immediate-intervention group and the delayed-intervention group (no intervention yet) was -3.4 kg. A majority (61.6%) of those in the immediate intervention group lost ≥5% of their baseline weight, compared to 18.1% in the no-intervention-yet group. Indicators of participant engagement included an average attendance of 11/16 sessions (69%), and 92% completed the 24-month data collection. The researchers concluded that the DWW program, which is community-engaged, culturally tailored, and provides language accessibility, successfully supported weight loss among Deaf ASL users.
AHRQ-funded; HS015700
Citation: Barnett S, Matthews K, DeWindt L .
Deaf Weight Wise: a novel randomized clinical trial with Deaf sign language users.
Obesity 2023 Apr;31(4):965-76. doi: 10.1002/oby.23702.
Keywords: Obesity: Weight Management, Disabilities, Obesity
Barlow SE, Yudkin J, Nelson V
Dynamo Kids!/¡Niños Dinámicos! A web site for pediatric primary care providers to offer parents of children 6-12 years old with overweight and obesity: web site development and protocol for pilot study.
The purpose of this study will be to determine whether a self-guided web site offered by pediatric primary care providers could assist parents with applying healthy behaviors. If successful, a large, controlled study may be conducted to further assess. The Dynamo Kids/¡Niños Dinámicos program was created with feedback from parents and health care professionals, developing a bilingual site for parents to about healthy behavior changes for their children and how to implement them. Electronic health record modifications alert providers to qualified children at well-child encounters. Parents complete online surveys before entering the site. In month 3 of the study, the practitioners will examine children in weight-focused appointments. Outcomes include change in Family Nutrition and Physical Activity parent survey score (primary) and change in child relative BMI (secondary). Additional data include time spent on site, provider surveys, and provider and parent interviews.
AHRQ-funded; HS022418.
Citation: Barlow SE, Yudkin J, Nelson V .
Dynamo Kids!/¡Niños Dinámicos! A web site for pediatric primary care providers to offer parents of children 6-12 years old with overweight and obesity: web site development and protocol for pilot study.
J Pediatr Health Care 2023 Jan-Feb; 37(1):17-24. doi: 10.1016/j.pedhc.2022.09.003..
Keywords: Children/Adolescents, Primary Care, Obesity, Obesity: Weight Management, Education: Patient and Caregiver, Family Health and History
Cedillo M, Kukhareva PV, Larsen SM
Impact of electronic health record-coaching features in weight change: a secondary analysis from the MAINTAIN-pc randomized trial.
This study evaluated whether coaching features were successfully transmitted via electronic health record (EHR) communication and to evaluate their relationship with weight change in a previously tested EHR-based coaching intervention. The authors conducted a secondary analysis from the Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) study randomized clinical trial in nine primary care practices and one specialty practice (endocrinology) affiliated with the University of Pittsburgh Medical Center. Eligible participants were aged 18 to 75 years, had intentional 5% weight loss in the previous 2 years, had access to an internet-connected computer, and had receipt of care from a University of Pittsburgh Medical Center primary care provider. Participants content with intervention delivery via the EHR and those who felt a strong connection to their coach had significantly less weight regain. Participants who had needs unmet by the intervention (e.g., "in-person" support in a group setting or individual settings) regained more weight. The results suggest heterogeneity in the patient population regarding preference for in-person versus EHR-based coaching formats.
AHRQ-funded; HS021162.
Citation: Cedillo M, Kukhareva PV, Larsen SM .
Impact of electronic health record-coaching features in weight change: a secondary analysis from the MAINTAIN-pc randomized trial.
Obesity 2023 Jan;31(1):31-36. doi: 10.1002/oby.23595..
Keywords: Electronic Health Records (EHRs), Obesity, Obesity: Weight Management, Lifestyle Changes
Shen MR, Jiang S, Millis MA
Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery.
The purpose of this study was to examine whether differences exist in baseline characteristics or access to care between white and non-white patients of bariatric surgery. The researchers utilized a statewide bariatric-specific data registry and assessed all patients of bariatric surgery who completed a baseline questionnaire prior to the operation and compared data among racial groups. A total of 73,141 patients were included with 25.5% self-identifying as non-white. Non-white males were the least represented group with 4% of all bariatric surgery cases performed. Despite having higher rates of college education, when compared to white patients non-white patients were more likely to be younger, disabled, and have Medicaid. Despite having higher rates of patients with a body mass index above 50 kg/m the median time from the first evaluation to surgery was longer among non-white patients (157 days vs. 127 days.) The study concluded that despite presenting with higher rates of severe obesity, when compared with white patients non-white patients of bariatric surgery are an extremely diverse group with greater socioeconomic disadvantages and longer wait times.
AHRQ-funded; HS000053.
Citation: Shen MR, Jiang S, Millis MA .
Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery.
Surg Endosc 2023 Jan; 37(1):564-70. doi: 10.1007/s00464-022-09292-w..
Keywords: Racial and Ethnic Minorities, Surgery, Obesity: Weight Management, Obesity, Disparities
Persaud A, Castro I, Simione M
Multi-sector stakeholder's perceptions of determinants of successful implementation of a pediatric weight management intervention.
The objective of this study was to examine the perspectives of local, state, and national clinic and community stakeholders as an aid to developing successful pediatric weight management interventions (PWMI) in primary care and community settings, and to identify barriers and facilitators to implementation. Stakeholders in health centers and predominantly lower income, Hispanic community YMCAs were interviewed. Twenty-six of the stakeholders perceived formal curriculum with illustrative examples, patient- and family-centered programs, group visits, and high-quality multidisciplinary personnel to be components needed for a PWMI. These responses led to the creation of a group visit curriculum, implementation trainings, and cross-site collaborative technical assistance. The authors conclude that their findings highlight the importance of engaging multi-sector stakeholders during pre-implementation to ensure that valued components are included.
AHRQ-funded; HS022986; HS024332.
Citation: Persaud A, Castro I, Simione M .
Multi-sector stakeholder's perceptions of determinants of successful implementation of a pediatric weight management intervention.
Front Public Health 2022 Aug 25;10:954063. doi: 10.3389/fpubh.2022.954063..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity
Chao GF, Chhabra KR, Yang J
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
The purpose of this study was to compare safety and healthcare use after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. The researchers analyzed Medicare claims from 2012-2017 for 30,105 bariatric surgery patients receiving benefits due to age or disability and compared all outcomes between sleeve and bypass for each benefit group at 30 days, 1 year, and 3 years. The study found that among the disabled patients (n = 21,595), sleeve gastrectomy was associated with lower 3-year ED utilization, complications, reinterventions, rehospitalizations, and mortality. Cumulative expenditures were $46,277 after sleeve gastrectomy and $48,211 after gastric bypass. Among the elderly (n = 8510), sleeve was associated with lower 3-year ED utilization, complications, reinterventions, and rehospitalizations. Expenditures were $38,632 after sleeve gastrectomy and $39,270 after gastric bypass. Procedure treatment effect significantly differed by benefit group for paraesophageal hernia repair, revision, and mortality. The study concluded that healthcare utilization benefits of sleeve over bypass are maintained across Medicare elderly populations and Medicare disabled subpopulations.
AHRQ-funded; HS025778.
Citation: Chao GF, Chhabra KR, Yang J .
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
Ann Surg 2022 Jul 1;276(1):133-39. doi: 10.1097/sla.0000000000004526..
Keywords: Obesity: Weight Management, Obesity, Surgery, Medicare, Elderly, Disabilities
Huo T, Li Q, Cardel MI
AHRQ Author: Mistry K
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Crockett KB, Borgatti A, Tan F
Weight discrimination experienced prior to enrolling in a behavioral obesity intervention is associated with treatment response among Black and White adults in the Southeastern U.S.
This study examined the role that weight discrimination and race is associated with pre-treatment depressive symptoms. A cohort of Black and White adults were enrolled in a 16-week obesity intervention treatment (N = 271; mean BMI = 35.7 kg/m2); 59% Black; 92% women). They reported prior experiences of weight discrimination and completed the Center for Epidemiological Studies Depression (CES-D) Scale at baseline. Their weekly attendance at group sessions was recorded, and weight was measured at baseline and post-treatment. Participants with a history of weight discrimination scored 2.4 points higher on the CES-D and lost 2% less weight relative to those without weight discrimination. Race modified the association between weight discrimination and treatment session attendance, such that Black participants attended fewer sessions if they had prior experience of weight discrimination. However, this association was not true among White individuals.
AHRQ-funded; HS013852.
Citation: Crockett KB, Borgatti A, Tan F .
Weight discrimination experienced prior to enrolling in a behavioral obesity intervention is associated with treatment response among Black and White adults in the Southeastern U.S.
Int J Behav Med 2022 Apr;29(2):152-59. doi: 10.1007/s12529-021-10009-x..
Keywords: Obesity, Obesity: Weight Management, Behavioral Health, Racial and Ethnic Minorities, Depression
Chhabra KR, Telem DA, Chao GF
Comparative safety of sleeve gastrectomy and gastric bypass: an instrumental variables approach.
This study compared the safety of sleeve gastrectomy versus gastric bypass surgery. Sleeve gastrectomy has become the most common bariatric surgery, rising from 52.6% in 2012 to 75% in 2016 among the cohort of 38,153 patients identified using commercially insured patients in the IBM MarketScan claims database. At 2 years from surgery, patients undergoing sleeve gastrectomy had fewer re-interventions (sleeve 9.9%, bypass 15.6%) and complications (sleeve 6.6%, bypass 9.6%), and lower overall healthcare spending ($47,891 vs $55,213), than patients undergoing gastric bypass. However, at the 2-year mark, revisions were slightly more common in sleeve gastrectomy than in gastric bypass (sleeve 0.6%, bypass 0.4%).
AHRQ-funded; HS025778.
Citation: Chhabra KR, Telem DA, Chao GF .
Comparative safety of sleeve gastrectomy and gastric bypass: an instrumental variables approach.
Ann Surg 2022 Mar;275(3):539-45. doi: 10.1097/sla.0000000000004297..
Keywords: Obesity: Weight Management, Obesity, Surgery, Patient Safety
Howard R, Chao GF, Yang J
Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass.
The purpose of this comparative effectiveness research study was to evaluate prior laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass patients and compare the incidence of medication discontinuation and restart of diabetes, hypertension, and hyperlipidemia medications. The researchers reviewed the records of adult Medicare beneficiaries who underwent sleeve gastrectomy or gastric bypass between January 1, 2012, to December 31, 2018, and had a claim for diabetes, hypertension, or hyperlipidemia medication in the 6 months before surgery with a corresponding diagnosis. The study found that when compared with sleeve gastrectomy, gastric bypass was associated with a slightly higher 5-year cumulative incidence of medication discontinuation among 30,588 patients with diabetes medication use and diagnosis at the time of surgery, 5,081 patients with antihypertensive medication use and diagnosis at the time of surgery and 35,055 patients with lipid-lowering medication use and diagnosis at the time of surgery. Among the patients who discontinued medication, gastric bypass was also associated with a slightly lower incidence of medication restart up to 5 years after discontinuation. The researchers concluded that gastric bypass was associated with a slightly higher incidence of medication discontinuation and a slightly lower incidence of medication restart among patients who discontinued medication than sleeve gastrectomy.
AHRQ-funded; HS025778; HS025365.
Citation: Howard R, Chao GF, Yang J .
Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass.
JAMA Surg 2022 Mar;157(3):248-56. doi: 10.1001/jamasurg.2021.6898..
Keywords: Obesity, Obesity: Weight Management, Surgery, Medication
Fiechtner 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
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)
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
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
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, Decision Making
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
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.
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