National Healthcare Quality and Disparities Report
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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 158 Research Studies DisplayedWiese AD, Huang X, Yu C
Changes in otitis media episodes and pressure equalization tube insertions among young children following introduction of the 13-valent pneumococcal conjugate vaccine: a birth cohort-based study.
The impact of 13-valent pneumococcal conjugate vaccine (PCV13) introduction on the occurrence of first and subsequent otitis media (OM) episodes in early childhood is unclear. In this study, the investigators compared the risk of OM episodes among children age <2 years before and after PCV13 introduction, accounting for the dependence between OM episodes. They concluded that the transition from PCV7 to PCV13 was associated with a decline of OM among children aged <2 years due to a reduction in the risk of both the first and subsequent OM episodes.
AHRQ-funded; HS022342.
Citation: Wiese AD, Huang X, Yu C .
Changes in otitis media episodes and pressure equalization tube insertions among young children following introduction of the 13-valent pneumococcal conjugate vaccine: a birth cohort-based study.
Clin Infect Dis 2019 Nov 27;69(12):2162-69. doi: 10.1093/cid/ciz142..
Keywords: Children/Adolescents, Ear Infections, Vaccination
Feldman AG, Sundaram SS, Beaty BL
Immunization status at the time of liver transplant in children and adolescents.
In this research letter, the authors quantified the percentage of patients at Society of Pediatric Liver Transplantation centers who were up to date for their age on immunizations at the time of transplant, and determined whether demographic and clinical factors were associated with immunization status at the time of transplant. They concluded that further research is needed to understand barriers to immunization in the pediatric transplant population and called for novel tools that provide pretransplant vaccine education and enhance communication between primary care and subspecialty clinicians.
AHRQ-funded; HS026510.
Citation: Feldman AG, Sundaram SS, Beaty BL .
Immunization status at the time of liver transplant in children and adolescents.
JAMA 2019 Nov 12;322(18):1822-24. doi: 10.1001/jama.2019.14386..
Keywords: Transplantation, Children/Adolescents, Vaccination, Surgery
O'Leary ST, Narwaney KJ, Wagner NM
Efficacy of a web-based intervention to increase uptake of maternal vaccines: an RCT.
Tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines are recommended for pregnant women in each pregnancy, yet uptake is suboptimal. This study tested the efficacy of an online vaccine resource in increasing uptake of Tdap and influenza vaccines among pregnant women. The investigators concluded that Web-based vaccination information sent to pregnant women can positively influence maternal influenza vaccine uptake.
AHRQ-funded; HS021492.
Citation: O'Leary ST, Narwaney KJ, Wagner NM .
Efficacy of a web-based intervention to increase uptake of maternal vaccines: an RCT.
Am J Prev Med 2019 Oct;57(4):e125-e33. doi: 10.1016/j.amepre.2019.05.018..
Keywords: Vaccination, Pregnancy, Women, Health Information Technology (HIT), Social Media, Influenza
Lee BY, Wedlock PT, Mitgang EA
How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.
Researchers developed a computational simulation model of Bihar, India's routine immunization supply chain where coping occurs to evaluate the broader impact of coping. They conclude that their results show how coping can hide major system design deficiencies and how restricting coping can improve problem diagnosis and potentially lead to enhanced system design.
AHRQ-funded; HS023317.
Citation: Lee BY, Wedlock PT, Mitgang EA .
How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.
BMJ Glob Health 2019 Sep 5;4(5):e001609. doi: 10.1136/bmjgh-2019-001609..
Keywords: Vaccination, System Design, Health Systems, Healthcare Delivery
Ozawa S, Yemeke TT, Evans DR
Defining hard-to-reach populations for vaccination.
Extending the benefits of vaccination to everyone who is eligible requires an understanding of which populations current vaccination efforts have struggled to reach. A clear definition of "hard-to-reach" populations is essential for estimating the size of target groups, sharing lessons learned based on consistent definitions, and allocating resources appropriately. In this paper, a literature review was conducted to determine what formal definitions of hard-to-reach populations exist and how they are being used, and to propose definitions to consider for future use.
AHRQ-funded; HS023317.
Citation: Ozawa S, Yemeke TT, Evans DR .
Defining hard-to-reach populations for vaccination.
Vaccine 2019 Sep 3;37(37):5525-34. doi: 10.1016/j.vaccine.2019.06.081..
Keywords: Vaccination, Vulnerable Populations, Access to Care
Bartsch SM, Asti L, Cox SN
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
The authors developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination, and then introduced various Zika outbreaks. Their models showed that, when considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Cox SN .
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
J Infect Dis 2019 Aug 9;220(6):920-31. doi: 10.1093/infdis/jiy688..
Keywords: Healthcare Costs, Vaccination, Public Health, Infectious Diseases
Adamson B, Garrison L, Barnabas RV
Competing biomedical HIV prevention strategies: potential cost-effectiveness of HIV vaccines and PrEP in Seattle, WA.
The authors estimated the cost-effectiveness of HIV vaccines considering their potential interaction with pre-exposure prophylaxis (PrEP) and condom use. They concluded that access to an HIV vaccine is desirable, as it could increase the overall effectiveness of combination HIV prevention efforts and improve population health. They recommended carefully considering the design of policies that guide interactions between vaccine and PrEP utilization and potential competition when planning for the rollout and scale-up of HIV vaccines.
AHRQ-funded; HS013853.
Citation: Adamson B, Garrison L, Barnabas RV .
Competing biomedical HIV prevention strategies: potential cost-effectiveness of HIV vaccines and PrEP in Seattle, WA.
J Int AIDS Soc 2019 Aug;22(8):e25373. doi: 10.1002/jia2.25373..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Costs, Vaccination
Blumenthal KG, Topaz M, Zhou L
Mining social media data to assess the risk of skin and soft tissue infections from allergen immunotherapy.
This study examined large social media databases including Facebook, Twitter, and Reddit to identify postings of rare incidents of contamination or infection from extracts for allergen immunotherapy (AIT). They used natural language processing (NLP) related to AIT from 2012 to 2016. They compared posts on adverse events for AIT compared to influenza vaccinations. The results showed that both types of posts are rare events.
AHRQ-funded; HS025375.
Citation: Blumenthal KG, Topaz M, Zhou L .
Mining social media data to assess the risk of skin and soft tissue infections from allergen immunotherapy.
J Allergy Clin Immunol 2019 Jul;144(1):129-34. doi: 10.1016/j.jaci.2019.01.029..
Keywords: Social Media, Skin Conditions, Adverse Events, Patient Safety, Vaccination, Risk
Bartsch SM, Bottazzi ME, Asti L
Economic value of a therapeutic Chagas vaccine for indeterminate and Chagasic cardiomyopathy patients.
Therapeutic vaccines to prevent Chagas disease progression to cardiomyopathy are under development because the only available medications (benznidazole and nifurtimox) are limited by their efficacy, long treatment course, and side effects. Better understanding the potential clinical and economic value of such vaccines can help guide development and implementation. In this study, the investigators developed a computational Chagas Markov model to evaluate the clinical and economic value of a therapeutic vaccine given in conjunction with benznidazole in indeterminate and chronic Chagas patients.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Bottazzi ME, Asti L .
Economic value of a therapeutic Chagas vaccine for indeterminate and Chagasic cardiomyopathy patients.
Vaccine 2019 Jun 19;37(28):3704-14. doi: 10.1016/j.vaccine.2019.05.028..
Keywords: Vaccination, Healthcare Costs
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination
Wedlock PT, Mitgang EA, Oron AP
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
The lack of specific policies on how many children must be present at a vaccinating location before a healthcare worker can open a measles-containing vaccine (MCV) - i.e. the vial-opening threshold - has led to inconsistent practices, which can have wide-ranging systems effects. Using HERMES-generated simulation models of the routine immunization supply chains of Benin, Mozambique and Niger, the investigators evaluated the impact of different vial-opening thresholds (none, 30% of doses must be used, 60%) and MCV presentations (10-dose, 5-dose) on each supply chain.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Oron AP .
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
Vaccine 2019 Apr 17;37(17):2356-68. doi: 10.1016/j.vaccine.2019.03.017..
Keywords: Vaccination, Infectious Diseases, Healthcare Costs, Public Health
Schaffer SJ, Rand CM, Humiston SG
Practical considerations in developing a successful school-located influenza vaccination (SLIV) program.
This paper discussed strategies in developing a successful school-located influenza vaccination (SLIV) program. The authors indicate that adequate planning is crucial for SLIV success. In addition, they delineate several components that are important for a SLIV program to be successful: 1. Buy-in from school districts and school nurses, 2. Timing of SLIV clinics, 3. Publicizing SLIV to parents, 4. Obtaining vaccination consent, 5. Adequacy of resources, 6. Billing, and 7. Sustainability
AHRQ-funded; HS021163.
Citation: Schaffer SJ, Rand CM, Humiston SG .
Practical considerations in developing a successful school-located influenza vaccination (SLIV) program.
Vaccine 2019 Apr 10;37(16):2171-73. doi: 10.1016/j.vaccine.2019.01.088..
Keywords: Vaccination, Influenza, Infectious Diseases, Children/Adolescents
Wiese AD, Griffin MR, Grijalva CG
Impact of pneumococcal conjugate vaccines on hospitalizations for pneumonia in the United States.
In this study, the investigators described the existing evidence for both the direct and indirect impact of Pneumococcal conjugate vaccines (PCVs) on pneumonia among children and adults in the US since PCV introduction. The introduction of PCVs into the US routine infant vaccination schedule led to important reductions in the burden of invasive pneumococcal diseases and non-invasive pneumonia among vaccinated and unvaccinated populations. The impact of direct vaccination of older adults in the US since 2014, though difficult to quantify, is currently being evaluated.
AHRQ-funded; HS022342.
Citation: Wiese AD, Griffin MR, Grijalva CG .
Impact of pneumococcal conjugate vaccines on hospitalizations for pneumonia in the United States.
Expert Rev Vaccines 2019 Apr;18(4):327-41. doi: 10.1080/14760584.2019.1582337..
Keywords: Vaccination, Pneumonia, Respiratory Conditions, Hospitalization, Prevention
Szilagyi PG, Schaffer S, Rand CM
Text message reminders for child influenza vaccination in the setting of school-located influenza vaccination: a randomized clinical trial.
This study assessed whether text message reminders to parents could raise rates for children receiving school-located influenza vaccination (SLIV). Researchers randomized families with children in urban elementary schools to receive either text message plus SLIV (intervention) or SLIV alone (comparison). All parents were also sent two ‘backpack’ notifications and two autodialer phone reminders about SLIV at a single SLIV clinic. The text message reminders did not raise influenza vaccination rates above those observed with SLIV alone, and the authors conclude that more intensive interventions are needed to raise influenza vaccination rates.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
Text message reminders for child influenza vaccination in the setting of school-located influenza vaccination: a randomized clinical trial.
Clin Pediatr 2019 Apr;58(4):428-36. doi: 10.1177/0009922818821878..
Keywords: Children/Adolescents, Influenza, Health Information Technology (HIT), Vaccination
Baker JM, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Longer-term direct and indirect effects of infant rotavirus vaccination across all ages in the US; 2000 - 2013: analysis of a large hospital discharge dataset.
Rotavirus disease dramatically declined among children under 5 years of age since the rotavirus vaccine was introduced in 2006. In this study, data from the Healthcare Cost and Utilization Project State Inpatient Database were used to conduct a time-series analysis of monthly hospital discharges across age groups for acute gastroenteritis and rotavirus from 2000-2013, in order to elucidate population level impacts.
AHRQ-authored.
Citation: Baker JM, Tate JE, Steiner CA .
Longer-term direct and indirect effects of infant rotavirus vaccination across all ages in the US; 2000 - 2013: analysis of a large hospital discharge dataset.
Clin Infect Dis 2019 Mar 15;68(6):976-83. doi: 10.1093/cid/ciy580..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Infectious Diseases, Vaccination
Shah PD, Calo WA, Gikey MB
Questions and concerns about HPV vaccine: a communication experiment.
The purpose of this study was to identify effective responses to parents' questions and concerns about human papillomavirus (HPV) vaccine, using a surveyed national sample of 1196 parents of children aged 9 - 17. Brief videos of a pediatrician providing messages that addressed seven HPV vaccination topics were recorded and parents viewed four videos on one randomly assigned topic, in random order, and evaluated the messages. The authors conclude that the most important principles for increasing message effectiveness are to include information on the benefits of vaccination, including cancer prevention, and to avoid expressing urgency to vaccinate when addressing parents' questions or concerns. The authors also recommend that providers need to be prepared to have longer conversations with parents who express concerns about the HPV vaccine.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Gikey MB .
Questions and concerns about HPV vaccine: a communication experiment.
Pediatrics 2019 Feb;143(2):pii: e20181872. doi: 10.1542/peds.2018-1872..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Infectious Diseases, Vaccination
Margolis MA, Brewer NT, Shah PD
Stories about HPV vaccine in social media, traditional media, and conversations.
To understand how stories from media and social interactions shape parents' HPV vaccination decisions, the authors sought to characterize parents' exposure to these stories, as well as associations between story exposure and vaccination behavior. They found that stories of HPV vaccine harms may be associated more strongly with vaccination behavior than stories of HPV vaccine preventable diseases. They recommended that communication campaigns consider strategies to elevate stories of preventable diseases in social and traditional media.
AHRQ-funded; HS000032.
Citation: Margolis MA, Brewer NT, Shah PD .
Stories about HPV vaccine in social media, traditional media, and conversations.
Prev Med 2019 Jan;118:251-56. doi: 10.1016/j.ypmed.2018.11.005..
Keywords: Caregiving, Children/Adolescents, Communication, Education: Patient and Caregiver, Health Promotion, Infectious Diseases, Prevention, Sexual Health, Social Media, Vaccination
Wedlock PT, Mitgang EA, Elsheikh F
The potential effects of introducing microneedle patch vaccines into routine vaccine supply chains.
Microneedle patch (MNP) technology is designed to simplify the process of vaccine administration; however, depending on its characteristics, MNP technology may provide additional benefits beyond the point-of-use, particularly for vaccine supply chains. Using the HERMES modeling software, the investigators examined replacing four routine vaccines - Measles-containing vaccine (MCV), Tetanus toxoid (TT), Rotavirus (Rota) and Pentavalent (Penta) - with MNP versions in the routine vaccine supply chains of Benin, Bihar (India), and Mozambique.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Elsheikh F .
The potential effects of introducing microneedle patch vaccines into routine vaccine supply chains.
Vaccine 2019 Jan 21;37(4):645-51. doi: 10.1016/j.vaccine.2018.12.008..
Keywords: Vaccination
Wedlock PT, Mitgang EA, Haidari LA
The value of tailoring vial sizes to populations and locations.
Frequently, a country will procure a single vaccine vial size, but the question remains whether tailoring the use of different size vaccine vial presentations based on populations or location characteristics within a single country could provide additional benefits, such as reducing open vial wastage (OVW) or reducing missed vaccination opportunities. Using the Highly Extensible Resource for Modeling Supply Chains (HERMES) software, the investigators built a simulation model of the Zambia routine vaccine supply chain.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Haidari LA .
The value of tailoring vial sizes to populations and locations.
Vaccine 2019 Jan 21;37(4):637-44. doi: 10.1016/j.vaccine.2018.12.010..
Keywords: Vaccination
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
Wedlock PT, Mitgang EA, Siegmund SS
Dual-chamber injection device for measles-rubella vaccine: the potential impact of introducing varying sizes of the devices in 3 countries.
The purpose of this study was to identify the ideal size for dual-chamber injection devices used in routine immunization programs. Vaccine supply chain models of the Republic of Benin, the Republic of Mozambique, and Bihar were generated using the HERMES modeling software to simulate the effects of replacing a 10-dose lyophilized measles-rubella vaccine with single-dose, dual-chamber injection devices of varying sizes and prices. Optimal volume-per-dose was identified as either improving or causing no change in vaccine availability, wastage, or supply-chain costs in comparison to the existing program. The study concludes that a single-dose, dual-chamber measles-rubella injection device would need to be no larger than 5.2cm(3) to not significantly impair the flow of other vaccines.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Siegmund SS .
Dual-chamber injection device for measles-rubella vaccine: the potential impact of introducing varying sizes of the devices in 3 countries.
Vaccine 2018 Sep 18;36(39):5879-85. doi: 10.1016/j.vaccine.2018.08.026..
Keywords: Public Health, Vaccination
Shah PD, Trogdon JG, Golden SD
Impact of pharmacists on access to vaccine providers: a geospatial analysis.
This study analyzed the impact of pharmacists on access to vaccines. The study concluded that pharmacists are more geographically dispersed across census tracts than primary care physicians. As a result, adding pharmacists to the workforce would increase the availability of vaccine providers in areas with inadequate primary care provider coverage.
AHRQ-funded; HS000032.
Citation: Shah PD, Trogdon JG, Golden SD .
Impact of pharmacists on access to vaccine providers: a geospatial analysis.
Milbank Q 2018 Sep;96(3):568-92. doi: 10.1111/1468-0009.12342.
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Keywords: Access to Care, Provider: Pharmacist, Vaccination
Shah PD, Calo WA, Marciniak MW
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380..
Keywords: Caregiving, Children/Adolescents, Infectious Diseases, Provider, Provider: Pharmacist, Provider: Physician, Vaccination
Daley MF, Narwaney KJ, Shoup JA
Addressing parents' vaccine concerns: a randomized trial of a social media intervention.
Successful strategies are needed to address parental vaccine hesitancy, a significant public health issue. The study objective was to assess whether an Internet-based platform with vaccine information and interactive social media components improved parents' vaccine-related attitudes. The authors concluded that among vaccine-hesitant parents, an Internet-based intervention improved parents' attitudes about vaccines.
AHRQ-funded; HS021492.
Citation: Daley MF, Narwaney KJ, Shoup JA .
Addressing parents' vaccine concerns: a randomized trial of a social media intervention.
Am J Prev Med 2018 Jul;55(1):44-54. doi: 10.1016/j.amepre.2018.04.010..
Keywords: Caregiving, Patient Safety, Social Media, Vaccination, Web-Based
Shah PD, Marciniak MW, Golden SD
Pharmacies versus doctors' offices for adolescent vaccination.
This study sought to understand the relative advantage of pharmacies compared to doctors' offices for delivering HPV vaccination to adolescents. The authors concluded that to be more appealing to parents as HPV vaccine providers, pharmacy providers within community and hospital settings should build on their relative advantage with respect to accessibility and enhance their appeal of their healthcare environment.
AHRQ-funded; HS000032.
Citation: Shah PD, Marciniak MW, Golden SD .
Pharmacies versus doctors' offices for adolescent vaccination.
Vaccine 2018 Jun 7;36(24):3453-59. doi: 10.1016/j.vaccine.2018.04.088..
Keywords: Children/Adolescents, Health Services Research (HSR), Ambulatory Care and Surgery, Provider: Pharmacist, Vaccination