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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
26 to 50 of 92 Research Studies DisplayedKang JX, Levanon Seligson A, Dragan KL
Identifying New York City neighborhoods at risk of being overlooked for interventions.
Public health agencies are often faced with difficult decisions about where and how to allocate funding and resources. In this study, the investigators walked readers through a process of identifying needs across different neighborhoods in New York City (NYC) by examining community district-level health outcomes using data from published Community Health Profile reports released by the NYC Department of Health and Mental Hygiene (DOHMH) in 2015.
AHRQ-funded; HS000055.
Citation: Kang JX, Levanon Seligson A, Dragan KL .
Identifying New York City neighborhoods at risk of being overlooked for interventions.
Prev Chronic Dis 2020 Apr 23;17:E32. doi: 10.5888/pcd17.190325..
Keywords: Public Health, Disparities, Urban Health, Vulnerable Populations
Heller CG, Parsons AS, Chambers EC
Social risks among primary care patients in a large urban health system.
The objective of this study was to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. Participants across nineteen ambulatory sites in the Bronx, New York, completed a 10-item screener. Findings showed that there were important differences in the prevalence of overall and individual social risks by subgroup. These findings should be considered to inform clinical care and social risk screening and interventions.
AHRQ-funded; HS026396.
Citation: Heller CG, Parsons AS, Chambers EC .
Social risks among primary care patients in a large urban health system.
Am J Prev Med 2020 Apr;58(4):514-25. doi: 10.1016/j.amepre.2019.11.011..
Keywords: Social Determinants of Health, Primary Care, Urban Health, Risk, Vulnerable Populations
Longo M, Pennington Z, Gelfand Y
Readmission after spinal epidural abscess management in urban populations: a bi-institutional study.
This study examined 90-day readmission rates and causes after spinal epidural abscess (SEA) occurrence in urban populations. Neurosurgery records from two large urban institutions were reviewed to identify patients who were treated with SEA. Out of 103 patients with identified SEA, 97 were included. The mean age was 57.1 years and 57.7% were male. The 90-readmission rate for all causes was 37.1% with infection being the most common cause. Patients with prior immunocompromised status or hepatic disease had higher odds of 90-day readmission after SEA treatment.
AHRQ-funded; HS026396.
Citation: Longo M, Pennington Z, Gelfand Y .
Readmission after spinal epidural abscess management in urban populations: a bi-institutional study.
J Neurosurg Spine 2020 Mar;32(3):465–72. doi: 10.3171/2019.8.Spine19790..
Keywords: Hospital Readmissions, Urban Health, Surgery, Risk
Lee SJC, Hamann HA, Browning T
Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
The authors sought to develop a population-based lung cancer screening program using low-dose computed tomography imaging at Parkland Health & Hospital System, Dallas County, Texas, providing coverage of uninsured patients through a combination of Medicare, Medicaid, and the Dallas medical assistance program for under- and uninsured, low-income county residents. They found that establishing a uniform clinical pathway connecting different clinical specialists requires a system-level view of care coordination to ensure that referrals trigger appointments, result reporting, and follow-up. Additionally, primary care providers need to educate and refer patients, address smoking cessation needs, and document shared decision-making counseling between the referring provider and the patient.
AHRQ-funded; HS022418.
Citation: Lee SJC, Hamann HA, Browning T .
Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
Healthc 2020 Mar;8(1):100370. doi: 10.1016/j.hjdsi.2019.100370.
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Keywords: Cancer: Lung Cancer, Cancer, Screening, Prevention, Urban Health, Rural/Inner-City Residents
Kirby JB, Yabroff KR
AHRQ Author: Kirby JB
Rural-urban differences in access to primary care: beyond the usual source of care provider.
This study used 2014-2016 MEPS data to analyze differences between rural and urban areas to primary care access beyond the usual source of care provider. While rural residents were more likely to have a usual source of care, they were less likely to have a provider with office hours on nights and weekends.
AHRQ-authored.
Citation: Kirby JB, Yabroff KR .
Rural-urban differences in access to primary care: beyond the usual source of care provider.
Am J Prev Med 2020 Jan;58(1):89-96. doi: 10.1016/j.amepre.2019.08.026..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Primary Care, Rural Health, Urban Health, Health Services Research (HSR)
Rawlett KE, N'Dri LA, dosReis S
Perceived needs for adolescent mental health in an urban community.
This paper discusses a set of focus groups that were conducted with teachers, families, and students in an urban middle school to discuss needs for adolescent psychological well-being. Six focus groups were conducted with a total of 29 participants. Approximately 70% of participants were female, African American (n=22), and the rest were multiracial (n=4), White (n=2) and Latino (n=1). Participants focused on needs for educational support, strengthening social skills, and changing the community landscape.
AHRQ-funded; HS022135.
Citation: Rawlett KE, N'Dri LA, dosReis S .
Perceived needs for adolescent mental health in an urban community.
J Pediatr Health Care 2019 Nov - Dec;33(6):633-38. doi: 10.1016/j.pedhc.2019.03.003..
Keywords: Children/Adolescents, Behavioral Health, Urban Health
Smith NA, Voisin DR, Yang JP
Keeping your guard up: hypervigilance among urban residents affected by community and police violence.
This study’s aim was to quantify the effects of hypervigilance among urban residents affected by community and police violence. A survey of 504 adults in Chicago in 2018 was done in a neighborhood affected by high levels of violence. It was found that exposure to police violence was associated with a 9.8% increase in hypervigilance while exposure to community violence caused a 5.5% increase. Among participants who had a police stop, it was associated with 20% increase in hypervigilance. Overall, the highest quartile of hypervigilance was associated with higher systolic blood pressure.
AHRQ-funded; HS023007.
Citation: Smith NA, Voisin DR, Yang JP .
Keeping your guard up: hypervigilance among urban residents affected by community and police violence.
Health Aff 2019 Oct;38(10):1662-69. doi: 10.1377/hlthaff.2019.00560..
Keywords: Urban Health, Social Determinants of Health, Behavioral Health, Patient-Centered Outcomes Research, Evidence-Based Practice
Tung EL, Hawkley LC, Cagney KA
Social isolation, loneliness, and violence exposure in urban adults.
This qualitative study’s goal was to empirically assess the relationship between violence exposure and social isolation in urban areas. Interviews were conducted in 2018 with 504 adults in Chicago from a high-crime neighborhood. Prior exposure to community violence was associated with a 3.3-point decrease in the frequent of interaction with associates, a 7.3-point reduction in perceived social support from friends, and a 7.8-point increase in loneliness.
AHRQ-funded; HS023007.
Citation: Tung EL, Hawkley LC, Cagney KA .
Social isolation, loneliness, and violence exposure in urban adults.
Health Aff 2019 Oct;38(10):1670-78. doi: 10.1377/hlthaff.2019.00563..
Keywords: Urban Health, Behavioral Health, Evidence-Based Practice, Patient-Centered Outcomes Research
Rundle AG, Chen Y, Quinn JW
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. In this study, the Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area.
AHRQ-funded; HS026120.
Citation: Rundle AG, Chen Y, Quinn JW .
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
J Urban Health 2019 Aug;96(4):583-90. doi: 10.1007/s11524-019-00370-4
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Keywords: Urban Health, Lifestyle Changes, Health Status, Social Determinants of Health
Cullen D, Woodford A, Fein J
Food for thought: a randomized trial of food insecurity screening in the emergency department.
Despite the growing interest in screening for food insecurity in the clinical setting, little evidence exists regarding screening formats that maximize disclosure and caregiver comfort. In this randomized trial, investigators asked English-speaking adult caregivers of pediatric patients in the emergency department at an urban, freestanding children's hospital to complete a validated, 2-question screen for food insecurity. Although both verbal interview and tablet-based screening modalities were effective in identifying food insecurity, tablet-based screening had a higher disclosure rate and was the participants' preferred screening method.
AHRQ-funded; HS026116.
Citation: Cullen D, Woodford A, Fein J .
Food for thought: a randomized trial of food insecurity screening in the emergency department.
Acad Pediatr 2019 Aug;19(6):646-51. doi: 10.1016/j.acap.2018.11.014..
Keywords: Children/Adolescents, Emergency Department, Nutrition, Screening, Urban Health, Caregiving
Tieu L, Hobbs A, Sarkar U
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
This study compared the acceptability of low-literacy tablet-based and traditional paper-based patient experience surveys in English and Spanish. The Consumer Assessment of Healthcare Providers & Systems Clinician & Group Survey (CG-CAHPS) was adapted for a pilot survey using low-literacy questions in Spanish and English. The majority of interview participants preferred the tablet version over the traditional paper-based survey. This was especially true for the younger and Latino respondents.
AHRQ-funded; HS022408.
Citation: Tieu L, Hobbs A, Sarkar U .
Adapting patient experience data collection processes for lower literacy patient populations using tablets at the point of care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S140-s48. doi: 10.1097/mlr.0000000000001030..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Health Literacy, Patient Experience, Primary Care, Quality of Care, Quality Improvement, Racial and Ethnic Minorities, Urban Health
Spees LP, Brewster WR, Varia MA
Examining urban and rural differences in how distance to care influences the initiation and completion of treatment among insured cervical cancer patients.
Although rural cancer patients encounter substantial barriers to care, they more often report receiving timely care than urban patients. In this study, the investigators examined whether geographic distance, a contributor to urban-rural health disparities, differentially influenced treatment initiation and completion among insured urban and rural cervical cancer patients. The investigators found that geographic distance differentially influenced the initiation and completion of treatment among urban and rural cervical cancer patients.
AHRQ-funded; HS000032.
Citation: Spees LP, Brewster WR, Varia MA .
Examining urban and rural differences in how distance to care influences the initiation and completion of treatment among insured cervical cancer patients.
Cancer Epidemiol Biomarkers Prev 2019 May;28(5):882-89. doi: 10.1158/1055-9965.Epi-18-0945..
Keywords: Rural Health, Urban Health, Disparities, Access to Care, Cancer: Cervical Cancer, Cancer
Louisias M, Petty CR, Sheehan W
Use of a school-based survey to screen students for symptoms concerning for asthma.
Researchers sought early identification of asthma in minority children. Their goal was to determine if they could apply screening surveys to an inner-city, school-based cohort. They found a significant number of children with a positive asthma screen and no parent-reported asthma. Children with symptoms suggestive of asthma had elevated rates of hospital care for breathing problems and an atopic background. The researchers conclude that these children without known asthma, but who experience increased morbidity, can be easily identified with a school-based asthma screening survey and should be closely monitored.
AHRQ-funded; HS000063; HS022986.
Citation: Louisias M, Petty CR, Sheehan W .
Use of a school-based survey to screen students for symptoms concerning for asthma.
Clin Pediatr 2019 May;58(5):586-89. doi: 10.1177/0009922819832087..
Keywords: Children/Adolescents, Asthma, Screening, Education, Diagnostic Safety and Quality, Urban Health
Patel M, Boutin-Foster C, Phillips E
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
This study’s objective was to compare the understanding of cardiovascular disease (CVD) risk factors among Bangladeshi immigrants to the general Caucasian population in the U.S. by surveying a sample group of immigrants in Queens, NY., Scores on the knowledge instrument used for the surveyed Bangladeshis were compared with Caucasians from the Coronary Artery Risk Development in Young Adults (CARDIA) study using multivariate regression modeling. The results of the study indicate that understanding of CVD risk factors was lower among Bangladeshis than whites, driven by the surveyed Bangladeshis having less awareness of how exercise and weight contribute to CVD risk. The authors recommend that community based interventions and health partnerships target these behavioral risk factors in the Bangladeshi population.
AHRQ-funded; HS000066.
Citation: Patel M, Boutin-Foster C, Phillips E .
Understanding of cardiovascular disease risk factors among Bangladeshi immigrants in New York City.
Ethn Health 2019 May;24(4):432-42. doi: 10.1080/13557858.2017.1346191..
Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Risk, Urban Health
Shah SC, Nakata C, Polydorides AD
Upper endoscopy up to 3 years prior to a diagnosis of gastric cancer is associated with lower stage of disease in a USA multiethnic urban population, a retrospective study.
This study focused on the feasibility of earlier diagnosis of non-cardia gastic cancer (NCGC) for high-risk populations in the US who include multiracial and ethnic populations. A retrospective study was conducted with patients who were positively identified endoscopically with NCGC at Mount Sinai Hospital in New York City. The primary outcome was an increased frequency of patients diagnosed with stage 0-Ia (38%) as opposed to stage Ib-III (34%) and stage IV (20.3%). For patients with stage 0-Ia if they had a prior negative endoscopy there was a 94% higher likelihood of the NCGC being in a curable stage.
AHRQ-funded; HS026395.
Citation: Shah SC, Nakata C, Polydorides AD .
Upper endoscopy up to 3 years prior to a diagnosis of gastric cancer is associated with lower stage of disease in a USA multiethnic urban population, a retrospective study.
J Prev Med Public Health 2019 May;52(3):179-87. doi: 10.3961/jpmph.18.262..
Keywords: Cancer, Diagnostic Safety and Quality, Digestive Disease and Health, Imaging, Racial and Ethnic Minorities, Urban Health
Spees LP, ledikwe JH, Kleinman NJ
Immediate motivators to seeking voluntary medical male circumcision among HIV-negative adult men in an urban setting in Botswana.
The goal of this study was to identify subpopulations of Botswanan men with high levels of voluntary medical male circumcision (VMMC) uptake. An observational cohort of men presenting for circumcision services at two high-volume clinics in Gabo-rone, Botswana's capital, were compared with a matched, population-based random sample of uncircumcised men with regard to factors that played a role in the men's decision to seek VMMC services. The results indicate that married men and highly educated men are more likely to undergo circumcision for personal hygiene reasons. The authors conclude that these findings have implications for activities designed to increase VMMC uptake in Botswana and reduce HIV acquisition risk in men.
AHRQ-funded; HS000032.
Citation: Spees LP, ledikwe JH, Kleinman NJ .
Immediate motivators to seeking voluntary medical male circumcision among HIV-negative adult men in an urban setting in Botswana.
AIDS Educ Prev 2019 Apr;31(2):136-51. doi: 10.1521/aeap.2019.31.2.136..
Keywords: Decision Making, Human Immunodeficiency Virus (HIV), Men's Health, Urban Health, Sexual Health
Sadasivaiah S, Lyles CR, Kyoi S
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
Offering hospitalized patients' enrollment into a health system's patient portal may improve patient experience and engagement throughout the care continuum, especially across care transitions, but this process is less studied than portal engagement in the ambulatory setting. The objective of this study was to evaluate sociodemographic characteristics associated with interest in a health care system's portal among hospitalized patients and reasons for no interest.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Sadasivaiah S, Lyles CR, Kyoi S .
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
J Med Internet Res 2019 Mar 26;21(3):e11421. doi: 10.2196/11421..
Keywords: Disparities, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Patient and Family Engagement, Urban Health
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
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Spees LP, Wheeler SB, Varia M
Evaluating the urban-rural paradox: the complicated relationship between distance and the receipt of guideline-concordant care among cervical cancer patients.
A recent study suggests that the distance to reach care may affect urban and rural cancer patients differentially; the authors of this article examined whether or not this urban-rural paradox exists among cervical cancer patients. Patients diagnosed with cervical cancer from 2004 to 2013 were identified via a statewide cancer registry linked to multi-payer insurance claims. 62% of the cervical cancer patients received guideline-concordant care. The association between distance and receipt of care differed by type of treatment. The authors conclude that there is evidence supporting the urban-rural paradox.
AHRQ-funded; HS000032.
Citation: Spees LP, Wheeler SB, Varia M .
Evaluating the urban-rural paradox: the complicated relationship between distance and the receipt of guideline-concordant care among cervical cancer patients.
Gynecol Oncol 2019 Jan;152(1):112-18. doi: 10.1016/j.ygyno.2018.11.010.
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Keywords: Access to Care, Cancer: Cervical Cancer, Disparities, Evidence-Based Practice, Rural Health, Urban Health
Oates GR, Phillips JM, Bateman LB
Determinants of obesity in two urban communities: perceptions and community-driven solutions.
Using Photovoice methodology, this study aimed to identify community perceptions of factors associated with obesity in two urban municipalities - one racially mixed and one predominantly African American - and to explore community-driven solutions to the problem of obesity.
AHRQ-funded; HS023009.
Citation: Oates GR, Phillips JM, Bateman LB .
Determinants of obesity in two urban communities: perceptions and community-driven solutions.
Ethn Dis 2018 Winter;28(1):33-42. doi: 10.18865/ed.28.1.33..
Keywords: Obesity, Racial and Ethnic Minorities, Urban Health
Oates GR, Hamby BW, Bae S
Bikeshare use in urban communities: individual and neighborhood factors.
This study examined factors associated with bikeshare use in a metropolitan area in the southern United States. The study found that higher neighborhood socioeconomic disadvantage was associated with higher bikeshare use. Bikeshare was a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Bae S .
Bikeshare use in urban communities: individual and neighborhood factors.
Ethn Dis 2017 Nov 9;27(Suppl 1):303-12. doi: 10.18865/ed.27.S1.303..
Keywords: Health Status, Social Determinants of Health, Urban Health
Baernholdt M, Hinton ID
Fall rates in urban and rural nursing units: does location matter?
This paper discusses a study of fall rates in 65 rural hospitals with 222 nursing units and 560 urban hospitals with 4274 nursing units. The authors found that geographic region, unit type, and nurse staffing, education, experience, and outcomes were associated with fall rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID .
Fall rates in urban and rural nursing units: does location matter?
J Nurs Care Qual 2018 Oct/Dec;33(4):326-33. doi: 10.1097/ncq.0000000000000319..
Keywords: Falls, Patient Safety, Rural Health, Urban Health
Harris VC, Links AR, Kim JM
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
The purpose of this study was to evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Researchers found that half of the children referred for sleep-disordered breathing evaluation are lost to follow-up from primary care. Obstructive sleep apnea severity did not predict follow-up or timeliness of treatment. They conclude that these findings suggest social determinants may pose barriers to care in addition to the clinical burden of sleep-disordered breathing.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Kim JM .
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
Otolaryngol Head Neck Surg 2018 Aug;159(2):371-78. doi: 10.1177/0194599818772035..
Keywords: Access to Care, Children/Adolescents, Disparities, Healthcare Delivery, Patient-Centered Healthcare, Quality of Care, Respiratory Conditions, Sleep Problems, Urban Health
Yoon S, Odlum M, Lee Y
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
In this study, the investigators applied deep learning algorithms to build correlate models that predicted tooth mobility in a convenience sample of urban Latinos. The authors suggest that their application was useful for gaining insights into the most important modifiable and non-modifiable factors predicting tooth mobility, and maybe useful for guiding targeted interventions in urban Latinos.
AHRQ-funded; HS019853.
Citation: Yoon S, Odlum M, Lee Y .
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
Stud Health Technol Inform 2018;251:241-44..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health