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
1 to 25 of 52 Research Studies DisplayedKrefman AE, Ciolino Jd, Kan AK
Rationale and design for Healthy Hearts for Michigan (HH4M): a pragmatic single-arm hybrid effectiveness-implementation study.
The objective of the Healthy Hearts for Michigan (HH4M) study is to promote hypertension management and smoking cessation through practice facilitation and quality improvement efforts. This three-year research program evaluates rural and medically underserved primary care practices’ ability to implement the quality improvement model and tests whether the model improves blood pressure control and tobacco use screening and cessation. Primary care practices in rural and underserved areas of Michigan were recruited to join HH4M. HH4M is part of the multi-state EvidenceNOW: Building State Capacity initiative to provide external support to primary care practices to improve care delivery.
AHRQ-funded; HS027954.
Citation: Krefman AE, Ciolino Jd, Kan AK .
Rationale and design for Healthy Hearts for Michigan (HH4M): a pragmatic single-arm hybrid effectiveness-implementation study.
Contemp Clin Trials Commun 2023 Oct; 35:101199. doi: 10.1016/j.conctc.2023.101199..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Lindner SR, Balasubramanian B, Marino M
Estimating the cardiovascular disease risk reduction of a quality improvement initiative in primary care: findings from EvidenceNOW.
The purpose of this study was to estimate decreases in 10-year atherosclerotic cardiovascular disease (ASCVD) risk associated with EvidenceNOW, an initiative spanning multiple states that sought to improve cardiovascular preventive care by providing supportive interventions such as practice facilitation to address the “ABCS”: (A)spirin for high-risk patients, (B)lood pressure control for hypertensive people, (C)holesterol management, and (S)moking screening and cessation counseling. The researchers conducted an analytic modeling study that combined 1) data from 1,278 EvidenceNOW practices collected from 2015 to 2017; (2) patient-level information of 1,295 individuals who participated in the 2015 to 2016 National Health and Nutrition Examination Survey; and (3) 10-year ASCVD risk prediction equations. The study found the average 10-year ASCVD risk of these patients before intervention was 10.11%. Improvements in ABCS due to EvidenceNOW reduced their 10-year ASCVD risk to 10.03% which would prevent 3,169 ASCVD events over 10 years and $150 million in 90-day direct medical costs.
AHRQ-funded; HS023940.
Citation: Lindner SR, Balasubramanian B, Marino M .
Estimating the cardiovascular disease risk reduction of a quality improvement initiative in primary care: findings from EvidenceNOW.
J Am Board Fam Med 2023 May 8; 36(3):462-76. doi: 10.3122/jabfm.2022.220331R1..
Keywords: Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Blood Pressure
McHugh M, Philbin S, Carroll AJ
An approach to evaluating multisector partnerships to support evidence-based quality improvement in primary care.
This study’s goal was to describe an approach for evaluating the development and effectiveness of a multisector partnership using data from the first year of the Healthy Hearts for Michigan (HH4M) Cooperative, a multisector partnership of nine organizations tasked with designing and implementing evidence-based QI strategies for hypertension management and tobacco cessation in 50 rural primary care practices. A 49-item survey focused on factors that facilitate or hinder multisector partnerships, drawing on implementation science and partnership, engagement, and collaboration research was developed. All 44 members of the HH4M Cooperative (79.5% response rate) were surveyed, interviews conducted with 14 members. Having a clear purpose and trust and respect among members were the strengths reported. A need for common terminology, clarification of roles and functions, and improvement in communication across workgroups were areas for improvement. The Cooperative’s biggest challenge was the lack of engagement from physician practices due to capacity constraints, exacerbated by the COVID-19 pandemic.
AHRQ-funded; HS027954.
Citation: McHugh M, Philbin S, Carroll AJ .
An approach to evaluating multisector partnerships to support evidence-based quality improvement in primary care.
Jt Comm J Qual Patient Saf 2023 Apr;49(4):199-206. doi: 10.1016/j.jcjq.2023.01.002.
Keywords: Quality Improvement, Evidence-Based Practice, Primary Care, Quality of Care, Patient-Centered Outcomes Research
Moise N, Paniagua-Avila A, Barbecho JM
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
This study used a collaborative care (CC) use case to describe a novel, theory-informed, stakeholder engaged process for operationalizing strategies for sustainability using a behavioral lens. The goal is to optimize depression treatment in primary care clinics using the Transform DepCare shared decision-making and psychoeducation patient tool. The authors applied the Behaviour Change Wheel to their prior mixed methods to identify key sustainability behaviors and determinants of sustainability. The authors enlisted 22 national and local stakeholders to operationalize and adapt a multi-level, multi-component implementation strategy to maximally target behavioral and contextual determinants of sustainability. They identified ongoing care manager CC delivery, provider treatment optimization, and patient enrollment as key sustainability behaviors. They determined that a waiting room that delivered DepCare, the results of which are delivered to providers, as well as ongoing problem-solving meetings/local technical assistance with care managers would be the most acceptable and equitable multi-level strategy in diverse settings seeking to sustain CC programs. Key improvements would include expanding the DepCare tool to incorporate anxiety/suicide screening, triage support, multi-modal delivery, and patient activation (vs. shared decision making) (patient); pairing summary reports with decisional support and yearly onboarding/motivational educational videos (provider); incorporating behavioral health providers into problem-solving meetings and shifting from billing support to quality improvement and triage (system).
AHRQ-funded; HS025198.
Citation: Moise N, Paniagua-Avila A, Barbecho JM .
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
Implement Sci Commun 2023 Jan 25; 4(1):10. doi: 10.1186/s43058-022-00383-2..
Keywords: Depression, Primary Care, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Kuzel AJ, Cuellar A, Nichols L
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
The purpose of this study was for The Heart of Virginia Health care (HVH) collaborative (one of the Agency for Healthcare Research and Quality's (AHRQ) Evidence Now project’s 7 collaboratives) to test different ways to improve performance and outcomes on ABCS clinical quality measures (appropriate Aspirin use, Blood pressure control, Cholesterol control, and Smoking cessation counseling) within small primary care practices. The researchers recruited 264 eligible practices and randomized them to 3 cohorts in a stepped wedge design, with 173, utilizing 16 different EHRs, participated through the entire initiative. Trained coaches delivered the practice support curriculum to improve performance on the ABCS measures. The program included an initial kickoff meeting, 3 months of focused support, 9 months of continued support, and access to online materials and faculty. The intervention phase was shortened due to difficulty in recruiting a sufficient number of practices. The study found that the short HVH intervention had a small but statistically significant positive average effects on appropriate use of aspirin and other anti-thrombotics, small negative effects on blood pressure control, except for those practices which did not attend the kickoff, and small negative effects on smoking cessation counseling. The researchers concluded that the truncation of the intervention contributed to the lack of substantial improvements in the ABCS.
AHRQ-funded; HS023913.
Citation: Kuzel AJ, Cuellar A, Nichols L .
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
J Am Board Fam Med 2022 Oct 18;35(5):979-89. doi: 10.3122/jabfm.2022.05.210021..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Primary Care, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Healthcare Delivery
Salloum RG, Bilello L, Bian J
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
The objective of this 3-year project is to study the adaptation and implementation of an existing interoperable clinical decision support (CDS) tool for pain treatment shared decision making, with tailored implementation support, in new clinical settings in the OneFlorida Clinical Research Consortium. The evaluation will be organized by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, with an adaptation and tailoring of PainManager, an open source interoperable CDS tool. It is anticipated that this evaluation will establish the feasibility and obtain preliminary data in preparation for a multi-site pragmatic trial targeting the effectiveness of PainManager and tailored implementation support on shared decision making and patient-reported pain and physical function.
AHRQ-funded; R18 HS028584.
Citation: Salloum RG, Bilello L, Bian J .
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
Implement Sci 2022 Jul 15;17(1):44. doi: 10.1186/s13012-022-01217-4..
Keywords: Clinical Decision Support (CDS), Pain, Chronic Conditions, Primary Care, Health Information Technology (HIT), Patient-Centered Outcomes Research, Patient-Centered Healthcare
Berry CA, Nguyen AM, Cuthel AM
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
This study measured implementation strategy fidelity for the HealthyHearts NYC intervention program, an AHRQ-funded program that uses practice facilitation (PF) to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Almost all (94.2%) of practices received at least the 13 PF visits with an average 26.3 hours spent at each site by facilitators. Most practices (95.7%) completed all Task List items, and 71.2% were educated on all Chronic Care Models, with the majority (65.8%) receiving full coverage.
AHRQ-funded; HS023922.
Citation: Berry CA, Nguyen AM, Cuthel AM .
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
Am J Med Qual 2021 Jul-Aug;36(4):270-76. doi: 10.1177/1062860620959450..
Keywords: Implementation, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care: Models of Care
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Cykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
AHRQ-funded; HS023912.
Citation: Cykert S, Keyserling TC, Pignone M .
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
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
Fernald DH, Mullen R,, Hall T
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
The authors identified practice characteristics associated with high performance on four cardiovascular disease cardiovascular clinical quality measures (CQMs). They found that multiple strategies - registries, prompts and protocols, patient self-management support, and patient-team partnership activities - were associated with delivering high-quality cardiovascular care over time, measured by CQMs.
AHRQ-funded; HS023904.
Citation: Fernald DH, Mullen R,, Hall T .
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
J Gen Intern Med 2020 Nov;35(11):3197-204. doi: 10.1007/s11606-020-06094-5..
Keywords: Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Cuthel A, Rogers E, Daniel F
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
This study examined barriers and facilitators in the recruitment and retention of small independent practices (SIPs) to participate in research studies. The authors used qualitative data from the HealthyHearts New York City program, part of the EvidenceNOW initiative. This randomized controlled trial took place from 2015 through 2018 across 5 boroughs in NYC. A total of 257 SIPs (<5 full-time clinicians) were recruited originally. The three main factors that facilitated rapid recruitment were: 1) a prior well-established relationship with the local health department; 2) alignment of project goals with practice priorities, and 3) having appropriate monetary incentives. Specific strategies that enhance recruitment of SIPS and fills gaps in knowledge about factors that influence retention are identified.
AHRQ-funded; HS023922.
Citation: Cuthel A, Rogers E, Daniel F .
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
Am J Med Qual 2020 Sep/Oct;35(5):388-96. doi: 10.1177/1062860619893422..
Keywords: Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
McClellan C, Maclean JC, Saloner B
AHRQ Author: McClellan C
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
This study provided the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. As of 2016, 16 states had adopted an HH for enrollees with serious mental illness and/or substance use disorder. Using data from the National Survey on Drug Use and Health, the authors found that HH adoption increased service use among enrollees and enrollee self-reported health improved post-HH.
AHRQ-authored.
Citation: McClellan C, Maclean JC, Saloner B .
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
Health Econ 2020 Sep;29(9):1086-97. doi: 10.1002/hec.4027..
Keywords: Behavioral Health, Medicaid, Substance Abuse, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Patient-Centered Outcomes Research
Persell SD, Liss DT, Walunas TL
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
Effective quality improvement (QI) strategies are needed for small practices. The objective of this study was to compare practice facilitation implementing point-of-care (POC) QI strategies alone versus facilitation implementing point-of-care plus population management (POC+PM) strategies on preventive cardiovascular care. The investigators concluded that facilitator-led QI promoting population management approaches plus POC improvement strategies was not clearly superior to POC strategies alone.
AHRQ-funded; HS023921.
Citation: Persell SD, Liss DT, Walunas TL .
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
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Keywords: Cardiovascular Conditions, Prevention, Primary Care: Models of Care, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery
Nguyen AM, Cuthel A, Padgett DK
How practice facilitation strategies differ by practice context.
The purpose of this study was to identify contextual factors that drive facilitators' strategies to meet practice improvement goals, and how these strategies are tailored to practice context. This study was conducted as part of a larger study, HealthyHearts New York City, which evaluated the impact of practice facilitation on adoption of cardiovascular disease prevention and treatment guidelines.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel A, Padgett DK .
How practice facilitation strategies differ by practice context.
J Gen Intern Med 2020 Mar;35(3):824-31. doi: 10.1007/s11606-019-05350-7..
Keywords: Quality Improvement, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care: Models of Care
Rogers ES, Cuthel AM, Berry CA
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
This study examined the effectiveness of practice facilitation to improve cardiovascular disease in 257 small independent primary care practices (SIPs) enrolled in the AHRQ-funded EvidenceNOW initiative called HealthyHearts. These SIPs were enrolled in HealthyHearts NYC in New York City. Interviews were conducted with SIPs with 3 or fewer office staff and their answers were compared with interviews with practices with more than 3 office staff. Three facilitation benefits were found to the most important, including 1. Creating awareness of quality gaps; 2. Connecting practices to information, resources, and strategies, and; 3. Optimizing the HER for QI goals.
AHRQ-funded; HS023922.
Citation: Rogers ES, Cuthel AM, Berry CA .
Clinician perspectives on the benefits of practice facilitation for small primary care practices.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S17-s23. doi: 10.1370/afm.2427..
Keywords: Primary Care, Provider: Clinician, Provider: Physician, Provider, Quality Improvement, Quality of Care, Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Knierim KE, Hall TL, Dickinson LM
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
The objective of this study was to determine how quickly primary care practices can report electronic clinical quality measures (eCQMs) and to identify the practice characteristics associated with faster reporting. Examining the EvidenceNOW Southwest initiative, the researchers’ results showed that the time to report eCQMs varied by measure and practice type, with very few practices reporting quickly. Additional support for practices to succeed in new programs that require eCQM reporting was recommended.
AHRQ-funded; HS023904.
Citation: Knierim KE, Hall TL, Dickinson LM .
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
JAMA Netw Open 2019 Aug 2;2(8):e198569. doi: 10.1001/jamanetworkopen.2019.8569..
Keywords: Primary Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT)
Sklar M, Hatch MR, Aarons GA
A climate for evidence-based practice implementation in the patient-centred medical home.
This paper discusses variations in climate for evidence-based practice (EBP) implementation in patient-centered medical homes (PCMHs) in the United States. The study compared two Rhode Island PCMHs, one a Family Care Center (FCC), and the other an Internal Medicine Clinic (IMC). The FCC staff had more positive attitudes towards EBP than IMC staff. They also reported greater educational support for EBPs than IMC staff and physicians. The importance of removing barriers to EBP implementation was emphasized.
AHRQ-funded; HS024192.
Citation: Sklar M, Hatch MR, Aarons GA .
A climate for evidence-based practice implementation in the patient-centred medical home.
J Eval Clin Pract 2019 Aug;25(4):637-47. doi: 10.1111/jep.13050..
Keywords: Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Provider
Parchman ML, Anderson ML, Coleman K
Assessing quality improvement capacity in primary care practices.
The Healthy Hearts Northwest (H2N) Study is part of an AHRQ initiative to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors. The three main risk factors are appropriate aspirin use, blood pressure control, and tobacco screening/cessation. A practice facilitator (PF) met with clinicians and staff in the participating practices to discuss the results for each item on the Quality Improvement Capacity Assessment (QICA) scale. The score was associated with prior experience managing change and moderately associated with two of the three risk factors: aspirin use and blood pressure control. The QICA was found to be a useful assessment tool to measure QI capacity within a practice.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Coleman K .
Assessing quality improvement capacity in primary care practices.
BMC Fam Pract 2019 Jul 25;20(1):103. doi: 10.1186/s12875-019-1000-1.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Heart Disease and Health, Outcomes, Patient-Centered Outcomes Research, Primary Care, Quality of Care, Quality Improvement
Hall TL, Knierim KE, Nease DE
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
The authors reported on practice characteristics associated with greater patient-team partnership scores. Using EvidenceNOW Southwest data, they found that practices can improve efforts to partner with patients to assess social needs, gather meaningful input on practice improvement and patient experience, and offer resource connections. These findings supplement recent evidence that patient registries and evidence-based guidelines may effectively prevent and manage cardiovascular disease.
AHRQ-funded; HS023904.
Citation: Hall TL, Knierim KE, Nease DE .
Primary care practices' implementation of patient-team partnership: findings from EvidenceNOW Southwest.
J Am Board Fam Med 2019 Jul-Aug;32(4):490-504. doi: 10.3122/jabfm.2019.04.180361..
Keywords: Cardiovascular Conditions, Clinician-Patient Communication, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement, Primary Care, Quality of Care, Quality Improvement
Riley AR, Paternostro JK, Walker BL
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
This retrospective match-controlled study examined the impact of behavioral health consultations on medical visit duration in pediatric primary care. Patient encounters involving behavioral health consultants were significantly longer (11 plus minutes) than matched controls, and had less time allowed for medical care. The authors of the study recommend that behavioral health consultants work with the clinician to improve time efficiency.
AHRQ-funded; HS022981.
Citation: Riley AR, Paternostro JK, Walker BL .
The impact of behavioral health consultations on medical encounter duration in pediatric primary care: a retrospective match-controlled study.
Fam Syst Health 2019 Jun;37(2):162-66. doi: 10.1037/fsh0000406..
Keywords: Behavioral Health, Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care
Lyles CR, Gupta R, Tieu L
After-visit summaries in primary care: mixed methods results from a literature review and stakeholder interviews.
This literature review examined the perception of the value of after visit summaries (AVS) in primary care practices to both patients and providers. Seventeen studies were identified, and overall patients reported a higher perceived value of AVS than providers. Even so, key informants found that AVS included incorrect information and that they weren’t being used to their potential to help educate patients.
AHRQ-funded; HS022408.
Citation: Lyles CR, Gupta R, Tieu L .
After-visit summaries in primary care: mixed methods results from a literature review and stakeholder interviews.
Fam Pract 2019 Mar 20;36(2):206-13. doi: 10.1093/fampra/cmy045..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Lyles CR, Tieu L, Sarkar U
A randomized trial to train vulnerable primary care patients to use a patient portal.
This study examined the use of patient care portals in primary care practices with vulnerable patients such as those with lower socioeconomic status or limited health literacy (LHL). A randomized control trial was created with 93 English-speaking patients with 1+ chronic diseases. The patients were provided with either an 1) in-person tutorial with a research assistant, or 2) a link to view the videos on their own. A third arm of the trial were control patients with just normal access to get to the portal. There was a higher rate of access (21%) after the trial was over with the two intervention groups as compared with 9% for the usual care patients.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Lyles CR, Tieu L, Sarkar U .
A randomized trial to train vulnerable primary care patients to use a patient portal.
J Am Board Fam Med 2019 Mar-Apr;32(2):248-58. doi: 10.3122/jabfm.2019.02.180263..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Literacy, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Vulnerable Populations
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Baldwin LM, Fischer MA, Powell J
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
This paper describes the efforts of the Healthy Hearts Northwest (H2N) EvidenceNOW cooperative in providing virtual outreach intervention in primary care based on the principles of academic detailing (AD). EvidenceNOW is AHRQ’s initiative to fund seven regional cooperatives to identify and implement effective strategies to improve the quality of cardiovascular care in communities across the United States. The H2N network covers three states: Oregon, Washington, and Idaho. For this initiative they recruited 259 primary care practices that had 10 full-time or fewer providers and met stage 1 electronic health record meaningful use criteria. The aim was to increase adoption of the four ABCS of heart disease prevention: Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. Due to the long distances and staffing limitations H2N decided to develop an educational outreach program using virtual visits instead of the traditional AD program structure. The findings and outcomes of this program is described in detail in this paper.
AHRQ-funded; HS023236; HS023908.
Citation: Baldwin LM, Fischer MA, Powell J .
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
J Contin Educ Health Prof 2018 Fall;38(4):269-75. doi: 10.1097/ceh.0000000000000224..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Primary Care, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Prevention