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 80 Research Studies DisplayedHails KA, Wellen BC, Simoni M
Parents' preferences for primary care-based behavioral services and the COVID-19 pandemic: a mixed method study.
This mixed method study examined how family factors impacted parents' attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic. The authors hypothesized that COVID-19 impact would predict family functioning challenges, and that pre-existing familial contextual factors would predict parents' interest in IBH modalities. A survey was completed by parents of children ages 1.5-5 years (N = 301) from five primary care clinics with measures assessing familial contextual factors (income, race and ethnicity, and parents' childhood adversity), COVID-19 impact on family relationships and wellbeing, family functioning (child behavior, parenting self-efficacy, and parent psychological functioning), and parents' preferences for behavioral support in primary care. A subsample of 23 parents completed qualitative interviews to provide deeper insights into quantitative relationships. The higher the COVID-19 impact, the more it was significantly associated with worse parent mental health and child behavior problems, as well as lower interest in IBH virtual support options. Lower SES and racial and/or ethnic minority parents both indicated greater interest in IBH modalities compared to higher SES and White parents, respectively. Qualitative interviews conducted found that pandemic stressors led to increases in parents’ desire for behavioral support from pediatricians, with parents sharing perspectives on the nature of support they desired, including proactive communication from providers and variety and flexibility in the behavioral supports offered.
AHRQ-funded; HS022981.
Citation: Hails KA, Wellen BC, Simoni M .
Parents' preferences for primary care-based behavioral services and the COVID-19 pandemic: a mixed method study.
J Pediatr Psychol 2023 Nov 16; 48(11):879-92. doi: 10.1093/jpepsy/jsad034..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Primary Care
Sequeria GM, Guler J, Reyes V
Adolescent and caregiver perspectives on receiving gender-affirming care in primary care.
The purpose of this study was to examine Transgender and gender-diverse (TGD) adolescents' and caregivers' experiences and perspectives about gender-affirming care delivery in pediatric primary care. Semi-structured, individual, virtual interviews were administered to TGD adolescents aged 14 to 17 and caregivers of TGD adolescents currently receiving gender-affirming medical care. A total of 15 adolescents and 18 caregivers (33 total participants) completed interviews. Adolescent participants primarily identified as transmasculine or trans male (73%), and caregiver participants were primarily mothers (83.3%). The study identified four themes, which included 1) barriers, such as microaggressions and poor psychosocial support, 2) benefits, such as existing trusted relationships with primary care providers (PCPs) and convenience, 3) improvement strategies, such as training and interdisciplinary collaboration, and 4) opportunities for integrating primary care and specialty gender-affirming care.
AHRQ-funded; HS026393.
Citation: Sequeria GM, Guler J, Reyes V .
Adolescent and caregiver perspectives on receiving gender-affirming care in primary care.
Pediatrics 2023 Oct 1; 152(4). doi: 10.1542/peds.2023-062210..
Keywords: Sex Factors, Children/Adolescents, Primary Care
Anan YH, Kahn NF, Garrison MM
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
The objective of this paper was to understand associations between low sleep duration and positive mental health screens among adolescents seen for preventive visits in primary care. Data were taken from two randomized controlled trials that tested the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. The results showed that low sleep duration was associated with greater odds of positive depression screen, but not with a positive anxiety or co-occurring positive depression and anxiety screens. The authors concluded that, as pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are necessary to ensure effective early intervention for adolescent sleep and mental health problems.
AHRQ-funded; HS023383.
Citation: Anan YH, Kahn NF, Garrison MM .
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
Acad Pediatr 2023 Aug; 23(6):1242-46. doi: 10.1016/j.acap.2023.02.013..
Keywords: Children/Adolescents, Sleep Problems, Primary Care, Behavioral Health, Screening
Sequeira GM, Kahn NF, Ricklefs C
Barriers pediatric PCP's identify to providing gender-affirming care for adolescents.
The purpose of this study was to explore pediatric primary care providers’ (PCPs) perspectives on barriers experienced in providing gender-affirming care to transgender and gender diverse (TGD) youth. Pediatric PCPs who had sought support from the Seattle Children's Gender Clinic were recruited to participate in semi-structured, one-hour interviews. They identified both health system and community-level barriers to providing gender-affirming care. The authors concluded that these barriers must be overcome in the pediatric primary care setting to ensure that TGD youth receive timely, effective, and more equitable gender-affirming care.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Kahn NF, Ricklefs C .
Barriers pediatric PCP's identify to providing gender-affirming care for adolescents.
J Adolesc Health 2023 Aug; 73(2):367-74. doi: 10.1016/j.jadohealth.2023.04.007..
Keywords: Children/Adolescents, Primary Care, Access to Care
Loo S, Brady KJS, Ragavan MI
Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings.
This study examined the validity of the Clinicians’ Cultural Sensitivity Survey (CCCS) for use in pediatric primary care, which was developed as a patient-reported survey assessing clinicians' recognition of cultural factors affecting care quality for older Latino patients. The authors adapted the survey for use with parents of pediatric patients. A convenience sampling approach was used to identify eligible parents during well-child visits at urban pediatric primary care clinic, and parents were administered the survey via electronic tablet. They first conducted exploratory factor analyses (EFAs) to explore the dimensionality of survey responses in the adapted CCSS, and then conducted a series of confirmatory factor analyses (CFAs) using maximum likelihood estimation based on the results of the EFAs. Exploratory and confirmatory factor analyses (N = 212 parent surveys) supported a three-factor structure assessing racial discrimination, culturally-affirming practices, and causal attribution of health problems. The 3-factor model also outperformed other potential factors in terms of fit statistics and demonstrated adequate fit.
AHRQ-funded; HS022242; HS026395.
Citation: Loo S, Brady KJS, Ragavan MI .
Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings.
J Immigr Minor Health 2023 Aug; 25(4):790-802. doi: 10.1007/s10903-023-01469-2..
Keywords: Children/Adolescents, Primary Care, Cultural Competence, Healthcare Delivery
Teixeira da Silva D, Makeneni S, Wall H
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
The purpose of this study was to develop and apply a cross-setting, sexually transmitted infection (STI) Care Continuum to improve STI care quality, to assess adherence to guideline-recommended care, and to standardize progress measurement toward National Strategic goals. Review of the CDC STI treatment guidelines identified seven distinct steps of care for gonorrhea, chlamydia, and syphilis; researchers used Youth Risk Behavior Surveillance Survey data to estimate step 1, and electronic health record data for steps 2, 3, 4, 6 and 7. The researchers concluded that local application of an STI Care Continuum identified STI testing, retesting, and HIV testing as areas for improvement. Similar methods may be applied to target resources, standardize data collection and reporting, and improve STI care quality.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Makeneni S, Wall H .
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
Sex Transm Infect 2023 Jun; 99(4):272-75. doi: 10.1136/sextrans-2022-055623..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Women, Human Immunodeficiency Virus (HIV), Quality Measures, Quality of Care
Ahmad FA, Chan P, McGovern C
Adapting an electronic STI risk assessment program for use in pediatric primary care.
This study’s goal was to evaluate the usability of an electronic risk assessment tool to support sexually transmitted disease (STI) testing in the authors’ pediatric emergency department that they had previously designed and implemented. They conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews was (1) to understand contextual factors related to STI screening in primary care, which they reported previously, and (2) to obtain feedback on their electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings. They received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications, with a score of 68 (range 0-100) being average usability. They recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool with a median score of 92.5, which shows a high level of usability.
AHRQ-funded; HS026704.
Citation: Ahmad FA, Chan P, McGovern C .
Adapting an electronic STI risk assessment program for use in pediatric primary care.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231172900. doi: 10.1177/21501319231172900..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Health Information Technology (HIT), Screening, Prevention
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
Safon CB, Estela MG, Rosenberg J
Implementation of a novel pediatric behavioral health integration initiative.
The purpose of this concurrent, qualitative-dominant mixed methods empirical study was to explore healthcare professionals' perceptions of the impact of behavioral health integration (BHI) on pediatric primary care delivery in community health centers (CHCs). The researchers utilized semi-structured interviews with healthcare professionals at the end of the implementation phase of a 3-year process and surveys administered at three time points. Qualitative themes were mapped onto the Relational Coordination (RC) conceptual framework to triangulate and complement final qualitative results with quantitative results. The researchers round five emergent themes aligning with RC domains. The results of the survey showed that healthcare professionals reported both greater behavioral healthcare integration into clinic practice and greater clinic readiness to address behavioral health needs. The researchers concluded that effective pediatric BHI and care delivery at CHCs may depend on solid professional relationships and communication.
AHRQ-funded; HS022242.
Citation: Safon CB, Estela MG, Rosenberg J .
Implementation of a novel pediatric behavioral health integration initiative.
J Behav Health Serv Res 2023 Jan;50(1):1-17. doi: 10.1007/s11414-022-09803-6..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Primary Care, Patient-Centered Healthcare, Community-Based Practice
Teixeira da Silva D, Petsis D, Santos T
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
This study describes retesting following Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting. Findings showed that guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Petsis D, Santos T .
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
J Adolesc Health 2022 Nov;71(5):545-51. doi: 10.1016/j.jadohealth.2022.06.014..
Keywords: Children/Adolescents, Young Adults, Sexual Health, Infectious Diseases, Primary Care
Hoopes AJ, Brandzel SD, Luce C
What do adolescents and their parents need from mental health integration in primary care? A qualitative exploration of design insights.
The purpose of this study was to 1) explore the challenges of primary care-based mental health and substance use screening and care for adolescents and 2) identify program design solutions. The researchers conducted interviews and focus groups with adolescents receiving care at Kaiser Permanente Washington in 2020, and separate interviews with the parents of the participants. The study found five overarching design principle themes emerged from the 41 interviews and 10 focus groups: 1) Engagement, 2) Privacy, 3) Communication, 4) Choice, and 5) Ease.
Citation: Hoopes AJ, Brandzel SD, Luce C .
What do adolescents and their parents need from mental health integration in primary care? A qualitative exploration of design insights.
J Pediatr Health Care 2022 Nov-Dec; 36(6):570-81. doi: 10.1016/j.pedhc.2022.06.006..
Keywords: Children/Adolescents, Patient-Centered Healthcare, Behavioral Health, Primary Care
Viswanathan M, Wallace IF, Cook Middleton J
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors sought to review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force. They found indirect evidence that suggested some screening instruments were reasonably accurate for detecting depression. Further, psychotherapy and pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide risk screening instruments and interventions.
AHRQ-funded; 290201500011I.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 18;328(15):1543-56. doi: 10.1001/jama.2022.16310..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Depression, Behavioral Health, Screening, Primary Care, Guidelines, Evidence-Based Practice, Prevention
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Bell N, Lòpez-De Fede A, Cai B
Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.
This retrospective cohort study examined geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures for pediatric patients with either attention deficit/hyperactivity disorder (ADD, ages 6-12) or asthma (MMA, ages 5-18) defined using Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. The authors investigated differences in avoidable and potentially avoidable ED visits by the beneficiary's primary care medical home (PCMH) attribution type and in relation to differences in proximity to their primary care providers versus hospitals. There was a 2.4 percentage point reduction in risk of avoidable emergency department (ED) visits among children in the ADD cohort who attended a PCMH versus those who did not which increased to 3.9 to 7.2 percentage points as relative proximity to primary care providers versus hospitals improved. Children in the ADD and MMA cohorts who were enrolled in a PCMH but did not attend one for primary care services exhibited a 5.4 and 3.0 percentage point increase in avoidable ED visits compared to children who were unenrolled and did not attend medical homes, but these differences were only observed when geographic proximity to hospitals was more convenient than primary care providers.
AHRQ-funded; HS026263.
Citation: Bell N, Lòpez-De Fede A, Cai B .
Geographic proximity to primary care providers as a risk-assessment criterion for quality performance measures.
PLoS One 2022 Sep 6;17(9):e0273805. doi: 10.1371/journal.pone.0273805..
Keywords: Children/Adolescents, Primary Care, Asthma, Medicaid, Emergency Department
Petts RA, Walker BL, Hails KA
Parents' preferences for behavioral services in primary care during the COVID-19 pandemic.
The purpose of the study was to evaluate whether the COVID-19 pandemic impacted parent’s preferences and priorities for receiving behavioral health services for their young children in the pediatric primary care setting. In 5 pediatric primary care sites across the U.S., between July 2020 and January 2021, 301 parents of young children completed surveys on their preferences for behavioral subjects and methods of service delivery in primary care. The responses were compared to the responses from 396 parents who had been surveyed on the same measures in 2018. The study concluded that priorities for behavioral subjects during the pandemic were similar to parent’s priorities before the pandemic, with only one behavioral subject (child self-calming) rated significantly more important by the parents in the pandemic group than the pre-pandemic parents. The parents in the pandemic group were also significantly more interested in remote and media-based services such as mobile applications and videos than parents in the pre-pandemic group. The researchers conclude that pediatric primary care practices may wish to consider providing mobile apps, videos, and/ or other multimedia resources as part of their behavioral health services practices.
AHRQ-funded; HS022981.
Citation: Petts RA, Walker BL, Hails KA .
Parents' preferences for behavioral services in primary care during the COVID-19 pandemic.
J Dev Behav Pediatr 2022 Jun-Jul;43(5):291-96. doi: 10.1097/dbp.0000000000001033..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Primary Care
Riley AR, Walker BL, Ramanujam K
A mixed-method investigation of parent perspectives on early childhood behavioral services in primary care.
This study used a sequential-explanatory mixed-method design to understand factors underlying parents' attitudes toward the content, sources, and delivery methods of behavioral guidance in primary care. Findings showed that parents emphasized a need for tailored behavioral guidance; multiple interconnected factors drove parents' attitudes toward behavioral primary care. Further, these attitudes varied based on socioeconomic status, child behavior symptoms, and reported use of corporal punishment.
AHRQ-funded; HS022981.
Citation: Riley AR, Walker BL, Ramanujam K .
A mixed-method investigation of parent perspectives on early childhood behavioral services in primary care.
J Behav Health Serv Res 2022 Apr;49(2):134-48. doi: 10.1007/s11414-021-09772-2..
Keywords: Children/Adolescents, Primary Care, Behavioral Health
Chen H, Upadhyay N, Lyu N
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
This study’s objective was to examine whether linkage with mental health (MH) treatment differed across 3 different integrated care agreements (ICAs) following diagnosis for Attention Deficit Hyperactive Disorder (ADHD) or Major Depressive Disorder (MDD) given by primary care providers (PCPs) in the pediatric setting. The ICAs were categorized as PCPs who practiced alone (non-co-located); PCPs practiced with specialist outside the practice but co-located at the practice site; and employed specialists who were co-located. A total of 4203 incident ADHD and 298 incident MDD diagnoses were identified, of which 74% of ADHD cases and 67% of MDD cases received treatment within 90 days of diagnosis. Children with ADHD were twice as likely to receive treatment if they were diagnosed by non-co-located or co-affiliated PCPs than those diagnosed by non-co-located PCPs. Those treated children were also 2 times more likely to receive guideline recommended psychotherapy and treated at the diagnosing site versus elsewhere.
AHRQ-funded; HS025251.
Citation: Chen H, Upadhyay N, Lyu N .
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
Acad Pediatr 2021 Sep-Oct;21(7):1187-94. doi: 10.1016/j.acap.2021.05.021..
Keywords: Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care, Healthcare Delivery, Depression
Breitenstein SM, Fehrenbacher C, Holod AF
A randomized trial of digitally delivered, self-administered parent training in primary care: effects on parenting and child behavior.
Researchers sought to evaluate the effects of a self-administered, digital behavioral parent training program (ezParent) on parent and child behavior for parents of young children. Their results suggested that ezParent as a self-administered behavioral parent training program may not be intense enough for child and parent behavioral change as a universal prevention model. Parents may require different levels of support for completion based on their level of service seeking, family characteristics, risk profile, and motivation for change.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Fehrenbacher C, Holod AF .
A randomized trial of digitally delivered, self-administered parent training in primary care: effects on parenting and child behavior.
J Pediatr 2021 Apr;231:207-14.e4. doi: 10.1016/j.jpeds.2020.12.016..
Keywords: Children/Adolescents, Caregiving, Primary Care, Education: Patient and Caregiver
Jones LD, Grout RW, Gilbert AL
How can healthcare professionals provide guidance and support to parents of adolescents? Results from a primary care-based study.
This study explored the rewards and difficulties of raising an adolescent and investigated parents' level of interest in receiving guidance from healthcare providers on parenting and adolescent health topics. Parents of adolescents who attended an outpatient pediatric clinic with their children were interviewed and completed a short survey via by telephone. Findings showed that parents identified several rewarding and difficult aspects associated with raising an adolescent and were open to receiving guidance on a range of parenting topics in a variety of formats through primary care settings. Recommendations for healthcare providers included considering how best to provide parenting support during this important developmental time period.
AHRQ-funded; HS022681.
Citation: Jones LD, Grout RW, Gilbert AL .
How can healthcare professionals provide guidance and support to parents of adolescents? Results from a primary care-based study.
BMC Health Serv Res 2021 Mar 20;21(1):253. doi: 10.1186/s12913-021-06200-1..
Keywords: Children/Adolescents, Primary Care, Caregiving
Richardson L, Parker EO, Zhou C
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
Health risk behaviors are the most common sources of morbidity among adolescents. Adolescent health guidelines (Guidelines for Preventive Services by the AMA and Bright Futures by the Maternal Child Health Bureau) recommend screening and counseling, but the implementation is inconsistent. This study aimed to test the efficacy of electronic risk behavior screening with integrated patient-facing feedback on the delivery of adolescent-reported clinician counseling and risk behaviors over time.
AHRQ-funded; HS023383.
Citation: Richardson L, Parker EO, Zhou C .
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
J Med Internet Res 2021 Mar 12;23(3):e24135. doi: 10.2196/24135..
Keywords: Children/Adolescents, Primary Care, Risk, Screening
Han B, Chen PG, Yu H
Access to after-hours primary care: a key determinant of children's medical home status.
Researchers sought to identify individual survey items or domains that best predict medical home (MH) status for children and use them to develop brief markers of MH status. Using MEPS data, they found that accessibility, especially the ability to access health care after regular office hours, appeared to be the major predictor of having a MH among children. They recommended that the ongoing efforts to promote the MH model target improving accessibility of health care after regular hours for children overall and especially for Latino children.
AHRQ-funded; HS023336.
Citation: Han B, Chen PG, Yu H .
Access to after-hours primary care: a key determinant of children's medical home status.
BMC Health Serv Res 2021 Feb 27;21(1):185. doi: 10.1186/s12913-021-06192-y..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Access to Care, Healthcare Delivery, Disparities, Racial and Ethnic Minorities
Radovic A, Odenthal K, Flores AT
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
Supporting Our Valued Adolescents (SOVA) is a web-based technology intervention designed to increase depression and anxiety treatment uptake by adolescents in the context of an anonymous peer community with an accompanying website for parents. With a goal of informing the design of a hybrid effectiveness-implementation randomized controlled trial, we conducted a pre-implementation study in two primary care practices to guide implementation strategy development. We conducted focus groups with primary care providers (PCPs) at three different timepoints with PCPs (14 total) from two community practices.
AHRQ-funded; HS022989.
Citation: Radovic A, Odenthal K, Flores AT .
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
J Clin Psychol Med Settings 2020 Dec;27(4):766-82. doi: 10.1007/s10880-019-09669-5.
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Keywords: Children/Adolescents, Depression, Anxiety, Behavioral Health, Primary Care, Health Information Technology (HIT), Implementation
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Mills J, Wonoprabowo L
AHRQ Author: Mills J
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
This case study concerns a 14-year-old patient who presents for a well-child visit. The patient eats a healthy diet, is part of a local soccer league, is an overall good student, and just started high school in the fall. The patient denies trying any illicit substances but reports trying to “get high” from cough syrup. Three questions are presented, and answers provided.
AHRQ-authored.
Citation: Mills J, Wonoprabowo L .
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
Am Fam Physician 2020 Oct 15;102(8):493-94..
Keywords: Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study, Guidelines, Evidence-Based Practice
Callejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies