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
701 to 725 of 795 Research Studies DisplayedShaikh U, Romano P, Paterniti DA
Organizing for quality improvement in health care: An example from childhood obesity prevention.
The researchers evaluated how the quality improvement (QI) intervention, Healthy Eating Active Living TeleHealth Community of Practice, at 7 rural California clinics addressed the challenges. of preventing and managing obesity and translation of evidence into practice. Key challenges were clinician and staff buy-in, changing ingrained clinical practices, and motivating patient and families. Facilitators included top-down organizational requirements for QI, linkages to local QI resources, and involvement of clinical champions.
AHRQ-funded; HS018567.
Citation: Shaikh U, Romano P, Paterniti DA .
Organizing for quality improvement in health care: An example from childhood obesity prevention.
Qual Manag Health Care 2015 Jul-Sep;24(3):121-8. doi: 10.1097/qmh.0000000000000066.
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Keywords: Quality Improvement, Children/Adolescents, Obesity, Prevention, Primary Care
Tang JW, Foster KE, Pumarino J
Perspectives on prevention of type 2 diabetes after gestational diabetes: a qualitative study of Hispanic, African-American and White women.
This qualitative study explored the perspectives of Hispanic, African-American, and White women affected by gestational diabetes mellitus (GDM). The goal is for this work to inform the development of effective approaches to engage diverse populations affected by GDM in taking steps to reduce their risk for type 2 diabetes mellitus.
AHRQ-funded; HS021141.
Citation: Tang JW, Foster KE, Pumarino J .
Perspectives on prevention of type 2 diabetes after gestational diabetes: a qualitative study of Hispanic, African-American and White women.
Matern Child Health J 2015 Jul;19(7):1526-34. doi: 10.1007/s10995-014-1657-y..
Keywords: Diabetes, Lifestyle Changes, Pregnancy, Prevention, Racial and Ethnic Minorities, Risk, Women
Gittner LS, Husaini BA, Hull PC
Use of Six Sigma for eliminating missed opportunities for prevention services.
Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. This study compare missed preventative service opportunities in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3 percent in the community clinic.
AHRQ-funded; HS011131.
Citation: Gittner LS, Husaini BA, Hull PC .
Use of Six Sigma for eliminating missed opportunities for prevention services.
J Nurs Care Qual 2015 Jul-Sep;30(3):254-60. doi: 10.1097/ncq.0000000000000113..
Keywords: Community-Based Practice, Prevention, Primary Care, Quality Improvement
Chenoweth CE, Hines SC, Hall KK
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
The purpose of this study was to observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. The researchers found considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68 percent (range, 45 percent–92 percent) across all facilities.
AHRQ-authored; AHRQ-funded; 290200600022I.
Citation: Chenoweth CE, Hines SC, Hall KK .
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
Infect Control Hosp Epidemiol 2015 Jul;36(7):802-6. doi: 10.1017/ice.2015.55..
Keywords: Kidney Disease and Health, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Prevention
Wang Y, Cai L, Wu Y
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
The researchers systematically evaluated the effectiveness of childhood obesity prevention programs conducted in high-income countries and implemented in various settings. Their review found at least moderately strong evidence supporting the effectiveness of school-based interventions involving physical activity, diet or combined diet and physical activity for preventing childhood obesity.
AHRQ-funded; 290200710061I.
Citation: Wang Y, Cai L, Wu Y .
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
Obes Rev 2015 Jul;16(7):547-65. doi: 10.1111/obr.12277..
Keywords: Children/Adolescents, Comparative Effectiveness, Obesity, Prevention
Nace DA, Lin CJ, Ross TM
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
The researchers compared high-dose to standard-dose inactivated influenza vaccine in residents of long-term-care facilities (LTCFs) during the 2011-2012 and 2012-2013 influenza seasons. They found that, among frail, elderly residents of LTCFs, high-dose influenza vaccine produced superior responses for all strains except influenza A(H1N1) in 2012-2013.
AHRQ-funded; HS023779.
Citation: Nace DA, Lin CJ, Ross TM .
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
J Infect Dis 2015 Jun 15;211(12):1915-24. doi: 10.1093/infdis/jiu622.
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Keywords: Elderly, Influenza, Long-Term Care, Prevention, Vaccination
Padula WV, Makic MB, Mishra MK
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
This study was conducted to determine the comparative effectiveness of quality improvement interventions associated with reduced hospital-acquired pressure ulcer rates. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Mishra MK .
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):246-5..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Patient Safety, Pressure Ulcers, Prevention, Quality Improvement
Leeman J, Myers AE, Ribisl KM
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
This paper describes the approach that two projects developed to disseminate policy and environmental change interventions. The Center for Training and Research Translation (Center TRT) disseminates evidence-based interventions (EBIs) to promote physical activity and healthy eating. Counter Tobacco disseminates EBIs to counter tobacco product sales and marketing in the retail environment.
AHRQ-funded; HS019468.
Citation: Leeman J, Myers AE, Ribisl KM .
Disseminating policy and environmental change interventions: insights from obesity prevention and tobacco control.
Int J Behav Med 2015 Jun;22(3):301-11. doi: 10.1007/s12529-014-9427-1..
Keywords: Communication, Evidence-Based Practice, Obesity, Policy, Prevention, Public Health, Tobacco Use, Implementation
Morgan DJ, Pineles L, Shardell M
Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) trial: a subgroup analysis.
The researchers report the results of a subgroup analysis of the Benefits of Universal Glove and Gown trial. In 20 intensive care units, the reduction in acquisition of methicillin-resistant Staphylococcus aureus observed in this trial was observed in units also using chlorhexidine bathing and in those that previously performed active surveillance.
AHRQ-funded; HS018111; 290200600015.
Citation: Morgan DJ, Pineles L, Shardell M .
Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) trial: a subgroup analysis.
Infect Control Hosp Epidemiol 2015 Jun;36(6):734-7. doi: 10.1017/ice.2015.33..
Keywords: Patient Safety, Prevention, Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Padula WV, Makic MB, Wald HL
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
This study was conducted to define changes in hospital-acquired pressure ulcers (HAPU) incidence and variance since 2008. It found that HAPU incidence rates decreased significantly among 210 University HealthSystems Consortium academic medical centers after the enactment of the CMS nonpayment policy. This suggests that governmental policy was a significant driver of change in clinical practice for wound care and created incentives for preventive efforts on the part of hospitals.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Wald HL .
Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):257-63..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Policy, Pressure Ulcers, Prevention, Quality Improvement
Yun L, Boles RE, Haemer MA
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
This paper delineates the study protocol for the Community Outreach Obesity Prevention Trial. COOPT is an ongoing, 4-year (October 2011-September 2015) randomized controlled trial that tests the effectiveness of a home-based patient navigator program delivered to preschoolers of a large urban safety-net health care system. The researchers believe that its home-based intervention venue will provide rich data characterizing barriers and facilitators to healthy behavior change within the home.
AHRQ-funded; HS021138.
Citation: Yun L, Boles RE, Haemer MA .
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
BMC Public Health 2015 May;15:506. doi: 10.1186/s12889-015-1833-z..
Keywords: Children/Adolescents, Community-Based Practice, Obesity, Prevention, Racial and Ethnic Minorities
Shepherd MM, Wipke-Tevis DD, Alexander GL
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
The purpose of this study was to compare pressure ulcer prevention programs in 2 long-term care facilities with diverse Information Technology Sophistication (ITS), one with high sophistication and one with low sophistication, and to identify implications for the WOC nurse. Its findings suggest that effective strategies for staff education and communication regarding pressure ulcer prevention differ based on the level of ITS within a given facility.
AHRQ-funded; HS016862.
Citation: Shepherd MM, Wipke-Tevis DD, Alexander GL .
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
J Wound Ostomy Continence Nurs 2015 May-Jun;42(3):235-41. doi: 10.1097/won.0000000000000136.
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Keywords: Health Information Technology (HIT), Pressure Ulcers, Prevention, Long-Term Care, Comparative Effectiveness
Scheck McAlearney A, Hefner J, Robbins J
AHRQ Author: Harrison MI
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
This study identified factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated bloodstream infections. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting to zero” infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
AHRQ-authored; AHRQ-funded; 290200600022.
Citation: Scheck McAlearney A, Hefner J, Robbins J .
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
Infect Control Hosp Epidemiol 2015 May;36(5):557-63. doi: 10.1017/ice.2015.27..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Prevention
Shi L, Lebrun-Harris LA, Chen LR
AHRQ Author: Ngo-Metzger Q
Preventive counseling services during primary care visits: a comparison of health centers versus other physician offices.
The authors compared preventive counseling services provided by health centers versus other physician offices. They found that health centers provided comparable rates of preventive counseling services compared with other physician offices in the areas of health education, disease management, asthma education, tobacco education, and weight reduction education.
AHRQ-authored.
Citation: Shi L, Lebrun-Harris LA, Chen LR .
Preventive counseling services during primary care visits: a comparison of health centers versus other physician offices.
J Health Care Poor Underserved 2015 May;26(2):519-35. doi: 10.1353/hpu.2015.0028.
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Keywords: Community-Based Practice, Prevention, Primary Care
Yawn BP, Bertram S, Kurland M
Repeated depression screening during the first postpartum year.
The researchers report a substudy of a large pragmatic trial of early post-partum depression screening and practice management, the Translating Research into Practice for Postpartum Depression (TRIPPD) study. They concluded that repeated PPD screening at 6 and 12 months’ postpartum increases the percentage of women identified as being at high risk of PPD.
AHRQ-funded; HS014744.
Citation: Yawn BP, Bertram S, Kurland M .
Repeated depression screening during the first postpartum year.
Ann Fam Med 2015 May-Jun;13(3):228-34. doi: 10.1370/afm.1777..
Keywords: Depression, Implementation, Screening, Prevention
Hamilton KW, Gerber JS, Moehring R
Point-of-prescription interventions to improve antimicrobial stewardship.
The purpose of this review was to discuss interventions focusing on antimicrobial prescribing at the point of prescription as well as a pilot project to engage unit-based healthcare providers in antimicrobial stewardship.
AHRQ-funded; HS023866.
Citation: Hamilton KW, Gerber JS, Moehring R .
Point-of-prescription interventions to improve antimicrobial stewardship.
Clin Infect Dis 2015 Apr 15;60(8):1252-8. doi: 10.1093/cid/civ018.
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Keywords: Antimicrobial Stewardship, Infectious Diseases, Medication, Patient Safety, Prevention
Croswell J, Chu K
AHRQ Author: Croswell J
Screening for abdominal aortic aneurysm.
The authors present a case study with three questions focused on an older patient who comes to the physician office for an annual well visit. He was advised by a relative, who is a physician, to be screened for an abdominal aortic aneurysm. The questions focus on different scenarios, types of testing, and statements about appropriate treatment.
AHRQ-authored
Citation: Croswell J, Chu K .
Screening for abdominal aortic aneurysm.
Am Fam Physician 2015 Apr 15;91(8):563-4..
Keywords: Case Study, Prevention, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Gance-Cleveland B, Aldrich H, Schmiege S
Clinician adherence to childhood overweight and obesity recommendations by race/ethnicity of the child.
This study describes school-based health center (SBHC) providers’ adherence to obesity guidelines. Providers (n = 28) were from SBHCs in six states serving children 5–12 years of age. Body mass index percentage was documented on 73 percent of charts and blood pressure percentage on 30.5 percent. Providers accurately diagnosed 40 percent overweight and 49.3 percent obese children.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Schmiege S .
Clinician adherence to childhood overweight and obesity recommendations by race/ethnicity of the child.
J Spec Pediatr Nurs 2015 Apr;20(2):115-22. doi: 10.1111/jspn.12107..
Keywords: Children/Adolescents, Guidelines, Obesity, Prevention
Maynard G, Kulasa K, Ramos P
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
In order to improve inpatient glycemic management in a 550-bed academic medical center, the researchers implemented a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. By using this approach with multiple mutually reinforcing interventions, they were able to cut severe inpatient hypoglycemia by more than half, while simultaneously improving glycemic control.
AHRQ-funded; HS020594
Citation: Maynard G, Kulasa K, Ramos P .
Impact of a hypoglycemia reduction bundle and a systems approach to inpatient glycemic management.
Endocr Pract. 2015 Apr;21(4):355-67. doi: 10.4158/ep14367.or..
Keywords: Care Management, Inpatient Care, Prevention
Hellinger FJ
AHRQ Author: Hellinger FJ
Measuring the cost effectiveness of HIV prevention interventions in the US: pitfalls and problems.
The author comments on a review of cost-effectiveness studies of four types of HIV prevention interventions in the US. He agrees with the primary conclusion of the review that more cost-effectiveness research is needed to fill the knowledge gaps of interventions related to prevention for HIV-positives, condom distribution, and policy initiatives, in order to help guide the most efficient use of resources.
AHRQ-authored.
Citation: Hellinger FJ .
Measuring the cost effectiveness of HIV prevention interventions in the US: pitfalls and problems.
Appl Health Econ Health Policy 2015 Apr;13(2):129-33. doi: 10.1007/s40258-015-0158-5..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Costs
Schackman BR, Fleishman JA, Su AE
AHRQ Author: Fleishman JA
The lifetime medical cost savings from preventing HIV in the United States.
The researchers sought to estimate the medical cost saved by averting 1 HIV infection in the United States. They found that the estimated discounted lifetime cost for persons who become HIV infected at age 35 is $326,500 (60% for antiretroviral medications, 15% for other medications, 25% nondrug costs.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Schackman BR, Fleishman JA, Su AE .
The lifetime medical cost savings from preventing HIV in the United States.
Med Care 2015 Apr;53(4):293-301. doi: 10.1097/mlr.0000000000000308..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Human Immunodeficiency Virus (HIV), Prevention
Michtalik HJ, Carolan HT, Haut ER
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
The researchers sequentially examined an individualized physician dashboard and pay-for-performance program to improve venous thromboembolism (VTE) prophylaxis rates among hospitalists. They found that direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program.
AHRQ-funded; HS017952; HS022331.
Citation: Michtalik HJ, Carolan HT, Haut ER .
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
J Hosp Med 2015 Mar;10(3):172-8. doi: 10.1002/jhm.2303..
Keywords: Provider Performance, Payment, Blood Clots, Prevention, Quality Improvement, Quality of Care, Hospitals, Patient Safety
Mabry-Hernandez I, Chu K
AHRQ Author: Mabry-Hernandez I
Screening for primary hypertension in children and adolescents.
This article presents a case study about a 14-year-old black adolescent who presents for a routine school physical examination. Her mother tells you that she and her husband have hypertension, and they worry about their daughter’s blood pressure. She asks you whether her child should be periodically checked for high blood pressure. The case study was coordinated with the AHRQ-administered US Preventive Services Task Force and published online on the American Academy of Family Practice website.
Citation: Mabry-Hernandez I, Chu K .
Screening for primary hypertension in children and adolescents.
Am Fam Physician 2015 Feb 15;91(4):257-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Prevention, Case Study
Wen KY, Miller SM, Roussi P
A content analysis of self-reported barriers and facilitators to preventing postpartum smoking relapse among a sample of current and former smokers in an underserved population.
The researchers conducted in-person interviews to characterize the barriers and facilitators that prevent postpartum relapse and maintain smoking abstinence among a socioeconomically underserved population. They found that participants reported four main strategies that helped them to successfully cope with postpartum cravings and relapses, including being informed of smoking risks, maintaining goal-oriented thoughts, focusing on their concerns about the baby's health, and receiving positive social support from families and friends.
AHRQ-funded; HS019001.
Citation: Wen KY, Miller SM, Roussi P .
A content analysis of self-reported barriers and facilitators to preventing postpartum smoking relapse among a sample of current and former smokers in an underserved population.
Health Educ Res 2015 Feb;30(1):140-51. doi: 10.1093/her/cyu048.
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Keywords: Education: Patient and Caregiver, Healthcare Delivery, Prevention, Tobacco Use, Vulnerable Populations
Hwang CS, Chang HY, Alexander GC
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
The researchers quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids. They found that the market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market.
AHRQ-funded; HS018960.
Citation: Hwang CS, Chang HY, Alexander GC .
Impact of abuse-deterrent OxyContin on prescription opioid utilization.
Pharmacoepidemiol Drug Saf 2015 Feb;24(2):197-204. doi: 10.1002/pds.3723.
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Keywords: Medication, Opioids, Prevention, Substance Abuse