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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 19 of 19 Research Studies DisplayedStransky ML, Fuchu P, Prendergast K
Beyond housing for health: using flexible funds to improve maternal and child health.
The purpose of this article is to describe the Upstreaming Housing for Health’s (UHfH) use of a flexible fund. The UHfH was a pilot program developed and implemented to improve housing stability and decrease health inequities among people with high-risk pregnancies and their babies. The flexible fund is a cash transfer policy that served 50 families from 2019 to 2020 and addressed housing stability and material needs that encouraged family stability within the context of their housing. The researchers found that 76% of the families accessed flexible funds for items such as rental assistance, cribs, and breast pumps, with average financial support of $1343 (standard deviation = $625). The researchers advise that cash transfer policies such as the flexible fund have been shown to positively impact family health and well-being around the world.
AHRQ-funded; HS022242.
Citation: Stransky ML, Fuchu P, Prendergast K .
Beyond housing for health: using flexible funds to improve maternal and child health.
J Urban Health 2022 Dec;99(6):1027-32. doi: 10.1007/s11524-022-00686-8..
Keywords: Children/Adolescents, Behavioral Health, Social Determinants of Health, Outcomes
Blanco C, Kato EU, Aklin WM
AHRQ Author: Kato EU, Tong ST, Bierman A, Meyers D
Research to move policy - using evidence to advance health equity for substance use disorders.
This paper discusses ways that evidence-based research can advance health equity for substance use disorder (SUD) treatment. Racial and ethnic disparities in treatment access and outcomes have widened, despite substantial efforts to address the epidemic of overdose-related deaths in the US. Overdose rates are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in White populations. Possible opportunities to address these disparities include addressing social determinants of health, implementing prevention measures, and supporting data science. The steps to ensure that research reduces disparities are to: 1) include members of underrepresented groups in the development of preventive interventions and treatments, 2) adequately recruit members of historically represented groups and ensure that studies are large enough to measure differences in outcomes according to race and ethnic group, 3) establish equitable partnerships with people who currently have or have had SUDS and their families and engage these groups in evidence production, 4) diversify the scientific workforce, and 4) have investigators measure the effects of policies and interventions on equity.
AHRQ-authored.
Citation: Blanco C, Kato EU, Aklin WM .
Research to move policy - using evidence to advance health equity for substance use disorders.
N Engl J Med 2022 Jun 16;386(24):2253-55. doi: 10.1056/NEJMp2202740..
Keywords: Substance Abuse, Behavioral Health, Policy, Racial and Ethnic Minorities, Disparities, Social Determinants of Health
Carroll AR, Hall M, Brown CM
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
This retrospective cohort study evaluated the associations of race/ethnicity and social determinants with 90-day rehospitalization of children with mental health conditions to acute non-psychiatric children’s hospitals. Children included were aged 5 to 18 years at 32 freestanding U.S. children’s hospitals from 2016-2018 using the Children’s Hospital Association’s Pediatric Health Information System (PHIS) database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Among 23,556 index hospitalizations, 5.9% (n = 1382) were rehospitalized for mental health within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children. Those with government insurance were 18% more likely to rehospitalized than those with private insurance. Those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location.
AHRQ-funded; HS026122.
Citation: Carroll AR, Hall M, Brown CM .
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
J Pediatr 2022 Jan;240:228-34.e1. doi: 10.1016/j.jpeds.2021.08.078..
Keywords: Children/Adolescents, Hospital Readmissions, Behavioral Health, Social Determinants of Health, Racial and Ethnic Minorities
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Jannat-Khah DP, Khodneva Y, Bryant K
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
This study examined whether time-varying depressive symptoms (TVDS) predict mortality and if racial and income differences moderate the association in a large cohort. The cohort from the REGARDS study was used to look at that determination. The REGARDS study used community-dwelling U.S. adults aged 45 years or older. They found that there was similar and statistically significant differences with white, black, and low-income ($35,000 or less) participants for the association between TVDS and mortality. High-income participants were found to have a lower hazard.
AHRQ-funded; HS025198.
Citation: Jannat-Khah DP, Khodneva Y, Bryant K .
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
Ann Epidemiol 2020 Jun;46:31-40.e2. doi: 10.1016/j.annepidem.2020.04.004..
Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Cardiovascular Conditions, Cancer, Low-Income, Social Determinants of Health, Mortality
Grafova IB, Monheit AC, Kumar R
How do changes in income, employment and health insurance affect family mental health spending?
This study used eight two-year panels from the MEPS data for 2004 to 2012 to examine the effect of economic shocks on mental health spending by families with children. Researchers wanted to determine whether the greatest impact on mental health spending comes from income, employment, or health insurance shocks. They used two-part expenditure models to estimate that employment losses are positively related to an increase in total family mental health expenditures. But no link was found between economic shocks and mental health spending on fathers.
AHRQ-funded; HS024053.
Citation: Grafova IB, Monheit AC, Kumar R .
How do changes in income, employment and health insurance affect family mental health spending?
Rev Econ Househ 2020 Mar;18(1:239-63. doi: 10.1007/s11150-018-9436-y.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Behavioral Health, Social Determinants of Health, Health Insurance
Klawetter S, McNitt C, Hoffman JA
Perinatal depression in low-income women: a literature review and innovative screening approach.
This paper is a literature review of perinatal depression prevalence, consequences, and screening among low-income women and women of color. The Warm Connections program has an innovative perinatal depression screening protocol and was used with WIC participants. The literature showed mixed findings of perinatal prevalence among low-income women and women of color. There were lower perinatal depression rates in the Warm Connections program in studies using less specific perinatal depression screening instruments with similar samples.
AHRQ-funded; HS026370.
Citation: Klawetter S, McNitt C, Hoffman JA .
Perinatal depression in low-income women: a literature review and innovative screening approach.
Curr Psychiatry Rep 2020 Jan 7;22(1):1. doi: 10.1007/s11920-019-1126-9.
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Keywords: Depression, Pregnancy, Women, Low-Income, Social Determinants of Health, Screening, Behavioral Health, Maternal Care, Disparities, Diagnostic Safety and Quality
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
Nasol E, Lindly OJ, Chavez AE
Unmet need and financial impact disparities for US children with ADHD.
The 5.1million US children with attention-deficit/hyperactivity disorder (ADHD) have pronounced needs in education, occupational and speech therapy, and medical and behavioral treatments. Given known associations of ADHD diagnosis with race/ethnicity and parent education, this study aimed to assess how measures of socioeconomic status correlate with both adverse family financial impact of ADHD and disparities in unmet treatment need for ADHD.
AHRQ-funded; HS000063.
Citation: Nasol E, Lindly OJ, Chavez AE .
Unmet need and financial impact disparities for US children with ADHD.
Acad Pediatr 2019 Apr;19(3):315-24. doi: 10.1016/j.acap.2018.09.001..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Costs, Social Determinants of Health
Zuckerman KE, Lindly OJ, Reyes NM
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
In this study, the investigators developed a brief, English/Spanish bilingual parent-reported scale of perceived community autism spectrum disorder (ASD) stigma and tested it in a multi-site sample of Latino and non-Latino white parents of children with ASD.
AHRQ-funded; HS000063.
Citation: Zuckerman KE, Lindly OJ, Reyes NM .
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
J Autism Dev Disord 2018 Sep;48(9):3199-209. doi: 10.1007/s10803-018-3586-x..
Keywords: Autism, Disabilities, Social Stigma, Social Determinants of Health, Behavioral Health
McClintock HF, Bogner HR
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). The pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.
AHRQ-funded; HS023445.
Citation: McClintock HF, Bogner HR .
Incorporating patients' social determinants of health into hypertension and depression care: a pilot randomized controlled trial.
Community Ment Health J 2017 Aug;53(6):703-10. doi: 10.1007/s10597-017-0131-x.
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Keywords: Depression, Behavioral Health, Blood Pressure, Social Determinants of Health, Patient-Centered Healthcare, Healthcare Delivery
Jutkowitz E, MacLehose RF, Gaugler JE
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
This study examined the effect of sociodemographic and clinical risk factors on cognitive, functional, and behavioral declines in incident dementia patients. Age of onset, region of residence, and history of hypertension and psychiatric problems predicted behaviors at diagnosis. Cognition explained changes in behavior. Sociodemographic characteristics and clinical comorbidities predicted cognitive and functional changes. Only cognitive status explained behavioral decline.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, MacLehose RF, Gaugler JE .
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
J Gerontol A Biol Sci Med Sci 2017 Feb;72(2):251-58. doi: 10.1093/gerona/glw079.
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Keywords: Dementia, Elderly, Behavioral Health, Neurological Disorders, Risk, Social Determinants of Health
Fiechtner L, Kleinman K, Melly SJ
Effects of proximity to supermarkets on a randomized trial studying interventions for obesity.
To determine whether proximity to a supermarket modified the effects of an obesity intervention, the researchers examined distance to the closest supermarket as an effect modifier.They concluded that living closer to a supermarket is associated with greater improvements in fruit and vegetable intake and weight status in an obesity intervention.
AHRQ-funded; HS022986.
Citation: Fiechtner L, Kleinman K, Melly SJ .
Effects of proximity to supermarkets on a randomized trial studying interventions for obesity.
Am J Public Health 2016 Mar;106(3):557-62. doi: 10.2105/ajph.2015.302986.
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Keywords: Obesity, Nutrition, Lifestyle Changes, Social Determinants of Health, Behavioral Health
Hwang SW, Chambers C, Katic M
Accuracy of self-reported health care use in a population-based sample of homeless adults.
The objective of this study was to assess the accuracy of self-reported ambulatory care visits, emergency department (ED) encounters, and overnight hospitalizations in a population-based sample of homeless adults.It found that adults experiencing homelessness are quite accurate reporters of their use of health care, especially for ED encounters and hospitalizations.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Katic M .
Accuracy of self-reported health care use in a population-based sample of homeless adults.
Health Serv Res 2016 Feb. doi: 10.1111/1475-6773.12329..
Keywords: Hospitalization, Behavioral Health, Social Determinants of Health, Healthcare Utilization, Emergency Department
Okuda M, Picazo J, Olfson M
Prevalence and correlates of anger in the community: results from a national survey.
This study assessed the prevalence, as well as the sociodemographic and clinical correlates of anger, in the general population and characterize adults that report inappropriate, intense, or poorly controlled anger. It found the overall prevalence of inappropriate, intense, or poorly controlled anger in the U.S. population was 7.8 percent. Anger was especially common among men and younger adults, and was associated with decreased psychosocial functioning.
AHRQ-funded; HS021112.
Citation: Okuda M, Picazo J, Olfson M .
Prevalence and correlates of anger in the community: results from a national survey.
CNS Spectr 2015 Apr;20(2):130-9. doi: 10.1017/s1092852914000182..
Keywords: Patient-Centered Outcomes Research, Behavioral Health, Substance Abuse, Social Determinants of Health
Okuda M, Olfson M, Wang S
Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey.
This study presents data on the association of intimate partner violence (IPV) perpetration and rates of psychiatric disorders, and other correlates. It finds that being younger, having an alcohol use disorder, a personality disorder, low levels of social support, and low income were associated with perpetration. Across a wide range of factors, IPV victimization itself had the strongest association with perpetration.
AHRQ-funded; HS021112.
Citation: Okuda M, Olfson M, Wang S .
Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey.
J Trauma Stress 2015 Feb;28(1):49-56. doi: 10.1002/jts.21986..
Keywords: Domestic Violence, Alcohol Use, Behavioral Health, Social Determinants of Health
Regenstein M, Andres E
Reducing hospital readmissions among Medicaid patients: a review of the literature.
This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. It concluded that much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population.
AHRQ-funded; 290202010000301.
Citation: Regenstein M, Andres E .
Reducing hospital readmissions among Medicaid patients: a review of the literature.
Qual Manag Health Care 2014 Oct-Dec;23(4):203-25. doi: 10.1097/qmh.0000000000000043..
Keywords: Hospital Readmissions, Medicaid, Behavioral Health, Substance Abuse, Social Determinants of Health
Chambers C, Chiu S, Scott AN
Factors associated with poor mental health status among homeless women with and without dependent children.
The researchers estimated the prevalence of mental health problems among homeless women as well as the effects of risk factors on those problems. They found that, in a group of 522 homeless women in Toronto, Canada, poor mental health was associated with low perceived access to social support, physical/sexual assault in the past 12 months, presence of a chronic health condition, and presence of a drug use problem.
AHRQ-funded; HS014129
Citation: Chambers C, Chiu S, Scott AN .
Factors associated with poor mental health status among homeless women with and without dependent children.
Community Ment Health J. 2014 Jul;50(5):553-9. doi: 10.1007/s10597-013-9605-7..
Keywords: Behavioral Health, Chronic Conditions, Social Determinants of Health, Risk
Chambers C, Katic M, Chiu S
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
This study identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
AHRQ-funded; HS014129.
Citation: Chambers C, Katic M, Chiu S .
Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults.
Am J Public Health 2013 Dec;103 Suppl 2:S380-8. doi: 10.2105/ajph.2013.301646..
Keywords: Hospitalization, Social Determinants of Health, Behavioral Health, Health Status