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- Behavioral Health (2)
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- (-) Children/Adolescents (13)
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- Rural/Inner-City Residents (3)
- (-) Rural Health (13)
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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 13 of 13 Research Studies DisplayedBenziger CP, Suess M, Allen CI
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
This paper’s objective is to describe the protocol for a study that will adapt an electronic health record linked, web-based clinical decision support (CDS) tool called PedsBP that identifies hypertension (HTN) in children for use in a mostly rural health system and to evaluate the effectiveness of PedsBP for repeat of hypertensive level blood pressure (BP) measurements and HTN recognition among youth 6-17 years of age in primary care settings, comparing low-intensity and high-intensity implementation approaches. A pilot of the tool was conducted in 2 primary care clinics and modified prior to the full trial. Forty community-based primary care clinics (or clusters of clinics) were randomly allocated equally to usual care, low-intensity implementation (CDS only), or high-intensity implementation (CDS plus in-person training, monthly use reports, and ongoing communication between study staff and clinics). Eligible patient recruitment started on August 1, 2022 and will continue for 18 months. Primary outcomes will include repeating hypertensive level BP measurements at office visits and clinical recognition of HTN. Secondary outcomes will include lifestyle counseling, dietician referral, and BP at follow-up.
AHRQ-funded; HS027402.
Citation: Benziger CP, Suess M, Allen CI .
Adapting a clinical decision support system to improve identification of pediatric hypertension in a rural health system: design of a pragmatic trial.
Contemp Clin Trials 2023 Sep; 132:107293. doi: 10.1016/j.cct.2023.107293..
Keywords: Clinical Decision Support (CDS), Children/Adolescents, Rural Health, Rural/Inner-City Residents, Blood Pressure
McDaniel CE, Leyenaar JK, Bryan MA
Urban-rural disparities in interfacility transfers for children during COVID-19.
This study’s goal was to identify temporal trends and differences in urban and rural pediatric interfacility transfers (IFTs) before and during the COVID-19 pandemic. The authors conducted a cross-sectional analysis of IFT among children <18 years from January 2019 to June 2022 using the Pediatric Health Information System. They calculated observed-to-expected (O-E) ratios of pre-pandemic (March 2019-Feb 2020) transfers compared to pandemic year 1 (March 2020-Feb 2021) and year 2 (March 2021-February 2022) using Poisson modeling. The O-E ratio of IFT in year 1 for urban children was 14.0% and 14.8% for rural children compared to pre-pandemic. In year 2, transfers rebounded with IFTs for rural-residing children increasing more than urban-residing children (101.7%) compared to 90.7%. For mental-health indications in year 2, rural transfer ratios were higher than urban, 126% compared to 113.7%.
AHRQ-funded; HS028683.
Citation: McDaniel CE, Leyenaar JK, Bryan MA .
Urban-rural disparities in interfacility transfers for children during COVID-19.
J Rural Health 2023 Jun; 39(3):611-16. doi: 10.1111/jrh.12746..
Keywords: COVID-19, Children/Adolescents, Disparities, Rural Health, Urban Health, Rural/Inner-City Residents
Eiraldi R, McCurdy BL, Khanna MS
Development and evaluation of a remote training strategy for the implementation of mental health evidence-based practices in rural schools: pilot study protocol.
This paper describes a pilot study protocol to develop and evaluate a remote training strategy for the implementation of mental health evidence-based practices (EBPs) in rural schools. Rural schools are increasingly implementing multi-tier positive behavioral interventions and supports (PBIS) to address school-climate problems. The study will use a mixed-methods approach for the development of the training platform, and a hybrid type 2, pilot randomized controlled trial to examine the implementation and student outcomes of two training strategies: Remote Video vs. Remote Video plus Coaching. The EPBs will be evaluated on appropriateness, feasibility, acceptability, usability, and preliminary student outcomes of the two online training strategies for the implementation of EPBs at PBIS Tier 2.
AHRQ-funded; HS027755.
Citation: Eiraldi R, McCurdy BL, Khanna MS .
Development and evaluation of a remote training strategy for the implementation of mental health evidence-based practices in rural schools: pilot study protocol.
Pilot Feasibility Stud 2022 Jun 17;8(1):128. doi: 10.1186/s40814-022-01082-4..
Keywords: Children/Adolescents, Behavioral Health, Evidence-Based Practice, Rural Health, Training
Davidson L, Haynes SC, Favila-Meza A
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
This study investigated patient and therapist experience and cost savings from the payer perspective associated with a novel tele-physiatry program for children living in rural and underserved communities. Study setting was four school-based clinics in Northern California with a total of 268 encounters (124 telemedicine and 144 in-person). Parent and therapists reported no difference in experience and perceived quality of care between telemedicine and in-person encounters. For parents whose children received a telemedicine encounter, 54.8% reported no preference for their child’s subsequent encounter, 28.8% preferred a physiatrist telemedicine visit, and 12 preferred a physiatrist in-person visit. There was also an average cost savings of $100 per clinic owing to physician milage for in-person visits.
AHRQ-funded; HS025714.
Citation: Davidson L, Haynes SC, Favila-Meza A .
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
Arch Phys Med Rehabil 2022 Jan;103(1):8-13. doi: 10.1016/j.apmr.2021.07.807..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Healthcare Costs, Rural Health, Vulnerable Populations, Disabilities, Rural/Inner-City Residents
Hoffmann JA, Hall M, Lorenz D
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
The authors sought to compare emergency department (ED) visit rates for suicidal ideation and/or self-harm among youth by urban-rural location of residence. Data was taken from the Nationwide Emergency Department Sample. They found that, compared with youths living in urban areas, youths living in rural areas had higher ED visit rates for self-harm, including self-inflicted firearm injuries. The researchers recommended preventive approaches for self-harm based in community and ED settings in order to help address these differences.
AHRQ-funded; HS026385.
Citation: Hoffmann JA, Hall M, Lorenz D .
Emergency department visits for suicidal ideation and self-harm in rural and urban youths.
J Pediatr 2021 Nov;238:282-89.e1. doi: 10.1016/j.jpeds.2021.07.013..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Behavioral Health, Rural Health, Urban Health, Healthcare Utilization
Jacob SA, Carroll AE, Bennett WE
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
The purpose of this cross-sectional, observational study was to determine the feasibility of using telemedicine for the provision of subspecialty pediatric (0-21 years old) Sickle Cell Disease care in a rural medically underserved area. METHODS: This was a cross-sectional, observational, feasibility study. The study found that 10 SCD patients initiated telemedicine visits during the study period. Approximately 60% of the eligible participants did not attend more than 50% of scheduled visits prior to beginning telemedicine visits or were lost to follow-up. After initiation of telemedicine, all Hb SS patients were started and/or maintained on hydroxyurea. Nine out of 10 patients who participated during this timeframe had a 100% follow-up rate. All the participants rated the comfort and ease of using the telehealth system as good or excellent, and all participants would take part in a telemedicine visit again.
AHRQ-funded; HS026390.
Citation: Jacob SA, Carroll AE, Bennett WE .
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
J Telemed Telecare 2021 Aug;27(7):431-35. doi: 10.1177/1357633x19883558..
Keywords: Children/Adolescents, Telehealth, Sickle Cell Disease, Rural Health, Chronic Conditions, Vulnerable Populations, Health Information Technology (HIT)
Davis MM, Spurlock M, Ramsey K
Milk options observation (MOO): a mixed-methods study of chocolate milk removal on beverage consumption and student/staff behaviors in a rural elementary school.
The researchers conducted a study of flavored milk removal at a rural primary school between May and June 2012. They measured beverage selection/consumption pre- and post-chocolate milk removal and collected observation field notes. Their conclusion was that removing flavored milk from school-provided lunches may lower students' daily added sugar consumption without considerably decreasing calcium and protein intake and may promote healthy weight.
AHRQ-funded; HS022981.
Citation: Davis MM, Spurlock M, Ramsey K .
Milk options observation (MOO): a mixed-methods study of chocolate milk removal on beverage consumption and student/staff behaviors in a rural elementary school.
J Sch Nurs 2017 Aug;33(4):285-98. doi: 10.1177/1059840517703744.
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Keywords: Children/Adolescents, Education, Nutrition, Rural Health
Peltz A, Wu CL, White ML
Characteristics of rural children admitted to pediatric hospitals.
The researchers assessed characteristics and hospitalizations of rural children admitted to US children's hospitals in 2012. They found that rural children more often resided in low-income ZIP codes and Health Professional Shortage Areas; they further noted that rural children had a higher prevalence of complex chronic conditions and medical technology assistance. Rural children also experienced higher inpatient costs and higher odds of 30-day readmission.
AHRQ-funded; HS023092.
Citation: Peltz A, Wu CL, White ML .
Characteristics of rural children admitted to pediatric hospitals.
Pediatrics 2016 May;137(5). doi: 10.1542/peds.2015-3156.
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Keywords: Children/Adolescents, Hospitalization, Children/Adolescents, Rural Health, Vulnerable Populations
Yang NH, Dharmar M, Yoo BK
Economic evaluation of pediatric telemedicine consultations to rural emergency departments.
The researchers conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. They found that treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. They concluded that telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving or cost-effective compared with telephone consultations.
AHRQ-funded; HS013179.
Citation: Yang NH, Dharmar M, Yoo BK .
Economic evaluation of pediatric telemedicine consultations to rural emergency departments.
Med Decis Making 2015 Aug;35(6):773-83. doi: 10.1177/0272989x15584916.
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Keywords: Healthcare Costs, Emergency Department, Children/Adolescents, Rural Health, Telehealth
Ray KN, Demirci JR, Bogen DL
Optimizing telehealth strategies for subspecialty care: recommendations from rural pediatricians.
The authors elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Rural pediatricians from 17 states described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians, through semistructured telephone interviews, provided recommendations for optimizing individual telehealth strategies.
AHRQ-funded; HS022989.
Citation: Ray KN, Demirci JR, Bogen DL .
Optimizing telehealth strategies for subspecialty care: recommendations from rural pediatricians.
Telemed J E Health 2015 Aug;21(8):622-9. doi: 10.1089/tmj.2014.0186.
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Keywords: Children/Adolescents, Children/Adolescents, Practice Patterns, Rural Health, Telehealth
Yang NH, Dharmar M, Kuppermann N
Appropriateness of disposition following telemedicine consultations in rural emergency departments.
The researchers compared the overall and stratified observed-to-expected hospital admission ratios between telemedicine and telephone cohorts of acutely ill and injured children. They found that there were no statistically significant differences between the observed-to-expected admission ratios using Pediatric Risk of Admission II and Revised Pediatric Emergency Assessment Tool.
AHRQ-funded; HS013179; HS019712.
Citation: Yang NH, Dharmar M, Kuppermann N .
Appropriateness of disposition following telemedicine consultations in rural emergency departments.
Pediatr Crit Care Med 2015 Mar;16(3):e59-64. doi: 10.1097/pcc.0000000000000337..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Hospitalization, Rural Health, Telehealth
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Dharmar M, Kuppermann N, Romano PS
Telemedicine consultations and medication errors in rural emergency departments.
This study compared the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). It found that the use of telemedicine to provide pediatric critical care consultations to rural EDs is associated with less frequent physician-related ED medication errors among seriously ill and injured children.
AHRQ-funded; HS013179; HS019712.
Citation: Dharmar M, Kuppermann N, Romano PS .
Telemedicine consultations and medication errors in rural emergency departments.
Pediatrics 2013 Dec;132(6):1090-7. doi: 10.1542/peds.2013-1374..
Keywords: Children/Adolescents, Medical Errors, Medication, Rural Health, Telehealth