National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (4)
- Asthma (3)
- Autism (1)
- Behavioral Health (3)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (1)
- Caregiving (3)
- Children/Adolescents (13)
- Chronic Conditions (2)
- Comparative Effectiveness (1)
- Complementary and Alternative Medicine (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- COVID-19 (2)
- Cultural Competence (1)
- Decision Making (2)
- Depression (3)
- Diabetes (3)
- Disabilities (2)
- Disparities (11)
- Ear Infections (1)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Family Health and History (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (3)
- Health Insurance (3)
- Health Literacy (1)
- Health Promotion (1)
- Health Status (1)
- Heart Disease and Health (2)
- Home Healthcare (1)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- (-) Low-Income (43)
- Medicaid (3)
- Medicare (2)
- Medication (1)
- Mortality (3)
- Newborns/Infants (1)
- Nutrition (1)
- Obesity (1)
- Orthopedics (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Self-Management (1)
- Policy (1)
- Pregnancy (2)
- Prevention (2)
- Primary Care (2)
- Public Health (2)
- Quality Improvement (1)
- Quality of Care (3)
- (-) Racial and Ethnic Minorities (43)
- Respiratory Conditions (1)
- Risk (1)
- Screening (2)
- Sexual Health (1)
- Sleep Problems (1)
- Social Determinants of Health (12)
- Stress (1)
- Surgery (2)
- Telehealth (2)
- Training (1)
- Urban Health (3)
- Vaccination (2)
- Vulnerable Populations (7)
- Web-Based (1)
- Women (4)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 43 Research Studies DisplayedRoberts ET, Kwon Y, Hames AG
Racial and ethnic disparities in health care use and access associated with loss of Medicaid supplemental insurance eligibility above the federal poverty level.
The purpose of this study was to examine whether exceeding the income threshold for Medicaid, which causes a sudden loss of Medicaid eligibility, is related with higher racial and ethnic disparities in access to and use of care. The researchers evaluated Medicare beneficiaries with incomes 0% to 200% of FPL from the 2008 to 2018 biennial waves of the Health and Retirement Study linked to Medicare administrative data. To identify racial and ethnic disparities related with the loss of Medicaid eligibility, the researchers compared discontinuities in outcomes among Black and Hispanic beneficiaries and White beneficiaries. Analyses were conducted between January 1, 2022, and October 1, 2022. The primary outcomes were patient-reported challenges accessing care due to cost and outpatient service use, medication fills, and hospitalizations measured from Medicare administrative data. The study included 8,144 participants representing 151,282, 957 weighted person-years in the community-dwelling population of Medicare beneficiaries aged 50 years and older and incomes less than 200% of the federal poverty level (FPL). Study findings indicate that exceeding the Medicaid eligibility threshold was related with a 43.8 percentage point (pp) lower probability of Medicaid enrollment among Black and Hispanic Medicare beneficiaries and a 31.0 pp lower probability of Medicaid enrollment among White beneficiaries. Among Black and Hispanic beneficiaries, exceeding the threshold was associated with increased cost-related barriers to care, lower outpatient use, and fewer medication fills, but it was not associated with a statistically significant discontinuity in hospitalizations. Discontinuities in these outcomes were smaller or nonsignificant among White beneficiaries. Consequently, exceeding the threshold was associated with widened disparities, including greater reductions in outpatient service use and medication fills among Black and Hispanic vs White beneficiaries.
AHRQ-funded; HS026727.
Citation: Roberts ET, Kwon Y, Hames AG .
Racial and ethnic disparities in health care use and access associated with loss of Medicaid supplemental insurance eligibility above the federal poverty level.
JAMA Intern Med 2023 Jun; 183(6):534-43. doi: 10.1001/jamainternmed.2023.0512..
Keywords: Disparities, Racial and Ethnic Minorities, Medicaid, Access to Care, Health Insurance, Low-Income, Access to Care
Kim B, Troxel WM, Dubowitz T
Neighborhood built environment and sleep health: a longitudinal study in low-income and predominantly African-American neighborhoods.
The purpose of this study was to explore the relationships between physical characteristics of neighborhoods and sleep health outcomes and evaluated the mediating role of physical activity in these relationships. The researchers conducted the longitudinal Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health (PHRESH) Zzz Study in 2 low-income, primarily African-American neighborhoods in Pittsburgh, Pennsylvania (n = 1,051). The study included repeated measures of neighborhood characteristics and sleep health outcomes from 2013 to 2018, and systematic field observations captured built environment measures of walkability, urban design, and neighborhood disorder. Sleep health outcomes included insufficient sleep, sleep duration, wakefulness after sleep onset, and sleep efficiency. Urban design features were correlated with lower levels of wakefulness after sleep onset. Neighborhood disorder and crime rate were negatively related with sleep efficiency. Neighborhood walkability was not associated with sleep outcomes.
AHRQ-funded; HS026120.
Citation: Kim B, Troxel WM, Dubowitz T .
Neighborhood built environment and sleep health: a longitudinal study in low-income and predominantly African-American neighborhoods.
Am J Epidemiol 2023 May 5; 192(5):736-47. doi: 10.1093/aje/kwad016..
Keywords: Sleep Problems, Racial and Ethnic Minorities, Low-Income
Wu AJ, Du N, Chen TY
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
The objective of this study was to examine sociodemographic differences between elective and nonelective admissions for failure to thrive. Researchers investigated associations between admission type and hospital resource utilization, including length of stay and feeding tube placement. The study included data on children less than 2 years old with failure to thrive in the Kids' Inpatient Database. The findings showed differences by race and ethnicity, income, and insurance type, among other factors. Nonelective admissions had higher proportions of infants who were Black, Hispanic, and of lower-income, and were associated with longer lengths of stay. The researchers concluded that future research is needed to elucidate drivers of these differences, particularly those related to racial and ethnic disparities and structural racism.
AHRQ-funded; HS000063.
Citation: Wu AJ, Du N, Chen TY .
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
J Pediatr Gastroenterol Nutr 2023 Mar;76(3):385-89. doi: 10.1097/mpg.0000000000003694.
Keywords: Newborns/Infants, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Utilization, Children/Adolescents, Racial and Ethnic Minorities, Low-Income
Blebu BE, Kuppermann M, Coleman-Phox K
A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic.
The COVID-19 pandemic has led to heightened social and economic stressors for expectant individuals. Although community and social services exist to alleviate stressors during pregnancy (e.g., food insecurity and financial difficulties) and decrease the likelihood of negative maternal outcomes, it remains uncertain how the pandemic influenced access to these resources, especially among low-income communities of color. The purpose of this study was to explore the experiences of low-income pregnant individuals of color in accessing community and social service resources during the COVID-19 pandemic. This qualitative study on COVID-related factors recruited participants from two sources—a prospective comparative effectiveness study comparing two enhanced prenatal care models and the California Black Infant Health Program between August and November 2020. The researchers conducted 62 interviews with Medicaid-eligible participants in California's Central Valley, asking them to describe their pregnancy-related experiences and the perceived impact of the pandemic on these experiences. The study identified two overarching themes: obstacles in accessing community and social service resources during the pandemic and potential avenues for enhancing access to these resources. Sub-themes regarding challenges encountered encompassed issues with remote access, complex registration procedures for community and social services, and concerns specific to COVID-19 resources (e.g., testing). Sub-themes associated with opportunities for improved access included capitalizing on instrumental support from perinatal staff and informational (e.g., practical) support from other community programs and pregnant peers. Participants suggested improved client experiences could be achieved through increased transparency and enhanced patient-provider communication.
AHRQ-funded; HS026407
Citation: Blebu BE, Kuppermann M, Coleman-Phox K .
A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic.
Womens Health 2023 Jan-Dec;19:17455057231156792. doi: 10.1177/17455057231156792.
Keywords: COVID-19, Racial and Ethnic Minorities, Low-Income, Women, Pregnancy, Public Health
Auty SG, Aswani MS, Wahbi RN
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
This study examined changes in access to care during the COVID-19 pandemic, stratified by race/ethnicity, household income, and state Medicaid expansion status. Data were extracted for all adults (N = 1,731,699) aged 18-64 surveyed in the 2015-2020 Behavioral Risk Factor Surveillance System from all 50 states and the District of Columbia. The pandemic was associated with a 1.2 percentage point decline in uninsurance for Medicaid expansion states, with reductions concentrated among respondents who were Black, multiracial, or low income. Rates of uninsurance were generally stable in nonexpansion states. Rates of avoided care because of cost fell by 3.5 percentage points in Medicaid expansion states, and by 3.6 percentage points in nonexpansion states. These declines were also concentrated among minority or low-income respondents.
AHRQ-funded; HS026395.
Citation: Auty SG, Aswani MS, Wahbi RN .
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
Med Care 2023 Jan;61(1):45-49. doi: 10.1097/mlr.0000000000001788..
Keywords: COVID-19, Access to Care, Medicaid, Public Health, Racial and Ethnic Minorities, Low-Income
Bastani R, Glenn BA, Singhal R
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
The human papillomavirus (HPV) vaccine has cancer prevention benefits, yet low uptake. The purpose of the study was to evaluate an intervention intended to improve vaccine uptake in low-income, ethnic minority adolescents using a telephone hotline to seek county health department services. The researchers recruited participants through randomization of health department hotline callers who were caregivers of never-vaccinated adolescents aged 11-17. The intervention included multi-lingual print and telephone education and personalized referral to a low cost or free provider of vaccines. Participants completed baseline, 3-month, and 9-month telephone surveys. The study found that by the end of the 9-month follow up period, the HPV vaccination rates had increased, however there were no differences between the intervention (45%) and control (42%) groups. The researchers also observed significant improvements in perceived HPV knowledge, perceived HPV risk, and barriers to vaccination. The study concluded that the county hotline intervention did not produce a greater increase in HPV vaccine rates in the intervention group than the group without the intervention. The study authors recommend that future studies should evaluate interventions which are more intensive and address accessing and using services in complex, safety net settings. The authors also noted that because 44% of unvaccinated adolescents in both the intervention and control groups received at least one dose of the vaccine during the study period, investigators of future studies should be aware of the potential priming effects of participation in the study, which may impact the results of interventions.
AHRQ-funded; HS000046.
Citation: Bastani R, Glenn BA, Singhal R .
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
Cancer Epidemiol Biomarkers Prev 2022 Jan;31(1):175-82. doi: 10.1158/1055-9965.Epi-20-1578..
Keywords: Children/Adolescents, Vaccination, Low-Income, Racial and Ethnic Minorities, Sexual Health, Prevention
Feinberg E, Kuhn J, Eilenberg JS
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
This study looked at impacts of a modification to a pilot program called Family Navigation to help low-income, minority children needing autism-related diagnostic services receive those services. An advisory group recommended modifications to recruitment criteria and study conditions. 40 parent-child dyad participants were randomized between the two pilots to receive usual care (UC) or modified FN. Participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment were compared. Recruitment improved significantly with the modified protocol (4.8% vs. 19.5%) and no participants were excluded from study enrollment compared to the first pilot (43.6%). Families in the second pilot were more likely to complete diagnostic assessment and report greater satisfaction with clinical care.
AHRQ-funded; HS022155; HS022242.
Citation: Feinberg E, Kuhn J, Eilenberg JS .
Improving family navigation for children with autism: a comparison of two pilot randomized controlled trials.
Acad Pediatr 2021 Mar;21(2):265-71. doi: 10.1016/j.acap.2020.04.007..
Keywords: Children/Adolescents, Autism, Patient-Centered Healthcare, Care Coordination, Racial and Ethnic Minorities, Low-Income, Patient and Family Engagement, Chronic Conditions
Hill LM, Lightfoot AF, Riggins L
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
The authors conducted a venue-based community survey with 53 African American women living in low-income neighborhoods of a Southeastern city in order to understand women's knowledge of and attitudes toward pre-exposure prophylaxis (PrEP). They found that awareness of PrEP was very low, with only 16% being aware that PrEP is used for HIV prevention. The vast majority reported that they would use or would consider using PrEP, most frequently citing a general interest in HIV prevention or a lack of awareness of their partners' HIV status as motivations for their interest. Some women expressed concerns about side effects or low perceived HIV risk as disincentives for PrEP use.
AHRQ-funded; HS000032.
Citation: Hill LM, Lightfoot AF, Riggins L .
Awareness of and attitudes toward pre-exposure prophylaxis among African American women living in low-income neighborhoods in a Southeastern city.
AIDS Care 2021 Feb;33(2):239-43. doi: 10.1080/09540121.2020.1769834..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Women, Low-Income, Prevention, Medication
Patel SA, Krasnow M, Long K
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.
AHRQ-funded; HS026081.
Citation: Patel SA, Krasnow M, Long K .
Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.
Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities
Joyce NR, Pfeiffer MR, Zullo AR
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
Using data from the New Jersey Safety Health Outcomes data warehouse 2004-2018, the authors compared characteristics of suspended drivers, their residential census tract, as well as access to public transportation and jobs, by reason for the suspension. They found that 91% of license suspensions were for non-driving-related events, with the most common reason for a suspension being failure to pay a fine. Non-driving-related suspended drivers lived in census tracts with a lower household median income, higher proportion of black and Hispanic residents and higher unemployment rates, but also better walkability scores and better access to public transportation and jobs. They recommended additional work to determine what effect this has for the social and economic well-being of suspended drivers.
AHRQ-funded; HS022998.
Citation: Joyce NR, Pfeiffer MR, Zullo AR .
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
J Transp Health 2020 Dec;19. doi: 10.1016/j.jth.2020.100933..
Keywords: Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations, Social Determinants of Health
Roberts ET, Mehrotra A
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
In this study, the investigators examined disparities in digital access (ie, access at home to technology that enables video telemedicine visits) among Medicare beneficiaries by socioeconomic and demographic characteristics. The investigators concluded that the proportion of beneficiaries who lacked digital access was higher among those with low socioeconomic status, those 85 years or older, and in communities of color.
AHRQ-funded; HS026727.
Citation: Roberts ET, Mehrotra A .
Assessment of disparities in digital access among Medicare beneficiaries and implications for telemedicine.
JAMA Intern Med 2020 Oct;180(10):1386-89. doi: 10.1001/jamainternmed.2020.2666..
Keywords: Elderly, Medicare, Telehealth, Health Information Technology (HIT), Disparities, Access to Care, Social Determinants of Health, Low-Income, Racial and Ethnic Minorities
Aguilera A, Figueroa CA, Hernandez-Ramos R
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE study.
In this randomized controlled trial, the researchers’ goal is to examine the effect of a text-messaging smartphone application to encourage physical activity in low-income ethnic minority patients with comorbid diabetes and depression. They will compare passively collected daily step counts, self-reported PHQ-8 and most recent hemoglobin A1c from medical records at baseline and at intervention completion at 6-month follow-up. They plan to submit manuscripts describing their user-designed methods and testing of the adaptive learning algorithm and will submit the results of the trial for publication in peer-reviewed journals and presentations at scientific meetings.
AHRQ-funded; HS025429.
Citation: Aguilera A, Figueroa CA, Hernandez-Ramos R .
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE study.
BMJ Open 2020 Aug 20;10(8):e034723. doi: 10.1136/bmjopen-2019-034723..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Low-Income, Health Promotion
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
Bass AR, Mehta B, Szymonifka J
Racial disparities in total knee replacement failure as related to poverty.
The authors sought to determine whether racial disparities in total knee replacement (TKR) failure are explained by poverty. Linking New York state patients to residential census tracts by geocoded addresses, they found that there was a trend toward higher TKR revision risk in blacks, but poverty did not modify the relationship between race and TKR revision or failure.
AHRQ-funded; HS016075.
Citation: Bass AR, Mehta B, Szymonifka J .
Racial disparities in total knee replacement failure as related to poverty.
Arthritis Care Res 2019 Nov;71(11):1488-94. doi: 10.1002/acr.24028..
Keywords: Disparities, Racial and Ethnic Minorities, Low-Income, Surgery, Orthopedics, Social Determinants of Health
Goff SL, Garb JL, Guhn-Knight H
Spatial analysis of factors influencing choice of paediatric practice for mothers from low-income and minority populations.
Publicly reported quality data theoretically enable parents to choose higher-performing paediatric practices. However, little is known about how parents decide where to seek paediatric care. In this study, the investigators explored the relationship between geographic factors, care quality and choice of practice to see if the decision-making process could be described in terms of a 'gravity model' of spatial data.
AHRQ-funded; HS021879.
Citation: Goff SL, Garb JL, Guhn-Knight H .
Spatial analysis of factors influencing choice of paediatric practice for mothers from low-income and minority populations.
J Paediatr Child Health 2019 Aug;55(8):948-55. doi: 10.1111/jpc.14322..
Keywords: Caregiving, Decision Making, Low-Income, Quality of Care, Racial and Ethnic Minorities
Burnett-Zeigler I, Hong S, Waldron EM
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
The authors piloted a streamlined mindfulness teacher training protocol for Federally Qualified Health Center (FQHC) staff. They also examined the distribution and variability of psychologic outcomes for participants in groups led by an experienced instructor compared to a FQHC staff instructor who received the streamlined training. They concluded that preliminary data indicate that health care staff who receive streamlined training to deliver mindfulness-based interventions have comparable outcomes as experienced instructors.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Hong S, Waldron EM .
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
J Altern Complement Med 2019 Jul;25(7):699-708. doi: 10.1089/acm.2018.0393..
Keywords: Behavioral Health, Comparative Effectiveness, Depression, Low-Income, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Vulnerable Populations, Training, Women
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities
Louisias M, Wright L, Phipatanakul W
Asthma in the melting pot.
This article highlights research advances related to asthma health disparities, and offers recommendations regarding innovative approaches to achieve equity and social justice for minority and low-income populations. Since traditional randomized controlled trials may not always be the most appropriate approach to health disparities research interventions, the authors suggest appropriate alternatives, such as the stepped-wedge design; or, because intervention trials are not always feasible, alternative analytic approaches such as mediation analysis or modeling could be used instead. Dissemination and implementation (D&I) research and the use of biomarkers to measure the social disadvantage impact of asthma outcomes are also discussed.
AHRQ-funded; HS022986.
Citation: Louisias M, Wright L, Phipatanakul W .
Asthma in the melting pot.
Ann Allergy Asthma Immunol 2019 Feb;122(2):136-39. doi: 10.1016/j.anai.2018.11.009.
.
.
Keywords: Asthma, Disparities, Respiratory Conditions, Low-Income, Racial and Ethnic Minorities
Knierim SD, Moore SL, Raghunath SG
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. The investigators concluded that a home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns.
AHRQ-funded; HS021138; HS022143.
Citation: Knierim SD, Moore SL, Raghunath SG .
Home visitations for delivering an early childhood obesity intervention in Denver: parent and patient navigator perspectives.
Matern Child Health J 2018 Nov;22(11):1589-97. doi: 10.1007/s10995-018-2553-7..
Keywords: Children/Adolescents, Home Healthcare, Low-Income, Obesity, Children/Adolescents, Racial and Ethnic Minorities
Kim DH, Bassett SM, So S
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
This study assessed whether future orientation and self-esteem affected the relationship between family stress and mental health problems among African American youth in predominantly low-income neighborhoods. Youths (mainly female, average age 15.83 years old) were sampled for family stress, self-esteem, future orientation, mental health and other covariates such as gender and sexual orientation. A correlation was found between future orientation and self-esteem levels and family stress and mental health problems.
AHRQ-funded; HS000078.
Citation: Kim DH, Bassett SM, So S .
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
Am J Orthopsychiatry 2019;89(2):125-33. doi: 10.1037/ort0000371..
Keywords: Children/Adolescents, Family Health and History, Low-Income, Behavioral Health, Racial and Ethnic Minorities, Stress, Vulnerable Populations
Zuckerman KE, Chavez AE, Regalado Murillo C
Disparities in familiarity with developmental disabilities among low-income parents.
Parent knowledge about developmental disabilities (DDs) may facilitate access to DD care; however, parents may vary in their knowledge and familiarity with common DDs. The objective of this study was to assess racial/ethnic and language differences in low-income families' familiarity, knowledge, and personal experience with DDs. The investigators concluded that low-income Latino-LEP and other race parents have less familiarity or personal experience with DDs and are less aware of early signs of DDs compared to low-income white parents.
AHRQ-funded; HS000063.
Citation: Zuckerman KE, Chavez AE, Regalado Murillo C .
Disparities in familiarity with developmental disabilities among low-income parents.
Acad Pediatr 2018 Nov - Dec;18(8):944-51. doi: 10.1016/j.acap.2018.06.011..
Keywords: Disabilities, Children/Adolescents, Caregiving, Health Literacy, Low-Income, Vulnerable Populations, Racial and Ethnic Minorities
Akwo EA, Kabagambe EK, Harrell FE, Jr.
Neighborhood deprivation predicts heart failure risk in a low-income population of blacks and whites in the southeastern United States.
The researchers investigated whether neighborhood deprivation predicts risk of incident heart failure (HF) beyond individual socioeconomic status in a low-income population. They concluded that, in a low-income population from the Southern Community Cohort Study, scant neighborhood resources compounded the risk of HF above and beyond individual socioeconomic status and traditional cardiovascular risk factors.
AHRQ-funded; HS022990.
Citation: Akwo EA, Kabagambe EK, Harrell FE, Jr. .
Neighborhood deprivation predicts heart failure risk in a low-income population of blacks and whites in the southeastern United States.
Circ Cardiovasc Qual Outcomes 2018 Jan;11(1):e004052. doi: 10.1161/circoutcomes.117.004052.
.
.
Keywords: Heart Disease and Health, Low-Income, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Goff SL, Mazor KM, Guhn-Knight H
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
The authors sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. They found that pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics.
AHRQ-funded; HS021864.
Citation: Goff SL, Mazor KM, Guhn-Knight H .
Factors that matter to low-income and racial/ethnic minority mothers when choosing a pediatric practice: a mixed methods analysis.
J Racial Ethn Health Disparities 2017 Dec;4(6):1051-60. doi: 10.1007/s40615-016-0309-x.
.
.
Keywords: Access to Care, Quality of Care, Low-Income, Children/Adolescents, Racial and Ethnic Minorities
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
.
.
Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Magnusson DM, Minkovitz CS, Kuhlthau KA
AHRQ Author: Mistry KB
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
This study sought to understand the role of health beliefs in shaping maternal decisions regarding help-seeking for children with developmental delay (DD) and explore differences between African American and Hispanic mothers. Five major themes emerged describing the role of maternal health beliefs in shaping key stages of the help-seeking pathway for children with DD. Differences between African American and Hispanic mothers are also described.
AHRQ-authored.
Citation: Magnusson DM, Minkovitz CS, Kuhlthau KA .
Beliefs regarding development and early intervention among low-income African American and Hispanic mothers.
Pediatrics 2017 Nov;140(5):pii: e20172059. doi: 10.1542/peds.2017-2059.
.
.
Keywords: Children/Adolescents, Decision Making, Disabilities, Low-Income, Racial and Ethnic Minorities