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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 30 Research Studies DisplayedMichelson KA, Samuels-Kalow ME
Association of elementary school reopening status and county COVID-19 incidence.
This study examined the association between elementary school opening status (ESOS) and pediatric COVID-19 incidence. The authors conducted a cross-sectional study of US counties with school districts with ≥500 elementary school students. The main exposure was ESOS in September 2020 and outcome was county incidence of COVID-19. Among 3220 US counties, 19.2% were remote, 12.1% were hybrid, and 62.8% were in person. In unadjusted models, COVID-19 incidence after school started was higher among children in hybrid or in-person counties compared with remote only counties. After adjusting for local COVID-19 incidence, the incidence rate ratio compared with remote counties was 1.01 in hybrid counties and 0.79 in in-person counties.
AHRQ-funded; HS026503.
Citation: Michelson KA, Samuels-Kalow ME .
Association of elementary school reopening status and county COVID-19 incidence.
Acad Pediatr 2022 May-Jun;22(4):667-70. doi: 10.1016/j.acap.2021.09.006..
Keywords: Children/Adolescents, COVID-19, Public Health, Education
Whooten RC, Horan C, Cordes J
Evaluating the implementation of a before-school physical activity program: a mixed-methods approach in Massachusetts, 2018.
The aim of this study was to evaluate the implementation of a widely available, before-school, physical activity program in a low-resource, racially/ethnically and socioeconomically diverse, urban school setting to identify adaptations needed for successful implementation. The investigators used a collaborative effort with stakeholders to implement the Build Our Kids' Success (BOKS) program in 3 schools in Revere, Massachusetts.
AHRQ-funded; HS000063.
Citation: Whooten RC, Horan C, Cordes J .
Evaluating the implementation of a before-school physical activity program: a mixed-methods approach in Massachusetts, 2018.
Prev Chronic Dis 2020 Oct 1;17:E116. doi: 10.5888/pcd17.190445..
Keywords: Children/Adolescents, Education, Implementation, Health Promotion, Prevention, Lifestyle Changes, Social Determinants of Health
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination, Value
Louisias M, Petty CR, Sheehan W
Use of a school-based survey to screen students for symptoms concerning for asthma.
Researchers sought early identification of asthma in minority children. Their goal was to determine if they could apply screening surveys to an inner-city, school-based cohort. They found a significant number of children with a positive asthma screen and no parent-reported asthma. Children with symptoms suggestive of asthma had elevated rates of hospital care for breathing problems and an atopic background. The researchers conclude that these children without known asthma, but who experience increased morbidity, can be easily identified with a school-based asthma screening survey and should be closely monitored.
AHRQ-funded; HS000063; HS022986.
Citation: Louisias M, Petty CR, Sheehan W .
Use of a school-based survey to screen students for symptoms concerning for asthma.
Clin Pediatr 2019 May;58(5):586-89. doi: 10.1177/0009922819832087..
Keywords: Children/Adolescents, Asthma, Screening, Education, Diagnostic Safety and Quality, Urban Health
Shaker MS, Greenhawt MJ
Analysis of value-based costs of undesignated school stock epinephrine policies for peanut anaphylaxis.
Children experiencing anaphylaxis at school may lack access to a personal epinephrine device, prompting recent legislation permitting undesignated (eg, non-student specific) stock epinephrine autoinjector units at school. However, epinephrine device costs vary, and the cost-effectiveness of undesignated school stock epinephrine is uncharacterized to date. The objective of this study was to define value-based strategies for undesignated school stock epinephrine programs.
AHRQ-funded; HS024599.
Citation: Shaker MS, Greenhawt MJ .
Analysis of value-based costs of undesignated school stock epinephrine policies for peanut anaphylaxis.
JAMA Pediatr 2019 Feb;173(2):169-75. doi: 10.1001/jamapediatrics.2018.4275..
Keywords: Value, Healthcare Costs, Education, Policy, Medication
Forster M, Amy GL, Areba E
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
The authors investigated whether internal assets (IAs), factors that promote healthy youth development, can mitigate the adverse effects of psychosocial risks on tobacco use. Their results indicated that every additional psychosocial risk factor was associated with an increase in the odds of using tobacco and in the estimated number of products used. IAs were inversely associated with tobacco use and attenuated the association between cumulative psychosocial risks and use. They concluded that bolstering resilience by facilitating students' IAs represents a promising direction for youth-focused prevention efforts.
AHRQ-funded; HS022236.
Citation: Forster M, Amy GL, Areba E .
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
Addict Behav 2019 Feb;89:240-47. doi: 10.1016/j.addbeh.2018.10.014..
Keywords: Tobacco Use, Children/Adolescents, Risk, Education
Cohen JFW, Gorski Findling MT, Rosenfeld L
The impact of 1 year of healthier school food policies on students' diets during and outside of the school day.
In 2012, Massachusetts implemented both the updated national school meal standards and comprehensive competitive food/beverage standards that closely align with current national requirements for school snacks. This study examines the impact of these combined standards on school meal and snack food selections, as well as food choices outside of school. The investigators concluded that with the reduction in the number of unhealthy school snacks, significantly more students selected school meals. Students did not compensate for lack of unhealthy snacks in school by increased consumption of unhealthy snacks outside of school.
AHRQ-funded; HS000055.
Citation: Cohen JFW, Gorski Findling MT, Rosenfeld L .
The impact of 1 year of healthier school food policies on students' diets during and outside of the school day.
J Acad Nutr Diet 2018 Dec;118(12):2296-301. doi: 10.1016/j.jand.2018.07.009..
Keywords: Children/Adolescents, Education, Nutrition, Policy
Parikh K, Paul J, Foushee N
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
This study focused on developing a comprehensive understanding of asthma care after hospitalization of children as reported by caregivers, health providers, and school nurses. The children had a median age of 7 years, mean hospital length of stay of 1.9 days, and 56% had a previous hospitalization in the last 12 months. Family caregivers and health professionals were given individual interviews while focus groups were conducted with school nurses. There were different health beliefs about asthma knowledge between caregivers and health professionals. School nurses highlighted specific barriers that focused on medication use in schools.
AHRQ-funded; HS024554.
Citation: Parikh K, Paul J, Foushee N .
Barriers and facilitators to asthma care after hospitalization as reported by caregivers, health providers, and school nurses.
Hosp Pediatr 2018 Nov;8(11):706-17. doi: 10.1542/hpeds.2017-0182..
Keywords: Asthma, Hospitalization, Children/Adolescents, Caregiving, Patient Adherence/Compliance, Education
Jaime MCD, McCauley HL, Tancredi DJ
Implementing a coach-delivered dating violence prevention program with high school athletes.
This paper describes the implementation of a coach-delivered dating violence prevention program with high school athletes. The program, Coaching Boys Into Men (CBIM), is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes.
AHRQ-funded; HS022236.
Citation: Jaime MCD, McCauley HL, Tancredi DJ .
Implementing a coach-delivered dating violence prevention program with high school athletes.
Prev Sci 2018 Nov;19(8):1113-22. doi: 10.1007/s11121-018-0909-2..
Keywords: Children/Adolescents, Domestic Violence, Education
Ciotoli C, Smith AJ, Keeling RP
Call to action: better care, better health, and greater value in college health.
This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring quality improvement (QI) to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.
AHRQ-funded; HS022520.
Citation: Ciotoli C, Smith AJ, Keeling RP .
Call to action: better care, better health, and greater value in college health.
J Am Coll Health 2018 Oct;66(7):625-39. doi: 10.1080/07448481.2018.1431908..
Keywords: Education, Quality of Care, Quality Improvement, Value
Monheit AC, Grafova IB
Education and family health care spending.
Using data from the 2004 to 2012 Medical Expenditure Panel Survey (MEPS), the investigators examined the association between parental education and family health care spending in single-mother and two-parent families. Controlling for family income and health insurance status, they found consistent evidence that parental education beyond 12 years of schooling was associated with increases in family health care spending and with reductions in the likelihood of adverse health conditions.
AHRQ-funded; HS02405.
Citation: Monheit AC, Grafova IB .
Education and family health care spending.
Southern Economic Journal 2018 Jul;85(1):71-92. doi: doi:10.1002/soej.12300..
Keywords: Education, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Saavedra-Avendano B, Schiavon R, Sanhueza P
Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City?
This study identified socio-demographic factors associated with presenting for abortion services past the gestational age (GA) limit (12 weeks), and thus not receiving services, in Mexico City's public sector first trimester abortion program. Adult women had significantly lower odds than adolescents of presenting past the limit. There was an educational gradient across all age groups.
AHRQ-funded; HS022981.
Citation: Saavedra-Avendano B, Schiavon R, Sanhueza P .
Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City?
PLoS One 2018 Feb 7;13(2):e0192547. doi: 10.1371/journal.pone.0192547.
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Keywords: Education, Pregnancy, Social Determinants of Health, Women
Szilagyi PG, Schaffer S, Rand CM
School-located influenza vaccinations for adolescents: a randomized controlled trial.
In this study, the investigators aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. In 2015-2016, they performed a cluster-randomized trial of adolescent SLIV in middle/high schools. They concluded that SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
School-located influenza vaccinations for adolescents: a randomized controlled trial.
J Adolesc Health 2018 Feb;62(2):157-63. doi: 10.1016/j.jadohealth.2017.09.021..
Keywords: Children/Adolescents, Education, Influenza, Prevention, Public Health, Vaccination
Gorski Findling MT, Werth PM, Musicus AA
Comparing five front-of-pack nutrition labels' influence on consumers' perceptions and purchase intentions.
In 2011, a National Academy of Medicine report recommended that packaged food in the U.S. display a uniform front-of-package nutrition label, using a system such as a 0-3 star ranking. This study compares five front-of-pack nutrition labels' influence on consumers' perceptions and purchase intentions. The authors indicated that results did not point to a clearly superior label design, but suggested that a 3-star label might not be best for educating consumers.
AHRQ-funded; HS000055.
Citation: Gorski Findling MT, Werth PM, Musicus AA .
Comparing five front-of-pack nutrition labels' influence on consumers' perceptions and purchase intentions.
Prev Med 2018 Jan;106:114-21. doi: 10.1016/j.ypmed.2017.10.022..
Keywords: Education, Nutrition, Obesity
Baiocchi M, Omondi B, Langat N
A behavior-based intervention that prevents sexual assault: the results of a matched-pairs, cluster-randomized study in Nairobi, Kenya.
This study was a cluster-randomized, matched-pairs, parallel trial of a behavior-based sexual assault prevention intervention in the informal settlements in Nairobi, Kenya. The study intervention combined parallel training for young adolescent girls and boys in school settings and showed significant reduction in the rate of sexual assault among girls in this population.
AHRQ-funded; HS022192.
Citation: Baiocchi M, Omondi B, Langat N .
A behavior-based intervention that prevents sexual assault: the results of a matched-pairs, cluster-randomized study in Nairobi, Kenya.
Prev Sci 2017 Oct;18(7):818-27. doi: 10.1007/s11121-016-0701-0..
Keywords: Children/Adolescents, Education, Prevention, Women
Wisk LE, Weitzman ER
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
This study sought to investigate educational aspirations, expectations, and attainment among youth with and without chronic conditions and to determine if these relationships mediated subsequent disparities in health and well-being. Findings suggest an important risk mechanism through which youth with chronic medical conditions may acquire socioeconomic disadvantage as they develop and progress through educational settings.
AHRQ-funded; HS022986; HS000063.
Citation: Wisk LE, Weitzman ER .
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
J Adolesc Health 2017 Oct;61(4):461-70. doi: 10.1016/j.jadohealth.2017.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Disparities, Education, Health Status
Payan DD, Sloane DC, Illum J
Perceived barriers and facilitators to healthy eating and school lunch meals among adolescents: a qualitative study.
The researchers explored how perceived barriers and facilitators influence healthy eating and investigated the acceptability of changes to school lunch meals among adolescents after implementation of the Healthy, Hunger-Free Kids Act of 2010. Their findings suggest the need to measure perceived and actual barriers to healthy eating among adolescents and to examine the effect of these barriers on dietary behavior.
AHRQ-funded; HS000046.
Citation: Payan DD, Sloane DC, Illum J .
Perceived barriers and facilitators to healthy eating and school lunch meals among adolescents: a qualitative study.
Am J Health Behav 2017 Sep 1;41(5):661-69. doi: 10.5993/ajhb.41.5.15.
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Keywords: Children/Adolescents, Education, Lifestyle Changes, Nutrition
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
Kaplan RM, Fang Z, Kirby J
Educational attainment and health outcomes: data from the Medical Expenditures Panel Survey.
This study explored the extent to which health care utilization and health risk-taking can explain the education-health gradient above and beyond what can be explained by previously examined mediators such as age, race, and poverty status. It found systematic graded relationships between educational attainment and health including, SF-12 PCS scores, self-rated health, and activity limitations. Education was associated with more office visits and outpatient visits and less risk tolerance.
AHRQ-authored.
Citation: Kaplan RM, Fang Z, Kirby J .
Educational attainment and health outcomes: data from the Medical Expenditures Panel Survey.
Health Psychol 2017 Jun;36(6):598-608. doi: 10.1037/hea0000431.
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Keywords: Education: Academic, Education, Health Status, Medical Expenditure Panel Survey (MEPS)
Rosenfeld LE, Cohen JF, Gorski MT
How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors.
In autumn 2012, Massachusetts schools implemented comprehensive competitive food and beverage standards similar to the US Department of Agriculture's Smart Snacks in School standards. In this study, the authors explored major themes raised by food-service directors (FSD) regarding their school-district-wide implementation of the standards. The investigators found that FSD in more-compliant districts were more likely to talk about themes than those in less-compliant districts.
AHRQ-funded; HS000055.
Citation: Rosenfeld LE, Cohen JF, Gorski MT .
How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors.
Public Health Nutr 2017 Feb;20(3):556-64. doi: 10.1017/s1368980016002044..
Keywords: Education, Nutrition
Eskreis-Winkler L, Shulman EP, Young V
Using wise interventions to motivate deliberate practice.
This study examined whether psychologically "wise" interventions targeting expectancies and values-stock antecedents of ordinary effortful behaviors-could motivate nonexperts to engage in deliberate practice and improve their achievement. Its findings provide preliminary support for the heretofore untested hypothesis that deliberate practice submits to the same laws that govern typical forms of effortful behavior.
AHRQ-funded; HS022990.
Citation: Eskreis-Winkler L, Shulman EP, Young V .
Using wise interventions to motivate deliberate practice.
J Pers Soc Psychol 2016 Nov;111(5):728-44. doi: 10.1037/pspp0000074.
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Keywords: Children/Adolescents, Education, Young Adults
Cohen JF, Gorski MT, Hoffman JA
Healthier standards for school meals and snacks: impact on school food revenues and lunch participation rates.
This study evaluated the impact of updated school meal standards and Massachusetts' comprehensive competitive food standards on school food revenues and school lunch participation. The study found that schools experienced initial revenue losses after implementation of the standards, yet longer-term school food revenues were not impacted and school meal participation increased among children eligible for reduced-price meals. Weakening the school meal or competitive food guidelines based on revenue concerns appears unwarranted.
AHRQ-funded; HS000055.
Citation: Cohen JF, Gorski MT, Hoffman JA .
Healthier standards for school meals and snacks: impact on school food revenues and lunch participation rates.
Am J Prev Med 2016 Oct;51(4):485-92. doi: 10.1016/j.amepre.2016.02.031..
Keywords: Children/Adolescents, Education, Nutrition
Gorski MT, Cohen JF, Hoffman JA
Impact of nutrition standards on competitive food quality in Massachusetts middle and high schools.
This study examined changes in competitive foods (items sold in a la carte lines, vending machines, and school stores that "compete" with school meals) in Massachusetts middle and high schools before and after implementation of a statewide nutrition law in 2012. It found that by 2014, 60 percent of competitive foods and 79 percent of competitive beverages were compliant.
AHRQ-funded; HS000055.
Citation: Gorski MT, Cohen JF, Hoffman JA .
Impact of nutrition standards on competitive food quality in Massachusetts middle and high schools.
Am J Public Health 2016 Jun;106(6):1101-8. doi: 10.2105/ajph.2016.303139.
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Keywords: Nutrition, Education, Children/Adolescents
Jonassaint CR, Beach MC, Haythornthwaite JA
The association between educational attainment and patterns of emergency department utilization among adults with sickle cell disease.
The authors aimed to determine what factors are related to emergency department visits in hopes of guiding treatments and early interventions. They concluded that early interventions addressing disparities in academic performance, especially for those children most at risk, may lead to improved long-term health outcomes in this population.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Beach MC, Haythornthwaite JA .
The association between educational attainment and patterns of emergency department utilization among adults with sickle cell disease.
Int J Behav Med 2016 Jun;23(3):300-09. doi: 10.1007/s12529-016-9538-y.
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Keywords: Education, Emergency Department, Healthcare Utilization, Pain, Sickle Cell Disease
