National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
76 to 100 of 252 Research Studies DisplayedTurer CB, Barlow SE, Sarwer DB
Association of clinician behaviors and weight change in school-aged children.
This study used clinical practice data to determine whether recommended weight management clinician behaviors were associated with weight status improvement in children aged 6-12 years who are overweight or obese. Electronic health record data (2009-2014) from 52 clinics were used. Weight status was examined from 1 visit to the next as dichotomous improvement (versus worsening or no change) and change in percentage overweight (over sex/age-specific BMI95).
AHRQ-funded; HS022418.
Citation: Turer CB, Barlow SE, Sarwer DB .
Association of clinician behaviors and weight change in school-aged children.
Am J Prev Med 2019 Sep;57(3):384-93. doi: 10.1016/j.amepre.2019.04.029..
Keywords: Children/Adolescents, Obesity, Obesity: Weight Management, Outcomes, Patient-Centered Outcomes Research
Campbell AD, Baker EH
Do income inequalities in higher weight status depend on social integration?
In this study, the investigators use data from the 2003-2008 National Health and Nutrition Examination Survey (NHANES) to examine whether the association between higher weight status and social integration varies by income. The investigators concluded that the association between income and higher weight status operates differently for women and men and is dependent, in part, on their level of social integration.
AHRQ-funded; HS013852.
Citation: Campbell AD, Baker EH .
Do income inequalities in higher weight status depend on social integration?
Soc Sci Res 2019 Sep;83:102301. doi: 10.1016/j.ssresearch.2019.04.014..
Keywords: Health Status, Obesity, Obesity: Weight Management, Social Determinants of Health
Drouin O, Sharifi M, Gerber M
Parents' willingness to pay for pediatric weight management programs.
This study examined parents’ interested in continuing and willingness to pay (WTP) for 2 pediatric weight management programs after their childrens’ participation. Participants were parents of 2- to 12-year-old children with a body mass index equal to or greater than the 85th percentile who participated in the Connect for Health trial. One group received enhanced primary care (EPC) and the other group EPC plus individualized coaching (EPC+C). After 1 year, they assessed parents’ self-reported WTP for a similar program and the maximum amount they would pay. Of 638 parents polled, 85% were interested in continuing and 38% of them were willing to pay. The median amount they were willing to pay was $25/month. Parents of Hispanic/Latino children versus white ethnicity and those reporting a higher satisfaction with the program more most likely to endorse WTP. Parents of children getting EPC+C were also more willing to pay.
AHRQ-funded; HS024332; HS022986.
Citation: Drouin O, Sharifi M, Gerber M .
Parents' willingness to pay for pediatric weight management programs.
Acad Pediatr 2019 Sep - Oct;19(7):764-72. doi: 10.1016/j.acap.2019.05.124..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Healthcare Costs, Caregiving, Primary Care, Primary Care: Models of Care
Zhang T, Lary CW, Zullo AR
Post-hip fracture mortality in nursing home residents by obesity status.
This research letter discusses a study that examined whether obesity status affected mortality in post-hip fracture patients who were nursing home residents. A national cohort of nursing home (NH) residents was examined from national Medicare fee-for-service claims linked to the Minimum Data Set (MDS) from January 2008 through the end of 2009. A total of 33, 622 long-stay residents were identified who had been hospitalized for a hip fracture. They excluded 6918 patients due to a number of factors. They classified residents based on their BMI: normal BMI, overweight, mild obesity, or moderate/severe obesity. They found that being moderate/severely obese did not increase mortality.
AHRQ-funded; HS022998.
Citation: Zhang T, Lary CW, Zullo AR .
Post-hip fracture mortality in nursing home residents by obesity status.
J Am Geriatr Soc 2019 Sep;67(9):1983-85. doi: 10.1111/jgs.16028..
Keywords: Injuries and Wounds, Surgery, Nursing Homes, Obesity, Mortality, Elderly, Long-Term Care, Patient-Centered Outcomes Research
Sheetz KH, Woodside KJ, Shahinian VB
Trends in bariatric surgery procedures among patients with ESKD in the United States.
This study examined trends in bariatric surgery among patients with end-stage kidney disease (ESKD) in the United States. There was an almost ninefold increase in surgery between 2006 and 2016 for ESKD patients and also for sleeve gastrectomy surgery. ESKD patients showed similar complication rates compared with non-ESKD patients, but there were more readmissions.
AHRQ-funded; HS023597; HS000053.
Citation: Sheetz KH, Woodside KJ, Shahinian VB .
Trends in bariatric surgery procedures among patients with ESKD in the United States.
Clin J Am Soc Nephrol 2019 Aug 7;14(8):1193-99. doi: 10.2215/cjn.01480219..
Keywords: Obesity, Surgery, Kidney Disease and Health, Obesity: Weight Management, Hospital Readmissions, Adverse Events, Outcomes
Smith ME, Lee JS, Bonham A
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
In this study, the investigators sought to determine the relationship between new persistent opioid use and 1-year postoperative outcomes for patients undergoing bariatric surgery. The investigators concluded that new persistent opioid use is common following bariatric surgery and associated with significantly worse physiologic and psychologic outcomes. More effective screening and postoperative surveillance tools are needed to identify these patients, who likely require more aggressive counseling and treatment to maximize the benefits of bariatric surgery.
AHRQ-funded; HS024403.
Citation: Smith ME, Lee JS, Bonham A .
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
Surg Endosc 2019 Aug;33(8):2649-56. doi: 10.1007/s00464-018-6542-0..
Keywords: Opioids, Surgery, Medication, Obesity: Weight Management, Obesity, Obesity: Weight Management, Pain, Outcomes
Ibrahim N, Alameddine M, Brennan J
New onset alcohol use disorder following bariatric surgery.
Researchers sought to characterize the patients and incidence of alcohol use disorder (AUD) following sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB). They found that the prevalence of alcohol use disorder in patients undergoing SG and RYGB was similar pre- and postoperatively, with the majority of patients developing AUD following their second postoperative year. The authors recommended understanding the timing and incidence of AUD in order to provide appropriate counseling and treatment.
AHRQ-funded; HS023621; HS024403.
Citation: Ibrahim N, Alameddine M, Brennan J .
New onset alcohol use disorder following bariatric surgery.
Surg Endosc 2019 Aug;33(8):2521-30. doi: 10.1007/s00464-018-6545-x..
Keywords: Alcohol Use, Behavioral Health, Obesity, Obesity: Weight Management, Substance Abuse, Surgery
Brenes-Monge A, Saavedra-Avendano B, Alcalde-Rabanal J
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition.
Researchers conducted a cross-sectional study to test the association between overweight and obesity and cesarean delivery in Mexico using data from the 2012 National Survey of Health and Nutrition (ENSANUT). They found that multiparous women with obesity are at higher risk of cesarean delivery in Mexico than multiparous women with normal body mass index. They recommend that efforts to reduce the cesarean deliveries rate take the obesity epidemic into account.
AHRQ-funded; HS022981.
Citation: Brenes-Monge A, Saavedra-Avendano B, Alcalde-Rabanal J .
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition.
BMC Pregnancy Childbirth 2019 Jul 11;19(1):239. doi: 10.1186/s12884-019-2393-5..
Keywords: Labor and Delivery, Obesity, Pregnancy, Risk, Women
Grant MC, Gibbons M M, Ko CY
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.
The authors conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery. They summarize the best available evidence to recommend the anesthetic components of care for enhanced recovery after bariatric surgery. The concluded that there is evidence in the literature, and from society guidelines, to support AHRQ’s Safety Program for Improving Surgical Care and Recovery goals for bariatric surgery.
AHRQ-funded; 233201500020I.
Citation: Grant MC, Gibbons M M, Ko CY .
Evidence review conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for bariatric surgery.
Anesth Analg 2019 Jul;129(1):51-60. doi: 10.1213/ane.0000000000003696..
Keywords: Evidence-Based Practice, Medication, Obesity, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Quality Improvement, Surgery
Pepper DJ, Demirkale CY, Sun J
Does obesity protect against death in sepsis? A retrospective cohort study of 55,038 adult patients.
The purpose of this study was to estimate the relationship between body mass index and sepsis mortality using detailed clinical data for case detection and risk adjustment. In adults with clinically-defined sepsis, results demonstrated lower short-term mortality in patients with higher body mass indices compared with those with normal body mass indices and higher short-term mortality in those with low body mass indices. Understanding how obesity improves survival in sepsis would inform prognostic and therapeutic strategies.
AHRQ-funded; HS025008.
Citation: Pepper DJ, Demirkale CY, Sun J .
Does obesity protect against death in sepsis? A retrospective cohort study of 55,038 adult patients.
Crit Care Med 2019 May;47(5):643-50. doi: 10.1097/ccm.0000000000003692..
Keywords: Sepsis, Obesity, Mortality
Derose KP, Williams MV, Florez KR
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
The purpose of this study was to implement a multilevel, church-based intervention with diverse disparity populations using community-based participatory research and evaluate feasibility, acceptability, and preliminary effectiveness in improving obesity-related outcomes. The investigators concluded that the intervention resulted in small improvements in obesity outcomes. They assert that a longer time line is needed to fully implement and assess effects of community and congregation environmental strategies and to allow for potential larger impacts of the intervention.
AHRQ-funded; HS000046.
Citation: Derose KP, Williams MV, Florez KR .
Eat, pray, move: a pilot cluster randomized controlled trial of a multilevel church-based intervention to address obesity among African Americans and Latinos.
Am J Health Promot 2019 May;33(4):586-96. doi: 10.1177/0890117118813333..
Keywords: Lifestyle Changes, Nutrition, Obesity, Outcomes, Racial and Ethnic Minorities
Vergis A, Hardy K, Stogryn S
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
This retrospective analysis investigated the completeness of reporting documentation for Roux-en-Y Gastric Bypass (RYGB) surgery. A total of 40 bariatric fellow and 40 attending RYGB narrative reports were analyzed. Fellows had a mean completion rate of 66.4% compared to 61.5% for attendings. Fellows also did a better job of completing subsections, with the exception of closure details. This information is important to communicating operative events and can make an impact on patient safety and quality.
AHRQ-funded; HS018546.
Citation: Vergis A, Hardy K, Stogryn S .
Fellow and attending surgeon operative notes are deficient in reporting established quality indicators for Roux-en-y gastric bypass: a preliminary retrospective analysis of operative dictation.
Cureus 2019 Apr 24;11(4):e4535. doi: 10.7759/cureus.4535..
Keywords: Obesity, Quality of Care, Quality Indicators (QIs), Patient Safety, Provider, Provider: Physician, Surgery
Mabry-Hernandez I, Ojeda LC
AHRQ Author: Mabry-Hernandez I
Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults.
This Putting Prevention Into Practice (PPIP) case-study quiz illustrates the recommendations of the U.S. Preventive Services Task Force on Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults. Three questions were created about a 32-year old women presents with normal blood glucose levels, but has a BMI of 34. The answers are given below the quiz which illustrate the recommendations that were given.
AHRQ-authored.
Citation: Mabry-Hernandez I, Ojeda LC .
Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults.
Am Fam Physician 2019 Apr 15;99(8):515-16..
Keywords: Case Study, Obesity, Obesity: Weight Management, Screening, U.S. Preventive Services Task Force (USPSTF)
Kemmick Pintor J, Mitchell DC, Schenker MB
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
This study explored if depression affects treatment for obesity among Latino immigrant farmworkers. The workplace pilot study called Pasos Saludables,was successful, but the participants at risk for depression had lower weight loss than the participants with no indication of depression.
AHRQ-funded; HS022236.
Citation: Kemmick Pintor J, Mitchell DC, Schenker MB .
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
J Immigr Minor Health 2019 Apr;21(2):383-92. doi: 10.1007/s10903-018-0743-4..
Keywords: Depression, Behavioral Health, Obesity, Racial and Ethnic Minorities, Vulnerable Populations
Baskind MJ, Taveras EM, Gerber MW
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. In this study, the investigators studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. The investigators found that among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity.
AHRQ-funded; HS024332; HS022986.
Citation: Baskind MJ, Taveras EM, Gerber MW .
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Prev Chronic Dis 2019 Mar 28;16:E39. doi: 10.5888/pcd16.180368..
Keywords: Children/Adolescents, Family Health and History, Lifestyle Changes, Obesity, Obesity: Weight Management, Risk, Stress
Dolan P, Afaneh C, Symer M
Assessment of public attitudes toward weight loss surgery in the United States.
The authors designed a national cross-sectional survey to assess attitudes toward weight loss surgery in the US general population. Their survey results suggested that a large percentage of the population has negative attitudes toward weight loss surgery, including men and non-Hispanic black respondents, who were more likely to think that people who chose weight loss surgery were taking the easy way out. The authors recommended further research with respect to normalizing weight loss surgery as a reasonable option for managing obesity.
AHRQ-funded; HS000066.
Citation: Dolan P, Afaneh C, Symer M .
Assessment of public attitudes toward weight loss surgery in the United States.
JAMA Surg 2019 Mar;154(3):264-66. doi: 10.1001/jamasurg.2018.4650..
Keywords: Obesity: Weight Management, Obesity, Surgery, Social Stigma
Gowey MA, Khodneva Y, Tison SE
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
The purpose of this study was to describe the relationship between metabolic health parameters and depressive symptoms and perceived stress, and determine whether the co-occurrence of these two psychological stressors had an additive influence on metabolic dysregulation in adults at different levels of body mass index (BMI) without diabetes. The investigators found that elevated depressive symptoms in conjunction with high levels of perceived stress were more strongly associated with several parameters of metabolic health than only one of these psychological constructs in a large, diverse cohort of adults.
AHRQ-funded; HS023009; HS013852.
Citation: Gowey MA, Khodneva Y, Tison SE .
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
Int J Obes 2019 Mar;43(3):615-32. doi: 10.1038/s41366-018-0270-3..
Keywords: Depression, Behavioral Health, Obesity, Stress
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
deMeireles A, Ross R, Ghaferi AA
Leveraging mobile technologies to improve longitudinal quality and outcomes following bariatric surgery.
This paper discusses the prevalence of obesity, annual cost attributable to obesity, data from observational studies which have evaluated weight trajectories following bariatric surgery, the importance of face to face follow-up for all patients who have undergone bariatric surgery, and novel telehealth strategies for longitudinal follow up that have begun to take shape in health systems.
AHRQ-funded; HS024403.
Citation: deMeireles A, Ross R, Ghaferi AA .
Leveraging mobile technologies to improve longitudinal quality and outcomes following bariatric surgery.
Mhealth 2019 Feb 25;5:6. doi: 10.21037/mhealth.2019.02.02..
Keywords: Health Information Technology (HIT), Obesity, Surgery, Telehealth
Whooten R, Kerem L, Stanley T
Physical activity in adolescents and children and relationship to metabolic health.
The purpose of this review was to summarize recent developments relating to the role of physical activity in insulin resistance and increased metabolic health in children and adolescents. Recent findings confirm the role of physical activity in decreasing insulin resistance and metabolic syndrome, but the authors note that the current literature is limited by unstandardized research methods and definitions. Future research that addresses these issues in order to offer targeted physical activity interventions is recommended.
AHRQ-funded; HS000063.
Citation: Whooten R, Kerem L, Stanley T .
Physical activity in adolescents and children and relationship to metabolic health.
Curr Opin Endocrinol Diabetes Obes 2019 Feb;26(1):25-31. doi: 10.1097/med.0000000000000455..
Keywords: Children/Adolescents, Diabetes, Lifestyle Changes, Obesity, Obesity: Weight Management
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
Bramante CT, Thornton RLJ, Bennett WL
Systematic review of natural experiments for childhood obesity prevention and control.
This article reviews the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. A search of PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 sought studies about policies evaluated by natural experiments reporting childhood BMI outcomes. Interventions were classified by environmental focus and stratified by setting; risk of bias was evaluated for each study. Most of the studies evaluated took place in a school setting. The most common environmental focus in any setting was food/beverage. All four of the studies that focused on food/beverage and physical activity in schools showed decreased prevalence of overweight/obesity in the subjects. BMI decreased in all four studies in both school and community settings. The authors note that while school-based policies focusing on both food/beverage and physical activity environments showed consistent improvement in BMI, most of these studies had high risk of bias. Improved methods for the evaluation of natural experiments for childhood obesity prevention are needed.
AHRQ-funded; 290201200007I.
Citation: Bramante CT, Thornton RLJ, Bennett WL .
Systematic review of natural experiments for childhood obesity prevention and control.
Am J Prev Med 2019 Jan;56(1):147-58. doi: 10.1016/j.amepre.2018.08.023..
Keywords: Children/Adolescents, Evidence-Based Practice, Obesity, Obesity: Weight Management, Prevention
Danilack VA, Brousseau EC, Phipps MG
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
Weight retention after pregnancy is a concern for adolescents who may be entering adulthood at unhealthy weights. In this article, the investigators studied associations between each of three measures: pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and post-pregnancy BMI in a longitudinal follow-up of an adolescent pregnancy study cohort. They concluded that teens experienced an increase in BMI from pre-pregnancy to within 4 years after their first delivery, and this increase was related to GWG.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Phipps MG .
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
J Womens Health 2018 Dec;27(12):1456-58. doi: 10.1089/jwh.2017.6635..
Keywords: Children/Adolescents, Pregnancy, Obesity: Weight Management, Obesity, Women
Kelsall AC, Cassidy R, Ghaferi AA
Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector.
The authors described hospital-level variation in roux-en-Y gastric bypass and sleeve gastrectomy in Michigan. Their findings suggested that there are previously underappreciated differences in episode payment variation between bariatric surgery procedures. The authors also suggested that sleeve gastrectomy may be more amenable to cost containment under bundled payment initiatives by virtue of the greater share of variation explained by readmission and post-discharge payments.
AHRQ-funded; HS023621; HS024403.
Citation: Kelsall AC, Cassidy R, Ghaferi AA .
Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector.
Ann Surg 2018 Dec;268(6):1014-18. doi: 10.1097/sla.0000000000002462..
Keywords: Surgery, Obesity: Weight Management, Obesity, Payment, Health Insurance, Healthcare Costs
Fink JT, Magnan EM, Johnson HM
Blood pressure control and other quality of care metrics for patients with obesity and diabetes: a population-based cohort study.
In this observational population-based cohort study, the investigators sought to examine the relationship between the extent of obesity and the achievement of guideline-recommended blood pressure goals and other quality of care metrics among patients with diabetes. The investigators suggest that although the cardiovascular risk for patients with obesity and diabetes is greater than for non-obese patients with diabetes, they found that patients with obesity are even further behind in achieving blood pressure control.
AHRQ-funded; HS021899.
Citation: Fink JT, Magnan EM, Johnson HM .
Blood pressure control and other quality of care metrics for patients with obesity and diabetes: a population-based cohort study.
High Blood Press Cardiovasc Prev 2018 Dec;25(4):391-99. doi: 10.1007/s40292-018-0284-x..
Keywords: Blood Pressure, Diabetes, Quality of Care, Obesity