National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Asthma (3)
- Behavioral Health (2)
- Caregiving (1)
- (-) Children/Adolescents (13)
- Chronic Conditions (3)
- Community-Based Practice (1)
- COVID-19 (1)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Education (1)
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- Healthcare Cost and Utilization Project (HCUP) (1)
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- Health Services Research (HSR) (1)
- Human Immunodeficiency Virus (HIV) (1)
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- Patient-Centered Healthcare (1)
- Patient Experience (1)
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- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (1)
- Quality of Care (1)
- Respiratory Conditions (2)
- Rural/Inner-City Residents (1)
- Rural Health (2)
- Screening (4)
- Sickle Cell Disease (1)
- Sleep Problems (1)
- Social Determinants of Health (3)
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- (-) Urban Health (13)
- Vulnerable Populations (2)
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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 DisplayedMcDaniel 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
Kim B, Mulready-Ward C, Thorpe LE
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
This study assessed the relationship between housing type (i.e., home ownership, public housing, rental assistance, rent-controlled housing, and other rental housing) and asthma outcomes among New York City (NYC) adults and children (ages 1-13). The authors used the 2019 NYC Community Health Survey (CHS) and 2019 NYC KIDS survey to analyze associations between housing type and ever having been diagnosed with asthma (“ever asthma”) and experiencing an asthma attack within the past year. They also examined whether associations were modified by smoking status (among adults), smoking within the house (among children), and overweight/obesity. Among adults, living in public housing, compared to home ownership, was associated with higher odds of ever asthma and past-year asthma attack. Rental assistance housing living was also significantly associated with ever asthma. Public or rental assistance housing associations and ever asthma were marginally significant among children but were more pronounced among ever smokers than among never smokers.
AHRQ-funded; HS026120.
Citation: Kim B, Mulready-Ward C, Thorpe LE .
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
Prev Med 2022 Aug;161:107147. doi: 10.1016/j.ypmed.2022.107147..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Social Determinants of Health, Vulnerable Populations, Urban Health, Chronic Conditions
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
Loo S, Brochier A, Wexler MG
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
The purpose of this study was to assess pediatric hematology clinic staff's perspectives regarding barriers and facilitators in addressing unmet basic needs for children with sickle cell disease. Six focus groups were held at urban pediatric hematology clinics in the Northeastern region of the U.S. Four themes emerged: families of children with SCD have numerous unmet basic needs; clinic staff felt they had a role to play in addressing these needs; staff felt their ability to address these needs depended upon caregivers' capacity to act on staff recommendations; clinic staff's ability to address these needs was limited by organizational and systemic factors beyond their control. These findings have important implications for how best to address adverse social determinants of health for this vulnerable pediatric population so that urban-based pediatric hematology clinics can more equitably support families.
AHRQ-funded; HS022242.
Citation: Loo S, Brochier A, Wexler MG .
Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.
BMC Health Serv Res 2021 Jan 12;21(1):55. doi: 10.1186/s12913-020-06055-y..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Social Determinants of Health, Provider: Clinician, Provider: Physician, Provider, Urban Health
Chambers EC, Heller C, Fiori K
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Findings showed that disparities in health conditions among youth in public housing were more common in early adolescence: asthma, obesity, depression/anxiety, and behavioral disorders. Chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing; however, this pattern is not consistent across all chronic conditions.
AHRQ-funded; HS026396.
Citation: Chambers EC, Heller C, Fiori K .
Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY.
Glob Pediatr Health 2020 Nov 11;7:2333794x20971164. doi: 10.1177/2333794x20971164..
Keywords: Children/Adolescents, Vulnerable Populations, Chronic Conditions, Urban Health
Rawlett KE, N'Dri LA, dosReis S
Perceived needs for adolescent mental health in an urban community.
This paper discusses a set of focus groups that were conducted with teachers, families, and students in an urban middle school to discuss needs for adolescent psychological well-being. Six focus groups were conducted with a total of 29 participants. Approximately 70% of participants were female, African American (n=22), and the rest were multiracial (n=4), White (n=2) and Latino (n=1). Participants focused on needs for educational support, strengthening social skills, and changing the community landscape.
AHRQ-funded; HS022135.
Citation: Rawlett KE, N'Dri LA, dosReis S .
Perceived needs for adolescent mental health in an urban community.
J Pediatr Health Care 2019 Nov - Dec;33(6):633-38. doi: 10.1016/j.pedhc.2019.03.003..
Keywords: Children/Adolescents, Behavioral Health, Urban Health
Cullen D, Woodford A, Fein J
Food for thought: a randomized trial of food insecurity screening in the emergency department.
Despite the growing interest in screening for food insecurity in the clinical setting, little evidence exists regarding screening formats that maximize disclosure and caregiver comfort. In this randomized trial, investigators asked English-speaking adult caregivers of pediatric patients in the emergency department at an urban, freestanding children's hospital to complete a validated, 2-question screen for food insecurity. Although both verbal interview and tablet-based screening modalities were effective in identifying food insecurity, tablet-based screening had a higher disclosure rate and was the participants' preferred screening method.
AHRQ-funded; HS026116.
Citation: Cullen D, Woodford A, Fein J .
Food for thought: a randomized trial of food insecurity screening in the emergency department.
Acad Pediatr 2019 Aug;19(6):646-51. doi: 10.1016/j.acap.2018.11.014..
Keywords: Children/Adolescents, Emergency Department, Nutrition, Screening, Urban Health, Caregiving
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
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Harris VC, Links AR, Kim JM
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
The purpose of this study was to evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Researchers found that half of the children referred for sleep-disordered breathing evaluation are lost to follow-up from primary care. Obstructive sleep apnea severity did not predict follow-up or timeliness of treatment. They conclude that these findings suggest social determinants may pose barriers to care in addition to the clinical burden of sleep-disordered breathing.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Kim JM .
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
Otolaryngol Head Neck Surg 2018 Aug;159(2):371-78. doi: 10.1177/0194599818772035..
Keywords: Access to Care, Children/Adolescents, Disparities, Healthcare Delivery, Patient-Centered Healthcare, Quality of Care, Respiratory Conditions, Sleep Problems, Urban Health
Gao TY, Howe CJ, Zullo AR
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. The study’s findings suggested that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians.
AHRQ-funded; HS022998.
Citation: Gao TY, Howe CJ, Zullo AR .
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
Vulnerable Child Youth Stud 2017;12(4):277-91. doi: 10.1080/17450128.2016.1268741..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Lifestyle Changes, Screening, Urban Health
Butz AM, Ogborn J, Mudd S
Factors associated with high short-acting beta2-agonist use in urban children with asthma.
The investigators examined factors associated with high short-acting β₂ agonist (SABA) use in inner-city children with asthma. They found that high SABA users were more than 5 times more likely to have an asthma hospitalization, almost 3 times more likely to have an asthma intensive care unit admission, and more than 3 times more likely to have prior specialty asthma care or positive cockroach sensitization than low to moderate SABA users.
AHRQ-funded; HS000029.
Citation: Butz AM, Ogborn J, Mudd S .
Factors associated with high short-acting beta2-agonist use in urban children with asthma.
Ann Allergy Asthma Immunol 2015 May;114(5):385-92. doi: 10.1016/j.anai.2015.03.002.
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Keywords: Asthma, Children/Adolescents, Medication, Urban Health
McIntosh S, Cirillo D, Wood N
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
The authors characterized health problems prompting neighborhood telemedicine use and to assessed parent perceptions of its value. They found that family preferences and the high value placed on neighborhood telemedicine suggest such service is important, and that service provided by neighborhood telemedicine holds potential to meet a large demand for care of acute childhood illness.
AHRQ-funded; HS018912.
Citation: McIntosh S, Cirillo D, Wood N .
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
Telemed J E Health 2014 Dec;20(12):1121-6. doi: 10.1089/tmj.2014.0032.
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Keywords: Children/Adolescents, Health Services Research (HSR), Patient Experience, Telehealth, Urban Health