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
1 to 20 of 20 Research Studies DisplayedHeintzman J, Springer R, Marino M
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Researchers examined the association between adolescent-mother language concordance and neighborhood social deprivation with adolescent vaccination completion in order to understand social/family factors related to Latino adolescent vaccination. They used a multistate, EHR-based dataset of community health center patients to compare three Latino groups; their sample included over 56,000 adolescent-mother dyads. Their findings indicated that English-preferring adolescents with Spanish-preferring mothers had the highest completion rates. The researchers concluded that future studies could attempt to understand what advantage this language dyad may have in adolescent vaccination completion.
AHRQ-funded; HS025962.
Citation: Heintzman J, Springer R, Marino M .
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Matern Child Health J 2023 Nov; 27(11):2026-37. doi: 10.1007/s10995-023-03742-0..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Vaccination, Children/Adolescents, Vulnerable Populations, Social Determinants of Health
Wirth AN, Cushman NA, Reilley BA
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
Researchers evaluated the extent to which Indian Country Extension for Community Healthcare Outcomes (ECHO) telehealth clinics increase access to hepatitis C virus (HCV) treatment and serve American Indians/Alaska Native (AI/AN) patients holistically. They conducted a retrospective descriptive analysis of Indian Country ECHO treatment recommendations from 2017 to 2021. Most patients received recommendations for HCV treatment by their primary care providers, along with recommendations beyond the scope of HCV. The researchers concluded that Indian Country ECHO telehealth clinic provided comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
AHRQ-funded; HS026370.
Citation: Wirth AN, Cushman NA, Reilley BA .
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
J Rural Health 2023 Mar;39(2):358-66. doi: 10.1111/jrh.12733.
Keywords: Hepatitis, Access to Care, Racial and Ethnic Minorities, Community-Based Practice, Telehealth, Health Information Technology (HIT), Chronic Conditions
Adams LB, Richmond J, Watson SN
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
This systematic review examined research on the relationship between community health worker (CHW) training curricula and intervention outcomes conducted among African American and Latinx populations. Studies included were quantitative, qualitative, and mixed methods studies employed to conduct outcome and process evaluations of CHW-led interventions. Out of 3,295 articles from the extensive literature search, only 36 met the review’s inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary health interventions in conditions such as hypertension and diabetes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that discussed training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training methods.
AHRQ-funded; HS000032; HS026122.
Citation: Adams LB, Richmond J, Watson SN .
Community health worker training curricula and intervention outcomes in African American and Latinx communities: a systematic review.
Health Educ Behav 2021 Aug;48(4):516-31. doi: 10.1177/1090198120959326..
Keywords: Community-Based Practice, Racial and Ethnic Minorities, Training, Outcomes, Provider: Health Personnel
Sedhom R, Nudotor R, Freund KM
Can community health workers increase palliative care use for African American patients? A pilot study.
African American patients with cancer underutilize advance care planning (ACP) and palliative care (PC). This feasibility study investigated whether community health workers (CHWs) could improve ACP and PC utilization for African American patients with advanced cancer. The investigators concluded that utilization of CHWs to address PC domains and social determinants of health was feasible. Although study enrollment was identified as a potential barrier, most recruited patients were retained on study.
AHRQ-funded; HS024736.
Citation: Sedhom R, Nudotor R, Freund KM .
Can community health workers increase palliative care use for African American patients? A pilot study.
JCO Oncol Pract 2021 Feb;17(2):e158-e67. doi: 10.1200/op.20.00574..
Keywords: Palliative Care, Community-Based Practice, Racial and Ethnic Minorities
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
This hybrid type II implementation-effectiveness cohort study aimed at evaluating appropriateness, acceptability and feasibility implementation outcomes, while also systematically examining the clinical effectiveness of a preconception care (PCC) intervention, the Gabby System, for Black and African American women receiving health services in community-based sites. Contextual factors that influenced uptake and appropriate implementation strategies were identified to inform future scalability of the intervention.
AHRQ-funded; HS025131.
Citation: Walter AW, Julce C, Sidduri N AW, Julce C, Sidduri N .
Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women.
BMC Health Serv Res 2020 Sep 21;20(1):889. doi: 10.1186/s12913-020-05726-0..
Keywords: Racial and Ethnic Minorities, Women, Health Information Technology (HIT), Evidence-Based Practice, Community-Based Practice, Implementation
Payán DD, Maggard-Gibbons M, Flórez KR
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. In this study, the investigators formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years) and conducted a randomized controlled trial of a health communication intervention for Latinas.
AHRQ-funded; HS019264.
Citation: Payán DD, Maggard-Gibbons M, Flórez KR .
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Cultural Competence, Health Promotion, Communication, Women, Community-Based Practice
Payán DD, Derose KP, Flórez KR
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
The authors developed a mapping component as part of a multilevel church-based intervention that used community-based participatory research to prevent obesity in African American and Latino churches in South Los Angeles. They developed neighborhood maps of local food environments and provided churches with standardized information on food access, availability, quality, and marketing practices. Including several tables as well as discussion, they stated that local food environment maps that are paired with data can inform community-based strategies to prevent obesity and food insecurity.
AHRQ-funded; HS000046.
Citation: Payán DD, Derose KP, Flórez KR .
The food environment in 3 neighborhoods in South Los Angeles, California: access, availability, quality, and marketing practices.
Prev Chronic Dis 2020 Jul 16;17:E61. doi: 10.5888/pcd17.200028.
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Keywords: Obesity, Racial and Ethnic Minorities, Prevention, Prevention, Community Partnerships, Community-Based Practice, Nutrition
Kubi B, Enumah ZO, Lee KT
Theory-based development of an implementation intervention using community health workers to increase palliative care use.
This study used the Behavior Change Wheel and Theoretical Domains Framework models to help design an implementation intervention using community health workers (CHWs) to increase palliative care use in African American communities. There were two phases to the study. In Phase 1, focus group sessions were conducted to identify barriers and facilitators of palliative care use. Phase 2 consisted of a stakeholder meeting to select intervention content and prioritize modes of delivery after applying the framework. There were 15 stakeholders total that participated in the study. Interventions identified were designed to improve patient capability and motivation, physician capability and motivation, and increase patient opportunities to use palliative care services. The strategies were all facilitated by CHWs and included creation and dissemination of brochures, empowerment and activation of patients to initiate goals-of-care discussions, outreach to community churches, and expanding patient social support.
AHRQ-funded; HS024736.
Citation: Kubi B, Enumah ZO, Lee KT .
Theory-based development of an implementation intervention using community health workers to increase palliative care use.
J Pain Symptom Manage 2020 Jul;60(1):10-19. doi: 10.1016/j.jpainsymman.2020.02.009..
Keywords: Community-Based Practice, Palliative Care, Healthcare Utilization, Racial and Ethnic Minorities, Implementation, Disparities, Healthcare Delivery
Whitley MD, Payán DD, Flórez KR
Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
Church-based programs can act on multiple levels to improve dietary and physical activity behaviors among African Americans and Latinos. However, the effectiveness of these interventions may be limited due to challenges in reaching all congregants or influencing behavior outside of the church setting. This study examined the feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
AHRQ-funded; HS000046.
Citation: Whitley MD, Payán DD, Flórez KR .
Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos.
Health Informatics J 2020 Jun;26(2):880-96. doi: 10.1177/1460458219853408..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Health Information Technology (HIT), Health Promotion
Burnett-Zeigler I, Satyshur MD, Hong S
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
The authors examined the acceptability and feasibility of a mindfulness-based group intervention for socio-economically disadvantaged women in an urban community health center. Participants reported benefits to the intervention as well as barriers to session attendance. The authors concluded that the mindfulness-based intervention for depression was acceptable, reduced stress, and improved coping and functioning among women in a community health center.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Satyshur MD, Hong S .
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
Complement Ther Med 2019 Aug;45:19-24. doi: 10.1016/j.ctim.2019.05.012..
Keywords: Community-Based Practice, Depression, Behavioral Health, Racial and Ethnic Minorities, Women
Sun CJ, Nall JL, Rhodes SD
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice.
AHRQ-funded; HS022981.
Citation: Sun CJ, Nall JL, Rhodes SD .
Perceptions of needs, assets, and priorities among black men who have sex with men with HIV: community-driven actions and impacts of a participatory photovoice process.
Am J Mens Health 2019 Jan-Feb;13(1):1557988318804901. doi: 10.1177/1557988318804901..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Men's Health, Community-Based Practice, Patient Adherence/Compliance
Cole MB, Wright B, Wilson IB
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
The purpose of this study was to evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. The authors found that within- and between-center racial/ethnic disparities in quality were evident and although quality outcomes in health centers continued to compare favorably to other care settings, there was no evidence of improved quality or reduced disparities in diabetes control, hypertension control, or birthweight from 2009 to 2014.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
J Gen Intern Med 2018 Jun;33(6):906-13. doi: 10.1007/s11606-018-4305-1..
Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Leung LB, Vargas-Bustamante A, Martinez AE
Disparities in diabetes care quality by English language preference in community health centers.
Researchers conducted a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. There were no significant differences in glycemic control by language for either Latino or Asian patients.
AHRQ-funded; HS020120.
Citation: Leung LB, Vargas-Bustamante A, Martinez AE .
Disparities in diabetes care quality by English language preference in community health centers.
Health Serv Res 2018 Feb;53(1):509-31. doi: 10.1111/1475-6773.12590.
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Keywords: Community-Based Practice, Cultural Competence, Diabetes, Disparities, Racial and Ethnic Minorities
Cole MB, Wilson IB, Trivedi AN
State variation in quality outcomes and disparities in outcomes in community health centers.
The researchers estimated between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. They found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers..
AHRQ-funded; HS024652.
Citation: Cole MB, Wilson IB, Trivedi AN .
State variation in quality outcomes and disparities in outcomes in community health centers.
Med Care 2017 Dec;55(12):1001-07. doi: 10.1097/mlr.0000000000000818.
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Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Hernandez SE, Taylor L, Grembowski D
A first look at PCMH implementation for minority veterans: room for improvement.
The researchers sought to determine if the degree of Patient Aligned Care Teams (a patient-centered medical home model), implementation at Veterans Health Administration hospital-based and community-based primary care facilities varied with the percentage of minority veteran patients at each facility. They found that overall implementation of the care teams varied with respect to the racial/ethnic composition of a facility, with medium and high minority facilities having lower implementation scores.
AHRQ-funded; HS013853; HS023376.
Citation: Hernandez SE, Taylor L, Grembowski D .
A first look at PCMH implementation for minority veterans: room for improvement.
Med Care 2016 Mar;54(3):253-61. doi: 10.1097/mlr.0000000000000512.
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Keywords: Patient-Centered Healthcare, Racial and Ethnic Minorities, Community-Based Practice, Primary Care
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
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Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement
Yun L, Boles RE, Haemer MA
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
This paper delineates the study protocol for the Community Outreach Obesity Prevention Trial. COOPT is an ongoing, 4-year (October 2011-September 2015) randomized controlled trial that tests the effectiveness of a home-based patient navigator program delivered to preschoolers of a large urban safety-net health care system. The researchers believe that its home-based intervention venue will provide rich data characterizing barriers and facilitators to healthy behavior change within the home.
AHRQ-funded; HS021138.
Citation: Yun L, Boles RE, Haemer MA .
A randomized, home-based, childhood obesity intervention delivered by patient navigators.
BMC Public Health 2015 May;15:506. doi: 10.1186/s12889-015-1833-z..
Keywords: Children/Adolescents, Community-Based Practice, Obesity, Prevention, Racial and Ethnic Minorities
Olenik NL, Gonzalvo JD, Snyder ME
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
This study aimed to identify perceptions of Spanish-speaking patients living in the U.S. with a focus on the care provided in community pharmacies, as well as to determine their satisfaction with community pharmacies. Based on 12 interviews, it found that primary themes included lack of insurance coupled with high medical care costs serving as a barrier for acquisition of health care and difficulty accessing timely and convenient primary care.
AHRQ-funded; HS022119.
Citation: Olenik NL, Gonzalvo JD, Snyder ME .
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
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Keywords: Access to Care, Community-Based Practice, Provider: Pharmacist, Racial and Ethnic Minorities
Halbert CH, Briggs V, Bowman M
Acceptance of a community-based navigator program for cancer control among urban African Americans.
The researchers evaluated acceptance of a community-based navigator program for cancer control and identified factors having significant independent associations with navigation acceptance in an urban sample of African Americans. They found that age and perceived risk of developing cancer had a significant independent association with navigation acceptance. Participants who believed that they were at high risk for developing cancer had a lower likelihood of completing navigation.
AHRQ-funded; HS019339.
Citation: Halbert CH, Briggs V, Bowman M .
Acceptance of a community-based navigator program for cancer control among urban African Americans.
Health Educ Res 2014 Feb;29(1):97-108. doi: 10.1093/her/cyt098..
Keywords: Cancer, Care Coordination, Care Management, Community-Based Practice, Racial and Ethnic Minorities, Urban Health