National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Behavioral Health (3)
- Children/Adolescents (1)
- (-) Community-Based Practice (7)
- Electronic Health Records (EHRs) (2)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (2)
- Patient-Centered Healthcare (3)
- (-) Primary Care (7)
- Quality Improvement (1)
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- Substance Abuse (1)
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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 7 of 7 Research Studies DisplayedAckerman SL, Wing H, Acves B
“We were trying to do quality versus quantity”: challenges and opportunities at the intersection of standardized and personalized social care in community health centers.
The purpose of this study was to explore activities to incorporate social risk programs into community health centers (CHCs) providing primary care services in Oregon. CHCs took part in either one or both of two large programs with the goal of incorporating standardized social risk screening and referral processes. The researchers conducted 42 semi-structured interviews with clinicians, managers and staff at 12 clinics affiliated with five CHCs to understand implementation procedures and challenges to those procedures. Thematic analysis utilized the Normalization Process Theory (NPT) to discover the dynamic, interactional nature of activities to integrate a complex sociotechnical intervention. The study found that standardized social care was expected to correspond well with institutional commitments and priorities. However, challenges maintaining support among staff was encountered, affected by competing priorities, staff turnover, and uncertainties about roles and responsibilities. The new tools were frequently altered or abandoned to retain the advantages of existing social care practices. Across clinics, the association between standardized procedures and existing social care activities, had a key role in patterns of adoption, non-adoption and adaptation, with standardized tools frequently experienced as undermining more relational, team-based social care.
AHRQ-funded; HS026435.
Citation: Ackerman SL, Wing H, Acves B .
“We were trying to do quality versus quantity”: challenges and opportunities at the intersection of standardized and personalized social care in community health centers.
SSM Qual Res Health 2023 Jun; 3:100267. doi: 10.1016/j.ssmqr.2023.100267..
Keywords: Community-Based Practice, Social Determinants of Health, Primary Care
Safon CB, Estela MG, Rosenberg J
Implementation of a novel pediatric behavioral health integration initiative.
The purpose of this concurrent, qualitative-dominant mixed methods empirical study was to explore healthcare professionals' perceptions of the impact of behavioral health integration (BHI) on pediatric primary care delivery in community health centers (CHCs). The researchers utilized semi-structured interviews with healthcare professionals at the end of the implementation phase of a 3-year process and surveys administered at three time points. Qualitative themes were mapped onto the Relational Coordination (RC) conceptual framework to triangulate and complement final qualitative results with quantitative results. The researchers round five emergent themes aligning with RC domains. The results of the survey showed that healthcare professionals reported both greater behavioral healthcare integration into clinic practice and greater clinic readiness to address behavioral health needs. The researchers concluded that effective pediatric BHI and care delivery at CHCs may depend on solid professional relationships and communication.
AHRQ-funded; HS022242.
Citation: Safon CB, Estela MG, Rosenberg J .
Implementation of a novel pediatric behavioral health integration initiative.
J Behav Health Serv Res 2023 Jan;50(1):1-17. doi: 10.1007/s11414-022-09803-6..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Primary Care, Patient-Centered Healthcare, Community-Based Practice
Komaromy M, Duhigg D, Metcalf A
Project ECHO (Extension for Community Healthcare Outcomes): a new model for educating primary care providers about treatment of substance use disorders.
ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning. This article describes a teleECHO clinic that is focused on treatment of substance use disorders (SUDs) and behavioral health disorders. It concluded that the ECHO model can promote expansion of access to treatment for opioid use disorder and other SUDs, particularly in underserved areas.
AHRQ-funded; HS016510.
Citation: Komaromy M, Duhigg D, Metcalf A .
Project ECHO (Extension for Community Healthcare Outcomes): a new model for educating primary care providers about treatment of substance use disorders.
Subst Abus 2016;37(1):20-4. doi: 10.1080/08897077.2015.1129388.
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Keywords: Community-Based Practice, Primary Care, Substance Abuse, Training, Health Information Technology (HIT)
Fulford D, Tuot DS, Mangurian C
Electronic psychiatric consultation in primary care in the safety net.
The authors examined the feasibility and acceptability of implementing a psychiatric eReferral program in a publicly funded, community-based primary care clinic in San Francisco staffed by eight primary care practitioners (PCPs). They found feasibility and acceptability of implementing an integrated electronic psychiatry consultation and referral service in a community-based primary care clinic and recommended future trials designed to examine the impact of this type of service on the delivery of high-quality mental health care and its cost-effectiveness in a safety-net health care system.
AHRQ-funded; HS021700.
Citation: Fulford D, Tuot DS, Mangurian C .
Electronic psychiatric consultation in primary care in the safety net.
Psychiatr Serv 2016 Oct;67(10):1160-61. doi: 10.1176/appi.ps.671003.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Behavioral Health, Primary Care, Health Information Technology (HIT)
Gao Y, Nocon RS, Gunter KE
AHRQ Author: Ngo-Metzger Q
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
The patient-centered medical home (PCMH) model is being implemented in health centers (HCs) that provide comprehensive primary care to vulnerable populations. The researchers identified characteristics associated with HCs' PCMH capability. EHR adoption likely played a role in HCs' improvement in PCMH capability. Other factors include a greater number of types of financial performance incentives, more types of hospital-HC affiliations, and state-level support and payment for PCMH activities.
AHRQ-authored; AHRQ-funded; HS000084.
Citation: Gao Y, Nocon RS, Gunter KE .
Characteristics associated with patient-centered medical home capability in health centers: a cross-sectional analysis.
J Gen Intern Med 2016 Sep;31(9):1041-51. doi: 10.1007/s11606-016-3729-8.
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Keywords: Patient-Centered Healthcare, Electronic Health Records (EHRs), Primary Care, Community-Based Practice, Vulnerable Populations
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