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 25 of 101 Research Studies DisplayedIsbell LM, Graber ML, Rovenpor DR
Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.
The purpose of this randomized experiment study was to investigate the influence of comorbid depression on diagnostic accuracy. The researchers utilized an interactive vignette that described a patient with a complex presentation of pernicious anemia. Fifty-nine physician participants were randomized to diagnose either a patient with or without (control) comorbid depression and related behaviors. All other clinical information was identical. Physicians recorded a differential diagnosis, ordered tests, and rated patient likeability. The study found that the patient with comorbid depression was less likeable than the control patient. Accuracy of diagnosis was lower in the depression condition compared to the control condition, but this difference was not statistically significant. Accuracy was lower in the depression condition (vs. control) when physicians ordered less tests, but there was no variation for physicians who ordered more tests.
AHRQ-funded; HS025752.
Citation: Isbell LM, Graber ML, Rovenpor DR .
Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment.
Diagnosis 2023 Aug; 10(3):257-66. doi: 10.1515/dx-2020-0106..
Keywords: Depression, Behavioral Health
Foot C, Korthuis PT, Tsui JI
Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.
The objective of this secondary analysis of data from two clinical trials comparing buprenorphine and extended-release naltrexone was to estimate the effect of ongoing stimulant use on return to illicit opioid use after initiation of medication for opioid use disorder (MOUD). The findings indicated that people on medication for opioid use disorder who subsequently used stimulants appeared more likely to return to non-prescribed opioids use compared with those without stimulant use; this association appeared stronger among patients who initiated buprenorphine compared with those who initiated extended-release naltrexone.
AHRQ-funded; HS026370.
Citation: Foot C, Korthuis PT, Tsui JI .
Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.
Addiction 2024 Jan; 119(1):149-57. doi: 10.1111/add.16334..
Keywords: Opioids, Substance Abuse, Medication, Behavioral Health
Adams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR .
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health
Wolf RM, Hall M, Williams DJ
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
This retrospective cohort study examined associations between pharmacologic restraint use and race and ethnicity among children (aged 5-≤18 years) admitted for mental health conditions to acute care nonpsychiatric children's hospitals. Study period was 2018 to 2022 and was conducted at 41 US children’s hospitals and included a cohort of 61,503 hospitalizations. Compared with non-Hispanic Black children, children of non-Hispanic White (adjusted odds ratio [aOR], 0.81), Asian (aOR, 0.82), or other race and ethnicity (aOR, 0.68) were less likely to receive pharmacologic restraint, with no significant difference with Hispanic children. When stratified by sex, racial/ethnic differences were magnified in males, except for Hispanic males, and not found in females. Sensitivity analysis revealed amplified disparities for all racial/ethnic groups, including Hispanic youth.
AHRQ-funded; HS026122.
Citation: Wolf RM, Hall M, Williams DJ .
Disparities in pharmacologic restraint for children hospitalized in mental health crisis.
Pediatrics 2024 Jan; 153(1). doi: 10.1542/peds.2023-061353..
Keywords: Disparities, Children/Adolescents, Behavioral Health, Inpatient Care, Hospitals, Medication
Goyal NK, Sood E, Gannon MA
Priorities for well child care of families affected by parental opioid use disorder.
This study’s objective was to explore priorities for well childcare (WCC) visit content for women in treatment with opioid use disorder to inform primary care recommendations for this population. Eligible participants had children 2 years or younger and were English speaking. Among the 30 parent participants, they were overwhelmingly White (83%) and unmarried (90%). Thirteen clinicians participated, of whom 9 were attending physicians. Interviews were conducted with parents and clinicians which led to five emerging themes: (1) improving knowledge and confidence related to child development, behavior, and nutrition; (2) mitigating safety concerns; (3) addressing complex health and subspecialty needs through care coordination; (4) acknowledging parental health and wellbeing in the pediatric encounter; and (5) supporting health education and care related to neonatal opioid withdrawal syndrome. These issues were expressed as hard to address by parents and clinicians due to time constraints, social determinants of health, and significant informational needs.
AHRQ-funded; HS027399.
Citation: Goyal NK, Sood E, Gannon MA .
Priorities for well child care of families affected by parental opioid use disorder.
J Addict Med 2024 Jan-Feb; 18(1):48-54. doi: 10.1097/adm.0000000000001243..
Keywords: Opioids, Substance Abuse, Behavioral Health, Caregiving, Children/Adolescents
Wasson LT, Cusmano A, Meli L
Association between learning environment interventions and medical student well-being: a systematic review.
This review sought to identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research.
AHRQ-funded; HS024598.
Citation: Wasson LT, Cusmano A, Meli L .
Association between learning environment interventions and medical student well-being: a systematic review.
JAMA 2016 Dec 6;316(21):2237-52. doi: 10.1001/jama.2016.17573.
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Keywords: Education: Academic, Evidence-Based Practice, Behavioral Health
Wilcox HC, Kharrazi H, Wilson RF
Data linkage strategies to advance youth suicide prevention: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This review sought to identify and describe data systems that can be linked to data from prevention studies to advance youth suicide prevention research. It concluded that there is untapped potential to evaluate and enhance suicide prevention efforts by linking suicide prevention data with existing data systems. However, sparse availability of data dictionaries and lack of adherence to standard data elements limit this potential.
AHRQ-funded; 290201200007I.
Citation: Wilcox HC, Kharrazi H, Wilson RF .
Data linkage strategies to advance youth suicide prevention: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med 2016 Dec 6;165(11):779-85. doi: 10.7326/m16-1281.
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Keywords: Behavioral Health, Children/Adolescents, Data, Evidence-Based Practice, Prevention
Aschbrenner KA, Naslund JA, Bartels SJ
A mixed methods study of peer-to-peer support in a group-based lifestyle intervention for adults with serious mental illness.
The authors explored peer-to-peer support among individuals participating in a group lifestyle intervention that included social media to enhance in-person weight management sessions. They found that participants described how shared learning and group problem-solving activities fostered friendships and provided essential support for health behavior change, while sharing information, personal successes and challenges, and "being in the same boat" as other group members were key features of peer-to-peer support.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Naslund JA, Bartels SJ .
A mixed methods study of peer-to-peer support in a group-based lifestyle intervention for adults with serious mental illness.
Psychiatr Rehabil J 2016 Dec;39(4):328-34. doi: 10.1037/prj0000219.
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Keywords: Lifestyle Changes, Lifestyle Changes, Behavioral Health, Obesity: Weight Management
Naslund JA, Aschbrenner KA, Bartels SJ
How people with serious mental illness use smartphones, mobile apps, and social media.
The researchers surveyed individuals with serious mental illness to explore their use of mobile devices or whether they access social media. Among respondents (n = 70), 93 percent owned cellphones, 78 percent used text messaging, 50 percent owned smartphones, and 71 percent used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media.
AHRQ-funded; HS021695.
Citation: Naslund JA, Aschbrenner KA, Bartels SJ .
How people with serious mental illness use smartphones, mobile apps, and social media.
Psychiatr Rehabil J 2016 Dec;39(4):364-67. doi: 10.1037/prj0000207.
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Keywords: Communication, Community-Based Practice, Health Promotion, Behavioral Health, Social Media
Sulzer SH, Muenchow E, Potvin A
Improving patient-centered communication of the borderline personality disorder diagnosis.
This study aimed to understand how clinicians communicate the diagnosis of borderline personality disorder (BPD) with patients, and compare these practices with patient communication preferences. It found that the majority of clinicians sampled did not actively share the BPD diagnosis with their patients, while the majority of patients wanted to be told that they had the disorder, as well as have their providers discuss the stigma they would face.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Muenchow E, Potvin A .
Improving patient-centered communication of the borderline personality disorder diagnosis.
J Ment Health 2016;25(1):5-9. doi: 10.3109/09638237.2015.1022253.
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Keywords: Communication, Diagnostic Safety and Quality, Behavioral Health, Clinician-Patient Communication, Social Stigma
Cochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Metz TD, Rovner P, Hoffman MC
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
This study ascertained demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) and to identify opportunities for prevention. It found that in seventeen percent (n=10) of maternal deaths there had been a known substance use disorder. Prior psychiatric diagnoses were documented in 54 percent (n=32) and prior suicide attempts in 10 percent (n=6).
AHRQ-funded; HS022143.
Citation: Metz TD, Rovner P, Hoffman MC .
Maternal deaths from suicide and overdose in Colorado, 2004-2012.
Obstet Gynecol 2016 Dec;128(6):1233-40. doi: 10.1097/aog.0000000000001695.
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Keywords: Behavioral Health, Pregnancy, Prevention, Maternal Care, Mortality
Brewer NT, DeFrank JT, Gilkey MB
Anticipated regret and health behavior: a meta-analysis.
The authors sought better understanding of anticipated regret's role in motivating health behaviors. They found that anticipated inaction regret has a stronger and more stable association with health behavior than previously thought and recommended giving greater attention to understanding how anticipated regret differs from similar constructs.
AHRQ-funded; HS021133.
Citation: Brewer NT, DeFrank JT, Gilkey MB .
Anticipated regret and health behavior: a meta-analysis.
Health Psychol 2016 Nov;35(11):1264-75. doi: 10.1037/hea0000294.
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Keywords: Behavioral Health, Patient Adherence/Compliance, Patient Self-Management
Strom MA, Fishbein AB, Paller AS
Association between atopic dermatitis and attention deficit hyperactivity disorder in US children and adults.
The researchers sought to determine if childhood and adult atopic dermatitis (AD) and AD severity are associated with ADD/ADHD and to delineate the factors contributing to such an association. It found that AD was most strongly associated with severe ADHD. AD unaccompanied by other allergic disease, was also associated with increased risk of ADD/ADHD in children.
AHRQ-funded; HS023011.
Citation: Strom MA, Fishbein AB, Paller AS .
Association between atopic dermatitis and attention deficit hyperactivity disorder in US children and adults.
Br J Dermatol 2016 Nov;175(5):920-29. doi: 10.1111/bjd.14697.
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Keywords: Skin Conditions, Behavioral Health, Risk
Zima BT, Rodean J, Hall M
Psychiatric disorders and trends in resource use in pediatric hospitals.
This study described recent, 10-year trends in pediatric hospital resource use with and without a psychiatric diagnosis and examine how these trends vary by type of psychiatric and medical diagnosis co-occurrence. It concluded that the 10-year rise in pediatric hospitalizations in US children's hospitals is 5 times greater for children with versus without a psychiatric diagnosis.
AHRQ-funded; HS023092.
Citation: Zima BT, Rodean J, Hall M .
Psychiatric disorders and trends in resource use in pediatric hospitals.
Pediatrics 2016 Nov;138(5). doi: 10.1542/peds.2016-0909.
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Keywords: Children/Adolescents, Behavioral Health, Hospitalization, Children/Adolescents
Ramchand R, Ayer L, Kotzias V
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
The researchers used a qualitative approach to gain insight about the concerns and nature of comments regarding suicidal ideation and intent among women veterans calling the Veterans Crisis Line (VCL). Interviewing 54 VCL call responders, the authors concluded that efforts to prevent and treat the consequences of military sexual trauma; to recognize, prevent, and treat non-suicidal self-harm; and to restrict access to lethal means most commonly reported among women veteran callers may be helpful to mitigate suicide risk in this vulnerable group of veterans.
AHRQ-funded; HS000029.
Citation: Ramchand R, Ayer L, Kotzias V .
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
Womens Health Issues 2016 Nov - Dec;26(6):667-73. doi: 10.1016/j.whi.2016.07.005.
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Keywords: Behavioral Health, Prevention, Stress, Women
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)
Kemper AR, Mabry-Hernandez IR, Grossman DC
AHRQ Author: Mabry-Hernandez IR
U.S. Preventive Services Task Force approach to child cognitive and behavioral health.
The authors described the meaning of the USPSTF grades, how these grades are determined, and the grades assigned to childhood cognitive, affective, and behavioral health recommendations. They summarized common themes in the evidence gaps and the future research necessary to advance the field and improve child health outcomes.
AHRQ-authored.
Citation: Kemper AR, Mabry-Hernandez IR, Grossman DC .
U.S. Preventive Services Task Force approach to child cognitive and behavioral health.
Am J Prev Med 2016 Oct;51(4 Suppl 2):S119-23. doi: 10.1016/j.amepre.2016.05.016.
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Keywords: Children/Adolescents, Evidence-Based Practice, Behavioral Health, Prevention, U.S. Preventive Services Task Force (USPSTF)
Brownley KA, Berkman ND, Peat CM
Binge-eating disorder in adults: a systematic review and meta-analysis.
This review summarized evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. It concluded that cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder.
AHRQ-funded; 290201200008U.
Citation: Brownley KA, Berkman ND, Peat CM .
Binge-eating disorder in adults: a systematic review and meta-analysis.
Ann Intern Med 2016 Sep 20;165(6):409-20. doi: 10.7326/m15-2455.
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Keywords: Obesity, Medication, Evidence-Based Practice, Behavioral Health, Comparative Effectiveness
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
Connolly Gibbons MB, Gallop R, Thompson D
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
The authors sought to determine whether dynamic psychotherapy (DT) is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Connolly Gibbons MB, Gallop R, Thompson D .
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
JAMA Psychiatry 2016 Sep;73(9):904-11. doi: 10.1001/jamapsychiatry.2016.1720.
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Keywords: Comparative Effectiveness, Community-Based Practice, Depression, Behavioral Health, Patient-Centered Outcomes Research
Elliot DL, Goldberg L, MacKinnon DP
Empiric validation of a process for behavior change.
In this report, the researchers compared the process of change for three evidence-based programs that shared theories, intervention elements and potential mediating variables. Each investigation assessed pre- and post-intervention variables using survey constructs with established reliability. Each used mediation analyses to define relationships. They found that knowledge was a significant mediator in each program, and that norms, perceived control abilities, and self-monitoring were confirmed in at least two studies. The researchers concluded that combined findings demonstrate a means to substantiate process aspects and theoretical models to advance understanding of behavior change.
AHRQ-funded; HS022981; HS019456.
Citation: Elliot DL, Goldberg L, MacKinnon DP .
Empiric validation of a process for behavior change.
Transl Behav Med 2016 Sep;6(3):449-56. doi: 10.1007/s13142-015-0343-y.
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Keywords: Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research
Aschbrenner KA, Naslund JA, Shevenell M
Feasibility of behavioral weight loss treatment enhanced with peer support and mobile health technology for individuals with serious mental illness.
This pilot study evaluated the feasibility of a behavioral weight loss intervention enhanced with peer support and mobile health (mHealth) technology for obese individuals with serious mental illness (SMI). Feasibility was assessed by program attendance, and participant satisfaction and suggestions for improving the model. It found that overall attendance amounted to approximately half of weekly sessions, with participants suggesting a number of modifications.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Naslund JA, Shevenell M .
Feasibility of behavioral weight loss treatment enhanced with peer support and mobile health technology for individuals with serious mental illness.
Psychiatr Q 2016 Sep;87(3):401-15. doi: 10.1007/s11126-015-9395-x.
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Keywords: Health Information Technology (HIT), Behavioral Health, Obesity: Weight Management, Obesity
Biegler K, Mollica R, Sim SE
AHRQ Author: Ngo-Metzger Q
Rationale and study protocol for a multi-component health information technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.
The authors described the rationale and protocol of a clustered randomized controlled trial to test the effectiveness of a health information technology (HIT) intervention that provides a multi-component approach to delivering culturally competent mental health care in the primary care setting. They expect the outcomes to include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder. They suggest that this technology has the potential to be adapted in order to facilitate mental health screening and treatment in the primary care setting.
AHRQ-authored.
Citation: Biegler K, Mollica R, Sim SE .
Rationale and study protocol for a multi-component health information technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.
Contemp Clin Trials 2016 Sep;50:66-76. doi: 10.1016/j.cct.2016.07.001.
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Keywords: Health Information Technology (HIT), Behavioral Health, Depression, Screening, Primary Care
Ali MM, Chen J, Mutter R
AHRQ Author: Novak P
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
The authors analyzed out-of-pocket spending as a share of total health care expenditures for young adults with behavioral health conditions before and after the implementation of the ACA dependent care provision. They found that the extension of health insurance coverage to young adults with behavioral health disorders has provided them with additional financial protection, which can be important given the low incomes and high debt burden that characterize the age group.
AHRQ-authored.
Citation: Ali MM, Chen J, Mutter R .
The ACA's dependent coverage expansion and out-of-pocket spending by young adults with behavioral health conditions.
Psychiatr Serv 2016 Sep;67(9):977-82. doi: 10.1176/appi.ps.201500346.
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Keywords: Behavioral Health, Healthcare Costs, Health Insurance, Medical Expenditure Panel Survey (MEPS), Young Adults