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
476 to 496 of 496 Research Studies DisplayedLoyland B, Wilmont S, Hessels AJ
Staff knowledge, awareness, perceptions, and beliefs about infection prevention in pediatric long-term care facilities.
The aims of this study were to explore direct care providers' knowledge about infection prevention and hand hygiene, attitudes regarding their own and others' hand hygiene practices, and ideas and advice for improving infection prevention efforts. Findings suggested that one essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Also, workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination.
AHRQ-funded; HS021470.
Citation: Loyland B, Wilmont S, Hessels AJ .
Staff knowledge, awareness, perceptions, and beliefs about infection prevention in pediatric long-term care facilities.
Nurs Res 2016 Mar-Apr;65(2):132-41. doi: 10.1097/nnr.0000000000000136.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Prevention
DeVoe JE, Tillotson CJ, Marino M
Trends in type of health insurance coverage for US children and their parents, 1998-2011.
The objective of this paper is to examine trends in health insurance type among US children and their parents. Using Medical Expenditure Panel Survey data (1998-2011), the authors found that low- and middle-income US families experienced a decrease in the percentage of child-parent pairs with private health insurance and pairs without insurance. At the same time, they found a rise in discordant coverage patterns - mainly publicly insured children with uninsured parents.
AHRQ-funded; HS018569.
Citation: DeVoe JE, Tillotson CJ, Marino M .
Trends in type of health insurance coverage for US children and their parents, 1998-2011.
Acad Pediatr 2016 Mar;16(2):192-9. doi: 10.1016/j.acap.2015.06.009.
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Keywords: Children/Adolescents, Health Insurance, Low-Income, Medical Expenditure Panel Survey (MEPS), Uninsured
Self WH, Williams DJ, Zhu Y
Respiratory viral detection in children and adults: comparing asymptomatic controls and patients with community-acquired pneumonia.
The researchers conducted a prospective study to identify the prevalence of 13 viruses in the upper respiratory tract of patients with CAP and concurrently enrolled asymptomatic controls with real-time reverse-transcriptase polymerase chain reaction. They concluded that the probability that a virus detected with real-time reverse-transcriptase polymerase chain reaction in patients with CAP contributed to symptomatic disease varied by age group and specific virus.
AHRQ-funded; HS022342.
Citation: Self WH, Williams DJ, Zhu Y .
Respiratory viral detection in children and adults: comparing asymptomatic controls and patients with community-acquired pneumonia.
J Infect Dis 2016 Feb 15;213(4):584-91. doi: 10.1093/infdis/jiv323.
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Keywords: Children/Adolescents, Community-Acquired Infections, Pneumonia, Respiratory Conditions
Silverberg JI
Association between childhood eczema and headaches: an analysis of 19 US population-based studies.
The researchers sought to determine whether childhood eczema is associated with increased headaches and whether such association is related to fatigue or sleep disturbance. After analyzing national survey data from 401,002 children and adolescents, they found that eczema is associated with increased headaches in childhood, particularly in patients with severe disease accompanied by atopy, fatigue, and sleep disturbances.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Association between childhood eczema and headaches: an analysis of 19 US population-based studies.
J Allergy Clin Immunol 2016 Feb;137(2):492-99.e5. doi: 10.1016/j.jaci.2015.07.020.
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Keywords: Children/Adolescents, Neurological Disorders, Sleep Problems, Risk, Skin Conditions
Loyland B, Wilmont S, Cohen B
Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area.
The authors described hand-hygiene practices in pediatric long-term care (pLTC) facilities and identified observed barriers to, and potential solutions for, improved infection prevention. They found that hand hygiene was performed for 40% of the 847 indications observed and recorded, and that adherence appeared to be influenced by individuals' knowledge, attitudes, beliefs and work setting. They concluded by offering suggestions for overcoming barriers or mitigating their effect and suggesting an adaptation of the '5 Moments for Hand Hygiene' to improve infection prevention in pLTC.
AHRQ-funded; HS021470.
Citation: Loyland B, Wilmont S, Cohen B .
Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area.
Int J Qual Health Care 2016 Feb;28(1):74-80. doi: 10.1093/intqhc/mzv097.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Prevention
Knackstedt ED, Stockmann C, Davis CR
Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship.
The researchers reviewed patient discharges with outpatient parenteral antimicrobial therapy (OPAT) to determine whether OPAT was modifiable or unnecessary at a large tertiary care children’s hospital. At least one modification definitely or possibly would have been recommended for 78 percent of episodes. For more than 40 percent of episodes, OPAT was potentially not indicated.
AHRQ-funded; HS023320.
Citation: Knackstedt ED, Stockmann C, Davis CR .
Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship.
Infect Control Hosp Epidemiol 2015 Feb;36(2):222-4. doi: 10.1017/ice.2014.27..
Keywords: Antimicrobial Stewardship, Children/Adolescents, Ambulatory Care and Surgery
Aalsma MC, Gilbert AL, Xiao S
Parent and adolescent views on barriers to adolescent preventive health care utilization.
The objective of the study was to determine adolescent and parent views of barriers to annual adolescent preventive care. Barriers for parents and adolescents include the belief that an appointment is only needed when a child is sick and family cannot afford cost. Barriers for parents include having their child see a specialist.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Gilbert AL, Xiao S .
Parent and adolescent views on barriers to adolescent preventive health care utilization.
J Pediatr 2016 Feb;169:140-5. doi: 10.1016/j.jpeds.2015.10.090.
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Keywords: Children/Adolescents, Access to Care, Prevention, Primary Care, Healthcare Utilization
Chinnadurai S, Fonnesbeck C, Snyder KM
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
The objective of this report was to meta-analyze studies of pharmacologic interventions for children with infantile hemangiomas (IH). It concluded that propranolol was effective at reducing IH size compared with placebo, observation, and other treatments including steroids in most studies. Corticosteroids demonstrated moderate effectiveness at reducing IH size/volume.
AHRQ-funded; 290201200009I.
Citation: Chinnadurai S, Fonnesbeck C, Snyder KM .
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
Pediatrics 2016 Feb;137(2):e20153896. doi: 10.1542/peds.2015-3896.
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Keywords: Medication, Children/Adolescents, Newborns/Infants, Comparative Effectiveness, Patient-Centered Outcomes Research
Lyons TW, Johnson KB, Michelson KA
Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus.
The purpose of this paper was to determine the yield of emergent neuroimaging among children with new-onset seizures presenting with status epilepticus. The authors found that a substantial minority of children with new-onset seizures presenting with status epilepticus have urgent or emergent intracranial pathology identified on neuroimaging and that magnetic resonance imaging is the preferred imaging modality when available and safe.
AHRQ-funded; HS000063.
Citation: Lyons TW, Johnson KB, Michelson KA .
Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus.
Seizure 2016 Feb;35:4-10. doi: 10.1016/j.seizure.2015.12.009.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Imaging, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Cocoros NM, Kleinman K, Priebe GP
Ventilator-associated events in neonates and children--a new paradigm.
The objective of this study was to identify a pediatric ventilator-associated condition definition for use in neonates and children by exploring whether potential ventilator-associated condition definitions identify patients with worse outcomes. It found that pediatric patients with ventilator-associated conditions are at substantially higher risk for mortality and morbidity across ICUs, regardless of thresholds used.
AHRQ-funded; HS021636.
Citation: Cocoros NM, Kleinman K, Priebe GP .
Ventilator-associated events in neonates and children--a new paradigm.
Crit Care Med 2016 Jan;44(1):14-22. doi: 10.1097/ccm.0000000000001372.
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Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Newborns/Infants, Children/Adolescents
Finnerty M, Neese-Todd S, Pritam R
Access to psychosocial services prior to starting antipsychotic treatment among Medicaid-insured youth.
The researchers sought to examine rates and predictors of receiving a psychosocial service before initiating antipsychotic treatment among young people in the Medicaid program. They found that less than one-half of youth received a psychosocial service before initiating antipsychotic treatment, and youth diagnosed with stress disorders were significantly more likely than those diagnosed with psychotic or bipolar disorders to have received a psychosocial service before starting an antipsychotic. They concluded that this service pattern highlights a critical gap in access to psychosocial services.
AHRQ-funded; HS019937; HS020503; HS021112.
Citation: Finnerty M, Neese-Todd S, Pritam R .
Access to psychosocial services prior to starting antipsychotic treatment among Medicaid-insured youth.
J Am Acad Child Adolesc Psychiatry 2016 Jan;55(1):69-76.e3. doi: 10.1016/j.jaac.2015.09.020.
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Keywords: Access to Care, Children/Adolescents, Medication, Behavioral Health
Drury KE, Schaeffer M, Silverberg JL
Association between atopic disease and anemia in US children.
Atopic disease is associated with chronic inflammation, food allergen avoidance, and use of systemic immunosuppressant medications. All these factors have been shown to be associated with anemia. This study investigated whether atopic disease is associated with increased risk of childhood anemia. It concluded that the association between atopic disease and anemia was reproducible in multiple cohorts.
AHRQ-funded; HS023011.
Citation: Drury KE, Schaeffer M, Silverberg JL .
Association between atopic disease and anemia in US children.
JAMA Pediatr 2016 Jan;170(1):29-34. doi: 10.1001/jamapediatrics.2015.3065..
Keywords: Asthma, Children/Adolescents, Chronic Conditions, Risk
Li S, Rehder KJ, Giuliano JS, Jr.
Development of a quality improvement bundle to reduce tracheal intubation-associated events in pediatric ICUs.
This paper described a methodology to develop a bundle to improve quality and safety of tracheal intubations in the pediatric intensive care unit. The Airway Bundle Checklist consists of four parts: a risk factor assessment, a plan generation, a preprocedure time-out, and a postprocedure huddle to identify improvement opportunities.
AHRQ-funded; HS021583.
Citation: Li S, Rehder KJ, Giuliano JS, Jr. .
Development of a quality improvement bundle to reduce tracheal intubation-associated events in pediatric ICUs.
Am J Med Qual 2016 Jan-Feb;31(1):47-55. doi: 10.1177/1062860614547259.
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Keywords: Adverse Events, Intensive Care Unit (ICU), Quality Improvement, Patient Safety, Children/Adolescents
Strom MA, Silverberg JI
Eczema is associated with childhood speech disorder: a retrospective analysis from the National Survey of Children's Health and the National Health Interview Survey.
The researchers sought to determine if eczema is associated with an increased risk of a speech disorder. They found that pooled prevalence of speech disorder in children with eczema was 4.7 percent compared with 2.2 percent in children without eczema. They concluded that pediatric eczema may be associated with increased risk of speech disorder.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Eczema is associated with childhood speech disorder: a retrospective analysis from the National Survey of Children's Health and the National Health Interview Survey.
J Pediatr 2016 Jan;168:185-92.e4. doi: 10.1016/j.jpeds.2015.09.066.
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Keywords: Children/Adolescents, Skin Conditions
Kaziunas E, Hanauer DA, Ackerman MS
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
The researchers conducted field observations and semi-structured interviews of pediatric hematopoietic stem cell transplantation (HSCT) caregivers and patients to identify informational challenges in the inpatient hospital setting. Theyn concluded that pediatric HSCT caregivers and patients have multiple informational needs that could be met with a health information technology system that integrates data from several sources, including electronic health records. Meeting these needs could reduce patients' and caregivers' anxiety surrounding the care process.
AHRQ-funded; HS023613.
Citation: Kaziunas E, Hanauer DA, Ackerman MS .
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
J Am Med Inform Assoc 2016 Jan;23(1):94-104. doi: 10.1093/jamia/ocv116.
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Keywords: Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Patient and Family Engagement, Transplantation
Zamora-Kapoor A, Nelson L, Buchwald D
Maternal correlates of body mass index in American Indian/Alaska Native and white adolescents: differences between mother/son and mother/daughter pairs.
This study sough to determine the influence of maternal correlates on adolescent body mass index (BMI), and the extent to which the size and significance of these correlates vary by adolescent sex and race. Its findings suggest that maternal factors are critical in the transmission of obesogenic behaviors from one generation to the next, and their effects vary between mother/son and mother/daughter pairs, and are similar for AI/ANs and Whites.
AHRQ-funded; HS021686.
Citation: Zamora-Kapoor A, Nelson L, Buchwald D .
Maternal correlates of body mass index in American Indian/Alaska Native and white adolescents: differences between mother/son and mother/daughter pairs.
Eat Behav 2016 Jan;20:43-7. doi: 10.1016/j.eatbeh.2015.11.002..
Keywords: Children/Adolescents, Obesity, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Hernandez M, Hojman N, Sadorra C
Pediatric critical care telemedicine program: a single institution review.
The researchers conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital between 2000 and 2014. They concluded that their review demonstrated that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community emergency departments is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.
AHRQ-funded; HS019712.
Citation: Hernandez M, Hojman N, Sadorra C .
Pediatric critical care telemedicine program: a single institution review.
Telemed J E Health 2016 Jan;22(1):51-5. doi: 10.1089/tmj.2015.0043.
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Keywords: Children/Adolescents, Critical Care, Emergency Department, Telehealth
Thienprayoon R, Marks E, Funes M
Perceptions of the pediatric hospice experience among English- and Spanish-speaking families.
The objective of this study was to explore parental perspectives of the hospice experience in children with cancer, and to explore how race/ethnicity impacts this experience. Both English and Spanish speakers described the importance of honest, direct communication by medical providers, and anxieties surrounding the expectation of the moment of death. English-speaking families were more likely to return to the hospital because of unsatisfactory symptom management.
AHRQ-funded; HS022418.
Citation: Thienprayoon R, Marks E, Funes M .
Perceptions of the pediatric hospice experience among English- and Spanish-speaking families.
J Palliat Med 2016 Jan;19(1):30-41. doi: 10.1089/jpm.2015.0137.
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Keywords: Children/Adolescents, Palliative Care, Long-Term Care, Racial and Ethnic Minorities, Cancer
Saville AW, Gurfinkel D, Sevick C
Provider preferences and experiences with a countywide centralized collaborative reminder/recall for childhood immunizations.
The researchers assessed among providers in Colorado where a collaborative centralized reminder/recall (CC-R/R) using the Colorado Immunization Information System (CIIS) was performed: 1) preferences about CC-R/R conducted by the public health department (PHD); and 2) experiences with including their name on CC-R/R notices. Most practices are accepting of the PHD centrally conducting R/R, but most prefer collaboration that includes their name.
AHRQ-funded; HS021138.
Citation: Saville AW, Gurfinkel D, Sevick C .
Provider preferences and experiences with a countywide centralized collaborative reminder/recall for childhood immunizations.
Acad Pediatr 2016 Jan-Feb;16(1):50-6. doi: 10.1016/j.acap.2015.09.002.
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Keywords: Public Health, Vaccination, Health Information Technology (HIT), Children/Adolescents, Practice Patterns
Kreider AR, French B, Aysola J
Quality of health insurance coverage and access to care for children in low-income families.
This study compared health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. It found that children with all insurance types experienced challenges in access to specialty care, with caregivers of children insured by the Children’s Health Insurance Program reporting the highest rates of difficulty accessing specialty care, problems obtaining a referral, and frustration obtaining health care services.
AHRQ-funded; HS021706.
Citation: Kreider AR, French B, Aysola J .
Quality of health insurance coverage and access to care for children in low-income families.
JAMA Pediatr 2016 Jan;170(1):43-51. doi: 10.1001/jamapediatrics.2015.3028..
Keywords: Children's Health Insurance Program (CHIP), Children/Adolescents, Access to Care, Low-Income
Boudreaux MH, Golberstein E, McAlpine DD
The long-term impacts of Medicaid exposure in early childhood: evidence from the program's origin.
This paper examines the long-term impact of exposure to Medicaid in early childhood on adult health and economic status. Its analyses suggest that exposure to Medicaid in early childhood (age 0-5) is associated with statistically significant and meaningful improvements in adult health (age 25-54), and this effect is only seen in subgroups targeted by the program.
AHRQ-funded; HS021690.
Citation: Boudreaux MH, Golberstein E, McAlpine DD .
The long-term impacts of Medicaid exposure in early childhood: evidence from the program's origin.
J Health Econ 2016 Jan;45:161-75. doi: 10.1016/j.jhealeco.2015.11.001.
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Keywords: Medicaid, Health Status, Children/Adolescents