National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Anxiety (1)
- Behavioral Health (7)
- Burnout (3)
- Cancer (4)
- Cancer: Colorectal Cancer (1)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Care Management (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Depression (5)
- Diabetes (2)
- Education: Continuing Medical Education (3)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Family Health and History (2)
- Genetics (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Health Status (2)
- Hospital Discharge (1)
- Lifestyle Changes (1)
- Low-Income (2)
- Medical Errors (1)
- Neurological Disorders (1)
- Newborns/Infants (2)
- Obesity (2)
- Obesity: Weight Management (1)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (1)
- Pregnancy (2)
- Prevention (1)
- Primary Care (2)
- Primary Care: Models of Care (1)
- Provider (6)
- Provider: Clinician (2)
- Provider: Health Personnel (1)
- Provider: Nurse (1)
- Provider: Physician (5)
- Provider Performance (1)
- Racial and Ethnic Minorities (3)
- Respiratory Conditions (1)
- Risk (1)
- Social Determinants of Health (2)
- (-) Stress (29)
- Stroke (1)
- Substance Abuse (1)
- Surgery (4)
- Tobacco Use (1)
- Tools & Toolkits (1)
- Training (3)
- Trauma (2)
- Treatments (1)
- Vulnerable Populations (2)
- Women (3)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 29 Research Studies DisplayedRudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Hu YY, Ellis RJ, Hewitt DB
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
A cross-sectional national survey of general surgery residents, administered with the 2018 American Board of Surgery In-Training Examination, assessed mistreatment, burnout, and suicidal thoughts during the past year. The authors assessed the association of mistreatment with burnout and suicidal thoughts; they found that mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
AHRQ-funded; HS000078.
Citation: Hu YY, Ellis RJ, Hewitt DB .
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
N Engl J Med 2019 Oct 31;381(18):1741-52. doi: 10.1056/NEJMsa1903759..
Keywords: Education: Continuing Medical Education, Burnout, Stress, Surgery, Provider: Physician, Provider, Training
Cook JM, Newman E, Simiola V
Trauma training: competencies, initiatives, and resources.
Traumatic stress is currently not a required component of the standard curricula in graduate-level education in clinical and counseling psychology. However, due to the high prevalence of trauma and its potentially deleterious physical and mental health effects in the general and clinical populations, it is imperative that psychology graduate students and practitioners understand the relevance of trauma in their clients' lives and its impact in clinical research. This paper discusses competencies, initiatives and resources related to trauma training.
AHRQ-funded; HS021602.
Citation: Cook JM, Newman E, Simiola V .
Trauma training: competencies, initiatives, and resources.
Psychotherapy 2019 Sep;56(3):409-21. doi: 10.1037/pst0000233..
Keywords: Education: Continuing Medical Education, Behavioral Health, Provider, Stress, Training, Trauma
Kroth PJ, Morioka-Douglas N, Veres S
Association of electronic health record design and use factors with clinician stress and burnout.
The authors sought to determine which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Surveying ambulatory primary care and subspecialty clinicians from 3 institutions, they found that, although EHR design and use factors are associated with clinician stress and burnout, other challenges, such as chaotic clinic atmospheres and workload control, explain considerably more of the variance in these adverse clinician outcomes.
AHRQ-funded; HS022065.
Citation: Kroth PJ, Morioka-Douglas N, Veres S .
Association of electronic health record design and use factors with clinician stress and burnout.
JAMA Netw Open 2019 Aug 2;2(8):e199609. doi: 10.1001/jamanetworkopen.2019.9609..
Keywords: Burnout, Stress, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician, Provider: Nurse
Papaleontiou M, Reyes-Gastelum D, Gay BL
Worry in thyroid cancer survivors with a favorable prognosis.
Researchers investigated cancer-related worry in thyroid cancer survivors with favorable prognosis. A diverse cohort of patients diagnosed with differentiated thyroid cancer, selected from the Surveillance, Epidemiology, and End Results (SEER) Program registries were surveyed for two to four years after diagnosis. The researchers recommended that physicians be aware that worry is a major issue for thyroid cancer survivors with favorable prognosis. Efforts should be undertaken to alleviate worry, especially among vulnerable groups, including female patients, younger patients, those with lower education, and racial/ethnic minorities.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Reyes-Gastelum D, Gay BL .
Worry in thyroid cancer survivors with a favorable prognosis.
Thyroid 2019 Aug;29(8):1080-88. doi: 10.1089/thy.2019.0163..
Keywords: Cancer, Anxiety, Stress, Health Status
Anton NE, Mizota T, Whiteside JA
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
The authors hypothesize that surgery residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. They find that their comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. They conclude that their results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees' technical performance during challenging clinical situations.
AHRQ-funded; R18 HS022080.
Citation: Anton NE, Mizota T, Whiteside JA .
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
Surgery 2019 Jun;165(6):1059-64. doi: 10.1016/j.surg.2019.01.011..
Keywords: Surgery, Education: Continuing Medical Education, Stress, Provider Performance, Training, Provider: Physician, Provider
Nocon RS, Fairchild PC, Gao Y
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
This study examined the impact of adopting the patient-centered medical home (PCMH) on clinicians and staff at primary care practices. A longitudinal study was done comparing baseline (201) and post-intervention (2013-2014) survey results. Five-hundred thirty-six providers and staff at baseline and 589 were surveyed post-intervention. Almost half of all clinics reported improved better job morale, job satisfaction, and freedom from burnout. However, there were some clinics that saw a decrease in the percentage of providers reporting high job satisfaction and freedom from burnout. Control clinics were not used in this study, so it is impossible to know if results were similar in non-PCMH primary care practices.
AHRQ-funded; HS000084.
Citation: Nocon RS, Fairchild PC, Gao Y .
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
J Gen Intern Med 2019 Jun;34(6):952-59. doi: 10.1007/s11606-019-04893-z..
Keywords: Burnout, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Clinician, Stress
Baskind MJ, Taveras EM, Gerber MW
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. In this study, the investigators studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. The investigators found that among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity.
AHRQ-funded; HS024332; HS022986.
Citation: Baskind MJ, Taveras EM, Gerber MW .
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Prev Chronic Dis 2019 Mar 28;16:E39. doi: 10.5888/pcd16.180368..
Keywords: Children/Adolescents, Family Health and History, Lifestyle Changes, Obesity, Obesity: Weight Management, Risk, Stress
Gowey MA, Khodneva Y, Tison SE
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
The purpose of this study was to describe the relationship between metabolic health parameters and depressive symptoms and perceived stress, and determine whether the co-occurrence of these two psychological stressors had an additive influence on metabolic dysregulation in adults at different levels of body mass index (BMI) without diabetes. The investigators found that elevated depressive symptoms in conjunction with high levels of perceived stress were more strongly associated with several parameters of metabolic health than only one of these psychological constructs in a large, diverse cohort of adults.
AHRQ-funded; HS023009; HS013852.
Citation: Gowey MA, Khodneva Y, Tison SE .
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
Int J Obes 2019 Mar;43(3):615-32. doi: 10.1038/s41366-018-0270-3..
Keywords: Depression, Behavioral Health, Obesity, Stress
Abelson JS, Chait A, Shen MJ
Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: a qualitative study.
This study researched the role that surgeons can play in managing stress in patients undergoing colorectal cancer surgery. Patients were interviewed in-depth using open-ended questions. While patients did not believe surgeons are responsible for helping them cope, they do believe that they can play a role in managing their distress.
AHRQ-funded; HS000066.
Citation: Abelson JS, Chait A, Shen MJ .
Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: a qualitative study.
Surgery 2019 Feb;165(2):461-68. doi: 10.1016/j.surg.2018.06.005..
Keywords: Cancer: Colorectal Cancer, Clinician-Patient Communication, Provider: Physician, Stress, Surgery
Brunwasser SM, Slavich GM, Newcomb DC
Sex-specific association between prenatal life stress exposure and infant pro-inflammatory cytokine levels during acute respiratory infection.
Prenatal life stress exposure is linked to dysregulated immune function and chronic inflammatory disease in offspring, but little is known about its effects on infant immune response during viral infection. To address this issue, the investigators examined associations between prenatal life stress exposure and infant upper-airway inflammatory markers during acute respiratory infection (ARI) using data from a prospective, population-based birth-cohort study (N=180).
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Slavich GM, Newcomb DC .
Sex-specific association between prenatal life stress exposure and infant pro-inflammatory cytokine levels during acute respiratory infection.
Brain Behav Immun 2019 Feb;76:275-79. doi: 10.1016/j.bbi.2018.12.002..
Keywords: Respiratory Conditions, Stress, Women
Elm JHL, Walls ML, Aronson BD
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Investigators analyzed focus group transcripts of American Indian adults with type 2 diabetes from five tribal communities and classified stressors using an inductive/deductive analytical approach. They identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for American Indians and concluded that stressors are generally experienced as chronic, regardless of the duration of the stressor.
AHRQ-funded; HS024180.
Citation: Elm JHL, Walls ML, Aronson BD .
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Am Indian Alsk Native Ment Health Res 2019;26(1):33-62. doi: 10.5820/aian.2601.2019.33..
Keywords: Diabetes, Chronic Conditions, Stress, Racial and Ethnic Minorities, Vulnerable Populations
Kim DH, Bassett SM, So S
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
This study assessed whether future orientation and self-esteem affected the relationship between family stress and mental health problems among African American youth in predominantly low-income neighborhoods. Youths (mainly female, average age 15.83 years old) were sampled for family stress, self-esteem, future orientation, mental health and other covariates such as gender and sexual orientation. A correlation was found between future orientation and self-esteem levels and family stress and mental health problems.
AHRQ-funded; HS000078.
Citation: Kim DH, Bassett SM, So S .
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
Am J Orthopsychiatry 2019;89(2):125-33. doi: 10.1037/ort0000371..
Keywords: Children/Adolescents, Family Health and History, Low-Income, Behavioral Health, Racial and Ethnic Minorities, Stress, Vulnerable Populations
Frazier SE, Parker SH
Measurement of physiological responses to acute stress in multiple occupations: a systematic review and implications for front line healthcare providers.
The purpose of this review was to examine and synthesize empirical literature to identify studies assessing physiological responses to acute stress, determine common methods for measuring acute stress in near real-time, and identify common research designs employed across industries. The authors suggest that their review demonstrated that acute stress was primarily assessed retrospectively, and that there was a pragmatic gap in methodological approach, with many data collection methods inappropriate for the healthcare environment.
AHRQ-funded; HS023465.
Citation: Frazier SE, Parker SH .
Measurement of physiological responses to acute stress in multiple occupations: a systematic review and implications for front line healthcare providers.
Transl Behav Med 2019 Jan;9(1):158-66. doi: 10.1093/tbm/iby019..
Keywords: Provider, Stress
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.
.
.
Keywords: Behavioral Health, Prevention, Stress, Women
Sumner JA, Khodneva Y, Muntner P
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, the authors examined associations among depressive symptoms and stress, alone and in combination, and incident cardiovascular disease (CVD) and all-cause mortality as a function of socioeconomic status. They found that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
AHRQ-funded; HS023009.
Citation: Sumner JA, Khodneva Y, Muntner P .
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
J Am Heart Assoc 2016 Oct 10;5(10). doi: 10.1161/jaha.116.003930.
.
.
Keywords: Cardiovascular Conditions, Depression, Social Determinants of Health, Stress, Stroke
Garfield CF, Simon CD, Rutsohn J
Paternal and maternal testosterone in parents of NICU infants transitioning home.
This study examined testosterone levels for parents of very low-birth-weight infants, including links between salivary testosterone and infant factors (such as breast-feeding), psychosocial stress, and changes over time. Using multilevel modeling approaches, the researchers reported significant associations between paternal testosterone by time and psychosocial adjustment and between both paternal and maternal testosterone and infant feeding mode.
AHRQ-funded; R21 HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Paternal and maternal testosterone in parents of NICU infants transitioning home.
J Perinat Neonatal Nurs 2016 Oct/Dec;30(4):349-58. doi: 10.1097/jpn.0000000000000218.
.
.
Keywords: Newborns/Infants, Stress, Caregiving, Hospital Discharge
Senders A, Sando K, Wahbeh H
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis.
AHRQ-funded; HS017582.
Citation: Senders A, Sando K, Wahbeh H .
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
J Health Psychol 2016 Aug;21(8):1676-87. doi: 10.1177/1359105314562084.
.
.
Keywords: Care Management, Neurological Disorders, Ambulatory Care and Surgery, Stress
Witt WP, Mandell KC, Wisk LE
Infant birthweight in the US: the role of preconception stressful life events and substance use.
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. It concluded that PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Infant birthweight in the US: the role of preconception stressful life events and substance use.
Arch Womens Ment Health 2016 Jun;19(3):529-42. doi: 10.1007/s00737-015-0595-z.
.
.
Keywords: Newborns/Infants, Pregnancy, Stress, Substance Abuse, Women
Kaplan RM, Milstein A
AHRQ Author: Kaplan RM
Financial strain and cancer outcomes.
This editorial discusses an article by Lathan et al. in the same issue that documents the strong associations between socioeconomic status and longevity. The editorial argues that many of the variables in that article are measured with error and, as a result, the multivariable analysis resulted in only partial adjustment. Two variables of particular importance, education and ethnicity, are discussed.
AHRQ-authored.
Citation: Kaplan RM, Milstein A .
Financial strain and cancer outcomes.
J Clin Oncol 2016 May 20;34(15):1711-2. doi: 10.1200/jco.2016.66.8079.
.
.
Keywords: Cancer, Health Status, Healthcare Costs, Low-Income, Outcomes, Social Determinants of Health, Stress
Rhoten BA
Body image disturbance in adults treated for cancer - a concept analysis.
The author analyzed the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. Rhoten used Walker and Avant's 8-step method of concept analysis and concluded that a better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and will assist nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Body image disturbance in adults treated for cancer - a concept analysis.
J Adv Nurs 2016 May;72(5):1001-11. doi: 10.1111/jan.12892.
.
.
Keywords: Behavioral Health, Cancer, Stress
Mathur MB, Epel E, Kind S
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
The researchers conducted a systematic review and meta-analysis to determine the association between self-reported, perceived psychological stress (PS) and telomere length (TL). They found that increased PS was associated with a very small decrease in TL and that this relationship was similar between sexes. They concluded that the association may be stronger with known major stressors and is similar in magnitude to that noted between obesity and TL. The authors recommended that futre research assess for potential confounders and use longitudinal, multidimensional models of stress.
AHRQ-funded; HS019816.
Citation: Mathur MB, Epel E, Kind S .
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
Brain Behav Immun 2016 May;54:158-69. doi: 10.1016/j.bbi.2016.02.002.
.
.
Keywords: Evidence-Based Practice, Genetics, Stress
Rocque GB, Taylor RA, Acemgil A
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
This study assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. It concluded that lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
AHRQ-funded; HS013852.
Citation: Rocque GB, Taylor RA, Acemgil A .
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
J Natl Compr Canc Netw 2016 Apr;14(4):407-14.
.
.
Keywords: Elderly, Cancer, Tools & Toolkits, Stress, Behavioral Health
Heberlein EC, Picklesimer AH, Billings DL
The comparative effects of group prenatal care on psychosocial outcomes.
This study compared the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care. It used a prospective cohort study of women who chose CP group or individual prenatal care. Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 percent greater increase in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 percent greater decrease in postpartum depressive symptom scores.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Picklesimer AH, Billings DL .
The comparative effects of group prenatal care on psychosocial outcomes.
Arch Womens Ment Health 2016 Apr;19(2):259-69. doi: 10.1007/s00737-015-0564-6.
.
.
Keywords: Pregnancy, Stress, Depression, Outcomes
Edrees H, Brock DM, Wu AW
The experiences of risk managers in providing emotional support for health care workers after adverse events.
The authors surveyed members of the American Society for Health Care Risk Management (ASHRM) about their training, experience, competence, and comfort with providing emotional support to health care workers. Risk managers who were comfortable listening to and supporting health care workers were more likely to report prior training. Most respondents expressed a preference to receive additional training.
AHRQ-funded; HS019531.
Citation: Edrees H, Brock DM, Wu AW .
The experiences of risk managers in providing emotional support for health care workers after adverse events.
J Healthc Risk Manag 2016 Apr;35(4):14-21. doi: 10.1002/jhrm.21219.
.
.
Keywords: Adverse Events, Medical Errors, Stress, Patient Safety