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
26 to 50 of 147 Research Studies DisplayedGarber J, Brunwasser SM, Zerr AA
Treatment and prevention of depression and anxiety in youth: test of cross-over effects.
The present meta-analytic review examined whether interventions for children and adolescents that explicitly targeted either anxiety or depression showed treatment specificity or also impacted the other outcome (i.e. cross-over effects). Anxiety prevention studies (n = 14) significantly affected anxious, but not depressive symptoms, indicating no cross-over effect of anxiety prevention trials on depression. For depression prevention studies (n = 15), the effects were not significant for either depressive or anxiety symptoms, although the effect was significantly larger for depressive than for anxious symptoms.
AHRQ-funded; HS022990.
Citation: Garber J, Brunwasser SM, Zerr AA .
Treatment and prevention of depression and anxiety in youth: test of cross-over effects.
Depress Anxiety 2016 Oct;33(10):939-59. doi: 10.1002/da.22519.
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Keywords: Anxiety, Children/Adolescents, Depression, Patient-Centered Outcomes Research
Ray KN, Mehrotra A
Trends in access to primary care for children in the United States, 2002-2013.
Using MEPS data, the authors described how access to primary care has changed over the last decade for children. They found no change in the proportion of children with a usual source of care (USC). Other measures improved, but out-of-pocket costs increased among privately insured children. Results suggested that after-hours accommodation within the USC is worsening, despite the promotion of patient-centered medical home initiatives. All measures of acceptability improved, consistent with a growing focus on family-centeredness of care.
AHRQ-funded; HS022989.
Citation: Ray KN, Mehrotra A .
Trends in access to primary care for children in the United States, 2002-2013.
JAMA Pediatr 2016 Oct;170(10):1023-25. doi: 10.1001/jamapediatrics.2016.0985.
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Keywords: Access to Care, Children/Adolescents, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS), Primary Care
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)
Denman DC, Baldwin AS, Marks EG
Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents.
The researchers investigated measures of motivation for HPV vaccination using confirmatory factor analysis to test a three-factor measurement model. Their findings support the use of three subscales to measure motivation in HPV vaccination and suggest possible cultural differences in motivation.
AHRQ-funded; HS022418.
Citation: Denman DC, Baldwin AS, Marks EG .
Modification and validation of the Treatment Self Regulation Questionnaire to assess parental motivation for HPV vaccination of adolescents.
Vaccine 2016 Sep 22;34(41):4985-90. doi: 10.1016/j.vaccine.2016.08.037.
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Keywords: Children/Adolescents, Education: Patient and Caregiver, Infectious Diseases, Patient and Family Engagement, Vaccination
Mannion ML, Xie F, Baddley J
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
This study investigated the utilization of health care services before and after transfer from pediatric to adult rheumatology care in clinical practice. It found that individuals with juvenile idiopathic arthritis (JIA) who transferred to adult care were more likely receive a diagnosis of rheumatoid arthritis instead of juvenile rheumatoid arthritis and were less likely to receive NSAIDs, but had no significant immediate changes to other medication use.
AHRQ-funded; HS021110.
Citation: Mannion ML, Xie F, Baddley J .
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
Pediatr Rheumatol Online J 2016 Sep 5;14(1):49. doi: 10.1186/s12969-016-0107-3.
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Keywords: Healthcare Utilization, Arthritis, Children/Adolescents
Breitenstein SM, Schoeny M, Risser H
A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care.
The purpose of this paper is to describe the study protocol evaluating the implementation, efficacy, and cost-effectiveness of implementing the tablet-based ezParent program in pediatric primary care settings. Data on parenting and child behavior outcomes will be obtained at baseline, and at 3, 6, and 12 months post baseline. The authors suggest that the implementation of the ezParent is an innovative opportunity to promote positive parenting with potential for universal access to the preschool population and for low cost by building on existing infrastructure in pediatric primary care settings.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Schoeny M, Risser H .
A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care.
Contemp Clin Trials 2016 Sep;50:229-37. doi: 10.1016/j.cct.2016.08.017.
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Keywords: Children/Adolescents, Healthcare Costs, Primary Care, Education: Patient and Caregiver, Caregiving
Strom MA, Silverberg JI
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
This study sought to determine whether asthma, hay fever, and food allergy are associated with speech disorder in children and whether disease severity, sleep disturbance, or ADD/ADHD modified such associations. It concluded that childhood asthma, hay fever, and food allergy are associated with increased risk of speech disorder.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
Pediatr Allergy Immunol 2016 Sep;27(6):604-11. doi: 10.1111/pai.12580.
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Keywords: Asthma, Children/Adolescents, Respiratory Conditions
Nieman CL, Tunkel DE, Boss EF
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
The study’s objective was to analyze the association of patient- and neighborhood-level demographics and SES with clinical indications for tympanostomy tube (TT). It found that among children receiving tubes, those from high poverty areas were more likely than those from low poverty neighborhoods to receive tubes for the indication of chronic otitis media with effusion (OME) as opposed to recurrent acute otitis media (RAOM).
AHRQ-funded; HS022932.
Citation: Nieman CL, Tunkel DE, Boss EF .
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
Int J Pediatr Otorhinolaryngol 2016 Sep;88:98-103. doi: 10.1016/j.ijporl.2016.06.029.
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Keywords: Children/Adolescents, Ear Infections, Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Low-Income
Henry MK, Zonfrillo MR, French B
Hospital variation in cervical spine imaging of young children with traumatic brain injury.
The authors sought to identify child-level and hospital-level factors associated with performance of cervical imaging of children with traumatic brain injury from falls and abusive head trauma. They found no association between annual hospital volume of injured children and cervical imaging performance.
AHRQ-funded; HS024194.
Citation: Henry MK, Zonfrillo MR, French B .
Hospital variation in cervical spine imaging of young children with traumatic brain injury.
Acad Pediatr 2016 Sep-Oct;16(7):684-91. doi: 10.1016/j.acap.2016.01.017.
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Keywords: Brain Injury, Children/Adolescents, Imaging, Hospitals, Practice Patterns
Wu AC, Li L, Fung V
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
The authors sought to assess provider prescribing patterns for asthma controller medications and to assess how frequently parental reports of children's asthma controller medicine use were mismatched with provider recommendations. They found that mismatches between parental reports and provider intentions regarding how the child was supposed to use inhaled steroids occurred for half of the children. They recommended that efforts focus on ways to reduce these mismatches.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Mismatching among guidelines, providers, and parents on controller medication use in children with asthma.
J Allergy Clin Immunol Pract 2016 Sep-Oct;4(5):910-6. doi: 10.1016/j.jaip.2016.04.004.
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Keywords: Asthma, Children/Adolescents, Guidelines, Medication, Practice Patterns
Shah AY, LLanos K, Dougherty D
AHRQ Author: Dougherty D
State challenges to child health quality measure reporting and recommendations for improvement.
The authors sought to assess reporting barriers of the Children's Health Insurance Program (CHIP) and to identify potential opportunities for improvement. They found that low reporting states believed they had inadequate staffing and that data collection and extraction was too time-consuming. They concluded that possible solutions to improve reporting would include funding and staff support, refining the technical assistance provided, and creating venues for state-to-state interaction.
AHRQ-authored.
Citation: Shah AY, LLanos K, Dougherty D .
State challenges to child health quality measure reporting and recommendations for improvement.
Healthc 2016 Sep;4(3):217-24. doi: 10.1016/j.hjdsi.2016.03.001.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Medicaid, Quality Indicators (QIs)
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals
Ray KN, Kahn JM, Miller E
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
The objectives of this study are to quantify the use of adult-trained medical subspecialists by children and to determine the association between geographic access to pediatric subspecialty care and the use of adult-trained subspecialists. Among medical subspecialty fields with pediatric and adult-trained subspecialists, the authors found that adult-trained subspecialists provided 10% of care to children overall and 18% of care to children living more than 90 minutes from pediatric referral centers.
AHRQ-funded; HS022989.
Citation: Ray KN, Kahn JM, Miller E .
Use of adult-trained medical subspecialists by children seeking medical subspecialty care.
J Pediatr 2016 Sep;176:173-81.e1. doi: 10.1016/j.jpeds.2016.05.073.
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Keywords: Access to Care, Children/Adolescents, Provider: Health Personnel, Children/Adolescents
McLeod L, Flynn J, Erickson M
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
The purpose of this study was to examine variation in hospital performance based on risk-standardized 60-day readmission rates for surgical-site infection (SSIs) and reoperation across 39 US Children's Hospitals. It found that reoperations were associated with an SSI in 70 percent of cases. Across hospitals, SSI and reoperation rates ranged from 1 percent to 11 percent and 1 percent to 12 percent, respectively.
AHRQ-funded; HS022198.
Citation: McLeod L, Flynn J, Erickson M .
Variation in 60-day readmission for surgical-site infections (SSIs) and reoperation following spinal fusion operations for neuromuscular scoliosis.
J Pediatr Orthop 2016 Sep;36(6):634-9. doi: 10.1097/bpo.0000000000000495.
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Keywords: Children/Adolescents, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Hospital Readmissions, Hospitals, Risk
Brand SR, Pickard L, Mack JW
What adult cancer care can learn from pediatrics.
However, pediatric cancer centers follow three core principles that enhance their patients’ overall care experience. This article discusses those principles, with the aim of helping adult cancer centers learn from what pediatric centers do well.
AHRQ-funded; HS000063.
Citation: Brand SR, Pickard L, Mack JW .
What adult cancer care can learn from pediatrics.
J Oncol Pract 2016 Sep;12(9):765-7. doi: 10.1200/jop.2016.015057..
Keywords: Cancer, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient Experience, Children/Adolescents
Trogdon JG, Shafer PR, Shah PD
Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents?
Researchers explored whether state laws allowing pharmacists to administer human papillomavirus (HPV) vaccinations to adolescents are associated with a higher likelihood of HPV vaccine uptake. They concluded that, as currently implemented, state laws allowing pharmacists to administer HPV vaccine to adolescents were not associated with uptake.
AHRQ-funded; HS000032.
Citation: Trogdon JG, Shafer PR, Shah PD .
Are state laws granting pharmacists authority to vaccinate associated with HPV vaccination rates among adolescents?
Vaccine 2016 Aug 31;34(38):4514-19. doi: 10.1016/j.vaccine.2016.07.056.
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Keywords: Children/Adolescents, Infectious Diseases, Policy, Provider: Pharmacist, Vaccination
Wittmeier KD, Restall G, Mulder K
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
The researchers evaluated the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. They found that central intake implementation achieved the intended outcomes of streamlining processes and improving transparency and access to pediatric physiotherapy for families of children with complex needs. They recommended future research to build on this single discipline case study approach.
AHRQ-funded; HS016657.
Citation: Wittmeier KD, Restall G, Mulder K .
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
BMC Health Serv Res 2016 Aug 31;16:455. doi: 10.1186/s12913-016-1700-3.
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Keywords: Access to Care, Children/Adolescents, Care Coordination, Patient Experience, Children/Adolescents
Lozano P, Henrikson NB, Dunn J
Lipid Screening in childhood and adolescence for detection of familial hypercholesterolemia: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the evidence on benefits and harms of screening adolescents and children for heterozygous Familial hypercholesterolemia (FH) for the US Preventive Services Task Force (USPSTF). They found no evidence for the effect of screening for FH in childhood on lipid concentrations or cardiovascular outcomes in adulthood, or on the long-term benefits or harms of beginning lipid-lowering treatment in childhood.
AHRQ-funded.
Citation: Lozano P, Henrikson NB, Dunn J .
Lipid Screening in childhood and adolescence for detection of familial hypercholesterolemia: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Aug 9;316(6):645-55. doi: 10.1001/jama.2016.6176.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Children/Adolescents, Screening, Evidence-Based Practice
Lozano P, Henrikson NB, Morrison CC
Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the evidence on benefits and harms of screening adolescents and children for multifactorial dyslipidemia for the US Preventive Services Task Force (USPSTF). They concluded that diagnostic yield of lipid screening varies by age and body mass index. No direct evidence was identified for benefits or harms of childhood screening or treatment on outcomes in adulthood. Intensive dietary interventions may be safe, with modest short-term benefit of uncertain clinical significance.
AHRQ-funded.
Citation: Lozano P, Henrikson NB, Morrison CC .
Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Aug 9;316(6):634-44. doi: 10.1001/jama.2016.6423.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Children/Adolescents, Screening, Evidence-Based Practice
Hinton CF, Homer CJ, Thompson AA
AHRQ Author: Dougherty D
A framework for assessing outcomes from newborn screening: on the road to measuring its promise.
The researchers proposed a framework for assessing outcomes for the health and well-being of children identified through newborn screening programs. As an example, they applied the framework to sickle cell disease and phenylketonuria, two diverse conditions with different outcome measures and potential sources of data. They concluded that their paper presented a customizable outcomes framework for organizing measures for newborn screening condition-specific health outcomes, and an approach to identifying sources and challenges to populating those measures.
AHRQ-authored.
Citation: Hinton CF, Homer CJ, Thompson AA .
A framework for assessing outcomes from newborn screening: on the road to measuring its promise.
Mol Genet Metab 2016 Aug;118(4):221-9. doi: 10.1016/j.ymgme.2016.05.017.
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Keywords: Children/Adolescents, Health Status, Newborns/Infants, Screening, Sickle Cell Disease
Kathuria P, Silverberg JI
Association of pollution and climate with atopic eczema in US children.
The authors sought to determine the relationship between childhood eczema, environmental pollutants, and climate. They found that pollutants, in conjunction with climate factors, may differentially impact eczema prevalence and severity.
AHRQ-funded; HS023011.
Citation: Kathuria P, Silverberg JI .
Association of pollution and climate with atopic eczema in US children.
Pediatr Allergy Immunol 2016 Aug;27(5):478-85. doi: 10.1111/pai.12543.
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Keywords: Children/Adolescents, Children/Adolescents, Skin Conditions
Ray KN, Ashcraft LE, Kahn JM
Family perspectives on high-quality pediatric subspecialty referrals.
The researchers sought to develop a framework for high-quality, patient-centered referrals from the perspectives of patients and their families. They identified family-centered outcomes, processes, and structures of high-quality pediatric subspecialty referrals which can be used to inform future interventions to improve patient-centered outcomes for children in need of specialty care.
AHRQ-funded; HS022989.
Citation: Ray KN, Ashcraft LE, Kahn JM .
Family perspectives on high-quality pediatric subspecialty referrals.
Acad Pediatr 2016 Aug;16(6):594-600. doi: 10.1016/j.acap.2016.05.147.
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Keywords: Children/Adolescents, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Children/Adolescents
Allaire BT, Raghavan R, Brown DS
Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid.
The researchers examined the association between receiving a morbid obesity diagnosis and second generation antipsychotics (SGAs) prescriptions among adolescents in foster care. They found that the risk increases with age. Quetiapine and clozapine increased the risk of a morbid obesity diagnosis more than 2.5 times, and two or more psychotropic drugs (polypharmacy) increased the risk fivefold.
AHRQ-funded; HS020269.
Citation: Allaire BT, Raghavan R, Brown DS .
Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid.
Child Youth Serv Rev 2016 Aug;67:27-31. doi: 10.1016/j.childyouth.2016.05.019.
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Keywords: Medicaid, Obesity, Medication, Children/Adolescents, Risk
Bonafide CP, Roland D, Brady PW
Rapid response systems 20 years later: new approaches, old challenges.
In this article, the authors propose a set of recommendations for a research agenda aimed at pursuing the work of optimizing the identification of deteriorating children. They recommend that the second generation of pediatric rapid response systems continue to build on past achievements while further optimizing use of the data, tools, and people available at the bedside to take the next leap forward.
AHRQ-funded; HS023827.
Citation: Bonafide CP, Roland D, Brady PW .
Rapid response systems 20 years later: new approaches, old challenges.
JAMA Pediatr 2016 Aug;170(8):729-30. doi: 10.1001/jamapediatrics.2016.0398.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Emergency Medical Services (EMS), Hospitals
Feraco AM, Starmer AJ, Sectish TC
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
This study developed validity evidence for the use of the Verbal Handoff Assessment Tool (VHAT),examined the reliability of VHAT scores, and determined whether implementation of a resident handoff bundle was associated with improved verbal patient handoffs among pediatric resident physicians. It found that verbal handoffs improved following implementation of a resident handoff bundle, though gains were variable across the two clinical units.
AHRQ-funded; HS019456.
Citation: Feraco AM, Starmer AJ, Sectish TC .
Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle.
Acad Pediatr 2016 Aug;16(6):524-31. doi: 10.1016/j.acap.2016.04.002.
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Keywords: Care Coordination, Communication, Children/Adolescents