National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Brain Injury (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Cultural Competence (1)
- Dental and Oral Health (2)
- Depression (2)
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- Heart Disease and Health (1)
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- Hospitalization (2)
- Human Immunodeficiency Virus (HIV) (2)
- Implementation (1)
- Injuries and Wounds (1)
- Lifestyle Changes (1)
- Low-Income (3)
- Maternal Care (1)
- Medication (2)
- Nursing (1)
- Nutrition (2)
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- Pressure Ulcers (1)
- Primary Care (2)
- Provider: Clinician (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (4)
- Racial and Ethnic Minorities (9)
- Respiratory Conditions (1)
- Risk (2)
- Rural/Inner-City Residents (3)
- Rural Health (3)
- Screening (1)
- Sleep Problems (1)
- Social Determinants of Health (4)
- Social Stigma (1)
- Stroke (1)
- Teams (1)
- (-) Urban Health (27)
- Vulnerable Populations (4)
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 27 Research Studies DisplayedOates GR, Phillips JM, Bateman LB
Determinants of obesity in two urban communities: perceptions and community-driven solutions.
Using Photovoice methodology, this study aimed to identify community perceptions of factors associated with obesity in two urban municipalities - one racially mixed and one predominantly African American - and to explore community-driven solutions to the problem of obesity.
AHRQ-funded; HS023009.
Citation: Oates GR, Phillips JM, Bateman LB .
Determinants of obesity in two urban communities: perceptions and community-driven solutions.
Ethn Dis 2018 Winter;28(1):33-42. doi: 10.18865/ed.28.1.33..
Keywords: Obesity, Racial and Ethnic Minorities, Urban Health
Oates GR, Hamby BW, Bae S
Bikeshare use in urban communities: individual and neighborhood factors.
This study examined factors associated with bikeshare use in a metropolitan area in the southern United States. The study found that higher neighborhood socioeconomic disadvantage was associated with higher bikeshare use. Bikeshare was a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Bae S .
Bikeshare use in urban communities: individual and neighborhood factors.
Ethn Dis 2017 Nov 9;27(Suppl 1):303-12. doi: 10.18865/ed.27.S1.303..
Keywords: Health Status, Social Determinants of Health, Urban Health
Baernholdt M, Hinton ID
Fall rates in urban and rural nursing units: does location matter?
This paper discusses a study of fall rates in 65 rural hospitals with 222 nursing units and 560 urban hospitals with 4274 nursing units. The authors found that geographic region, unit type, and nurse staffing, education, experience, and outcomes were associated with fall rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID .
Fall rates in urban and rural nursing units: does location matter?
J Nurs Care Qual 2018 Oct/Dec;33(4):326-33. doi: 10.1097/ncq.0000000000000319..
Keywords: Falls, Patient Safety, Rural Health, Urban Health
Harris VC, Links AR, Kim JM
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
The purpose of this study was to evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Researchers found that half of the children referred for sleep-disordered breathing evaluation are lost to follow-up from primary care. Obstructive sleep apnea severity did not predict follow-up or timeliness of treatment. They conclude that these findings suggest social determinants may pose barriers to care in addition to the clinical burden of sleep-disordered breathing.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Kim JM .
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
Otolaryngol Head Neck Surg 2018 Aug;159(2):371-78. doi: 10.1177/0194599818772035..
Keywords: Access to Care, Children/Adolescents, Disparities, Healthcare Delivery, Patient-Centered Healthcare, Quality of Care, Respiratory Conditions, Sleep Problems, Urban Health
Yoon S, Odlum M, Lee Y
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
In this study, the investigators applied deep learning algorithms to build correlate models that predicted tooth mobility in a convenience sample of urban Latinos. The authors suggest that their application was useful for gaining insights into the most important modifiable and non-modifiable factors predicting tooth mobility, and maybe useful for guiding targeted interventions in urban Latinos.
AHRQ-funded; HS019853.
Citation: Yoon S, Odlum M, Lee Y .
Applying deep learning to understand predictors of tooth mobility among urban Latinos.
Stud Health Technol Inform 2018;251:241-44..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health
Yoon S, Choi T, Odlum M
Machine learning to identify behavioral determinants of oral health in inner city older Hispanic adults.
In this study, the investigators applied machine learning techniques to a community-based behavioral dataset to build prediction models to gain insights about minority dental health and population aging as the foundation for future interventions for urban Hispanics. Their application of machine learning techniques identified emotional and systemic factors such as chronic stress and health literacy as the strongest predictors of self-reported dental health among hundreds of possible variables.
AHRQ-funded; HS019853.
Citation: Yoon S, Choi T, Odlum M .
Machine learning to identify behavioral determinants of oral health in inner city older Hispanic adults.
Stud Health Technol Inform 2018;251:253-56..
Keywords: Dental and Oral Health, Elderly, Racial and Ethnic Minorities, Urban Health
Cheng TL, Mistry KB, Wang G
AHRQ Author: Mistry KB
Folate nutrition status in mothers of the Boston birth cohort, sample of a US urban low-income population.
Researchers examined maternal folic acid supplementation and plasma folate concentrations in the Boston Birth Cohort, a predominantly urban, low-income, minority population. Their findings indicated that fewer than 5 percent of mothers in the Boston Birth Cohort started folic acid supplements before pregnancy, and approximately one third of mothers had either too low or too high plasma folate levels.
AHRQ-authored.
Citation: Cheng TL, Mistry KB, Wang G .
Folate nutrition status in mothers of the Boston birth cohort, sample of a US urban low-income population.
Am J Public Health 2018 Jun;108(6):799-807. doi: 10.2105/ajph.2018.304355.
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Keywords: Nutrition, Maternal Care, Low-Income, Urban Health, Rural/Inner-City Residents
Co MC, Bakken S
Influence of the local food environment on hispanics' perceptions of healthy food access in New York City.
This study aimed to characterize the local food environment in New York City's Washington Heights and Inwood community and to examine its influence on Hispanics' perceptions of healthy food access. Among other results, the investigators found that fruit/vegetable markets significantly increased participants' odds of perceiving the availability of a large selection as well as the high quality of fresh fruits and vegetables in their neighborhood.
AHRQ-funded; HS019853; HS022961.
Citation: Co MC, Bakken S .
Influence of the local food environment on hispanics' perceptions of healthy food access in New York City.
Hisp Health Care Int 2018 Jun;16(2):76-84. doi: 10.1177/1540415318788068..
Keywords: Nutrition, Racial and Ethnic Minorities, Urban Health
Ratanawongsa N, Quan J, Handley MA
Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.
In a multilingual urban safety net population, the researchers examined the validity of assessing adherence using automated telephone self-management (ATSM) queries, when compared with non-adherence using continuous medication gap (CMG) on pharmacy claims. They concluded that language-concordant ATSM demonstrated modest potential for assessing adherence.
AHRQ-funded; HS022561; HS023558; HS017261; HS020684.
Citation: Ratanawongsa N, Quan J, Handley MA .
Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.
BMC Health Serv Res 2018 Apr 6;18(1):254. doi: 10.1186/s12913-018-3071-4.
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Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Urban Health
Shelley D, Blechter B, Siman N
Quality of cardiovascular disease care in small urban practices.
This study described small, independent primary care practices' performance in meeting the Million Hearts ABCSs (aspirin use, blood pressure control, cholesterol management, and smoking screening and counseling). It concluded that achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (i.e., 70 percent or greater).
AHRQ-funded; HS023922.
Citation: Shelley D, Blechter B, Siman N .
Quality of cardiovascular disease care in small urban practices.
Ann Fam Med 2018 Apr;16(Suppl 1):S21-s28. doi: 10.1370/afm.2174.
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Keywords: Cardiovascular Conditions, Quality of Care, Primary Care, Quality Improvement, Urban Health
Tung EL, Wroblewski KE, Boyd K
Police-recorded crime and disparities in obesity and blood pressure status in Chicago.
The purpose of this study was to examine associations between several types of police-recorded crime (violent, nonviolent, and homicide) and cardiometabolic health (obesity and elevated blood pressure [BP]), and to determine if associations were modified by age and sex. It concluded that in a densely populated, high-poverty region in Chicago, recurrent exposure to high rates of violent crime was consistently associated with obesity and elevated BP, but rare exposure to homicide was not.
AHRQ-funded; HS023007.
Citation: Tung EL, Wroblewski KE, Boyd K .
Police-recorded crime and disparities in obesity and blood pressure status in Chicago.
J Am Heart Assoc 2018 Mar 24;7(7). doi: 10.1161/jaha.117.008030.
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Keywords: Blood Pressure, Disparities, Risk, Social Determinants of Health, Urban Health
Kay ES, Rice WS, Crockett KB
Experienced HIV-related stigma in health care and community settings: mediated associations with psychosocial and health outcomes.
This study examined the effects of HIV-related stigma in 203 patients at a Southeastern US urban HIV clinic. Psychosocial and health outcomes related to stigma in community and health care settings was investigated. The study showed that stigma was associated with subclinical outcomes such as viral nonsuppression, poor mental health and interpersonal outcomes. Interventions to address stigma in health care settings were recommended to help these patients.
AHRQ-funded; HS013852.
Citation: Kay ES, Rice WS, Crockett KB .
Experienced HIV-related stigma in health care and community settings: mediated associations with psychosocial and health outcomes.
J Acquir Immune Defic Syndr 2018 Mar;77(3):257-63. doi: 10.1097/qai.0000000000001590..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Urban Health
Han B, Cohen DA, Derose KP
Violent crime and park use in low-income urban neighborhoods.
This study aimed to assess the association between crime rates and use of local parks in low-income urban neighborhoods. The study concluded that gun-related violent crimes have relatively long-term negative associations with population health by reducing utilization of outdoor park space.
AHRQ-funded; HS000046.
Citation: Han B, Cohen DA, Derose KP .
Violent crime and park use in low-income urban neighborhoods.
Am J Prev Med 2018 Mar;54(3):352-58. doi: 10.1016/j.amepre.2017.10.025..
Keywords: Low-Income, Urban Health
Rinehart DJ, Oronce C, Durfee MJ
Identifying subgroups of adult superutilizers in an urban safety-net system using latent class analysis: implications for clinical practice.
The objective of the study was to identify clinically distinct subgroups of adult superutilizers. The overall cohort had high rates of multiple chronic medical conditions, mental health and substance use disorders, and homelessness. However, the patterns of these conditions were different between subgroups, providing important information for tailoring interventions.
AHRQ-funded; HS023901.
Citation: Rinehart DJ, Oronce C, Durfee MJ .
Identifying subgroups of adult superutilizers in an urban safety-net system using latent class analysis: implications for clinical practice.
Med Care 2018 Jan;56(1):e1-e9. doi: 10.1097/mlr.0000000000000628.
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Keywords: Healthcare Utilization, Hospitalization, Urban Health, Rural/Inner-City Residents
Williams D, Jr., Holmes M
Rural health care costs: are they higher and why might they differ from urban health care costs?
Do health care costs differ between rural and urban populations, and if so, why might that be? Rural Americans are more vulnerable than their urban counterparts, which could lead one to suspect rural health care costs are higher. However, the answer may differ depending on how costs are measured and who is paying.
AHRQ-funded; HS000032.
Citation: Williams D, Jr., Holmes M .
Rural health care costs: are they higher and why might they differ from urban health care costs?
N C Med J 2018 Jan-Feb;79(1):51-55. doi: 10.18043/ncm.79.1.51.
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Keywords: Healthcare Costs, Rural Health, Urban Health
Beck A, Davidson AJ, Xu S
A multilevel analysis of individual, health system, and neighborhood factors associated with depression within a large metropolitan area.
This study geocoded depression diagnosis and demographic data from electronic health records to obtain both individual and neighborhood factors related to depression. The researchers found higher depression rates associated with greater age, female gender, white race, medical comorbidities, and with lower rates of home owner occupancy, residential stability, and higher educational attainment, but not with economic disadvantage. Among the cohort, higher depression rates were associated with higher crime rates and a lower percent of foreign born residents and single mother households.
AHRQ-funded; HS022143.
Citation: Beck A, Davidson AJ, Xu S .
A multilevel analysis of individual, health system, and neighborhood factors associated with depression within a large metropolitan area.
J Urban Health 2017 Dec;94(6):780-90. doi: 10.1007/s11524-017-0190-x..
Keywords: Depression, Electronic Health Records (EHRs), Social Determinants of Health, Urban Health
Gao TY, Howe CJ, Zullo AR
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. The study’s findings suggested that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians.
AHRQ-funded; HS022998.
Citation: Gao TY, Howe CJ, Zullo AR .
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
Vulnerable Child Youth Stud 2017;12(4):277-91. doi: 10.1080/17450128.2016.1268741..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Lifestyle Changes, Screening, Urban Health
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Hong S, Burnett-Zeigler I
The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study.
This report examined the frequency of a post-traumatic stress disorder (PTSD) diagnosis and subthreshold PTSD among 72 female participants with depressive symptoms in a mindfulness-based intervention for depression at an urban federally qualified health center. The authors reported the high frequency of PTSD diagnosis and subthreshold PTSD among underserved women with depressive symptoms.
AHRQ-funded; HS023011.
Citation: Hong S, Burnett-Zeigler I .
The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study.
J Racial Ethn Health Disparities 2017 Dec;4(6):1069-73. doi: 10.1007/s40615-016-0311-3.
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Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Urban Health, Vulnerable Populations
Masterson Creber R, Chen T, Wei C
Brief report: patient activation among urban hospitalized patients with heart failure.
The purpose of this study was to identify whether patient activation is associated with patient-reported health outcomes in an urban and racially diverse inpatient sample of patients with heart failure. The study concluded that patient activation can be easily measured in hospitalized patients with heart failure and is associated with clinically meaningful patient-reported health outcomes.
AHRQ-funded; HS021816.
Citation: Masterson Creber R, Chen T, Wei C .
Brief report: patient activation among urban hospitalized patients with heart failure.
J Card Fail 2017 Nov;23(11):817-20. doi: 10.1016/j.cardfail.2017.08.452..
Keywords: Heart Disease and Health, Hospitalization, Patient and Family Engagement, Patient Self-Management, Urban Health
Sadasivaiah S, Smith DE, Goldman S
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
A multidisciplinary team designed an EHR-facilitated medication reconciliation program by which pharmacy technicians engaged newly admitted patients and their caregivers at the bedside to develop and electronically document the best possible medication history (BPMH). They found that, by optimizing not only the health information technology platform but also the operational processes, the program achieved a nearly 80 percent generation of BPMH completed by a highly trained pharmacy technician.
AHRQ-funded; HS022561; HS023558.
Citation: Sadasivaiah S, Smith DE, Goldman S .
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
BMJ Open Qual 2017 Oct 21;6(2):e000102. doi: 10.1136/bmjoq-2017-000102.
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Keywords: Electronic Health Records (EHRs), Medication, Patient Safety, Urban Health, Vulnerable Populations
Clarity C, Sarkar U, Lee J
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Missed or delayed follow-up of abnormal subcritical tests (tests that do not require immediate medical attention) can lead to poor patient outcomes. Safety-net health systems with limited resources and socially complex patients are vulnerable to safety gaps resulting from delayed management. In this study, clinician perspectives to identify system challenges, vulnerable situations, and potential solutions, were sought in focus groups.
AHRQ-funded; HS023558.
Citation: Clarity C, Sarkar U, Lee J .
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):517-23. doi: 10.1016/j.jcjq.2017.05.007..
Keywords: Urban Health, Rural/Inner-City Residents, Diagnostic Safety and Quality, Patient Safety, Vulnerable Populations, Ambulatory Care and Surgery, Communication, Provider: Clinician
Squires A, Peng TR, Barrón-Vaya Y
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
In a 2-year period, this study showed that among the 238,513 visits with 18,132 limited English proficiency patients, only 20 percent of visits were language concordant. The study suggests that home health care services may not be meeting the demand for language services, but more research is needed to determine the right “dose” of bilingual home care visits to optimize home care outcomes and establish a standard for care.
AHRQ-funded; HS023593.
Citation: Squires A, Peng TR, Barrón-Vaya Y .
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
Home Health Care Management & Practice 2017 Aug 1;29(3):161-67. doi: 10.1177/1084822317696706.
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Keywords: Cultural Competence, Home Healthcare, Clinician-Patient Communication, Racial and Ethnic Minorities, Urban Health
Sangha RS, Naidech AM, Corado C
Challenges in the medical management of symptomatic intracranial stenosis in an urban setting.
The researchers hypothesized that recurrent stroke risk among patients treated with aggressive medical management (AMM) is similar to that found in the medical arm of the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis). However, results indicated that recurrent stroke risk within 30 days in patients with symptomatic intracranial atherosclerotic disease was higher than that observed in the medical arm of SAMMPRIS even in the subgroup receiving AMM.
AHRQ-funded; HS023437.
Citation: Sangha RS, Naidech AM, Corado C .
Challenges in the medical management of symptomatic intracranial stenosis in an urban setting.
Stroke 2017 Aug;48(8):2158-63. doi: 10.1161/strokeaha.116.016254.
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Keywords: Brain Injury, Urban Health, Stroke, Patient-Centered Outcomes Research, Care Management
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health