National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 73 Research Studies DisplayedDanilack VA, Brousseau EC, Phipps MG
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
Weight retention after pregnancy is a concern for adolescents who may be entering adulthood at unhealthy weights. In this article, the investigators studied associations between each of three measures: pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and post-pregnancy BMI in a longitudinal follow-up of an adolescent pregnancy study cohort. They concluded that teens experienced an increase in BMI from pre-pregnancy to within 4 years after their first delivery, and this increase was related to GWG.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Phipps MG .
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
J Womens Health 2018 Dec;27(12):1456-58. doi: 10.1089/jwh.2017.6635..
Keywords: Children/Adolescents, Pregnancy, Obesity: Weight Management, Obesity, Women
Kelsall AC, Cassidy R, Ghaferi AA
Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector.
The authors described hospital-level variation in roux-en-Y gastric bypass and sleeve gastrectomy in Michigan. Their findings suggested that there are previously underappreciated differences in episode payment variation between bariatric surgery procedures. The authors also suggested that sleeve gastrectomy may be more amenable to cost containment under bundled payment initiatives by virtue of the greater share of variation explained by readmission and post-discharge payments.
AHRQ-funded; HS023621; HS024403.
Citation: Kelsall AC, Cassidy R, Ghaferi AA .
Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector.
Ann Surg 2018 Dec;268(6):1014-18. doi: 10.1097/sla.0000000000002462..
Keywords: Surgery, Obesity: Weight Management, Obesity, Payment, Health Insurance, Healthcare Costs
Fink JT, Magnan EM, Johnson HM
Blood pressure control and other quality of care metrics for patients with obesity and diabetes: a population-based cohort study.
In this observational population-based cohort study, the investigators sought to examine the relationship between the extent of obesity and the achievement of guideline-recommended blood pressure goals and other quality of care metrics among patients with diabetes. The investigators suggest that although the cardiovascular risk for patients with obesity and diabetes is greater than for non-obese patients with diabetes, they found that patients with obesity are even further behind in achieving blood pressure control.
AHRQ-funded; HS021899.
Citation: Fink JT, Magnan EM, Johnson HM .
Blood pressure control and other quality of care metrics for patients with obesity and diabetes: a population-based cohort study.
High Blood Press Cardiovasc Prev 2018 Dec;25(4):391-99. doi: 10.1007/s40292-018-0284-x..
Keywords: Blood Pressure, Diabetes, Quality of Care, Obesity
Oates 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
Felix HC, Bradway C, Bird TM
Safety of obese persons in nursing homes.
This paper discusses the emergence of obese persons as a vulnerable group in the nursing home community. The authors discuss the special needs of this population including that obese residents require special protocols, trained staff, and appropriately sized equipment to prevent and treat skin breakdown.
AHRQ-funded; HS025703.
Citation: Felix HC, Bradway C, Bird TM .
Safety of obese persons in nursing homes.
Med Care 2018 Dec;56(12):1032-34. doi: 10.1097/mlr.0000000000000997..
Keywords: Long-Term Care, Obesity, Nursing Homes, Patient Safety, Skin Conditions
Grout RW, Thompson-Fleming R, Carroll AE
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
The objective of this study was to determine the rate of positive pain screenings in pediatric primary care and evaluate the relationship between reported pain and obesity, demographics, and exam findings during routine pediatric encounters. The investigators concluded that pain is common in general pediatric encounters, and occurs more frequently in obese children and those who previously reported pain. Pain reporting may be influenced by seasonal variation and clinic factors.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Grout RW, Thompson-Fleming R, Carroll AE .
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
BMC Pediatr 2018 Nov 21;18(1):363. doi: 10.1186/s12887-018-1335-0..
Keywords: Children/Adolescents, Obesity, Pain, Children/Adolescents, Primary Care
Fiechtner L, Fonte ML, Castro I
Determinants of binge eating symptoms in children with overweight/obesity.
In this study, the investigators examined the prevalence and multilevel determinants of three binge eating symptoms: (1) sneaking, hiding, or hoarding food; (2) eating in the absence of hunger, and (3) inhibition or embarrassment when eating in front of others among 817 children aged 5-12 years old with overweight/obesity receiving primary care in eastern Massachusetts. They examined the associations of child and parent/household characteristics with the prevalence ratios (PRs) of these three binge eating symptoms.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Fonte ML, Castro I .
Determinants of binge eating symptoms in children with overweight/obesity.
Child Obes 2018 Nov/Dec;14(8):510-17. doi: 10.1089/chi.2017.0311..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Nutrition, Family Health and History, Patient-Centered Healthcare
Luthe SK, Hirayama A, Goto T
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
This study examined the association between obesity and exacerbation of asthma symptoms in hospitalized adults (age 18-54 years). This retrospective cohort study used data from 8 diverse US states from 2010-2013. Among 72,086 patients hospitalized for asthma exacerbation, 24% were considered obese. Obesity was associated with a higher use of mechanical ventilation as well as a longer hospital stay. These findings were consistent among all ages, sex, and race/ethnicity.
AHRQ-funded; HS023305.
Citation: Luthe SK, Hirayama A, Goto T .
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):1936-41.e4. doi: 10.1016/j.jaip.2018.02.001..
Keywords: Asthma, Hospitalization, Obesity, Respiratory Conditions
Kumar V, Encinosa W, Thakur K
AHRQ Author: Encinosa W
Just living with obese family members increases your risk of type 2 diabetes.
Although diabetes has been associated with the incidence of obesity, many diabetes patients are not obese. In this paper the authors discuss how just living in a household with one or more obese biologically related family members is a major risk factor for diabetes, even after accounting for all the other traditional risk factors.
AHRQ-authored.
Citation: Kumar V, Encinosa W, Thakur K .
Just living with obese family members increases your risk of type 2 diabetes.
Clin Diabetes 2018 Oct;36(4):305-11. doi: 10.2337/cd17-0091..
Keywords: Diabetes, Obesity, Risk
Sterling MR, Silva AF, Robbins L
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
This qualitative study examined the role of numeracy (basic number skills) in the management of patients with heart failure (HF). Thirty men and women aged 47-89 years with a history of HF were recruited from an urban academic primary care practice. Participants all had a history of HF within the past year, were seen at the practice within the last year, and had been hospitalized for HF within the last 6 months. They were interviewed about their numeracy to help manage monitoring weight, maintaining a low-salt diet, and monitoring blood pressure. A wide range of knowledge and understanding was found and fear served as a barrier and facilitator to carrying out HF self-care tasks involving numbers. If the patient has a caregiver who also lacks those skills or does not have HF care training, patients may not be managing their HF as well as they should.
AHRQ-funded; HS000066.
Citation: Sterling MR, Silva AF, Robbins L .
Let's talk numbers: a qualitative study of community-dwelling US adults to understand the role of numeracy in the management of heart failure.
BMJ Open 2018 Sep 19;8(9):e023073. doi: 10.1136/bmjopen-2018-023073..
Keywords: Patient Self-Management, Education: Patient and Caregiver, Care Management, Heart Disease and Health, Nutrition, Lifestyle Changes, Obesity: Weight Management, Obesity, Blood Pressure, Cardiovascular Conditions
Kline CE, Burke LE, Sereika SM
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
This study examined the relationship between weight change and obstructive sleep apnea (OSA) in the context of behavioral weight loss intervention. A total of 114 adults who were overweight or obese participated in a 12-month behavioral weight loss intervention program from April 2012 to February 2015. Over half (58%) had OSA at the baseline. Those with OSA were found to lose less weight and were less adherent to daily calorie and activity goals. The results suggest that OSA screening should be used before attempting weight loss and also may indicate additional behavioral counseling.
AHRQ-funded; HS022989.
Citation: Kline CE, Burke LE, Sereika SM .
Bidirectional relationships between weight change and sleep apnea in a behavioral weight loss intervention.
Mayo Clin Proc 2018 Sep;93(9):1290-98. doi: 10.1016/j.mayocp.2018.04.026..
Keywords: Sleep Problems, Obesity: Weight Management, Obesity, Lifestyle Changes, Respiratory Conditions
Pellegrini CA, Chang RW, Dunlop DD
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
This article reports the results of a randomized pilot study that assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement. The feasibility of recruiting and retaining participants over 26 weeks was also examined. Recruitment outreach was extended to patients scheduled for knee replacement. Sixteen participants were randomly assigned to a 14-session weight loss program that started either at least 6 weeks before surgery or at 12 weeks following surgery. The authors conclude that behavioral intervention is challenging but feasible in a knee replacement population. Preliminary evidence suggests that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks when compared to a program that begins before knee replacement.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Chang RW, Dunlop DD .
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
Obes Res Clin Pract 2018 Sep - Oct;12(5):472-78. doi: 10.1016/j.orcp.2018.06.009..
Keywords: Orthopedics, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Obesity: Weight Management, Surgery, Obesity, Outcomes
Wahl TS, Patel FC, Goss LE
The obese colorectal surgery patient: surgical site infection and outcomes.
The purpose of this study was to understand the association between BMI and 30-day postoperative outcomes, including surgical site infection, among patients undergoing colorectal surgery. The study found that patients with increasing BMI showed an incremental and independent risk for adverse 30-day postoperative outcomes, especially surgical site infections.
AHRQ-funded; HS013852
Citation: Wahl TS, Patel FC, Goss LE .
The obese colorectal surgery patient: surgical site infection and outcomes.
Dis Colon Rectum 2018 Aug;61(8):938-45. doi: 10.1097/dcr.0000000000001085..
Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Obesity, Patient-Centered Outcomes Research, Surgery
Pellegrini CA, Ledford G, Chang RW
Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.
The researchers sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty. They found that identifying specific eating and activity barriers and facilitators provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Ledford G, Chang RW .
Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.
Disabil Rehabil 2018 Aug;40(17):2004-10. doi: 10.1080/09638288.2017.1323026.
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Keywords: Nutrition, Obesity, Orthopedics, Surgery
Hanna RM, Fischer G, Conroy MB
Online lifestyle modification intervention: survey of primary care providers' attitudes and views.
The aim of this study was to evaluate the response of primary care providers (PCPs) to a referral model for implementing a year-long online intervention for weight loss to obese adult patients. The investigators suggest that understanding providers' views and barriers regarding the integration of online tools will facilitate widespread implementation of an online lifestyle modification intervention.
AHRQ-funded; HS018155.
Citation: Hanna RM, Fischer G, Conroy MB .
Online lifestyle modification intervention: survey of primary care providers' attitudes and views.
J Med Internet Res 2018 Jun 8;20(6):e167. doi: 10.2196/jmir.8616..
Keywords: Health Information Technology (HIT), Lifestyle Changes, Obesity, Primary Care, Provider
Bennett WL, Wilson RF, Zhang A
Methods for evaluating natural experiments in obesity: a systematic review.
The researchers identified studies that report effects of programs, policies, or built environment changes on obesity prevention and control and described their methods. They found many methodologically diverse natural experiments and experimental studies that reported effects of U.S. and non-U.S. programs, policies, or built environment changes on obesity prevention and control, reinforcing the need for methodological and analytic advances to strengthen evaluations of obesity prevention and control initiatives.
AHRQ-funded; 290201200007I.
Citation: Bennett WL, Wilson RF, Zhang A .
Methods for evaluating natural experiments in obesity: a systematic review.
Ann Intern Med 2018 Jun 5;168(11):791-800. doi: 10.7326/m18-0309.
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Keywords: Obesity, Patient-Centered Outcomes Research, Prevention, Research Methodologies
Gorski Findling MT, Wolfson JA, Rimm EB
Differences in the neighborhood retail food environment and obesity among US children and adolescents by SNAP participation.
The authors sought to understand the association between children's neighborhood food access and overweight/obesity in a national sample of US households, and whether this association differs by Supplemental Nutrition Assistance Program (SNAP) participation or household purchases. Using data from the National Household Food Acquisition and Purchase Survey, 2012-2013, they found that the odds of childhood overweight/obesity were higher with greater access to combination grocery/other stores overall and for children in SNAP. Eligible non-SNAP children had higher odds of overweight/obesity with greater access to convenience stores. The average child lived in a household with 6.3% of total spending at food outlets on sugary beverages. They concluded that greater neighborhood access to combination grocery/other stores is associated with higher obesity prevalence for children overall and those in SNAP.
AHRQ-funded; HS000055.
Citation: Gorski Findling MT, Wolfson JA, Rimm EB .
Differences in the neighborhood retail food environment and obesity among US children and adolescents by SNAP participation.
Obesity 2018 Jun;26(6):1063-71. doi: 10.1002/oby.22184.
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Keywords: Children/Adolescents, Low-Income, Nutrition, Obesity, Social Determinants of Health
Sorkin DH, Rook KS, Campos B
AHRQ Author: Ngo-Metzger Q
Rationale and study protocol for Unidas por la Vida (United for Life): a dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters.
The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. Both the dyadic and individual lifestyle interventions are expected to produce greater weight loss at 6, 12, and 18 months than those in minimal intervention control group.
AHRQ-authored.
Citation: Sorkin DH, Rook KS, Campos B .
Rationale and study protocol for Unidas por la Vida (United for Life): a dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters.
Contemp Clin Trials 2018 Jun;69:10-20. doi: 10.1016/j.cct.2018.03.013.
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Keywords: Diabetes, Lifestyle Changes, Obesity, Racial and Ethnic Minorities, Obesity: Weight Management
Wong MS, Chan KS, Jones-Smith JC
The neighborhood environment and obesity: understanding variation by race/ethnicity.
The researchers examined the relationship between soda consumption and weight status with neighborhood sociodemographic, social, and built environments by race/ethnicity. Merging data on adults from the 2011-2013 California Health Interview Survey, U.S. Census data, and InfoUSA, they found that lower neighborhood educational attainment was associated with higher odds of obesity and soda consumption in all racial/ethnic groups. They found fewer associations between study outcomes and the neighborhood, especially the built environment, among non-Hispanic African Americans and non-Hispanic Asians. They concluded that, while improvements to neighborhood environment may be promising to reduce obesity, null associations among minority subgroups suggest that changes, particularly to the built environment, may alone be insufficient to address obesity in these groups.
AHRQ-funded; HS000029.
Citation: Wong MS, Chan KS, Jones-Smith JC .
The neighborhood environment and obesity: understanding variation by race/ethnicity.
Prev Med 2018 Jun;111:371-77. doi: 10.1016/j.ypmed.2017.11.029.
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Keywords: Disparities, Obesity, Racial and Ethnic Minorities, Social Determinants of Health
Stevens H, Carlin AM, Ross R
Effect of surgeon age on bariatric surgery outcomes.
This study examined the effect of surgeon age on complication rates for bariatric surgery. A retrospective study was done with 71 surgeons in Michigan who participated in a statewide collaborative improvement program. Older surgeons performed more Roux-en Y Gastric Bypass (40%) and less sleeve gastrectomy (38.8%) than younger surgeons. There was not found to be any statistically significant differences in patient outcome between the two age groups.
AHRQ-funded; HS024403.
Citation: Stevens H, Carlin AM, Ross R .
Effect of surgeon age on bariatric surgery outcomes.
Ann Surg 2018 May;267(5):905-09. doi: 10.1097/sla.0000000000002297..
Keywords: Adverse Events, Obesity, Outcomes, Patient Safety, Provider, Provider: Physician, Provider Performance
Fiechtner L, Perkins M, Biggs V
Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Recent studies have demonstrated the effectiveness of family-centered, pediatric weight management programs in reducing childhood obesity. Yet, programs to optimize the care of low-income children with obesity are needed. The investigators sought to examine the comparative effectiveness of two, potentially scalable pediatric weight management programs delivered to low-income children in a clinical or community setting.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Perkins M, Biggs V .
Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Contemp Clin Trials 2018 Apr;67:16-22. doi: 10.1016/j.cct.2018.01.002..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Low-Income, Vulnerable Populations, Nutrition, Patient-Centered Healthcare, Family Health and History, Evidence-Based Practice, Comparative Effectiveness
Foster BA, Fu E, Bendiks N
Capacity-oriented approaches to developing childhood obesity interventions: a systematic review.
Capacity-oriented approaches to health interventions seek to empower the target population or community to manage the health issue themselves using resources they can control. Positive deviance, resilience and asset-based approaches are three such methods of developing and implementing health interventions. This study aimed to review the efficacy of interventions explicitly applying these methods in addressing childhood obesity using adiposity as the primary outcome, measured by standardized body mass index.
AHRQ-funded; HS024332.
Citation: Foster BA, Fu E, Bendiks N .
Capacity-oriented approaches to developing childhood obesity interventions: a systematic review.
Clin Obes 2018 Apr;8(2):95-104. doi: 10.1111/cob.12234..
Keywords: Children/Adolescents, Obesity, Patient-Centered Outcomes Research
Chang SH, Freeman NLB, Lee JA
Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis.
This systematic review and meta-analysis assesses <30-d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. The review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre-surgery body mass index of 46.5 kg m(-2).
AHRQ-funded; HS022330.
Citation: Chang SH, Freeman NLB, Lee JA .
Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis.
Obes Rev 2018 Apr;19(4):529-37. doi: 10.1111/obr.12647..
Keywords: Adverse Events, Evidence-Based Practice, Obesity, Patient Safety, Surgery
Knierim SD, Newcomer S, Castillo A
Latino parents' perceptions of pediatric weight counseling terms.
This study analyzed what would the least offensive terms to use with Latino parents when clinicians talk to them about their childrens’ weight, particularly for counseling obese youth. Latino parents across demographic groups were surveyed in English or Spanish and rated the most and least offensive terms to describe excess weight using a 5-point scale. The least offensive term was “demasiado peso para su salud”, or “too much weight for his/her health” in English. The most offensive was “gordo” or “muy gordo” meaning chubby or fat. Terminology makes a difference in how the parents will respond to weight counseling and follow-up.
AHRQ-funded; HS022143.
Citation: Knierim SD, Newcomer S, Castillo A .
Latino parents' perceptions of pediatric weight counseling terms.
Acad Pediatr 2018 Apr;18(3):342-53. doi: 10.1016/j.acap.2017.09.006..
Keywords: Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management, Racial and Ethnic Minorities
Abdel Khalik H, Stevens H, Carlin AM
Site-specific approach to reducing emergency department visits following surgery.
The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. The investigators concluded that current practices aimed at reducing ED visits appeared to be ineffective. They suggested that due to heterogeneity in patient populations and local infrastructure, a more tailored approach to ED visit reduction may be more successful.
AHRQ-funded; HS023621; HS024403.
Citation: Abdel Khalik H, Stevens H, Carlin AM .
Site-specific approach to reducing emergency department visits following surgery.
Ann Surg 2018 Apr;267(4):721-26. doi: 10.1097/sla.0000000000002226.
Keywords: Adverse Events, Emergency Department, Healthcare Utilization, Obesity, Surgery