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
126 to 149 of 149 Research Studies DisplayedHorner-Johnson W, Moe EL, Stoner RC
Contraceptive knowledge and use among women with intellectual, physical, or sensory disabilities: a systematic review.
The objective of this study was to systematically review published literature on women with disabilities and: 1) contraceptive knowledge; 2) attitudes and preferences regarding contraception; 3) contraceptive use; 4) barriers and facilitators to informed contraceptive use; and 5) effectiveness of interventions to improve informed contraceptive decision-making and use. The investigators concluded that women with disabilities may use a more narrow mix of contraceptive methods and were often less knowledgeable about contraceptives than women without disabilities.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Moe EL, Stoner RC .
Contraceptive knowledge and use among women with intellectual, physical, or sensory disabilities: a systematic review.
Disabil Health J 2019 Apr;12(2):139-54. doi: 10.1016/j.dhjo.2018.11.006..
Keywords: Disabilities, Sexual Health, Women
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Maurer M, Carman KL, Yang M
Increasing the use of comparative quality information in maternity care: results from a randomized controlled trial.
The authors tested an intervention to increase uptake of hospital-level maternity care quality reports among 245 pregnant women in North Carolina. They found that intervention participants were significantly more likely to report adopting behaviors to inform care, such as thinking through preferences, talking with their doctor, or creating a birth plan. They concluded that reports designed to put quality information into the larger context of what consumers want and need to know, along with targeted and timely communications, can increase consumer use of quality information and prompt them to talk with providers about care preferences and evidence-based practices.
AHRQ-funded; HS021873.
Citation: Maurer M, Carman KL, Yang M .
Increasing the use of comparative quality information in maternity care: results from a randomized controlled trial.
Med Care Res Rev 2019 Apr;76(2):208-28. doi: 10.1177/1077558717712290.
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Keywords: Maternal Care, Patient and Family Engagement, Quality Improvement, Women, Pregnancy
Giess CS, Wang A, Ip IK
Patient, radiologist, and examination characteristics affecting screening mammography recall rates in a large academic practice.
This retrospective study examined patient, radiologist and examination characteristics affecting screening mammography recall rates. This study used 61,198 examinations from an academic center and two outpatient centers from October 1, 2012 to May 31, 2015. Radiologists’ risk aversion, stress from uncertainty, and malpractice concerns and cancer detection rates were derived from the survey. Their annual screening volumes, clinical experience, and concentration in breast imaging was calculated. About 9.3% of screening examinations were recalled. There was no association found with radiologists’ risk aversion, stress from uncertainty, malpractice concerns and cancer detection rates and high recall rates. The most variation was found with radiologists’ annual reading volume and experience.
AHRQ-funded; HS24722.
Citation: Giess CS, Wang A, Ip IK .
Patient, radiologist, and examination characteristics affecting screening mammography recall rates in a large academic practice.
J Am Coll Radiol 2019 Apr;16(4 Pt A):411-18. doi: 10.1016/j.jacr.2018.06.016..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Imaging, Prevention, Screening, Women
Muzny CA, Tamhane AR, Eaton EF
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients.
Trichomonas vaginalis infection contributes to HIV transmission. The purpose of this retrospective cohort study was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. The investigators indicated that T. vaginalis reinfection was high among HIV-infected women in the sample, necessitating enhanced disease control efforts in this high-risk population.
AHRQ-funded; HS023009.
Citation: Muzny CA, Tamhane AR, Eaton EF .
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients.
Trichomonas vaginalis infection contributes to HIV transmission. The purpose of this retrospective cohort study was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. The investigators indicated that T. vaginalis reinfection was high among HIV-infected women in the sample, necessitating enhanced disease control efforts in this high-risk population..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Women
Milla C, Guo M, Chang A
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Childbirth is a national priority area for healthcare quality improvement. Patient perspectives are increasingly valued in healthcare, yet Asian American and Pacific Islander (AAPI) perspectives of healthcare quality are often understudied, particularly from individuals with limited English proficiency (LEP). In this study, the goal was to understand factors that consumers in Hawai'i, including AAPI and those with LEP, used to compare patient care in hospitals, especially for childbirth.
AHRQ-funded; HS021903.
Citation: Milla C, Guo M, Chang A .
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Hawaii J Med Public Health 2019 Mar;78(3):89-97..
Keywords: Labor and Delivery, Pregnancy, Hospitals, Quality Improvement, Quality of Care, Cultural Competence, Women
Dinan MA, Wilson LE, Reed SD
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
This study examined whether associations between 21-gene recurrence score (RS) genomic testing and lower costs among patients with early-stage, estrogen receptor-positive breast cancer were observable in real-world data from the Medicare population. The investigators found that RS testing was associated with lower overall and chemotherapy-related costs in patients with high-risk disease, consistent with lower chemotherapy use among these patients. Higher overall costs for patients with intermediate-risk and low-risk disease were driven largely by non-treatment-related costs.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
J Natl Compr Canc Netw 2019 Mar;17(3):245-54. doi: 10.6004/jnccn.2018.7097..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Healthcare Costs, Medicare, Women
Horner-Johnson W, Biel FM, Caughey AB
Differences in prenatal care by presence and type of maternal disability.
This study examined timing and frequency of prenatal care of women with disabilities by disability type. A retrospective cohort study was done of all births in California from 2000-2012. Women with intellectual/developmental disabilities, or limited hearing had the most significant risk of receiving less prenatal care compared to women with physical disabilities. However women with intellectual/developmental or physical disabilities may have a higher than normal number of prenatal visits. Delays in prenatal care may result in poorer birth outcomes.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Biel FM, Caughey AB .
Differences in prenatal care by presence and type of maternal disability.
Am J Prev Med 2019 Mar;56(3):376-82. doi: 10.1016/j.amepre.2018.10.021..
Keywords: Disabilities, Healthcare Utilization, Pregnancy, Vulnerable Populations, Women
fRIEDMAN j, Saavedra-Avendano B, Schiavon R
Quantifying disparities in access to public-sector abortion based on legislative differences within the Mexico City metropolitan area.
This study examined abortion access and use in the Mexico City metropolitan area, where it is only legal in the city center. Researchers calculated abortion rates for 75 municipalities in the metropolitan area for 2011-2012. Abortion rates were much lower for women who had to travel into the city center (18.6%) than if they had local access. Each additional 15 minutes of travel reduced access by 33.7%. Women who did travel were most likely in a higher socioeconomic status with a higher education level.
AHRQ-funded; HS025155; HS022981.
Citation: fRIEDMAN j, Saavedra-Avendano B, Schiavon R .
Quantifying disparities in access to public-sector abortion based on legislative differences within the Mexico City metropolitan area.
Contraception 2019 Mar;99(3):160-64. doi: 10.1016/j.contraception.2018.11.012..
Keywords: Access to Care, Disparities, Policy, Women
Mehra R, Shebi FM, Cunningham SD
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
This research studied the association between area-level deprivation and preterm birth. A retrospective cohort study was conducted using data obtained from the Health Care Cost Institute that uses national, commercial health claims data from 2011. The highest quartile of area-level deprivation experienced the highest number of preterm birth (24.9%) as opposed to the lowest quarter (9.6%). This was true even among commercially-insured women.
AHRQ-funded; HS017589; HS022242.
Citation: Mehra R, Shebi FM, Cunningham SD .
Area-level deprivation and preterm birth: results from a national, commercially-insured population.
BMC Public Health 2019 Feb 27;19(1):236. doi: 10.1186/s12889-019-6533-7..
Keywords: Health Insurance, Newborns/Infants, Pregnancy, Social Determinants of Health, Women
O'Connor E, Senger CA, Henninger ML
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
This evidence review, funded by the U.S. Preventive Services Task Force examined if interventions to prevent perinatal depression was effective. A large number of studies were identified, and 50 were included in the review. There was an absolute difference in the risk of perinatal depression from 1.3% reduction in the control group to 31.8% greater reduction in the intervention group. Most of the studies were limited to women at increased risk for perinatal depression. Counseling interventions seemed to be the most effective.
AHRQ-funded; 290201500017I.
Citation: O'Connor E, Senger CA, Henninger ML .
Interventions to prevent perinatal depression: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Feb 12;321(6):588-601. doi: 10.1001/jama.2018.20865.
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Keywords: Depression, Evidence-Based Practice, Pregnancy, U.S. Preventive Services Task Force (USPSTF), Women, Behavioral Health, Maternal Care
Herrick CJ, Keller MR, Trolard AM
Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010-2015.
This study looked at postpartum screening for type 2 diabetes among low-income women who were previously diagnosed with gestational diabetes. Gestational diabetes increases risk for developing type 2 diabetes 7-fold so it is recommended that screening is done within months after delivery. Results in a Missouri population found that almost 20% were screened within the first year of delivery.
AHRQ-funded; HS019455.
Citation: Herrick CJ, Keller MR, Trolard AM .
Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010-2015.
BMC Public Health 2019 Feb 4;19(1):148. doi: 10.1186/s12889-019-6475-0..
Keywords: Diabetes, Low-Income, Pregnancy, Screening, Women
Gadgil MD, Ehrlich SF, Zhu Y
Dietary quality and glycemic control among women with gestational diabetes mellitus.
Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with GDM. The authors concluded that clinicians should be aware that even a small improvement in diet quality may be beneficial for the achievement of improved glycemic control in women with GDM.
AHRQ-funded; HS019367.
Citation: Gadgil MD, Ehrlich SF, Zhu Y .
Dietary quality and glycemic control among women with gestational diabetes mellitus.
J Womens Health 2019 Feb;28(2):178-84. doi: 10.1089/jwh.2017.6788..
Keywords: Pregnancy, Diabetes, Nutrition, Women, Risk, Prevention
Gourevitch RA, Mehrotra A, Galvin G
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
This study examined whether pregnant women who use cesarean delivery rate data from hospitals influences their choice of obstetric hospital. A randomized controlled trial of 18,293 users of the Ovia Health mobile app from 2016-2017 was conducted. Enrollees were given an explanation of the cesarean rate data and were randomized to an intervention group who also were given an interactive tool to display data for the 10 closest hospitals with obstetric services. There was no significant difference between the intervention and control groups in their hospital selection.
AHRQ-funded; HS000055.
Citation: Gourevitch RA, Mehrotra A, Galvin G .
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
Am J Manag Care 2019 Feb;25(2):e33-e38..
Keywords: Pregnancy, Women, Hospitals, Maternal Care, Labor and Delivery
Mehra R, Cunningham SD, Lewis JB
Recommendations for the pilot expansion of Medicaid coverage for doulas in New York state.
AHRQ-funded; HS017589.
Citation: Mehra R, Cunningham SD, Lewis JB .
Recommendations for the pilot expansion of Medicaid coverage for doulas in New York state.
Am J Public Health 2019 Feb;109(2):217-19. doi: 10.2105/ajph.2018.304797..
Keywords: Medicaid, Pregnancy, Maternal Care, Health Insurance, Healthcare Costs, Prevention, Women, Disparities
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
Payan DD, Derose KP, Fulcar MA
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. In this study, the investigators conducted in-depth interviews with 30 women living with HIV in the Dominican Republic to explore the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings.
AHRQ-funded; HS000046.
Citation: Payan DD, Derose KP, Fulcar MA .
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18. doi: 10.1177/2325958219849042..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Women, Social Stigma, Depression, Behavioral Health
Turan B, Crockett KB, Kempf MC
Internal working models of attachment relationships and hiv outcomes among women living with HIV.
Treatment adherence and viral suppression remain suboptimal in the United States. Attachment insecurity may be one understudied factor affecting adherence. In this study, the investigators examined cross-sectional associations of the 2 attachment-related insecurity dimensions with antiretroviral treatment (ART) adherence, HIV visit adherence, CD4 cell counts, and viral suppression. The authors suggest that interventions may need to focus on the vulnerable subpopulation with high attachment insecurity and incorporate existing strategies that address insecure attachment models.
AHRQ-funded; HS013852.
Citation: Turan B, Crockett KB, Kempf MC .
Internal working models of attachment relationships and hiv outcomes among women living with HIV.
J Acquir Immune Defic Syndr 2019 Jan;80(1):e1-e8. doi: 10.1097/qai.0000000000001872..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Women, Medication
Thomas HN, Hamm M, Borrero S
Thomas HN, Hamm M, Borrero S, Hess R, Thurston RC. Body image, attractiveness, and sexual satisfaction among midlife women: a qualitative study.
Women often undergo physical changes during the menopause transition, but the relationship between body image and sexual function in midlife is unclear. In this study, the investigators used a qualitative approach to explore how body image relates to sexual function and satisfaction in midlife women. The investigators concluded that supporting positive body image may help midlife women maintain sexual satisfaction with aging.
AHRQ-funded; HS022989.
Citation: Thomas HN, Hamm M, Borrero S .
Thomas HN, Hamm M, Borrero S, Hess R, Thurston RC. Body image, attractiveness, and sexual satisfaction among midlife women: a qualitative study.
J Womens Health 2019 Jan;28(1):100-06. doi: 10.1089/jwh.2018.7107..
Keywords: Women, Sexual Health
Phillippi JC, Holley SL, Thompson JL
A planning checklist for interprofessional consultations for women in midwifery care.
This article describes a planning checklist tool designed by using feedback from women, nurses, midwives, and physicians, to improve communication within one health system and to develop a community-engaged approach for the care of women who began care with midwives but developed risks for poor perinatal outcomes. In feasibility testing, the checklist provided a prompt to generate a comprehensive plan for maternity care and to elucidate the rationale for interventions to women and future health care providers. In post-implementation interviews, women said they were pleased with the information they received, and nurses, midwives, and physicians were positive about improved communication. The article details the creation, implementation, and qualitative evaluation of the planning checklist.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Holley SL, Thompson JL .
A planning checklist for interprofessional consultations for women in midwifery care.
J Midwifery Womens Health 2019 Jan;64(1):98-103. doi: 10.1111/jmwh.12900..
Keywords: Care Coordination, Care Management, Communication, Maternal Care, Pregnancy, Women
Shorten A, Shorten B, Fagerlin A
A study to assess the feasibility of implementing a web-based decision aid for birth after cesarean to increase opportunities for shared decision making in ethnically diverse settings.
This article describes a study that tested the feasibility and acceptability of implementing a Health Insurance Portability and Accountability Act-secure, Web-based decision aid tool that supports shared decisionmaking with regard to birth choices after cesarean in urban, ethnically diverse outpatient settings. Sixty-eight women participated in the study; the measures included the women's knowledge, decisional conflict, birth preferences and outcomes, decision aid use and acceptability ratings, and views on how the decision aid supported shared decisionmaking. The women rated the content, features, and functions as good or excellent. Most indicated they would recommend it to others. The researchers conclude that while the decision aid is feasible, strategies are needed to improve women's access and to encourage timely decision aid usage to prepare them for decision discussions with health care providers.
AHRQ-funded; HS022114.
Citation: Shorten A, Shorten B, Fagerlin A .
A study to assess the feasibility of implementing a web-based decision aid for birth after cesarean to increase opportunities for shared decision making in ethnically diverse settings.
J Midwifery Womens Health 2019 Jan;64(1):78-87. doi: 10.1111/jmwh.12908..
Keywords: Decision Making, Education: Patient and Caregiver, Health Information Technology (HIT), Pregnancy, Racial and Ethnic Minorities, Web-Based, Women
Matsen CB, Lyons S, Goodman MS
Decision role preferences for return of results from genome sequencing amongst young breast cancer patients.
The purpose of this study was to better understand decision role preferences in women diagnosed with breast cancer at a young age for return of results of genome sequencing in research and clinical settings. The investigators found that most women in their study preferred to share in decision making and that participants had somewhat different role preferences for clinical and research contexts, with greater preference for active roles in the research context.
AHRQ-funded; HS024784.
Citation: Matsen CB, Lyons S, Goodman MS .
Decision role preferences for return of results from genome sequencing amongst young breast cancer patients.
Patient Educ Couns 2019 Jan;102(1):155-61. doi: 10.1016/j.pec.2018.08.004..
Keywords: Cancer, Cancer: Breast Cancer, Decision Making, Genetics, Women
Xu X, Lee HC, Lin H
Hospital variation in utilization and success of trial of labor after a prior cesarean.
The purpose of this study was to examine hospital variation in utilization and success of trial of labor after cesarean delivery (TOLAC) and to identify associated institutional characteristics and patient outcomes. The investigators found that utilization and success rates of TOLAC varied considerably across hospitals. Strategies to promote vaginal birth should be tailored to hospital needs and characteristics (e.g., increase availability at low TOLAC rate hospitals while being more selective at high TOLAC rate hospitals, and targeted support for lower capacity hospitals).
AHRQ-funded; HS023801.
Citation: Xu X, Lee HC, Lin H .
Hospital variation in utilization and success of trial of labor after a prior cesarean.
Am J Obstet Gynecol 2019 Jan;220(1):98.e1-98.e14. doi: 10.1016/j.ajog.2018.09.034.
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Keywords: Labor and Delivery, Pregnancy, Women
Clowse MEB, Eudy AM, Revels J
Provider perceptions on the management of lupus during pregnancy: barriers to improved care.
This paper discusses a focus group that was created of women with lupus who either were pregnant or were planning to get pregnant. Outcomes in women with lupus is bad for more than half of pregnancies for the mother or the fetus. The focus group’s objective was to discuss issues about pregnancy planning and management. Problems include ill-timed pregnancies, and medication non-adherence. Communication gaps between the rheumatologist and the obstetrician/gynecologist can result in confusion for the patient with optimal treatment plans.
AHRQ-funded; HS023443.
Citation: Clowse MEB, Eudy AM, Revels J .
Provider perceptions on the management of lupus during pregnancy: barriers to improved care.
Lupus 2019 Jan;28(1):86-93. doi: 10.1177/0961203318815594..
Keywords: Care Management, Chronic Conditions, Maternal Care, Pregnancy, Provider, Women