National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (2)
- Cancer (1)
- Care Coordination (1)
- Caregiving (1)
- (-) Children/Adolescents (15)
- Chronic Conditions (4)
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- Medication: Safety (1)
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- Patient-Centered Healthcare (2)
- Patient Adherence/Compliance (1)
- Prevention (1)
- Primary Care (1)
- Provider (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Rural/Inner-City Residents (1)
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- Sickle Cell Disease (3)
- (-) Telehealth (15)
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- Vulnerable Populations (2)
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 15 of 15 Research Studies DisplayedJolliff A, Coller RJ, Kearney H
An mHealth design to promote medication safety in children with medical complexity.
This study describes an effort to design a health information technology tool to improve medication safety for children with medical complexity (CMC). The study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a co-design process to identify: 1) medication safety challenges experienced by CMC caregivers and, 2) design requirements for a mobile health application to improve medication safety for CMC in the home. Family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program participated in virtual co-design sessions. During these sessions, the facilitator guided 16 co-designers in generating and converging upon medication safety challenges and design requirements. These sessions were recorded and reviewed after conclusion to confirm that all designer comments had been captured. An analysis yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines.
AHRQ-funded; HS028409.
Citation: Jolliff A, Coller RJ, Kearney H .
An mHealth design to promote medication safety in children with medical complexity.
Appl Clin Inform 2024 Jan; 15(1):45-54. doi: 10.1055/a-2214-8000..
Keywords: Children/Adolescents, Medication: Safety, Medication, Health Information Technology (HIT), Chronic Conditions, Telehealth, Caregiving
Jones SA, Van Driest S, Sommer EC
Direct-to-patient telehealth equity: Reaching diverse pediatric populations in primary care.
This study’s goal was to assess disparities in direct-to-patient (DTP) telehealth experience for pediatric patients. The authors examined DTP telehealth for low-income pediatric patient-families and compared the experience of English and non-English speakers. Providers completed an electronic survey with patient feedback about the telehealth experience and their own providers for visits from April 2020 to May 2020 at a pediatric primary care clinic (80% Medicaid-insured, 40% non-English-speaking). The majority of telehealth visits were in English and English speakers had a positive experience overall. Non-English speakers had more barriers, although most telehealth visits were rated as satisfactory.
AHRQ-funded; HS026122.
Citation: Jones SA, Van Driest S, Sommer EC .
Direct-to-patient telehealth equity: Reaching diverse pediatric populations in primary care.
Fam Syst Health 2023 Mar;41(1):61-67. doi: 10.1037/fsh0000685.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Disparities
Reeves SL, Patel PN, Madden B
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
This study’s goal was to determine telehealth use before and during the COVID pandemic for children ages 1-17 years old with sickle cell anemia (SCA). The authors identified children with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The study population consisted of 493 children with SCA with a mean age of 8.7 years at study entry. Pre-pandemic there were 4,367 outpatient visits, with all but 19 in-person. Telehealth visits peaked in April 2020 and then began declining. The majority of telehealth visits were with hematologists, followed up adult subspecialists (27%) and pediatrics/family medicine.
AHRQ-funded; HS027632.
Citation: Reeves SL, Patel PN, Madden B .
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
Telemed J E Health 2022 Aug;28(8):1166-71. doi: 10.1089/tmj.2021.0132..
Keywords: Children/Adolescents, COVID-19, Telehealth, Health Information Technology (HIT), Sickle Cell Disease, Chronic Conditions, Access to Care
Ray KN, Bohnhoff JC, Schweiberger K
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
The authors performed a survey of general pediatricians and pediatric subspecialists about the use of telemedicine for patients newly referred for pediatric subspecialty care. They found that 76% of respondents thought telemedicine should be offered for some and 11% thought telemedicine should be offered for all initial subspecialist visits. Factors perceived to reduce the appropriateness of telemedicine for subspecialty consultation included the need for interpreter services and a prior history of frequent no-shows. They further found that responses from generalists and subspecialists rarely differed significantly.
AHRQ-funded; HS026393.
Citation: Ray KN, Bohnhoff JC, Schweiberger K .
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
Healthc 2022 Mar;10(1):100600. doi: 10.1016/j.hjdsi.2021.100600..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Provider: Physician, Ambulatory Care and Surgery
Davidson L, Haynes SC, Favila-Meza A
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
This study investigated patient and therapist experience and cost savings from the payer perspective associated with a novel tele-physiatry program for children living in rural and underserved communities. Study setting was four school-based clinics in Northern California with a total of 268 encounters (124 telemedicine and 144 in-person). Parent and therapists reported no difference in experience and perceived quality of care between telemedicine and in-person encounters. For parents whose children received a telemedicine encounter, 54.8% reported no preference for their child’s subsequent encounter, 28.8% preferred a physiatrist telemedicine visit, and 12 preferred a physiatrist in-person visit. There was also an average cost savings of $100 per clinic owing to physician milage for in-person visits.
AHRQ-funded; HS025714.
Citation: Davidson L, Haynes SC, Favila-Meza A .
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
Arch Phys Med Rehabil 2022 Jan;103(1):8-13. doi: 10.1016/j.apmr.2021.07.807..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Healthcare Costs, Rural Health, Vulnerable Populations, Disabilities, Rural/Inner-City Residents
Cibrian FL, Monteiro E, Ankrah E
Parents' perspectives on a smartwatch intervention for children with ADHD: rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19.
This paper explores how smartwatch technology, including timing notifications, can support children with ADHD during distance learning due to COVID-19. The researchers used a Digital Health Intervention which included a smartwatch and a smartphone. Their results demonstrated that children successfully adopted the use of the smartwatch, and parents believed that the intervention was helpful, especially in supporting the development of organizational skills in their children. The authors included suggestions to help professionals teach children with ADHD to use smartwatches to improve organization and task completion, especially as it applies to supporting remote instruction.
AHRQ-funded; HS026058.
Citation: Cibrian FL, Monteiro E, Ankrah E .
Parents' perspectives on a smartwatch intervention for children with ADHD: rapid deployment and feasibility evaluation of a pilot intervention to support distance learning during COVID-19.
PLoS One 2021 Oct 27;16(10):e0258959. doi: 10.1371/journal.pone.0258959..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance
Jacob SA, Carroll AE, Bennett WE
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
The purpose of this cross-sectional, observational study was to determine the feasibility of using telemedicine for the provision of subspecialty pediatric (0-21 years old) Sickle Cell Disease care in a rural medically underserved area. METHODS: This was a cross-sectional, observational, feasibility study. The study found that 10 SCD patients initiated telemedicine visits during the study period. Approximately 60% of the eligible participants did not attend more than 50% of scheduled visits prior to beginning telemedicine visits or were lost to follow-up. After initiation of telemedicine, all Hb SS patients were started and/or maintained on hydroxyurea. Nine out of 10 patients who participated during this timeframe had a 100% follow-up rate. All the participants rated the comfort and ease of using the telehealth system as good or excellent, and all participants would take part in a telemedicine visit again.
AHRQ-funded; HS026390.
Citation: Jacob SA, Carroll AE, Bennett WE .
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
J Telemed Telecare 2021 Aug;27(7):431-35. doi: 10.1177/1357633x19883558..
Keywords: Children/Adolescents, Telehealth, Sickle Cell Disease, Rural Health, Chronic Conditions, Vulnerable Populations, Health Information Technology (HIT)
Huth K, Amar-Dolan L, Perez JM
Visiting Jack: mixed methods evaluation of a virtual home visit curriculum with a child with medical complexity.
This study’s objective was to evaluate the impact of participation in a virtual home visit curriculum on pediatric residents’ confidence, knowledge, and application of knowledge in caring for children with medical complexity (CMC) in the home and community. This prospective pre-post intervention study was conducted in 2019 with first-year pediatric residents using quantitative and qualitative methods. The intervention used was an online video-based curriculum followed by an in-person seminar. Twenty-four residents participated. All reported increased confidence in all aspects of complex care presented in the curriculum. Half of them (12) participated in a follow-up interview or focus group. Four themes identified were: 1) recognizing prior attitudes towards complexity; 2) new mental framework for mental care at home; 3) drivers of behavior change; and 4) commitment to change practice.
AHRQ-funded; HS000063.
Citation: Huth K, Amar-Dolan L, Perez JM .
Visiting Jack: mixed methods evaluation of a virtual home visit curriculum with a child with medical complexity.
Acad Pediatr 2020 Sep-Oct;20(7):1020-28. doi: 10.1016/j.acap.2020.05.001..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Chronic Conditions, Education: Continuing Medical Education
Ramsey WA, Heidelberg RE, Gilbert AM
eHealth and mHealth interventions in pediatric cancer: a systematic review of interventions across the cancer continuum.
The primary objectives of this study were to (a) identify current published research in electronic health (eHealth) and mobile health (mHealth) interventions for youth undergoing cancer treatment and child, adolescent, and young adult survivors of childhood cancer and (b) critically appraise the current scientific evidence on their effectiveness and efficacy. As an exploratory aim, the investigators identified pediatric cancer patients' and survivors' perceptions, attitudes, and concerns related to eHealth and mHealth interventions.
AHRQ-funded; HS023011.
Citation: Ramsey WA, Heidelberg RE, Gilbert AM .
eHealth and mHealth interventions in pediatric cancer: a systematic review of interventions across the cancer continuum.
Psychooncology 2020 Jan;29(1):17-37. doi: 10.1002/pon.5280..
Keywords: Children/Adolescents, Cancer, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Patient-Centered Healthcare
Breitenstein SM, Laurent S, Pabalan L
Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.
The authors studied implementation of mobile delivery to deliver parent training in order to identify and address barriers and facilitators and inform sustainability efforts. They suggest that implementation fidelity may improve with additional education and training of the interdisciplinary team, clear messaging regarding the purpose and content of the program, defining roles within the care team, identifying practice champions, and use of the electronic health record. Findings from this evaluation, including data from the randomized controlled trial and literature to support intervention effectiveness and implementation, will be used to develop an implementation toolkit to include specific strategies for implementation and ideas for local adaptations.
AHRQ-funded; HS024273.
Citation: Breitenstein SM, Laurent S, Pabalan L .
Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.
Fam Syst Health 2019 Dec;37(4):282-90. doi: 10.1037/fsh0000447..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Children/Adolescents, Education: Patient and Caregiver
Doarn CR, Zacharias S, Keck CS
Design and implementation of an interactive website for pediatric voice therapy-the concept of in-between care: a telehealth model.
The purpose of this article was to describe the design and implementation of a web-based portal that was developed to provide supported home practice between weekly voice therapy sessions delivered through telehealth to children with voice disorders. Participants and speech-language pathologists used the portal effectively, finding it useful for in-between care and reinforcement of therapeutic exercises. The authors add that a versatile individual, who is able to work with all project staff is essential to the development process.
AHRQ-funded; HS021781.
Citation: Doarn CR, Zacharias S, Keck CS .
Design and implementation of an interactive website for pediatric voice therapy-the concept of in-between care: a telehealth model.
Telemed J E Health 2018 May;20(2):e66. doi: 10.1089/tmj.2018.0108..
Keywords: Children/Adolescents, Health Information Technology (HIT), Telehealth
Auger KA, Shah SS, Tubbs-Cooley HL
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
The purpose of this study was to determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. The investigators concluded that although postdischarge nurse contact did not decrease the reutilization rate of postdischarge urgent health care services, the method showed promise to bolster postdischarge education.
AHRQ-funded; HS024735.
Citation: Auger KA, Shah SS, Tubbs-Cooley HL .
Effects of a 1-time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial.
JAMA Pediatr 2018 Sep;172(9):e181482. doi: 10.1001/jamapediatrics.2018.1482..
Keywords: Care Coordination, Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Healthcare Delivery, Healthcare Utilization, Hospital Discharge, Outcomes, Provider, Provider: Nurse, Telehealth, Transitions of Care
Badawy SM, Cronin RM, Hankins J
Patient-centered eHealth Interventions for children, adolescents, and adults with sickle cell disease: systematic review.
In this study, researchers systematically evaluated the most recent evidence in the literature to (1) review the different types of technological tools used for self-management of sickle cell disease, (2) discover and describe what self-management activities these tools were used for, and (3) assess the efficacy of these technologies in self-management. They concluded that despite the promising feasibility and acceptability of eHealth interventions in improving self-management of sickle cell disease, the evidence overall is modest.
AHRQ-funded; HS023011.
Citation: Badawy SM, Cronin RM, Hankins J .
Patient-centered eHealth Interventions for children, adolescents, and adults with sickle cell disease: systematic review.
J Med Internet Res 2018 Jul 19;20(7):e10940. doi: 10.2196/10940..
Keywords: Children/Adolescents, Health Information Technology (HIT), Patient-Centered Healthcare, Sickle Cell Disease, Telehealth
Radovic A, Vona PL, Santostefano AM
Smartphone applications for mental health.
This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. The most common purported purpose for the 208 apps studied was symptom relief (41 percent) and general mental health education (18 percent). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21 percent).
AHRQ-funded; HS022989.
Citation: Radovic A, Vona PL, Santostefano AM .
Smartphone applications for mental health.
Cyberpsychol Behav Soc Netw 2016 Jul;19(7):465-70. doi: 10.1089/cyber.2015.0619.
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Keywords: Behavioral Health, Telehealth, Education: Patient and Caregiver, Children/Adolescents, Health Information Technology (HIT)
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth