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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
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- (-) Implementation (11)
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- Organizational Change (2)
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- Quality Improvement (1)
- Quality of Care (1)
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- (-) Screening (11)
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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 11 of 11 Research Studies DisplayedFrehn JL, Li JN, Liu KR
Implementation of a universal screening and follow-up care system for pediatric developmental and behavioral health in federally qualified health center sites.
This study assessed the results of implementing an intervention to increase screening of developmental delays in children at six federally qualified health center (FQHC) sites in Northern California from April 2014 to April 2017. The goals of the intervention were to increase (a) standardized developmental screening at recommended intervals and (b) follow-up care and support for early intervention services. The aim was to optimize each site's screening processes, supported by an automated electronic tablet-based system. Social workers were hired to conduct follow-up clinical assessments, provide psychosocial education and treatment, provide referrals, provide case management support, and collaborate with service partners. During the last year of the intervention, when tablet-based screening was adopted, the sites screened an estimated 6,550 children ages 0-18 at 23 intervals in three domains (developmental, autism, and psychosocial/behavioral), compared to a baseline where they screened children ages 0-3 at four intervals in one domain. Screening rates increased from 65.3% to 75.5% after automation was extended from the first to the second site and continued its’ increase to 91.8% after automation was expanded to the remaining sites. Ranges for follow-up visits were between 74% and 88%.
AHRQ-funded; HS000046.
Citation: Frehn JL, Li JN, Liu KR .
Implementation of a universal screening and follow-up care system for pediatric developmental and behavioral health in federally qualified health center sites.
Fam Syst Health 2023 Dec; 41(4):454-66. doi: 10.1037/fsh0000803..
Keywords: Children/Adolescents, Disabilities, Screening, Implementation
Reese TJ, Schlechter CR, Kramer H
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
This study explored the implementation of lung cancer screening with low-dose computed tomography (CT) in primary care. The study’s two goals included exploring the implementation of lung cancer screening primary care in the context of integrating a decision aid into the electronic health record and a designing of implementation strategies that target hypothesized mechanics of change and context-specific barriers. The two phases included a Qualitative Analysis phase including semi-structured interviews with primary care physicians to elicit key task behaviors, and an Implementation Strategy Design phase consisting of defining implementation strategies and hypothesizing causal pathways to improve screening with a decision aid. Fourteen interviews were conducted and out of that 3 key task behaviors and four behavioral determinants emerged. Strategies included increasing provider self-efficacy toward performing shared decision making and using the decision aid, improving provider performance expectancy, increasing social influence, and addressing key facilitators to using the decision aid.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Kramer H .
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
Transl Behav Med 2022 Feb 16;12(2):187-97. doi: 10.1093/tbm/ibab115..
Keywords: Cancer: Lung Cancer, Cancer, Primary Care, Screening, Implementation, Decision Making
Jonas DE, Barclay C, Grammer D
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
This paper describes a randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in primary care practices in North Carolina with 10 or fewer providers. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.
AHRQ-funded; HS027078.
Citation: Jonas DE, Barclay C, Grammer D .
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
Trials 2021 Nov 16;22(1):810. doi: 10.1186/s13063-021-05641-7..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Screening, Implementation
Wallace AS, Luther BL, Sisler SM
Integrating social determinants of health screening and referral during routine emergency department care: evaluation of reach and implementation challenges.
Despite the importance of social determinants in health outcomes, little is known about the best practices for screening and referral during clinical encounters. This study aimed to implement universal social needs screening and community service referrals in an academic emergency department (ED), evaluating for feasibility, reach, and stakeholder perspectives. The investigators concluded that despite the limited time and technical barriers, few patients with social needs ultimately received service referrals.
AHRQ-funded; HS026505.
Citation: Wallace AS, Luther BL, Sisler SM .
Integrating social determinants of health screening and referral during routine emergency department care: evaluation of reach and implementation challenges.
Implement Sci Commun 2021 Oct 7;2(1):114. doi: 10.1186/s43058-021-00212-y..
Keywords: Social Determinants of Health, Emergency Department, Screening, Implementation
Spalluto LB, Lewis JA, Stolldorf D
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. In this study, the investigators evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening.
AHRQ-funded; HS026395.
Citation: Spalluto LB, Lewis JA, Stolldorf D .
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
J Am Coll Radiol 2021 Jun;18(6):809-19. doi: 10.1016/j.jacr.2020.12.010..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Implementation, Organizational Change
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
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Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organizational Change, Implementation
Brault MA, Spiegelman D, Abdool Karim SS
Integrating and interpreting findings from the latest treatment as prevention trials.
This paper examined findings from some 2018-2019 international studies assessing the effectiveness of reducing HIV incidence by expanding HIV testing, linkage to HIV treatment, and helping persons living with HIV adhere to their medications (called the 90-90-90 strategy). A number of these “treatment as prevention” (TasP) tests had complex results. The studies examined included the TasP/ANRS 12249 study in South Africa, the SEARCH study in Kenya and Uganda, and one comparison (arms A to C) of the HPtn 071 (PopART) study in South Africa and Zambia as well as the Botswana Ya Tsie study. All but the Botswana Ya Tsie study and the second comparison (arms B to C) of PopART did not demonstrate a community impact on HIV incidence. But those two studies indicated significant (30%) reductions in HIV incidence in the intervention communities.
AHRQ-funded; HS023000.
Citation: Brault MA, Spiegelman D, Abdool Karim SS .
Integrating and interpreting findings from the latest treatment as prevention trials.
Curr HIV/AIDS Rep 2020 Jun;17(3):249-58. doi: 10.1007/s11904-020-00492-4..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Implementation, Medication, Screening
Fiori K, Patel M, Sanderson D
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
The authors described their experience implementing a novel social needs screening program at an academic pediatric clinic. They found that, on average, 76% of providers had their patients screened on more than half of eligible well-child visits. Their experience suggested that screening for social needs at well-child visits is feasible as part of routine primary care. They recommended that success would best be achieved by leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
AHRQ-funded; HS026396.
Citation: Fiori K, Patel M, Sanderson D .
From policy statement to practice: integrating social needs screening and referral assistance with community health workers in an urban academic health center.
J Prim Care Community Health 2019 Jan-Dec;10:2150132719899207. doi: 10.1177/2150132719899207..
Keywords: Children/Adolescents, Community-Based Practice, Healthcare Delivery, Implementation, Screening, Social Determinants of Health, Urban Health, Workflow, Primary Care
Yawn BP, Bertram S, Kurland M
Repeated depression screening during the first postpartum year.
The researchers report a substudy of a large pragmatic trial of early post-partum depression screening and practice management, the Translating Research into Practice for Postpartum Depression (TRIPPD) study. They concluded that repeated PPD screening at 6 and 12 months’ postpartum increases the percentage of women identified as being at high risk of PPD.
AHRQ-funded; HS014744.
Citation: Yawn BP, Bertram S, Kurland M .
Repeated depression screening during the first postpartum year.
Ann Fam Med 2015 May-Jun;13(3):228-34. doi: 10.1370/afm.1777..
Keywords: Depression, Implementation, Screening, Prevention
Katz DF, Sun J, Khatri V
QTc interval screening in an opioid treatment program.
This pilot study supports the feasibility of implementing a population-based electrocardiographic monitoring program in order to decrease the QTc interval in high-risk patients undergoing methadone maintenance in an opioid treatment program. Clinical characteristics alone were inadequate to identify patients in need of electrocardiographic screening.
AHRQ-funded; HS021138
Citation: Katz DF, Sun J, Khatri V .
QTc interval screening in an opioid treatment program.
Am J Cardiol. 2013 Oct 1;112(7):1013-8. doi: 10.1016/j.amjcard.2013.05.037..
Keywords: Opioids, Medication, Substance Abuse, Screening, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Risk, Implementation