National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Behavioral Health (1)
- Breast Feeding (1)
- Caregiving (3)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (2)
- COVID-19 (1)
- Decision Making (3)
- Diabetes (2)
- Domestic Violence (1)
- Education: Patient and Caregiver (4)
- Electronic Health Records (EHRs) (5)
- Evidence-Based Practice (1)
- Healthcare Delivery (2)
- (-) Health Information Technology (HIT) (17)
- Health Promotion (1)
- Hospitals (1)
- Influenza (1)
- Labor and Delivery (1)
- Lifestyle Changes (1)
- Maternal Care (6)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Safety (1)
- (-) Pregnancy (17)
- Prevention (1)
- Provider (1)
- Provider: Nurse (1)
- Racial and Ethnic Minorities (1)
- Screening (1)
- Social Media (2)
- Substance Abuse (1)
- Telehealth (4)
- Vaccination (1)
- Web-Based (3)
- Women (13)
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 17 of 17 Research Studies DisplayedKonnyu KJ, Danilack VA, Adam GP
Changes to prenatal care visit frequency and telehealth: a systematic review of qualitative evidence.
This study systematically reviewed patient, partner or family, and clinician perspectives, preferences, and experiences related to prenatal care visit schedules and televisits for routine prenatal care. This review is a subset of a larger review on both the qualitative experiences and quantitative benefits and harms of reduced prenatal care visit schedules and televisits for routine prenatal care that was produced by the Brown Evidence-based Practice Center for AHRQ. The authors synthesized barriers and facilitators to the implementation of reduced care visits or of televisits into 1 of 14 domains defined by the Theoretical Domains Framework (TDF) and a Best Fit Framework approach and summarized themes within TDF domains. They assessed their confidence in the summary statements using the GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) tool. They found four studies that addressed the number of scheduled routine prenatal visits, and five studies that addressed televisits. These studies found that health care professionals believed fewer routine visits may be more convenient for patients and may increase clinic capacity to provide additional care for patients with high-risk pregnancies. But both patients and clinicians had concerns about potential lesser care with fewer visits, including concerns about quality of care and challenges with implementing new delivery-of-care models.
AHRQ-funded; 290201500002I.
Citation: Konnyu KJ, Danilack VA, Adam GP .
Changes to prenatal care visit frequency and telehealth: a systematic review of qualitative evidence.
Obstet Gynecol 2023 Feb;141(2):299-323. doi: 10.1097/aog.0000000000005046.
Keywords: Maternal Care, Pregnancy, Women, Telehealth, Health Information Technology (HIT)
Fareed N, Swoboda C, Singh P
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
The objective of this study was to develop user specifications for a tailored and integrated technology, patient application (mHealth) and provider dashboard, that provides a complete view of Medicaid-enrolled patients with type 2 diabetes (T2D) during pregnancy and to develop prototypes based on users’ needs. Participating patients and providers stated a core set of expectations for the mHealth and dashboard applications. Participants then provided feedback to improve these applications. The authors concluded that digital health tools could transform health care among Medicaid-enrolled patients with T2D during pregnancy, with the goal of managing their blood glucose levels. Refining the stated needs and preferences of patients and providers to develop applications holds potential for tackling complicated health care issues.
AHRQ-funded; HS028822.
Citation: Fareed N, Swoboda C, Singh P .
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
Digit Health 2023 Jan-Dec; 9:20552076221144181. doi: 10.1177/20552076221144181..
Keywords: Patient-Centered Healthcare, Telehealth, Diabetes, Pregnancy, Chronic Conditions, Women, Health Information Technology (HIT)
Jaynes S, Brathwaite D, Tully KP
Systematic review of the effect of technology-mediated education intervention on maternal outcomes in the first year after birth.
This systematic literature review synthesized the findings on the effect of technology-mediated education intervention in the first year after birth on maternal health outcomes and to evaluate interventions for participant perspectives and health equity. The literature search found articles published between 2010 and 2020. The authors identified 21 articles that met their inclusion criteria. Videos were the most commonly reported education intervention, followed by text messages, phone calls, and websites. Maternal health topics addressed in the included articles were mental health, weight loss, breastfeeding, general postpartum education, perineal care, and substance use. These technology-mediated interventions were shown to positively affect mental health, weight loss, and breastfeeding outcomes.
AHRQ-funded; HS027260.
Citation: Jaynes S, Brathwaite D, Tully KP .
Systematic review of the effect of technology-mediated education intervention on maternal outcomes in the first year after birth.
J Obstet Gynecol Neonatal Nurs 2022 May;51(3):278-89. doi: 10.1016/j.jogn.2022.02.005..
Keywords: Pregnancy, Women, Maternal Care, Education: Patient and Caregiver, Health Information Technology (HIT)
Bui LN, Marshall C, Miller-Rosales C
Hospital adoption of electronic decision support tools for preeclampsia management.
Maternal morbidity and mortality can be reduced by the utilization of evidence-based clinical guidelines for preeclampsia management. Electronic health record (EHR)-based clinical decision support tools can improve the use of those guidelines. The purpose of this study was to investigate the organizational capabilities and hospital adoption of HER-based decision tools for preeclampsia management. The researchers conducted a cross-sectional analysis of hospitals that provided obstetric care in 2017. A total of 739 hospitals that responded to the 2017-2018 National Survey of Healthcare Organizations and Systems (NSHOS) and their results were linked to the 2017 Area Health Resources File (AHRF) and the American Hospital Association (AHA) Annual Survey Database. A final total of 425 hospitals from 49 states were analyzed. The primary outcome of the analysis was whether a hospital adopted EHR-based clinical decision support tools for preeclampsia management. The study found that 68% of the hospitals utilized EHR-based decision support tools for preeclampsia, and that hospitals with a single EHR system were more likely to adopt EHR-based decision support tools for preeclampsia than hospitals with multiple systems, including a combination of EHR and paper-based systems. The researchers also determined that hospitals with more processes to disseminate best patient care practices were more likely to adopt EHR-based decision support tools for preeclampsia management. The study concluded that having standardized EHRs and policies to disseminate evidence can help hospitals advance the use of EHR-based decision support tools for preeclampsia management in those hospitals that have not yet adopted them.
AHRQ-funded; HS024075.
Citation: Bui LN, Marshall C, Miller-Rosales C .
Hospital adoption of electronic decision support tools for preeclampsia management.
Qual Manag Health Care 2022 Apr-Jun;31(2):59-67. doi: 10.1097/qmh.0000000000000328..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Pregnancy, Women
Tang LA, Jeffery AD, Leech AA
A comparison of methods to identify antenatal substance use within electronic health records.
This study described the development of a natural-language-processing-based algorithm for detecting antenatal substance use among individuals receiving perinatal care. Findings showed that the accuracy of antenatal substance use detection was improved with more stringent case definitions; however, the overall proportion of true cases confirmed by manual chart review decreased.
AHRQ-funded; HS026395.
Citation: Tang LA, Jeffery AD, Leech AA .
A comparison of methods to identify antenatal substance use within electronic health records.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100535. doi: 10.1016/j.ajogmf.2021.100535..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse, Pregnancy, Women, Behavioral Health
Peahl AF, Powell A, Berlin H
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
The authors evaluated institutional-level adoption and patient and provider experiences with a coronavirus disease 2019 prenatal care model. They found that reduced visit schedules and virtual visits were rapidly integrated into real-world care, with positive experiences for many patients and providers. They recommended future research to understand the health outcomes and care experience associated with alternative approaches to prenatal care delivery across more diverse patient populations outside of the coronavirus disease 2019 pandemic to inform broader health policy decisions.
AHRQ-funded; HS025465.
Citation: Peahl AF, Powell A, Berlin H .
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
Am J Obstet Gynecol 2021 Apr;224(4):384.e1-84.e11. doi: 10.1016/j.ajog.2020.10.008..
Keywords: Maternal Care, Pregnancy, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Peahl AF, Smith RD, Moniz MN
Prenatal care redesign: creating flexible maternity care models through virtual care.
Each year, over 98% of the almost 4 million pregnant patients in the United States receive prenatal care-a crucial preventive service to improve outcomes for moms and babies. In this paper, the authors outline their experience rapidly transitioning prenatal care to a new model with 4 in-person visits, 1 ultrasound visit, and 4 virtual visits (the 4-1-4 prenatal plan). They then explore how lessons from this implementation can inform patient-centered prenatal care redesign during and beyond the COVID-19 pandemic.
AHRQ-funded; HS025465.
Citation: Peahl AF, Smith RD, Moniz MN .
Prenatal care redesign: creating flexible maternity care models through virtual care.
Am J Obstet Gynecol 2020 Sep;223(3):389.e1-89.e10. doi: 10.1016/j.ajog.2020.05.029..
Keywords: Maternal Care, Telehealth, Health Information Technology (HIT), Pregnancy, Women, Healthcare Delivery, Patient-Centered Healthcare
Tan M, Lipman S, Lee H
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
The impact of the electronic medical record (EMR) on nursing workload is not well understood. The objective of this descriptive study was to measure the actual and perceived time that nurses spend on the EMR in the operating room during cesarean births. The investigators found that on average, nurses spent 40% of their intraoperative time on the EMR during cesarean births, and this time burden was distributed across the perioperative period.
AHRQ-funded; HS023506.
Citation: Tan M, Lipman S, Lee H .
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
J Patient Saf 2019 Dec;15(4):e82-e85. doi: 10.1097/pts.0000000000000467..
Keywords: Electronic Health Records (EHRs), Labor and Delivery, Provider: Nurse, Health Information Technology (HIT), Provider, Pregnancy
O'Leary ST, Narwaney KJ, Wagner NM
Efficacy of a web-based intervention to increase uptake of maternal vaccines: an RCT.
Tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines are recommended for pregnant women in each pregnancy, yet uptake is suboptimal. This study tested the efficacy of an online vaccine resource in increasing uptake of Tdap and influenza vaccines among pregnant women. The investigators concluded that Web-based vaccination information sent to pregnant women can positively influence maternal influenza vaccine uptake.
AHRQ-funded; HS021492.
Citation: O'Leary ST, Narwaney KJ, Wagner NM .
Efficacy of a web-based intervention to increase uptake of maternal vaccines: an RCT.
Am J Prev Med 2019 Oct;57(4):e125-e33. doi: 10.1016/j.amepre.2019.05.018..
Keywords: Vaccination, Pregnancy, Women, Health Information Technology (HIT), Social Media, Influenza
Jefferson UT, Zachary I, Majee W
Employing a user-centered design to engage mothers in the development of a mHealth breastfeeding application.
The Mother's Milk Connection mHealth application was designed to improve breastfeeding duration and access to support. This article describes a user-centered design process to engage mothers in the development of the Mother's Milk Connection application. Stakeholder and user engagement indicated the integration of four distinct features acceptable for use as a comprehensive mHealth intervention to improve access to breastfeeding support. Further, mHealth has the potential to be a useful strategy for providing breastfeeding support, and a clinical trial regarding the efficacy of the Mother's Milk Connection application is needed.
AHRQ-funded; HS022140.
Citation: Jefferson UT, Zachary I, Majee W .
Employing a user-centered design to engage mothers in the development of a mHealth breastfeeding application.
Comput Inform Nurs 2019 Oct;37(10):522-31. doi: 10.1097/cin.0000000000000549..
Keywords: Breast Feeding, Maternal Care, Pregnancy, Women, Health Information Technology (HIT), Patient and Family Engagement, Patient Adherence/Compliance, Health Promotion, Education: Patient and Caregiver, Caregiving
Gance-Cleveland B, Leiferman J, Aldrich H
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
The purpose of this study was to develop StartSmart, a mobile health (mHealth) intervention to support evidence-based prenatal screening, brief intervention, and referral to treatment for risk and protective factors in pregnancy. Expert clinicians provided guidance on the screening instruments, resources, and practice guidelines. Clinicians suggested identifying specific prenatal visits for the screening. Patients reported that the tablet-based screening was useful to promote adherence to guidelines and provided suggestions for improvement.
AHRQ-funded; HS024738.
Citation: Gance-Cleveland B, Leiferman J, Aldrich H .
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
J Midwifery Womens Health 2019 Sep;64(5):630-40. doi: 10.1111/jmwh.13009..
Keywords: Health Information Technology (HIT), Domestic Violence, Clinical Decision Support (CDS), Decision Making, Pregnancy, Women, Evidence-Based Practice, Screening, Prevention
Dorst MT, Anders SH, Chennupati S
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
This study’s objective was to determine the number and nature of the components of the support systems of pregnant women and their caregivers (family members) and the role of health information technologies (HIT) in these support systems. Pregnant women and their caregivers were enrolled from advanced maternal-fetal and group prenatal care clinics. Participants filled out surveys which addressed stress levels, socioeconomic status, health literacy, and they drew a diagram of their support systems. Pregnant women overall had a larger support system than their caregivers. Their source of medical information was more likely to be specific medical information websites, while caregivers used more general internet search engines. No association was found between stress, support system size, and support system components.
AHRQ-funded; HS021496.
Citation: Dorst MT, Anders SH, Chennupati S .
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
J Med Internet Res 2019 May 9;21(5):e10865. doi: 10.2196/10865..
Keywords: Health Information Technology (HIT), Pregnancy, Caregiving, Women, Social Media
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
Hedderson MM, Brown SD, Ehrlich SF
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
The purpose of this study was to evaluate whether a tailored letter improved gestational weight gain (GWG) and whether GWG mediated a multicomponent intervention's effect on postpartum weight retention among women with gestational diabetes mellitus (GDM). The authors concluded that a tailored electronic health record-based letter improved GWG, which mediated the effect of a multicomponent intervention in reducing postpartum weight retention.
AHRQ-funded; HS019367.
Citation: Hedderson MM, Brown SD, Ehrlich SF .
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
Diabetes Care 2018 Jul;41(7):1370-77. doi: 10.2337/dc17-1133..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Lifestyle Changes, Patient-Centered Outcomes Research, Pregnancy, Women
Webb J, Sorensen A, Sommerness S
AHRQ Author: Mistry K
Advancing perinatal patient safety through application of safety science principles using health IT.
Researchers used semi-structured interviews with Labor and Delivery (L&D) units participating in AHRQ's Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation. Seventy percent of the units reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Webb J, Sorensen A, Sommerness S .
Advancing perinatal patient safety through application of safety science principles using health IT.
BMC Med Inform Decis Mak 2017 Dec 19;17(1):176. doi: 10.1186/s12911-017-0572-8.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Pregnancy, Maternal Care
Holroyd LE, Anders S, Robinson JR
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
AHRQ-funded; HS021496.
Citation: Holroyd LE, Anders S, Robinson JR .
This study examined the relationships among Multidimensional Health Locus of Control (MHLC) scores, information-seeking behaviors, and health-related needs in 71 pregnant women and 29 caregivers.
AMIA Annu Symp Proc 2017 Apr 16;2017:902-11..
Keywords: Caregiving, Education: Patient and Caregiver, Health Information Technology (HIT), Pregnancy, Web-Based
Shorten A, Fagerlin A, Illuzzi J
Developing an Internet-based decision aid for women choosing between vaginal birth after cesarean and planned repeat cesarean.
This article is part of a series that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. The authors outlined a framework and process used to create an Internet-based decision aid about birth choices after previous cesarean. They transformed a paper-based decision aid into a secure, interactive Web site to meet the diverse needs of women and providers.
AHRQ-funded; HS022114.
Citation: Shorten A, Fagerlin A, Illuzzi J .
Developing an Internet-based decision aid for women choosing between vaginal birth after cesarean and planned repeat cesarean.
J Midwifery Womens Health 2015 Jul-Aug;60(4):390-400. doi: 10.1111/jmwh.12298.
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Keywords: Decision Making, Health Information Technology (HIT), Pregnancy, Web-Based, Women