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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 489 Research Studies Displayed
Coley RY, Walker RL, Cruz M
Clinical risk prediction models and informative cluster size: assessing the performance of a suicide risk prediction algorithm.
Investigators used data from seven health systems to predict suicide attempt within 90 days. They recommended dividing clustered data on the person level, rather than visit level, to ensure strong performance in prospective use and accurate estimation of future performance at the time of model development.
AHRQ-funded; HS026369.
Citation:
Coley RY, Walker RL, Cruz M .
Clinical risk prediction models and informative cluster size: assessing the performance of a suicide risk prediction algorithm.
Biom J 2021 Oct;63(7):1375-88. doi: 10.1002/bimj.202000199..
Keywords:
Behavioral Health, Risk
Bonilla AG, Pourat N, Chuang E
Mental health staffing at HRSA-funded health centers may improve access to care.
This study examines the association between mental health staffing at health centers funded by the Health Resources and Services Administration (HRSA) and patients' receipt of mental health treatment. Data from the 2014 HRSA-funded Health Center Patient Survey and the 2013 Uniform Data System were used. Findings showed that co-locating mental health staff at health centers increased the probability of patients' access to such treatment on site as well as from off-site providers.
AHRQ-funded; HS000046.
Citation:
Bonilla AG, Pourat N, Chuang E .
Mental health staffing at HRSA-funded health centers may improve access to care.
Psychiatr Serv 2021 Sep;72(9):1018-25. doi: 10.1176/appi.ps.202000337..
Keywords:
Behavioral Health, Access to Care
Luo Z, Gritz M, Connelly L
A survey of primary care practices on their use of the intensive behavioral therapy for obese Medicare patients.
The objective of this study was to fill the gap in knowledge on systematic differences between primary care practices (PCP) that do or do not provide intensive behavioral therapy (IBT) for obese Medicare patients. The investigators concluded that although the Centers for Medicare and Medicaid Services established payment codes for PCPs to deliver IBT for obesity in 2011, very few providers submitted fee-for-service claims for these services after almost 10 years.
AHRQ-funded; HS024843.
Citation:
Luo Z, Gritz M, Connelly L .
A survey of primary care practices on their use of the intensive behavioral therapy for obese Medicare patients.
J Gen Intern Med 2021 Sep;36(9):2700-08. doi: 10.1007/s11606-021-06596-w..
Keywords:
Primary Care, Obesity, Behavioral Health, Medicare, Elderly
Connell SK, To T, Arora K, Ramos J, SK, To T, Arora K
Perspectives of parents and providers on reasons for mental health readmissions: a content analysis study.
This retrospective study is a survey of parents and providers on the reasons for pediatric mental health readmissions. The survey was administered to parents and providers of patients with a 14-day readmission to an inpatient pediatric psychiatry unit between May 2017 and August 2018. The authors had completed survey responses from 89 (64%) of 138 readmission encounters. The top three readmission reasons given by parents were discordant inpatient stay expectations with providers (41%), discharge hesitancy (34%), and treatment plan failure (13%). Among providers, the top reasons were access to inpatient care (30%), treatment adherence (13%), a challenging home (11%) and social environment (11%).
AHRQ-funded; HS024299.
Citation:
Connell SK, To T, Arora K, Ramos J, SK, To T, Arora K .
Perspectives of parents and providers on reasons for mental health readmissions: a content analysis study.
Adm Policy Ment Health 2021 Sep;48(5):830-38. doi: 10.1007/s10488-021-01134-6..
Keywords:
Children/Adolescents, Behavioral Health, Hospital Readmissions
Chen H, Upadhyay N, Lyu N
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
This study’s objective was to examine whether linkage with mental health (MH) treatment differed across 3 different integrated care agreements (ICAs) following diagnosis for Attention Deficit Hyperactive Disorder (ADHD) or Major Depressive Disorder (MDD) given by primary care providers (PCPs) in the pediatric setting. The ICAs were categorized as PCPs who practiced alone (non-co-located); PCPs practiced with specialist outside the practice but co-located at the practice site; and employed specialists who were co-located. A total of 4203 incident ADHD and 298 incident MDD diagnoses were identified, of which 74% of ADHD cases and 67% of MDD cases received treatment within 90 days of diagnosis. Children with ADHD were twice as likely to receive treatment if they were diagnosed by non-co-located or co-affiliated PCPs than those diagnosed by non-co-located PCPs. Those treated children were also 2 times more likely to receive guideline recommended psychotherapy and treated at the diagnosing site versus elsewhere.
AHRQ-funded; HS025251.
Citation:
Chen H, Upadhyay N, Lyu N .
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
Acad Pediatr 2021 Sep-Oct;21(7):1187-94. doi: 10.1016/j.acap.2021.05.021..
Keywords:
Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care, Healthcare Delivery, Depression, Attention Deficit Hyperactivity Disorder (ADHD)
Hickey EJ, Stransky M, Kuhn J
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
This study examined trajectories of parenting stress, coping, and perceived family impact over time throughout the autism diagnostic process among Hispanic and non-Hispanic families. Findings showed that Hispanic families reported lower levels of parenting stress, coping, and negative family impact across time. Further, there were differences in the change in use of coping and the amount of negative family impact reported between Hispanic and non-Hispanic parents over time.
AHRQ-funded; HS022242.
Citation:
Hickey EJ, Stransky M, Kuhn J .
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
Autism 2021 Aug;25(6):1694-708. doi: 10.1177/13623613211001611..
Keywords:
Children/Adolescents, Autism, Stress, Behavioral Health, Racial / Ethnic Minorities
Wallace DD, Lytle LA, Albrecht S
All of that causes me stress: an exploration of the sources of stress experienced by Latinxs living with prediabetes.
Latinxs immigrants in the United States experience sources of stress (i.e., stressors) that can limit their ability to engage in healthy behaviors. Stress has been linked to increased type 2 diabetes (T2D) risk in Latinxs living with prediabetes, a group disproportionately affected by T2D. The purpose of this qualitative study was to describe and contextualize the variety of stressors experienced by Latinxs immigrants diagnosed with prediabetes.
AHRQ-funded; HS000032.
Citation:
Wallace DD, Lytle LA, Albrecht S .
All of that causes me stress: an exploration of the sources of stress experienced by Latinxs living with prediabetes.
J Lat Psychol 2021 Aug;9(3):204-16. doi: 10.1037/lat0000168..
Keywords:
Stress, Racial / Ethnic Minorities, Diabetes, Chronic Conditions, Behavioral Health
Olfson M, Stroup TS, Huang C
Suicide risk in Medicare patients with schizophrenia across the life span.
The purpose of this study was to describe suicide mortality rates and correlates among adults with schizophrenia across the life span and standardized mortality ratios (SMRs) for suicide compared with the general US population. The investigators concluded that in this cohort study of adult Medicare patients with schizophrenia, suicide risk was elevated, with the highest absolute and relative risk among young adults. They indicated that these patterns supported suicide prevention efforts with a focus on young adults with schizophrenia, especially those with suicidal symptoms and substance use.
AHRQ-funded; HS023258.
Citation:
Olfson M, Stroup TS, Huang C .
Suicide risk in Medicare patients with schizophrenia across the life span.
JAMA Psychiatry 2021 Aug;78(8):876-85. doi: 10.1001/jamapsychiatry.2021.0841..
Keywords:
Medicare, Behavioral Health
Zuvekas SH, Grosse SD, Lavelle TA
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
Published healthcare cost estimates for children with autism spectrum disorder (ASD) vary widely. One possible contributor is different methods of case ascertainment. In this study, autism spectrum disorder (ASD) case status was determined using two sources of parent reports among 45,944 children ages 3-17 years in the Medical Expenditure Panel Survey (MEPS) linked to the National Health Interview Survey (NHIS) Sample Child Core questionnaire. In this paper, the investigators describe their process and conclusions.
AHRQ-authored.
Citation:
Zuvekas SH, Grosse SD, Lavelle TA .
Healthcare costs of pediatric autism spectrum disorder in the United States, 2003-2015.
J Autism Dev Disord 2021 Aug;51(8):2950-58. doi: 10.1007/s10803-020-04704-z..
Keywords:
Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Autism, Healthcare Costs, Behavioral Health
Klawetter S, Glaze K, Sward A
Warm Connections: integration of infant mental health services into WIC.
Warm Connections is an innovative integrated behavioral health program delivered in the Special Supplemental Nutrition Program for Women, Infants, and Children and rooted in an infant and early childhood mental health framework. This exploratory study describes Warm Connections and provides evaluation results from its pilot implementation. Findings suggest Warm Connections may reduce distress and increase parenting efficacy among low-income mothers and support further research of this program's feasibility.
AHRQ-funded; HS026370.
Citation:
Klawetter S, Glaze K, Sward A .
Warm Connections: integration of infant mental health services into WIC.
Community Ment Health J 2021 Aug;57(6):1130-41. doi: 10.1007/s10597-020-00744-y..
Keywords:
Newborns/Infants, Maternal Care, Behavioral Health, Patient-Centered Healthcare, Low-Income, Vulnerable Populations
Jennissen S, Connolly Gibbons MB, Crits-Christoph P
Insight as a mechanism of change in dynamic therapy for major depressive disorder.
This study’s goal was to investigate change in insight into maladaptive interpersonal patterns over the course of psychotherapy, as well as the specificity of insight as a change mechanism in dynamic treatments. Participants received up to 16 sessions of either cognitive or dynamic therapy for major depressive disorder in a randomized clinical trial. Results provided support for insight as a change factor in dynamic therapies. Better self-understanding of dysfunctional interaction patterns could help patients to find more adaptive ways of behaving, to form more satisfying relationships, and to improve their depression.
AHRQ-funded; HS018440.
Citation:
Jennissen S, Connolly Gibbons MB, Crits-Christoph P .
Insight as a mechanism of change in dynamic therapy for major depressive disorder.
J Couns Psychol 2021 Jul;68(4):435-45. doi: 10.1037/cou0000554..
Keywords:
Depression, Behavioral Health
Calthorpe LM, Baer RJ, Chambers BD
The association between preterm birth and postpartum mental healthcare utilization among California birthing people.
This study’s objective was to determine whether preterm birth is associated with postpartum inpatient and emergency mental healthcare utilization. The study sample was taken from a database of live-born neonates delivered in California, 2011-2017, and included all births to singleton infants between the gestational ages of 20 and 44 weeks. The findings indicate found that preterm birth is an independent risk factor for postpartum mental healthcare utilization. These findings suggest that screening for and providing mental health resources to birthing people after delivery are crucial, particularly among people giving birth to preterm infants, regardless of mental health history.
AHRQ-funded; HS026383.
Citation:
Calthorpe LM, Baer RJ, Chambers BD .
The association between preterm birth and postpartum mental healthcare utilization among California birthing people.
Am J Obstet Gynecol MFM 2021 Jul;3(4):100380. doi: 10.1016/j.ajogmf.2021.100380..
Keywords:
Behavioral Health, Pregnancy, Women, Labor and Delivery, Risk
Wilkinson ST, Kitay BM, Harper A
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder; yet, its use is confined to <1% of individuals with this disorder. In this study, the authors aimed to examine barriers to ECT from the perspective of the provider. The investigators concluded that coordinated efforts to overcome identified barriers may allow ECT to be more broadly implemented. Investments in education may increase the number of competent practitioners.
AHRQ-funded; HS023000.
Citation:
Wilkinson ST, Kitay BM, Harper A .
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Psychiatr Serv 2021 Jul;72(7):752-57. doi: 10.1176/appi.ps.202000387..
Keywords:
Depression, Behavioral Health, Treatments
Choi KR, Martinez-Hollingsworth A, Mead M
Adolescent psychiatric emergencies precipitated by the COVID-19 pandemic.
The purpose of this retrospective case series was to describe adolescent psychiatric emergencies precipitated by the coronavirus disease 2019 (COVID-19) pandemic. Findings showed that COVID-19-precipitated admissions were 24% of total admissions from March 15 to May 31, 2020; however, total admissions during this time period were reduced from the same time period in prior years. The COVID-19 pandemic and corresponding shelter-in-place orders may precipitate psychiatric emergencies among adolescents both with and without existing mental health disorders.
AHRQ-funded; HS026407.
Citation:
Choi KR, Martinez-Hollingsworth A, Mead M .
Adolescent psychiatric emergencies precipitated by the COVID-19 pandemic.
J Psychosoc Nurs Ment Health Serv 2021 Jul;59(7):17-21. doi: 10.3928/02793695-20201203-05..
Keywords:
Children/Adolescents, COVID-19, Behavioral Health, Emergency Department
Coley RY, Johnson E, Simon GE
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
This study looked at racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visit. The main outcome measured was the suicide rate within 90 days after a mental health visit. The study used a 50% sample of visits from a random set of outpatients at 7 large integrated health care systems by patients 13 years and older (6,984,184 visits). Suicide rates were highest for visits by patients with no race/ethnicity recorded, followed by Asian, White, American Indian/Alaskan Native, Hispanic, and Black. Sensitivity of both models used were high for White, Hispanic, and Asian patients and poor for Black and American Indian/Alaskan Native patients and patients with no race/ethnicity recorded.
AHRQ-funded; HS026369.
Citation:
Coley RY, Johnson E, Simon GE .
Racial/ethnic disparities in the performance of prediction models for death by suicide after mental health visits.
JAMA Psychiatry 2021 Jul;78(7):726-34. doi: 10.1001/jamapsychiatry.2021.0493..
Keywords:
Disparities, Racial / Ethnic Minorities, Behavioral Health, Mortality, Risk
Bushnell GA, Crystal S, Olfson M
Trends in antipsychotic medication use in young privately insured children.
This study’s objective was to estimate trends in annual antipsychotic medication use by privately insured young children (aged 2-7 years) in the United States and to describe the clinical and treatment characteristics of these children. Young children from a nationwide commercial claims database from 2007-2017 was used to estimate annual antipsychotic use by age and sex. Annual antipsychotic use decreased over the time period, from a peak of 0.29% in 2009 and significantly declined to 0.17% in 2017. Antipsychotic use was higher in boys than in girls with a greater proportion receiving a mental disorder diagnosis in 2017 than in 2009. The most common clinical diagnoses were pervasive development disorder, conduct or disruptive behavior disorder, and attention-deficit/hyperactivity disorder. In 2017, 32% had 4+ psychotherapy claims, 43% had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant.
AHRQ-funded; HS023258; HS026001.
Citation:
Bushnell GA, Crystal S, Olfson M .
Trends in antipsychotic medication use in young privately insured children.
J Am Acad Child Adolesc Psychiatry 2021 Jul;60(7):877-86. doi: 10.1016/j.jaac.2020.09.023..
Keywords:
Children/Adolescents, Medication, Behavioral Health
Lillie KM, Shaw J, Jansen KJ
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). The investigators concluded that younger patients and those with co-occurring substance use remained at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people.
AHRQ-funded; HS023207.
Citation:
Lillie KM, Shaw J, Jansen KJ .
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
J Addict Med 2021 Jul-Aug 01;15(4):297-302. doi: 10.1097/adm.0000000000000757..
Keywords:
Opioids, Substance Abuse, Behavioral Health, Medication, Racial / Ethnic Minorities, Vulnerable Populations
Adams LB, Baxter SLK, Lightfoot AF
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
This study’s goal was to look at why prevalence of depression is lower for Black males despite cumulative socioeconomic disadvantage and risk factors. For Black men, emotional vulnerability is often seen as a sign of weakness which may potentially mask the timely identification of mental health needs in this population. The authors use concept mapping, which is a structured mixed methods approach to determine how stakeholders of Black men’s health conceptualize their depressive symptoms. Thirty-six stakeholders comprised of Black men, Black women, and primary care providers participated in separate stakeholder groups in 2018. Participants generated 68 characteristics of Black men’s depression reflected in six conceptual clusters: 1) physical states; 2) emotional states; 3) diminished drive; 4) internal conflicts; 5) communication with others; and 6) social pressures. Using a content analysis approach, they found that items comprising the “social pressures” cluster were not reflected in any common depression scales.
AHRQ-funded; HS000032.
Citation:
Adams LB, Baxter SLK, Lightfoot AF .
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
BMC Public Health 2021 Jun 22;21(1):1194. doi: 10.1186/s12889-021-11137-5..
Keywords:
Men's Health, Racial / Ethnic Minorities, Depression, Behavioral Health, Diagnosis
Levis B, Benedetti A, Ioannidis JPA
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
The authors compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. They found that PHQ-9 ≥10 substantially overestimated depression prevalence, as there was too much heterogeneity to correct statistically in individual studies.
AHRQ-funded; HS018246.
Citation:
Levis B, Benedetti A, Ioannidis JPA .
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
J Clin Epidemiol 2020 Jun;122:115-28.e1. doi: 10.1016/j.jclinepi.2020.02.002..
Keywords:
Depression, Behavioral Health, Diagnostic Safety and Quality, Diagnosis
Simon CB, Klein JW, Bradley KA
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
One potential challenge of treating OUD in primary care is comorbidity. Mental health and substance use disorders and chronic pain are common in patients with Opioid Use Disorders (OUDs) in specialty OUD treatment settings and on confidential surveys, but the prevalence of such comorbidity in primary care patients with OUD has not been confirmed. This brief report addressed that gap.
AHRQ-funded; HS023173.
Citation:
Simon CB, Klein JW, Bradley KA .
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
J Gen Intern Med 2021 Jun;36(6):1799-801. doi: 10.1007/s11606-020-05820-3..
Keywords:
Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Simmel C, Bowden CF, Neese-Todd S
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
AHRQ-funded; HS026001.
Citation:
Simmel C, Bowden CF, Neese-Todd S .
Antipsychotic treatment for youth in foster care: Perspectives on improving youths' experiences in providing informed consent.
Am J Orthopsychiatry 2021;91(2):258-70. doi: 10.1037/ort0000532..
Keywords:
Children/Adolescents, Vulnerable Populations, Behavioral Health, Medication, Patient Experience
Hua CL, Cornell PY, Zimmerman S
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
This study examined trends in the prevalence of serious mental illness (SMI) in assisted living (AL) communities in the United States over time and in relationship to characteristics such as dual eligibility and health conditions. Using Medicare data, findings showed that the prevalence of SMI in AL increased by 54% from 2007 to 2017. Residents with SMI were more likely to be dually eligible for Medicare and Medicaid than residents without SMI. Approximately 10% of AL communities had over half of the sample's AL residents with SMI.
AHRQ-funded; HS000011.
Citation:
Hua CL, Cornell PY, Zimmerman S .
Trends in serious mental illness in US assisted living compared to nursing homes and the community: 2007-2017.
Am J Geriatr Psychiatry 2021 May;29(5):434-44. doi: 10.1016/j.jagp.2020.09.011..
Keywords:
Elderly, Behavioral Health, Nursing Homes, Long-Term Care, Medicare
Gurka MJ, Siddiqi SU, Filipp SL
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Investigators estimated the proximal change in BMI associated with start of medication and to assess whether medication-specific departures in BMI varied by age and sex in patients with attention deficit hyperactivity disorder (ADHD). Longitudinal electronic health records from children aged 4-19 years with an ADHD diagnosis at one healthcare system were analyzed. They found that all medications had larger impacts at younger ages; decreased BMI was observed with stimulants, while antidepressants and antipsychotics led to BMI increases as did alpha-agonists, significantly varying by sex and age. They recommended future research to study further the interactions of these medications on long-term impacts on obesity.
AHRQ-funded; HS025298.
Citation:
Gurka MJ, Siddiqi SU, Filipp SL .
Attention deficit hyperactivity disorder medications and BMI trajectories: the role of medication type, sex and age.
Pediatr Obes 2021 Apr;16(4):e12738. doi: 10.1111/ijpo.12738..
Keywords:
Children/Adolescents, Attention Deficit Hyperactivity Disorder (ADHD), Behavioral Health, Medication, Obesity
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation:
Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords:
Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Pfaff N, DaSilva A, Ozer E
Adolescent risk behavior screening and interventions in hospital settings: a scoping review.
Risky behaviors are the main threats to adolescents' health; consequently, evidence-based guidelines recommend annual comprehensive risk behavior screening. The objective of this research was to review studies of adolescent risk behavior screening and interventions in urgent care, emergency department (ED), and hospital settings. Data sources included PubMed (1965-2019) and Embase (1947-2019). The investigators concluded that rates of adolescent risk behavior screening were low in urgent care, ED, and hospital settings.
AHRQ-funded; HS024592; HS027041.
Citation:
Pfaff N, DaSilva A, Ozer E .
Adolescent risk behavior screening and interventions in hospital settings: a scoping review.
Pediatrics 2021 Apr;147(4). doi: 10.1542/peds.2020-020610..
Keywords:
Children/Adolescents, Behavioral Health, Screening
