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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.
Results1 to 25 of 125 Research Studies Displayed
Moza R, Truong DT, Lambert LM
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
The purpose of this study was to investigate change in weight-for-age z-scores (WAZ) and risk factors for impaired weight gain between stage 1 palliation (S1P) for single ventricle physiology and discharge. Data from the National Pediatric Cardiology Quality Improvement Collaborative Phase II database was analysed. Findings showed that nearly all infants lost weight after S1P, with little recovery by hospital discharge. At discharge, three-quarters of the infants were at-risk for impaired weight gain or had failure to thrive. Most risk factors associated with change in WAZ were unmodifiable or surrogates of disease severity.
Citation: Moza R, Truong DT, Lambert LM . Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset. J Pediatr 2021 Jul;234:20-26.e2. doi: 10.1016/j.jpeds.2021.03.035..
Keywords: Newborns/Infants, Centers for Education and Research on Therapeutics (CERTs), Heart Disease and Health, Cardiovascular Conditions, Health Status, Risk
Fraiman YS, Litt JS, Davis JM
Racial and ethnic disparities in adult COVID-19 and the future impact on child health.
This article discusses the impact of the COVID-19 pandemic on children who are racial and ethnic minorities and the disproportionate harm to them. The authors urge that COVID-19-focused research consider racial and ethnic disparity. The paper discusses the lasting and intergenerational impact of COVID-19 on communities of color, especially children, due to increase in stress, material hardship, food insecurity, and long-term school readiness.
Citation: Fraiman YS, Litt JS, Davis JM . Racial and ethnic disparities in adult COVID-19 and the future impact on child health. Pediatr Res 2021 Apr;89(5):1052-54. doi: 10.1038/s41390-021-01377-x..
Keywords: COVID-19, Children/Adolescents, Racial / Ethnic Minorities, Disparities, Health Status, Social Determinants of Health
Thomson J, Hall M, Nelson K
Timing of co-occurring chronic conditions in children with neurologic impairment.
Children with neurologic impairment (NI) are at risk for developing co-occurring chronic conditions, increasing their medical complexity and morbidity. In this study, the authors assessed the prevalence and timing of onset for those conditions in children with NI. They concluded that children with NI enrolled in Medicaid had substantial multimorbidity that developed early in life.
Citation: Thomson J, Hall M, Nelson K . Timing of co-occurring chronic conditions in children with neurologic impairment. Pediatrics 2021 Feb;147(2):e2020009217. doi: 10.1542/peds.2020-009217..
Keywords: Children/Adolescents, Neurological Disorders, Chronic Conditions, Medicaid, Health Status
Wang S, Hanneman P, Xu C
Critical Care Recovery Center: a model of agile implementation in intensive care unit (ICU) survivors.
As many as 70% of intensive care unit (ICU) survivors suffer from long-term physical, cognitive, and psychological impairments known as post-intensive care syndrome (PICS). In this study, the investigators described how the first ICU survivor clinic in the United States, the Critical Care Recovery Center (CCRC), was designed to address PICS using the principles of Agile Implementation (AI).
Citation: Wang S, Hanneman P, Xu C . Critical Care Recovery Center: a model of agile implementation in intensive care unit (ICU) survivors. Int Psychogeriatr 2020 Dec;32(12):1409-18. doi: 10.1017/s1041610219000553..
Keywords: Intensive Care Unit (ICU), Critical Care, Health Status, Caregiving
Sonik RA, Coleman-Jensen A, Parish SL
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
The purpose of this study was to compare exposure to household food insufficiency and the relationship between household food insufficiency and both health status and emergency healthcare utilization among children with and without special healthcare needs (SHCN). The investigators concluded that compared with other children, children with SHCN have an elevated risk of exposure to household food insufficiency and experiencing greater reductions in health status when exposed.
Citation: Sonik RA, Coleman-Jensen A, Parish SL . Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs. Public Health Nutr 2020 Dec;23(17):3204-10. doi: 10.1017/s1368980020000361..
Keywords: Children/Adolescents, Nutrition, Health Status, Emergency Department, Public Health
Odlum M, Moise N, Kronish IM
Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018.
This study used records extracted from the Behavioral Risk Factor Surveillance System to determine which health indicators have improved or became worse among Black and Hispanic middle-aged (45 and older) adults compared to Whites from 1999 to 2018. This data is required by the Minority Health and Health Disparities Research and Education Act of 2000. A sample included of 4,856,326 participants, of them 60.9% women, mean age 60.4. During the last 20 years, Black adults showed an overall decrease showing improvement in uninsured status and physical inactivity while showing an overall increase in hypertension, diabetes, asthma, and stroke, and also the same increases and decreases in the Black-White gap. Hispanic adults showed improvement in physical inactivity and perceived poor health, while they showed overall deterioration in hypertension and diabetes. The Hispanic-White gap improved in coronary heart disease, stroke, kidney disease, asthma, arthritis, depression and physical inactivity while it increased for diabetes, hypertension, and uninsured status.
Citation: Odlum M, Moise N, Kronish IM . Trends in poor health indicators among Black and Hispanic middle-aged and older adults in the United States, 1999-2018. JAMA Netw Open 2020 Nov 2;3(11):e2025134. doi: 10.1001/jamanetworkopen.2020.25134..
Keywords: Elderly, Racial / Ethnic Minorities, Disparities, Health Status, Health Insurance, Diabetes, Hypertension, Chronic Conditions
Johnson J, Rodriguez MA, Al Snih S
Life-space mobility in the elderly: current perspectives.
The authors conducted a narrative review: a) to provide a summary of the articles that have assessed validation of the University of Alabama at Birmingham Life-Space Assessment instrument, the most widely used instrument to assess life-space mobility (LSM) in older adults; and b) to provide a summary of the research articles that have examined LSM as independent or outcome variable. They found that the identified studies showed that LSM instruments can accurately predict morbidity, mortality, and healthcare use.
Citation: Johnson J, Rodriguez MA, Al Snih S . Life-space mobility in the elderly: current perspectives. Clin Interv Aging 2020;15:1665-74. doi: 10.2147/cia.S196944..
Keywords: Elderly, Health Status
Kulhawy-Wibe SC, Zell J, Michaud K
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Researchers conducted a systematic review and appraisal of the cross-cultural adaptation and cross-cultural validity of the Health Assessment Questionnaire and its derivatives, and of the more recent Patient-Reported Outcomes Measurement Information System (PROMIS) functional status assessment measures (FSAMs) in rheumatoid arthritis. They concluded that their review highlighted a paucity of data on the cross-cultural validity of FSAMs and the mostly poor- or fair-quality methods by which they were translated and adapted.
Citation: Kulhawy-Wibe SC, Zell J, Michaud K . Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis. Arthritis Care Res 2020 Jun;72(6):798-805. doi: 10.1002/acr.23904..
Keywords: Arthritis, Cultural Competence, Health Status
Senft N, Abrams J, Katz
eHealth activity among African American and white cancer survivors: a new application of theory.
eHealth is a promising resource for cancer survivors and may contribute to reducing racial disparities in cancer survivorship. This research applied the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine eHealth activity among African American (AfAm) and White cancer survivors.
Citation: Senft N, Abrams J, Katz . eHealth activity among African American and white cancer survivors: a new application of theory. Health Commun 2020 Mar;35(3):350-55. doi: 10.1080/10410236.2018.1563031..
Keywords: Racial / Ethnic Minorities, Cancer, Disparities, Health Status, Telehealth, Health Information Technology (HIT)
Rundell SD, Resnik L, Heagerty PJ
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
The purpose of this prospective cohort study was to determine how well the functional comorbidity index (FCI) predicted outcomes in older adults with back pain compared to Quan's modification of the Charlson comorbidity index (Quan-Charlson comorbidity index) and the Elixhauser comorbidity index. The investigators concluded that all indices performed similarly in predicting outcomes. The authors indicated that there is still a need to develop better function-based risk-adjustment models that improve prediction of functional outcomes versus standard comorbidity indices.
AHRQ-funded; HS019222; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ . Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain. J Orthop Sports Phys Ther 2020 Mar;50(3):143-48. doi: 10.2519/jospt.2020.8764..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Healthcare Utilization, Health Status
Angraal S, Mortazavi BJ, Gupta A
Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction.
This study developed models to predict the risk of death and hospitalization in patients with heart failure (HF) with preserved ejection fraction (HFpEF). Data was used from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) clinical trial. Five methods: logistic regression with a forward selection of variables; logistic regression with a lasso regularization for variable selection; random forest (RF); gradient descent boosting; and support vector machine, were used to train models for assessing risks of mortality and HF hospitalization through 3 years of follow-up and were validated using 5-fold cross-validation. RF was found to be the best performing model for predicting mortality and HF hospitalization. Blood urea nitrogen levels, body mass index, and Kansas City Cardiomyopathy Questionnaire (KCCQ) subscale scores were strongly associated with mortality, while hemoglobin level, blood urea nitrogen, time since previous HF hospitalization, and KCCQ scores were the most significant predictors of HF hospitalization.
Citation: Angraal S, Mortazavi BJ, Gupta A . Machine learning prediction of mortality and hospitalization in heart failure with preserved ejection fraction. JACC Heart Fail 2020 Jan;8(1):12-21. doi: 10.1016/j.jchf.2019.06.013..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Mortality, Hospitalization, Risk, Health Status, Health Information Technology (HIT)
Hong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA
Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities.
This cohort study compared functional status improvements of poststroke patients who either went to an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF). The study used data from Medicare claims for stroke from January 2013 through November 2014. A total of 99,185 patients were studied. Patients admitted to SNFs tended to be older, female, and had a longer hospital length of stay than those admitted to IRFs. Stroke patients admitted to IRFs had larger improvements for mobility score points and for self-care on admission compared with those admitted to SNFs. There was found to be no statistical difference in the odds of 30- to 365-day mortality.
AHRQ-funded; HS024711; HS022134.
Citation: Hong I, Goodwin JS, Reistetter TA, I, Goodwin JS, Reistetter TA . Comparison of functional status improvements among patients with stroke receiving postacute care in inpatient rehabilitation vs skilled nursing facilities. JAMA Netw Open 2019 Dec 2;2(12):e1916646. doi: 10.1001/jamanetworkopen.2019.16646..
Keywords: Stroke, Cardiovascular Conditions, Rehabilitation, Health Status, Hospitalization, Nursing Homes
Barber CEH, Zell J, Yazdany J
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
This study’s objective was to develop American College of Rheumatology (ACR) Functional Status Assessment Measures (FSAMs) for patient reporting in most clinic settings. The authors convened a workgroup to conduct a systematic literature review through March 2017. They focused on the following FSAMs: the Health Assessment Questionnaire (HAQ) and derived measures from the Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Out of 11,835 articles identified in the search, 56 were included in the review. A modified Delphi process identified 7 measures which fulfilled the minimum standard for regular use, and 3 measures were recommended: the PROMIS 10-item short form, the HAQ-II, and the Multidimensional HAQ.
Citation: Barber CEH, Zell J, Yazdany J . 2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis. Arthritis Care Res 2019 Dec;71(12):1531-39. doi: 10.1002/acr.24040..
Keywords: Arthritis, Health Status, Guidelines, Evidence-Based Practice
Roy B, Riley C, Herrin J
Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states.
The objective of this study was to evaluate the association between community well-being, a positively framed, multidimensional assessment of the health and quality of life of a geographic community, and hospitalisation rates. The investigators found that community well-being was inversely associated with local hospitalisation rates. They suggest that in addition to health and quality-of-life benefits, higher community well-being may also result in fewer unnecessary hospitalisations.
Citation: Roy B, Riley C, Herrin J . Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states. BMJ Open 2019 Nov 27;9(11):e030017. doi: 10.1136/bmjopen-2019-030017..
Keywords: Hospitalization, Health Status, Quality of Life, Healthcare Utilization, Social Determinants of Health, Socioeconomic Factors
Calthorpe LM, Pantell MS
Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health.
This study examined differences in childhood exposures to adverse childhood experiences (ACEs) by geography and determined whether geography moderates the relationship between ACE exposure and health outcomes including overall health, asthma, ADHD, and special health care needs. Cross-sectional data from 2017-2017 National Survey of Children’s Health (NSCH) was analyzed. Rural residency was associated with 1.29 times increased odds of exposure to 4+ ACEs compared to suburban residency. Urban residency status was observed to increase the association between ACEs and asthma.
Citation: Calthorpe LM, Pantell MS . Differences in the prevalence of childhood adversity by geography in the 2017-18 National Survey of Children's Health. Child Abuse Negl 2021 Jan;111:104804. doi: 10.1016/j.chiabu.2020.104804..
Keywords: Children/Adolescents, Social Determinants of Health, Health Status
McKellar MS, Kuchibhatla MN, Oursler KAK
Racial differences in change in physical functioning in older male veterans with HIV.
Little is known about longitudinal change in physical functioning of older African American/Black and White HIV-infected persons. In this study, the investigators examined up to 10 years of data on African American and White men with HIV infection and comparable HIV-negative men age 50-91 years from the Veterans Aging Cohort Study Survey sample.
AHRQ-funded; HS021112; HS023464; HS023258.
Citation: McKellar MS, Kuchibhatla MN, Oursler KAK . Racial differences in change in physical functioning in older male veterans with HIV. AIDS Res Hum Retroviruses 2019 Nov/Dec;35(11-12):1034-43. doi: 10.1089/aid.2018.0296..
Keywords: Human Immunodeficiency Virus (HIV), Veterans, Health Status, Racial / Ethnic Minorities, Elderly, Men's Health
Zullo AR, Adams JW, Gantenberg JR
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. The investigators found that strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. They suggest that researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
Citation: Zullo AR, Adams JW, Gantenberg JR . Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data. Ann Epidemiol 2019 Nov;39:8-14.e4. doi: 10.1016/j.annepidem.2019.09.010..
Keywords: Children/Adolescents, Low-Income, Vulnerable Populations, Disparities, Social Determinants of Health, Socioeconomic Factors, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
Huguet N, Angier H, Hoopes MJ
Prevalence of pre-existing conditions among community health center patients before and after the Affordable Care Act.
Investigators assessed the prevalence of pre-existing conditions for community health center (CHC) patients who gained insurance coverage post-Affordable Care Act (ACA). They found that their study emphasized the high prevalence of pre-existing conditions among CHC patients and the large increase in the proportion of patients with at least one of these diagnoses post-ACA. They conclude that, given how common these conditions are, repealing pre-existing condition protections could be extremely harmful to millions of patients and would likely exacerbate health care and health disparities.
Citation: Huguet N, Angier H, Hoopes MJ . Prevalence of pre-existing conditions among community health center patients before and after the Affordable Care Act. J Am Board Fam Med 2019 Nov-Dec;32(6):883-89. doi: 10.3122/jabfm.2019.06.190087..
Keywords: Health Status, Community-Based Practice, Chronic Conditions, Health Insurance, Policy
Vistnes JP, Hill SC
AHRQ Author: Vistnes JP, Hill SC
The dynamics Of Medicaid enrollment, employment, and beneficiary health status.
In this article, the authors discuss the dynamics of Medicaid enrollment, employment and beneficiary status. Using national data, the investigators found that 13.9 percent of new, nonelderly adult Medicaid beneficiaries in 2015-16 had experienced a decline in health before enrollment, and a similar percentage had had jobs that ended before they enrolled.
Citation: Vistnes JP, Hill SC . The dynamics Of Medicaid enrollment, employment, and beneficiary health status. Health Aff 2019 Sep;38(9):1491-95. doi: 10.1377/hlthaff.2019.00066..
Keywords: Health Status, Medicaid, Medical Expenditure Panel Survey (MEPS), Policy
Campbell AD, Baker EH
Do income inequalities in higher weight status depend on social integration?
In this study, the investigators use data from the 2003-2008 National Health and Nutrition Examination Survey (NHANES) to examine whether the association between higher weight status and social integration varies by income. The investigators concluded that the association between income and higher weight status operates differently for women and men and is dependent, in part, on their level of social integration.
Citation: Campbell AD, Baker EH . Do income inequalities in higher weight status depend on social integration? Soc Sci Res 2019 Sep;83:102301. doi: 10.1016/j.ssresearch.2019.04.014..
Keywords: Health Status, Obesity, Obesity: Weight Management, Socioeconomic Factors
Papaleontiou M, Reyes-Gastelum D, Gay BL
Worry in thyroid cancer survivors with a favorable prognosis.
Researchers investigated cancer-related worry in thyroid cancer survivors with favorable prognosis. A diverse cohort of patients diagnosed with differentiated thyroid cancer, selected from the Surveillance, Epidemiology, and End Results (SEER) Program registries were surveyed for two to four years after diagnosis. The researchers recommended that physicians be aware that worry is a major issue for thyroid cancer survivors with favorable prognosis. Efforts should be undertaken to alleviate worry, especially among vulnerable groups, including female patients, younger patients, those with lower education, and racial/ethnic minorities.
Citation: Papaleontiou M, Reyes-Gastelum D, Gay BL . Worry in thyroid cancer survivors with a favorable prognosis. Thyroid 2019 Aug;29(8):1080-88. doi: 10.1089/thy.2019.0163..
Keywords: Cancer, Anxiety, Stress, Health Status
Rundle AG, Chen Y, Quinn JW
Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades.
To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. In this study, the Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area.
Citation: Rundle AG, Chen Y, Quinn JW . Development of a neighborhood walkability index for studying neighborhood physical activity contexts in communities across the U.S. over the past three decades. J Urban Health 2019 Aug;96(4):583-90. doi: 10.1007/s11524-019-00370-4
Keywords: Urban Health, Lifestyle Changes, Health Status, Social Determinants of Health
Nguyen UDT, Perneger T, Franklin PD
Improvement in mental health following total hip arthroplasty: the role of pain and function.
This prospective study examined whether mental health improved in patients who had total hip arthroplasty (THA) due to improvement in pain and function 1 year post-surgery. Patients enrolled in a THA registry from 2010 to 2014 were included and the mental component score (MCS) was examined before and 1 year post-surgery. There was a significant improvement in mental health due to less pain and improved function.
Citation: Nguyen UDT, Perneger T, Franklin PD . Improvement in mental health following total hip arthroplasty: the role of pain and function. BMC Musculoskelet Disord 2019 Jun 29;20(1):307. doi: 10.1186/s12891-019-2669-y..
Keywords: Health Status, Behavioral Health, Orthopedics, Outcomes, Pain, Patient-Centered Outcomes Research, Quality of Life, Surgery
Ahmad FS, Kallen MA, Schifferdecker KE
Development and initial validation of the PROMIS(R)-Plus-HF profile measure.
This paper describes the efforts to develop and validate the PROMIS®-Plus-HF (Patient-Reported Outcomes Measurement Information System®-Plus-Heart Failure) profile measure. The authors conducted 8 focus groups with 61 patients with HF and phone interviews with 10 HF clinicians. They tested the measure with a 600-patient sample. Validity was analyzed and confirmed using Pearson r and Spearman rho correlations with Kansas City Cardiomyopathy Questionnaire subscores. The measure consists of 86 items across 18 domains.
Citation: Ahmad FS, Kallen MA, Schifferdecker KE . Development and initial validation of the PROMIS(R)-Plus-HF profile measure. Circ Heart Fail 2019 Jun;12(6):e005751. doi: 10.1161/circheartfailure.118.005751.
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Cardiovascular Conditions, Decision Making, Quality of Life, Health Status
Angraal S, Gupta A, Khera R
Association of access to exercise opportunities and cardiovascular mortality.
The purpose of this study is to examine the patterns of cardiovascular disease (CVD) mortality in varying degrees of access within the U.S. at the county level. The results indicate that access to exercise opportunities has a significant association with adjusted CVD mortality--higher access correlates with lower CVD mortality. Counties that have lower access to exercise facilities show a higher prevalence of obesity and diabetes in comparison with counties that have higher access. States with fewer people living in close proximity to a park have higher percentage of people who do not engage in any leisure physical activity. These results suggest means by which opportunities to increase access may be developed.
Citation: Angraal S, Gupta A, Khera R . Association of access to exercise opportunities and cardiovascular mortality. Am Heart J 2019 Jun;212:152-56. doi: 10.1016/j.ahj.2019.02.010..
Keywords: Cardiovascular Conditions, Health Status, Mortality, Social Determinants of Health