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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 25 of 80 Research Studies DisplayedMcMurtry CL, Findling MG, Casey LS
Discrimination in the United States: experiences of Asian Americans.
This study examined the prevalence of racial discrimination among Asian Americans and its impact on health outcomes. A nationally representative, probability-based telephone survey was conducted comparing 500 Asian and 902 white US adults from January to April 2017. Thirteen percent of Asians reported discrimination in healthcare encounters, and at least one in four experienced discrimination in employment, housing, and experienced microaggressions (35%) or racial slurs (32%). This resulted in Asians having higher odds than whites of reporting avoiding health care due to discrimination concerns.
AHRQ-funded; HS000055.
Citation: McMurtry CL, Findling MG, Casey LS .
Discrimination in the United States: experiences of Asian Americans.
Health Serv Res 2019 Dec;54(Suppl2):1419-30. doi: 10.1111/1475-6773.13225..
Keywords: Racial and Ethnic Minorities, Disparities, Social Determinants of Health, Patient Experience
Bi S, Gunter KE, Lopez FY
Improving shared decision making for Asian American Pacific Islander sexual and gender minorities.
This study examined the challenges Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) encounter with shared decision making (SDM) with their providers, especially concerning mental health. Focus groups were conducted in San Francisco and interviews were conducted in Chicago and San Francisco. The participants were surveyed about attitudes towards SGM disclosure and preferences about providers. Many participants felt that providers either ignored or overemphasized their identities. Some shared the stigma of SGM identities and effects on mental health in their own families.
AHRQ-funded; HS023050.
Citation: Bi S, Gunter KE, Lopez FY .
Improving shared decision making for Asian American Pacific Islander sexual and gender minorities.
Med Care 2019 Dec;57(12):937-44. doi: 10.1097/mlr.0000000000001212..
Keywords: Shared Decision Making, Racial and Ethnic Minorities, Vulnerable Populations, Patient and Family Engagement, Patient-Centered Healthcare, Behavioral Health, Social Stigma
Sun K, Szymonifka J, Tian H
Is traditional Chinese medicine use associated with worse patient-reported outcomes among Chinese American rheumatology patients?
Chinese Americans are a fast-growing immigrant group with more severe rheumatic disease manifestations than whites and often a strong cultural preference for traditional Chinese medicine (TCM). In this study, the investigators aimed to examine TCM use patterns and association with patient-reported outcomes (PRO) among Chinese American rheumatology patients. The investigators concluded that among these Chinese American rheumatology patients, TCM users had worse PRO in many physical and mental health domains.
AHRQ-funded; HS000066.
Citation: Sun K, Szymonifka J, Tian H .
Is traditional Chinese medicine use associated with worse patient-reported outcomes among Chinese American rheumatology patients?
J Rheumatol 2019 Dec;46(12):1634-39. doi: 10.3899/jrheum.181148..
Keywords: Complementary and Alternative Medicine, Racial and Ethnic Minorities, Outcomes
Vu JV, Gunaseelan V, Dimick JB
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Black patients and older adults are less likely to receive minimally invasive hernia repair. In this study, the investigators explored the association between race, age, and surgeon utilization of minimally invasive surgery (MIS) with the likelihood of receiving MIS inguinal hernia repair. The investigators concluded that race differences were explained by surgeon MIS utilization, implicating access to MIS-performing surgeon as a mediator. Conversely, age disparity was independent of MIS utilization, even after adjusting for comorbidities, indicating some degree of provider bias against performing MIS repair in older patients.
AHRQ-funded; HS025778.
Citation: Vu JV, Gunaseelan V, Dimick JB .
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Surg Endosc 2019 Dec;33(12):4032-37. doi: 10.1007/s00464-019-06695-0..
Keywords: Racial and Ethnic Minorities, Surgery, Elderly, Access to Care, Healthcare Utilization
Rhodes RL, Ukoha NCE, Williams KA
Understanding underuse of advance care planning among a cohort of African American patients with advanced cancer: formative research that examines gaps in intent to discuss options for care.
Advance care planning (ACP), palliative care (PC), and hospice are often underutilized by African Americans. This study assessed the impact of stage of intent to discuss ACP options as key potential barriers. The investigators concluded that despite being hospitalized with advanced cancer and having poor prognosis, intent to discuss ACP options, PC, and hospice in this population was variable, and completion of these activities was low.
AHRQ-funded; HS022418.
Citation: Rhodes RL, Ukoha NCE, Williams KA .
Understanding underuse of advance care planning among a cohort of African American patients with advanced cancer: formative research that examines gaps in intent to discuss options for care.
Am J Hosp Palliat Care 2019 Dec;36(12):1057-62. doi: 10.1177/1049909119843276..
Keywords: Cancer, Palliative Care, Patient-Centered Healthcare, Racial and Ethnic Minorities
Quan VL, Erickson T, Daftary K
Atopic dermatitis across shades of skin.
This narrative review discussed key terminology related to atopic dermatitis (AD) across shades of skin, including modern definitions of 'race', 'ethnicity', and 'skin of color (SOC)'. Current literature describing disparities in AD prevalence, disease recognition, and burden was synthesized alongside data regarding genetic and immunologic findings across SOC populations. The authors highlighted key concomitant social determinants of health, including environmental factors, socioeconomic status, and access to care, within the context of these findings. They also discussed future efforts to move toward a more inclusive understanding of AD that encompasses all shades of skin and ensures equitable representation of diverse populations in high impact research.
AHRQ-funded; HS026385.
Citation: Quan VL, Erickson T, Daftary K .
Atopic dermatitis across shades of skin.
Am J Clin Dermatol 2023 Sep; 24(5):731-51. doi: 10.1007/s40257-023-00797-1..
Keywords: Skin Conditions, Racial and Ethnic Minorities
Biener AI, Zuvekas SH
AHRQ Author: Zuvekas SH
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
AHRQ-authored.
Citation: Biener AI, Zuvekas SH .
Do racial and ethnic disparities in mental health treatment vary with underlying mental health?
Med Care Res Rev 2021 Aug;78(4):392-403. doi: 10.1177/1077558720903589..
Keywords: Medical Expenditure Panel Survey (MEPS), Behavioral Health, Disparities, Racial and Ethnic Minorities, Access to Care
Aroke EN, Jackson P, Overstreet DS
Race, social status, and depressive symptoms: a moderated mediation analysis of chronic low back pain interference and severity.
Clin J Pain 2020 Sep;36(9):658-66. doi: 10.1097/ajp.0000000000000849.
Citation: Aroke EN, Jackson P, Overstreet DS .
Race, social status, and depressive symptoms: a moderated mediation analysis of chronic low back pain interference and severity.
Clin J Pain 2020 Sep;36(9):658-66. doi: 10.1097/ajp.0000000000000849.
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Keywords: Back Health and Pain, Chronic Conditions, Pain, Racial and Ethnic Minorities
Bass AR, Mehta B, Szymonifka J
Racial disparities in total knee replacement failure as related to poverty.
The authors sought to determine whether racial disparities in total knee replacement (TKR) failure are explained by poverty. Linking New York state patients to residential census tracts by geocoded addresses, they found that there was a trend toward higher TKR revision risk in blacks, but poverty did not modify the relationship between race and TKR revision or failure.
AHRQ-funded; HS016075.
Citation: Bass AR, Mehta B, Szymonifka J .
Racial disparities in total knee replacement failure as related to poverty.
Arthritis Care Res 2019 Nov;71(11):1488-94. doi: 10.1002/acr.24028..
Keywords: Disparities, Racial and Ethnic Minorities, Low-Income, Surgery, Orthopedics, Social Determinants of Health
Goins RT, Jones J, Schure M
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
This study’s purpose was to examine beliefs, attitudes, and practices of older Native Americans regarding type 2 diabetes mellitus (T2DM) management. This disease is one the leading causes of morbidity and mortality among Native Americans, and they are twice as likely to have T2DM, and over three times the mortality rate from T2DM as Whites. Semi-structured in-depth qualitative interviews were conducted with 28 participants with a mean age of 73 years, with 57% female. Participants’ mean confidence score of their T2DM management was 8.0 on a scale of 1 to 10 and their mean Hb1Ac was 7.3.%. Overall 5 themes were discussed: sociocultural factors, causes and consequences, cognitive and affective assessment, diet and exercise, and medical management.
AHRQ-funded; HS000078.
Citation: Goins RT, Jones J, Schure M .
Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices.
Ethn Health 2020 Nov;25(8):1055-71. doi: 10.1080/13557858.2018.1493092..
Keywords: Diabetes, Chronic Conditions, Elderly, Racial and Ethnic Minorities, Patient Self-Management, Care Management
Rice WS, Stringer KL, Sohail M
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
Limited studies to date assess barriers to and facilitators of pre-exposure prophylaxis (PrEP) uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. In this study, the investigators examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama.
AHRQ-funded; HS013852.
Citation: Rice WS, Stringer KL, Sohail M .
Accessing pre-exposure prophylaxis (PrEP): perceptions of current and potential prEP users in Birmingham, Alabama.
AIDS Behav 2019 Nov;23(11):2966-79. doi: 10.1007/s10461-019-02591-9..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Utilization, Patient-Centered Healthcare, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Access to Care, Health Promotion
Nguyen KH, Trivedi AN
Asian American access to care in the Affordable Care Act era: findings from a population-based survey in California.
This study compared coverage and access to care between non-Hispanic White and Asian American adults after the ACA in California. The data was disaggregated into the five most populous ethnic subgroups (Chinese, Korean, Filipino, Vietnamese, and Japanese). The outcomes measured were 1) being uninsured, 2) having a usual source of care, 3) delaying necessary medical care, and 4) delaying necessary prescription medications. The sample included 19,201 non-Hispanic White and 3077 Asian American adults aged 18 to 64 in California. Koreans were significantly less likely to report a usual source of care relative to non-Hispanic whites while Chinese and Vietnamese adults were significantly less likely to delay necessary care.
AHRQ-funded; HS000011.
Citation: Nguyen KH, Trivedi AN .
Asian American access to care in the Affordable Care Act era: findings from a population-based survey in California.
J Gen Intern Med 2019 Nov;34(11):2660-68. doi: 10.1007/s11606-019-05328-5..
Keywords: Racial and Ethnic Minorities, Access to Care, Disparities, Health Insurance, Uninsured, Policy
Li J, Pesko MF, Unruh MA
Effect of the Medicaid primary care rate increase on prenatal care utilization among Medicaid-insured women.
The purpose of this study was to evaluate the effect of the 2013-2014 ACA Medicaid Primary Care Rate Increase on Medicaid-insured women's prenatal care utilization, overall and by race and ethnicity. The investigators concluded that the Medicaid "fee bump" improved prenatal care utilization for non-Hispanic Black and White women. They suggest that policymakers may consider reinstating higher Medicaid reimbursements to improve access to care for disadvantaged populations.
AHRQ-funded; HS024357.
Citation: Li J, Pesko MF, Unruh MA .
Effect of the Medicaid primary care rate increase on prenatal care utilization among Medicaid-insured women.
Matern Child Health J 2019 Nov;23(11):1564-72. doi: 10.1007/s10995-019-02804-6..
Keywords: Medicaid, Primary Care, Maternal Care, Pregnancy, Women, Healthcare Utilization, Racial and Ethnic Minorities, Disparities
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), Health Status, Racial and Ethnic Minorities, Elderly, Men's Health
Howard SD, Lee KL, Nathan AG
Healthcare experiences of transgender people of color.
Researchers investigated how transgender people of color (TPOC) healthcare experiences are shaped by both race/ethnicity and gender identity. Using interviews and focus groups with participants in the Chicago area, they found that all participants described healthcare experiences where providers responded negatively to their race/ethnicity and/or gender identity. A majority of participants sought out healthcare locations designated as lesbian, gay, bisexual, and transgender-friendly in an effort to avoid discrimination, but feared experiencing racism there. When describing positive healthcare experiences, participants were most likely to highlight providers' respect for their gender identity. The researchers concluded that TPOC have different experiences compared with white transgender or cisgender racial/ethnic minorities and recommended that providers improve understanding of intersectional experiences of TPOC to improve quality of care.
AHRQ-funded; HS023050.
Citation: Howard SD, Lee KL, Nathan AG .
Healthcare experiences of transgender people of color.
J Gen Intern Med 2019 Oct;34(10):2068-74. doi: 10.1007/s11606-019-05179-0..
Keywords: Patient Experience, Vulnerable Populations, Cultural Competence, Racial and Ethnic Minorities, Primary Care, Ambulatory Care and Surgery
Hanchate AD, Paasche-Orlow MK, Baker WE
Association of race/ethnicity with emergency department destination of emergency medical services transport.
The authors examined the patterns of emergency department (ED) destination of emergency medical services (EMS) transport according to patient race/ethnicity and compared the patterns between those transported by EMS and those who did not draw on EMS. Using Medicare claims data, they found race/ethnicity variation in ED destination for patients using EMS transport, with black and Hispanic patients more likely to be transported to a safety-net hospital ED compared with white patients living in the same zip code.
AHRQ-funded; HS022242.
Citation: Hanchate AD, Paasche-Orlow MK, Baker WE .
Association of race/ethnicity with emergency department destination of emergency medical services transport.
JAMA Netw Open 2019 Sep 4;2(9):e1910816. doi: 10.1001/jamanetworkopen.2019.10816..
Keywords: Emergency Medical Services (EMS), Emergency Department, Racial and Ethnic Minorities, Medicare, Disparities
Vadlamani A, Perry JA, McCunn M
Racial differences in discharge location after a traumatic brain injury among older adults.
The purpose of this retrospective cohort study was to determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center. The authors concluded that in this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites.
AHRQ-funded; HS024560.
Citation: Vadlamani A, Perry JA, McCunn M .
Racial differences in discharge location after a traumatic brain injury among older adults.
Arch Phys Med Rehabil 2019 Sep;100(9):1622-28. doi: 10.1016/j.apmr.2019.03.008.
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Keywords: Racial and Ethnic Minorities, Brain Injury, Trauma, Elderly, Hospital Discharge, Rehabilitation, Medicare
Burnett-Zeigler I, Satyshur MD, Hong S
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
The authors examined the acceptability and feasibility of a mindfulness-based group intervention for socio-economically disadvantaged women in an urban community health center. Participants reported benefits to the intervention as well as barriers to session attendance. The authors concluded that the mindfulness-based intervention for depression was acceptable, reduced stress, and improved coping and functioning among women in a community health center.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Satyshur MD, Hong S .
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
Complement Ther Med 2019 Aug;45:19-24. doi: 10.1016/j.ctim.2019.05.012..
Keywords: Community-Based Practice, Depression, Behavioral Health, Racial and Ethnic Minorities, Women
Polubriaginof FCG, Ryan P, Salmasian H
Challenges with quality of race and ethnicity data in observational databases.
This study assessed the quality of race and ethnicity information in observational health databases as well as electronic health records (EHRs) and to propose patient self-recording as a way to improve accuracy. Data from the Healthcare Cost and Utilization Project (HCUP) and Optum Labs, and from a single New York City healthcare system’s EHR was compared. Among 160 million patients in the HCUP database, no race or ethnicity data was recorded for 25% of the records. Among the 2.4 million patients in the New York City HER, race or ethnicity was unknown for 57%. However, when patients were allowed to directly record their race and ethnicity, percentages rose to 86%.
AHRQ-funded; HS021816; HS023704; HS024713.
Citation: Polubriaginof FCG, Ryan P, Salmasian H .
Challenges with quality of race and ethnicity data in observational databases.
J Am Med Inform Assoc 2019 Aug;26(8-9):730-36. doi: 10.1093/jamia/ocz113..
Keywords: Healthcare Cost and Utilization Project (HCUP), Data, Racial and Ethnic Minorities, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
Sun CJ, Tobin K, Spikes P
Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention.
Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006-2009 identified individual and social network characteristics of Black MSM that were associated with disclosure that may be leveraged to increase disclosure.
AHRQ-funded; HS022981.
Citation: Sun CJ, Tobin K, Spikes P .
Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention.
AIDS Care 2019 Aug;31(8):1011-18. doi: 10.1080/09540121.2018.1548753..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Sexual Health, Men's Health, Prevention
Goff SL, Garb JL, Guhn-Knight H
Spatial analysis of factors influencing choice of paediatric practice for mothers from low-income and minority populations.
Publicly reported quality data theoretically enable parents to choose higher-performing paediatric practices. However, little is known about how parents decide where to seek paediatric care. In this study, the investigators explored the relationship between geographic factors, care quality and choice of practice to see if the decision-making process could be described in terms of a 'gravity model' of spatial data.
AHRQ-funded; HS021879.
Citation: Goff SL, Garb JL, Guhn-Knight H .
Spatial analysis of factors influencing choice of paediatric practice for mothers from low-income and minority populations.
J Paediatr Child Health 2019 Aug;55(8):948-55. doi: 10.1111/jpc.14322..
Keywords: Caregiving, Shared Decision Making, Low-Income, Quality of Care, Racial and Ethnic Minorities
Lipira L, Williams EC, Huh D
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
Investigators recruited a sample of African-American women living with HIV to participate in a stigma-reduction intervention. The women lived in Chicago and Birmingham from 2013 to 2015. The relationship between HIV-related stigma and viral suppression was evaluated and the role of depression and nonadherence to antiretroviral therapy (ART) was assessed. Among 100 women who participated 95% reported some level of HIV-related stigma. Those who reported higher levels of stigma did have lower odds of being virally suppressed. The indirect effects of depression and ART nonadherence were not statistically significant.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Huh D .
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
AIDS Behav 2019 Aug;23(8):2025-36. doi: 10.1007/s10461-018-2301-4..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Stigma, Women
Wright NC, Melton ME, Sohail M
Race plays a role in the knowledge, attitudes, and beliefs of women with osteoporosis.
This study examined racial disparities in knowledge of osteoporosis among women aged 65 and over with osteoporosis. Focus groups were created with a total of 48 women (36 white, 12 African American) enrolled. A knowledge scale called “Osteoporosis & You” was used to compare scores. White women had a mean score of 7.8 versus African American women who scored a mean of 6.6 out of 10 on the scale. The “powerful others” domain was significantly higher among African Americans versus white women as well. These racial differences can impact bone health and indicated a need to improve education and awareness about osteoporosis among African American women.
AHRQ-funded; HS023009.
Citation: Wright NC, Melton ME, Sohail M .
Race plays a role in the knowledge, attitudes, and beliefs of women with osteoporosis.
J Racial Ethn Health Disparities 2019 Aug;6(4):707-18. doi: 10.1007/s40615-019-00569-w..
Keywords: Disparities, Racial and Ethnic Minorities, Osteoporosis, Women
Gorges RJ, Sanghavi P, Konetzka RT
A national examination of long-term care setting, outcomes, and disparities among elderly dual eligibles.
The authors investigated the outcomes of expanding Medicaid funding for long-term care home and community-based services (HCBS). Using national Medicaid claims data on older adults enrolled in both Medicare and Medicaid, they found that overall hospitalization rates were similar for HCBS and nursing facility users. They concluded that home and community-based services need to be carefully targeted to avoid adverse outcomes and that the racial/ethnic disparities in access to high-quality institutional long-term care are also present in HCBS.
AHRQ-funded; HS000084.
Citation: Gorges RJ, Sanghavi P, Konetzka RT .
A national examination of long-term care setting, outcomes, and disparities among elderly dual eligibles.
Health Aff 2019 Jul;38(7):1110-18. doi: 10.1377/hlthaff.2018.05409..
Keywords: Elderly, Medicaid, Medicare, Long-Term Care, Home Healthcare, Disparities, Racial and Ethnic Minorities
Schure M, Goins RT, Jones J
Dietary beliefs and management of older American Indians with type 2 diabetes.
This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM). The investigators concluded that American Indian older adults face a variety of challenges to dietary management of T2DM. The investigators suggested that future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM.
AHRQ-funded; HS000078.
Citation: Schure M, Goins RT, Jones J .
Dietary beliefs and management of older American Indians with type 2 diabetes.
J Nutr Educ Behav 2019 Jul-Aug;51(7):826-33. doi: 10.1016/j.jneb.2018.11.007..
Keywords: Elderly, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Nutrition, Patient Self-Management