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Research Studies is a compilation of published research articles funded by ´óÏóÊÓƵor authored by ´óÏóÊÓƵresearchers.

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1 to 15 of 15 Research Studies Displayed
Brooks Carthon JM, Tibbitt C, Amenyedor KE
Pre-implementation strategies to support adaptation of Thrive: a care transitions model for economically disadvantaged patients with serious mental illness.
This study explored pre-implementation strategies for adapting Thrive, a nurse-led transitional care model for economically disadvantaged patients with serious mental illness who face care transition challenges after hospitalization. Researchers employed Evidence Based Quality Improvement meetings and Formative Evaluation research, which included semi-structured interviews analyzed through Rapid Qualitative Analysis. The investigation led to modifications of Thrive's core components and identified implementation support strategies.
AHRQ-funded; HS029815.
Citation: Brooks Carthon JM, Tibbitt C, Amenyedor KE . Pre-implementation strategies to support adaptation of Thrive: a care transitions model for economically disadvantaged patients with serious mental illness. Nurs Rep 2024 Dec 2; 14(4):3803-18. doi: 10.3390/nursrep14040278..
Keywords: Behavioral Health, Transitions of Care, Vulnerable Populations, Low-Income
Negro D, Yazdani M, Benitez L
Caregiver perspectives on improving government nutrition benefit programs.
The objective of this study was to understand Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) beneficiaries' perceptions and suggestions for improving both programs. Researchers conducted phone interviews with caregivers of pediatric patients who were current or former WIC and SNAP beneficiaries at two academic pediatric primary care clinics. The participants identified several modifiable barriers to enrollment and benefits redemption.
AHRQ-funded; HS028555; HS029396.
Citation: Negro D, Yazdani M, Benitez L . Caregiver perspectives on improving government nutrition benefit programs. Pediatrics 2024 Nov 1; 154(5). doi: 10.1542/peds.2024-067012.
Keywords: Caregiving, Nutrition, Low-Income, Vulnerable Populations
Levison JH, Fung V, Wilson A
Predictors of COVID-19 infection and hospitalization in group homes for individuals with intellectual and/or developmental disabilities.
The objective of this study was to identify correlates of COVID-19 and related hospitalizations among people with intellectual and/or developmental disabilities (ID/DD) in group homes in Massachusetts. The results showed that, compared with Massachusetts residents, group home residents had higher age-adjusted rates of COVID-19 and of hospitalization in the first two waves of the pandemic. COVID-19 infections and hospitalizations were more likely among residents aged over 65 and in group homes with more than six resident beds and recent infection among staff and residents. The authors concluded that aggressive efforts to decrease resident density, staff-to-resident ratios, and staff infections may reduce COVID-19 and related hospitalizations in people with ID/DD living in group homes.
AHRQ-funded; HS000063.
Citation: Levison JH, Fung V, Wilson A . Predictors of COVID-19 infection and hospitalization in group homes for individuals with intellectual and/or developmental disabilities. Disabil Health J 2024 Oct; 17(4):101645. doi: 10.1016/j.dhjo.2024.101645..
Keywords: COVID-19, Disabilities, Hospitalization, Vulnerable Populations, Public Health
Cartier Y, Fichtenberg C, Grounds K
"We need to know these things": Use Cases for combined social and clinical data among primary care-based clinical and social care providers.
A qualitative study in San Diego County examined how healthcare providers view the integration of clinical and social data in primary care settings. Through interviews with 39 providers from six organizations, researchers identified three main benefits: comprehensive patient understanding, improved care customization, and enhanced team coordination. Both clinical and social care providers emphasized the value of accessing combined data sets to better serve patient needs, suggesting opportunities for practice innovations and improved care delivery systems.
AHRQ-funded; HS027394.
Citation: Cartier Y, Fichtenberg C, Grounds K . "We need to know these things": Use Cases for combined social and clinical data among primary care-based clinical and social care providers. J Prim Care Community Health 2024 Jan-Dec; 15. doi: 10.1177/21501319241286306.
Keywords: Primary Care, Social Determinants of Health, Patient-Centered Healthcare, Vulnerable Populations
Fowler ME, Harmon C, Tucker A
The association between social vulnerability and geriatric assessment impairments among older adults with gastrointestinal cancers-The CARE Registry.
Researchers examined the association between social vulnerability and aging outcomes among older adults with cancer. The study included adults aged 60 and older who were recently diagnosed with gastrointestinal (GI) cancer and were undergoing geriatric assessments (GAs) at their first prechemotherapy visit to the University of Alabama at Birmingham oncology clinic; outcomes were frailty and total number of GA impairments. The results indicated that greater social vulnerability was associated with a higher prevalence of frailty and an increasing average number of GA impairments. The researchers concluded that intervention on social vulnerability may decrease the risk of frailty and GA impairments, but associations of race and education should be further evaluated.
AHRQ-funded; HS013852.
Citation: Fowler ME, Harmon C, Tucker A . The association between social vulnerability and geriatric assessment impairments among older adults with gastrointestinal cancers-The CARE Registry. Cancer 2024 Sep 15; 130(18):3188-97. doi: 10.1002/cncr.35390..
Keywords: Elderly, Cancer, Social Determinants of Health, Vulnerable Populations
Moon KJ, Linton SL, Kazerouni NJ
Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies.
A nationwide telephone audit investigated buprenorphine dispensing practices at community pharmacies across the United States, examining potential disparities in access to opioid use disorder treatment medication. The study evaluated 858 pharmacies across 473 counties using secret shopper calls to assess prescription filling capabilities. Researchers measured county-level segregation patterns using the Index of Concentration at the Extremes, analyzing racial, ethnic, economic, and combined racial-economic factors. The investigation revealed that pharmacies in areas with high economic deprivation and ethnic segregation demonstrated greater likelihood of restricted buprenorphine dispensing. These dispensing limitations were particularly evident in socially and economically disadvantaged communities.
AHRQ-funded; HS026370.
Citation: Moon KJ, Linton SL, Kazerouni NJ . Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies. Drug Alcohol Depend Rep 2024 Sep; 12:100255. doi: 10.1016/j.dadr.2024.100255..
Keywords: Opioids, Medication, Provider: Pharmacist, Substance Abuse, Behavioral Health, Access to Care, Disparities, Racial and Ethnic Minorities, Vulnerable Populations
Harrison J, McDermott G, Dixon EL
Eligibility of emergency department patients for public benefit programs.
The objective of this study was to survey emergency department (ED) patients to determine the proportion that were eligible for unclaimed public benefits. In addition, the authors surveyed patients to assess whether screening for benefits eligibility in the ED was appropriate and explored strategies for optimal linkage to application services. The researchers determined whether patients were potentially eligible for benefits via an existing web-based screening application, Benefits Launch Express (BLX). The application determined eligibility among 15 benefits of interest. Out of 282 eligible patients approached in the ED, 202 completed the survey. A total of 129 had Medicaid only, 48 had Medicare only, and 7 had no health insurance. Of the 15 benefits assessments, participants were already enrolled in a mean of 1.1 benefits. However, participants were eligible for a mean of 3.7 additional unclaimed benefits. The most common benefits participants were eligible were earned income tax credit (EITC), Low-Income Home Energy Assistance Program (LIHEAP), property tax/rent rebate, and Supplemental Nutrition Assistance Program (SNAP). Most participants (52.5%) reported having previously applied for benefits, with most (77.2%) reporting future interest in applying for benefits. The authors found that ED patients with no public or no health insurance were often eligible for unclaimed state or federal benefits.
AHRQ-funded; HS026372.
Citation: Harrison J, McDermott G, Dixon EL . Eligibility of emergency department patients for public benefit programs. Acad Emerg Med 2024 Aug; 31(8):820-23. doi: 10.1111/acem.14870..
Keywords: Emergency Department, Vulnerable Populations, Social Determinants of Health
Hoang TN, Berenson AB, Shan Y
Trends in HPV-associated cancer incidence in Texas medically underserved regions.
This study examined trends in HPV-associated cancer incidence in medically underserved areas of Texas, including cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers. The authors used cancer data from the TX Cancer Registry for 2006 to 2009. They calculated incidence rate (IR) per 100,000 and drew heat maps to visualize cancer IR by county. To control potential confounders, they added county-level risk factors: rates for smoking, excessive drinking, obesity, STIs, primary care provider availability and dentist availability, from the County Health Rankings and Roadmaps program. They reported IRs by region and time and estimated unadjusted and adjusted risk ratio (RR) for association of each type of cancer and region. Lastly, they created adjusted models for each cancer by period to see time trends of regional differences. They found that risk of anal, cervical, and oropharyngeal cancer was lower at parts of the Border than in the rest of TX in the adjusted model. They also observed increasing anal and oropharyngeal cancer risk and decreasing cervical and vaginal cancer risk over time.
AHRQ-funded; HS026133.
Citation: Hoang TN, Berenson AB, Shan Y . Trends in HPV-associated cancer incidence in Texas medically underserved regions. Cancer Med 2024 Aug; 13(16):e70133. doi: 10.1002/cam4.70133..
Keywords: Cancer, Vulnerable Populations, Sexual Health
Liaw W, King B, Olaisen H
´óÏóÊÓƵAuthor: Olaisen H
How an academic direct primary care clinic served patients from vulnerable communities.
This AHRQ-authored paper’s purpose was to describe the demographics and appointments of a now closed, academic direct primary care (DPC) clinic and determine whether there are differences in vulnerability between census tracts with and without any clinic patients. The authors linked geocoded data from the DPC's electronic health record with the social vulnerability index (SVI). They described the users’ age, sex, language, membership, diagnoses, and appointments. To determine differences in SVI, they calculated a localized SVI percentile within Harris County. They included 322 patients and 772 appointments, with patients seen an average of 2.4 times and predominantly female (58.4%). More than a third spoke Spanish. Census tracts in which DPC patients lived had significantly higher SVI scores (i.e., more vulnerable) than tracts where no DPC clinic patients resided (median, 0.60 vs 0.47).
AHRQ-authored.
Citation: Liaw W, King B, Olaisen H . How an academic direct primary care clinic served patients from vulnerable communities. J Am Board Fam Med 2024 May-Jun; 37(3):455-65. doi: 10.3122/jabfm.2023.230346R1..
Keywords: Primary Care, Vulnerable Populations, Community-Based Practice, Access to Care
Bhalla S, Natchimuthu V, Lee JL
Effect of patient navigation on completion of lung cancer screening in vulnerable populations.
A randomized controlled trial in an urban safety-net healthcare system evaluated the effectiveness of telephone-based navigation for low-dose CT lung cancer screening (LCS). The study found no significant difference in the completion of the first three consecutive LCS steps between patients receiving navigation and those in usual care. However, when LCS steps were ordered, patients who received navigation demonstrated higher completion rates. Notably, the lack of order placement emerged as a key factor contributing to incomplete LCS steps. Based on these findings, researchers suggest that a combination of clinical team education, streamlined order placement processes, and patient navigation may be effective strategies for improving LCS uptake and completion in safety-net settings.
AHRQ-funded; HS022418.
Citation: Bhalla S, Natchimuthu V, Lee JL . Effect of patient navigation on completion of lung cancer screening in vulnerable populations. J Natl Compr Canc Netw 2024 Mar 15; 22(3):151-57. doi: 10.6004/jnccn.2023.7094..
Keywords: Cancer: Lung Cancer, Cancer, Vulnerable Populations, Screening, Patient-Centered Healthcare, Patient and Family Engagement
Kahn NF, Asante PG, Guler J
Caregiver perspectives on receiving gender-affirming care with their transgender and gender diverse adolescents via telemedicine.
This study explored caregivers' perspectives on the use of telemedicine for gender-affirming care for transgender and gender diverse (TGD) adolescents. The researchers conducted semi-structured interviews with 18 caregivers of TGD adolescents aged 14-17, aiming to understand their views on this care delivery modality. The analysis revealed several advantages of telemedicine, including the convenience of participating in visits from home, reduced anxiety, COVID-19 safety, increased family member attendance, elimination of transportation needs, and effective care delivery. However, caregivers also noted disadvantages such as potential dysphoria or discomfort with self-image during video calls, impersonal provider-patient interactions, video conferencing fatigue, difficulties with portal navigation, connectivity issues, and privacy concerns. Interestingly, caregivers generally deferred to their child's preference regarding the choice of visit modality. Many expressed a preference for conducting the initial visit in-person, followed by telemedicine for follow-up and less complex appointments.
AHRQ-funded; HS026393.
Citation: Kahn NF, Asante PG, Guler J . Caregiver perspectives on receiving gender-affirming care with their transgender and gender diverse adolescents via telemedicine. LGBTQ Fam 2024; 20(3):190-200. doi: 10.1080/27703371.2024.2317139..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Vulnerable Populations, Caregiving
Sequeira GM, Asante PG, Bocek K
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
An electronic consultation (e-consult) platform was introduced to conduct a study to aid pediatric primary care providers (PCPs) in providing gender-affirming care to transgender and nonbinary (TNB) adolescents. A study assessed its impact on PCP confidence and referral patterns. Results showed increased confidence and a 19% decrease in specialty referrals among PCPs. The platform received positive usability feedback, suggesting its potential to enhance care access and reduce specialty referrals for TNB adolescents.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Asante PG, Bocek K . Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents. Telemed J E Health 2024 Feb; 30(2):595-600. doi: 10.1089/tmj.2023.0266.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Primary Care, Vulnerable Populations
Engelberg RS, Scheidell JD, Islam N
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
This study’s objective was to assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia. The authors performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). They used Poisson regression to estimate the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. They evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian) with an analytic sample of 4,015 Add Health respondents. Outcome measures included hypertension, systolic blood pressure >130 mmHG, and hyperglycemia. There was no evidence of an association between incarceration and measured health outcomes among non-Hispanic Black and non-Hispanic White participants. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1) and hypertension (ARR: 1.7) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5) among Asian subgroups.
AHRQ-funded; HS026120.
Citation: Engelberg RS, Scheidell JD, Islam N . Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups. J Gen Intern Med 2024 Jan; 39(1):5-12. doi: 10.1007/s11606-023-08327-9..
Keywords: Vulnerable Populations, Racial and Ethnic Minorities, Blood Pressure, Cardiovascular Conditions, Risk
Brooks Carthon M, Muir J, Iroegbu C
COVID-19 mortality disparities among socially vulnerable Medicare beneficiaries associated with the quality of nurse work environments in U.S. hospitals.
Research examining COVID-19 mortality among Medicare beneficiaries explored relationships between social vulnerability, hospital nursing environments, and patient outcomes in New York and Illinois. Patients with high social vulnerability experienced higher mortality rates compared to those with low vulnerability. The study found that high-quality nursing work environments had a particularly strong positive impact on survival rates among the most socially vulnerable patients, suggesting that improved nursing conditions could help reduce healthcare disparities during public health emergencies.
AHRQ-funded; HS028978.
Citation: Brooks Carthon M, Muir J, Iroegbu C . COVID-19 mortality disparities among socially vulnerable Medicare beneficiaries associated with the quality of nurse work environments in U.S. hospitals. Inquiry 2024 Jan-Dec; 61:469580241284959. doi: 10.1177/00469580241284959.
Keywords: COVID-19, Disparities, Mortality, Medicare, Vulnerable Populations, Hospitals, Nursing
Zamalin D, Hamlin Shults, J J
Predictors of making a referral to child protective services prior to expert consultation.
This study investigated factors affecting child protective services (CPS) referrals before consultation by a Child Abuse Pediatrician (CAP) for suspected cases of physical abuse in children under 5 years old. Analysis revealed that despite the CAP expressing low concern for abuse in 38% of cases, 61% received preconsultation referrals. Socioeconomic biases, particularly evident in referral rates based on insurance status, were found to influence referral decisions.
AHRQ-funded; HS028847.
Citation: Zamalin D, Hamlin Shults, J J . Predictors of making a referral to child protective services prior to expert consultation. Acad Pediatr 2024 Jan-Feb; 24(1):78-86. doi: 10.1016/j.acap.2023.05.002..
Keywords: Children/Adolescents, Domestic Violence, Vulnerable Populations

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