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Research Studies is a compilation of published research articles funded by 大象视频or authored by 大象视频researchers.

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1 to 25 of 486 Research Studies Displayed
Sliwinski K, McHugh MD, Squires AP
Nurse work environment and hospital readmission disparities between patients with and without limited English proficiency.
Researchers used multivariable logistic regression models to examine how hospital nurse work environment was associated with decreased disparities in hospital readmissions between patients with or without limited English proficiency (LEP). Significant interaction was found between patient LEP status and nurse work environment; patients with LEP experienced lower odds of 7-day readmission in more favorable nurse work environments.
AHRQ-funded; HS000078.
Citation: Sliwinski K, McHugh MD, Squires AP . Nurse work environment and hospital readmission disparities between patients with and without limited English proficiency. Res Nurs Health 2025 Jun; 48(3):398-405. doi: 10.1002/nur.22462.
Keywords: Provider: Nurse, Hospital Readmissions, Disparities
Bentley-Edwards K, Glover L, Johnson AE
Testing interventions that address kidney health disparities.
The purpose of this study was to develop and test clinical trials addressing kidney health disparities through the ERASE-KD consortium. The consortium designed five phase 2 randomized clinical trials targeting related barriers to optimal kidney care, with input from community partners including patients, caregivers, and advocates. Four trials focus on reducing disparities in kidney transplantation or optimal kidney replacement therapy for stage 4-5 chronic kidney disease, while one addresses unplanned healthcare utilization in earlier stages. The interventions range from high-intensity patient-level approaches to system-based interventions. The consortium developed a conceptual framework identifying the root causes of kidney health differences and established specific foci for each intervention.
AHRQ-funded; HS028684.
Citation: Bentley-Edwards K, Glover L, Johnson AE . Testing interventions that address kidney health disparities. J Am Soc Nephrol 2025 May; 36(5):970-72. doi: 10.1681/asn.0000000609.
Keywords: Kidney Disease and Health, Disparities
Levy DE, Lee SS, Qian Y
Disparities in cigarette smoking and the health of marginalized populations in the U.S.: a simulation analysis.
This study used the Simulation of Tobacco and Nicotine Outcomes and Policy (STOP) microsimulation model to project life expectancy as a function of subpopulation (low socioeconomic status (SES), higher SES, serious psychological distress (SPD), or non-SPD) and cigarette smoking status. Low SES was defined as having at least one of the following: income below poverty, less than high school education, or Medicaid insurance with higher SES individuals belonging to none of these categories. The authors simulated 40-year-olds stratified by gender, subpopulation (by SES or by SPD, with no change), and smoking status (current/never, with no change) to project individual life expectancy losses from smoking. To project time to reach 5% cigarette smoking prevalence (U.S.) - reflecting one tobacco "endgame" threshold - in each subpopulation, they simulated the entire subpopulations of people with low SES, higher SES, SPD, and non-SPD, incorporating corresponding distributions of gender, age, and smoking status and accounting for changes in smoking behaviors and secular smoking trends. The model showed that, for individuals with low SES or SPD, smoking is associated with substantial loss of life expectancy from 9.8 to 11.5 years. Marginalized subpopulations would reach 5% smoking prevalence 20 years (low SES) and 17 years (SPD) sooner if smoking trends mirrored their less marginalized counterparts; these differences result in 5.3 million (low SES) and 966,000 (SPD) excess life-years lost over 40 years.
AHRQ-funded; HS000063.
Citation: Levy DE, Lee SS, Qian Y . Disparities in cigarette smoking and the health of marginalized populations in the U.S.: a simulation analysis. BMC Public Health 2025 Apr 25; 25(1):1546. doi: 10.1186/s12889-025-22658-8.
Keywords: Tobacco Use, Vulnerable Populations, Disparities, Mortality, Simulation
Tu KJ, Vakkalanka JP, Okoro UE
Provider-to-provider telemedicine for sepsis is used less frequently in communities with high social vulnerability.
This study鈥檚 objective was to determine if county-level social vulnerability index (SVI) was associated with provider-to-provider emergency department (ED)-based telehealth consultation (tele-ED) use for sepsis and, if so, which SVI elements were most strongly associated. The authors used data from the TELEmedicine as a Virtual Intervention for Sepsis in Rural Emergency Department study. Providers in counties with a high SVI were less likely to use tele-ED, an effect principally attributable to the housing type and transportation component of SVI. Providers who treated fewer sepsis patients (1鈥10 vs. 31+ over study period) and therefore may have been less experienced in sepsis care, were more likely to activate tele-ED.
AHRQ-funded; HS025753.
Citation: Tu KJ, Vakkalanka JP, Okoro UE . Provider-to-provider telemedicine for sepsis is used less frequently in communities with high social vulnerability. J Rural Health 2025 Jan; 41(1):e12861. doi: 10.1111/jrh.12861.
Keywords: Telehealth, Health Information Technology (HIT), Sepsis, Rural Health, Rural/Inner-City Residents, Emergency Department, Vulnerable Populations, Disparities
Freeman JQ, Huo D, Howard FM
ASO author reflections: breast-conserving surgery after neoadjuvant systemic therapy for early-stage breast cancer: quantitative biomarkers and disparities in the precision-medicine Era.
This study鈥檚 goal was to quantify the likelihood of achieving breast-conserving surgery (BCS vs. mastectomy) after neoadjuvant chemotherapy or endocrine therapy as a function of demographics, quantitative ER/PR/Ki-67 expressions, 21-gene recurrence scores, or 70-gene risk scores in early-stage, and hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Using the 2010-2020 National Cancer Database, the authors found that the BCS rate after neoadjuvant chemotherapy was higher among patients with high 21-gene recurrence scores, lower ER/PR expression, or higher Ki-67 expression. Asian women were less likely to undergo BCS after neoadjuvant treatments than white women, as well as those lacking health insurance.
AHRQ-funded; HS025806.
Citation: Freeman JQ, Huo D, Howard FM . ASO author reflections: breast-conserving surgery after neoadjuvant systemic therapy for early-stage breast cancer: quantitative biomarkers and disparities in the precision-medicine Era. Ann Surg Oncol 2024 Dec; 31(13):8904-05. doi: 10.1245/s10434-024-16265-x.
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Disparities
Marcotte LM, Wheat CL, Rao M
Evaluating equity in a national virtual care management intervention: delivery and outcomes by race/ethnicity among veterans with hypertension and diabetes.
The objective of this study was to evaluate whether the Preventive Health Inventory (PHI), a virtual care management intervention implemented in the Veterans Health Administration (VHA), was delivered equitably among racial/ethnic groups. Researchers used data from the VHA Corporate Data Warehouse among veterans enrolled in primary care nationally. Their findings suggested that the PHI intervention was deployed equitably across race/ethnicity groups without significantly impacting most existing inequities in hypertension and diabetes.
AHRQ-funded; HS026369.
Citation: Marcotte LM, Wheat CL, Rao M . Evaluating equity in a national virtual care management intervention: delivery and outcomes by race/ethnicity among veterans with hypertension and diabetes. Health Serv Res 2024 Dec; 59(6):e14352. doi: 10.1111/1475-6773.14352.
Keywords: Diabetes, Blood Pressure, Racial and Ethnic Minorities, Disparities, Primary Care, Telehealth, Health Information Technology (HIT)
Sandal S, Ahn J, Chen Y
Differences in racial and ethnic disparities between first and repeat kidney transplantation.
Research examined racial and ethnic disparities in first-time versus repeat kidney transplantation using United States Renal Data System data from 1995-2018. The study analyzed outcomes for over 2.4 million patients, including White, Black, and Hispanic individuals. The investigation revealed that Black patients experienced greater disparities in accessing repeat transplantation compared to first-time procedures. Hispanic patients faced increased barriers to waitlisting for repeat transplantation versus initial transplants. The findings indicate persistent systemic barriers affecting access to repeat kidney transplantation among racial and ethnic minority groups.
AHRQ-funded; HS024600.
Citation: Sandal S, Ahn J, Chen Y . Differences in racial and ethnic disparities between first and repeat kidney transplantation. Transplantation 2024 Oct; 108(10):2144-52. doi: 10.1097/tp.0000000000005051..
Keywords: Transplantation, Kidney Disease and Health, Disparities, Racial and Ethnic Minorities, Access to Care
Kilaru AS, Liao JM, Wang E
Association between mandatory bundled payments and changes in socioeconomic disparities for joint replacement outcomes.
This study鈥檚 objective was to determine whether mandatory participation by hospitals in bundled payments for lower extremity joint replacement (LEJR) was associated with changes in outcome disparities for patients dually eligible for Medicare and Medicaid. The authors used Medicare claims data for beneficiaries undergoing LEJR in the United States between 2011 and 2017. They conducted a retrospective observational study using a differences-in-differences method to compare changes in outcome disparities between dual-eligible and non-dual eligible beneficiaries after hospital participation in the Comprehensive Care for Joint Replacement (CJR) program, with the primary outcome LEJR complications. In adjusted analysis, CJR participation was associated with a reduced difference in complications between dual-eligible and non-dual-eligible beneficiaries (-0.9 percentage points). The reduction in disparities was observed among hospitals without prior experience in a voluntary LEJR bundled payment model, and there were no differential changes in 90-day readmissions or mortality.
AHRQ-funded; HS027595.
Citation: Kilaru AS, Liao JM, Wang E . Association between mandatory bundled payments and changes in socioeconomic disparities for joint replacement outcomes. Health Serv Res 2024 Oct; 59(5):e14369. doi: 10.1111/1475-6773.14369..
Keywords: Disparities, Orthopedics, Surgery, Payment, Outcomes, Social Determinants of Health
Khan A, Baird J, Mauskar S
A coproduced family reporting intervention to improve safety surveillance and reduce disparities.
The objective of this study was to examine family safety-reporting after implementing a parent-nurse-physician-leader intervention for hospitalized families of children with medical complexity. The authors implemented an English and Spanish mobile reporting tool, as well as staff and family education and a process for sharing comments with unit leaders in a dedicated inpatient complex care service at a pediatric hospital. The results showed that family safety-reporting was unchanged overall after implementing the tool, although reporting increased among families with lower educational attainment and during the COVID-19 pandemic. The tool identified events not otherwise captured by staff-only voluntary incident reporting.
AHRQ-funded; HS025781.
Citation: Khan A, Baird J, Mauskar S . A coproduced family reporting intervention to improve safety surveillance and reduce disparities. Pediatrics 2024 Oct 1; 154(4). doi: 10.1542/peds.2023-065245.
Keywords: Disparities, Patient Safety, Health Literacy, Children/Adolescents
Borsky AE, Zodet M, Wolf TA
大象视频Author: Zodet M, Wolf TA, Bierman AS
Disparities in receipt of high-priority clinical preventive services.
This AHRQ-authored paper鈥檚 purpose was to examine potential disparities in the receipt of high-priority, clinical preventive services among adults. This study is based on a cross-sectional survey from the 2018 MEPS and includes non-institutionalized adults age 鈮35 in the United States (n=14,615). Receipt of all recommended prevention services among adults age 35 and older was low (6%). Black adults were 37% less likely than white adults; those with a high school education or less were less than half as likely as college graduates; poor and low-income individuals were much less likely than those with higher incomes; the uninsured were 89% less likely than those with private insurance; and adults who spoke a language other than English had 35% lower odds than those who spoke English to receive all high-priority services.
AHRQ-authored.
Citation: Borsky AE, Zodet M, Wolf TA . Disparities in receipt of high-priority clinical preventive services. Discover Health Systems 2024 Sep 6; 3(76)..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Prevention, Access to Care, Healthcare Utilization
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
Gibas KM, Rebeiro PF, Brantley M
Geographic disparities in late HIV diagnoses in Tennessee: opportunities for interventions in the rural Southeast.
A Tennessee study of 3,652 new HIV diagnoses between 2015-2019 investigated geographic disparities in late HIV detection. The research revealed that people living in rural areas had a higher risk of late diagnosis compared to urban residents, while Hispanic individuals also showed a significantly higher risk. Among the cohort, most were male (79.7%) and Black (56.3%), with 11.2% residing in rural areas. The findings highlight the need for targeted HIV testing and prevention strategies for rural and Hispanic populations.
AHRQ-funded; HS026122.
Citation: Gibas KM, Rebeiro PF, Brantley M . Geographic disparities in late HIV diagnoses in Tennessee: opportunities for interventions in the rural Southeast. J Rural Health 2024 Sep; 40(4):699-708. doi: 10.1111/jrh.12829.
Keywords: Human Immunodeficiency Virus (HIV), Disparities, Rural Health, Rural/Inner-City Residents, Diagnostic Safety and Quality
De Marchis EH, Aceves B, Razon N
Adjusting clinical plans based on social context.
The authors conducted surveys/interviews to explore clinician perspectives and practices of adjusting medical care based on awareness of patients' social risk factors in a group of Texas community health centers (CHCs). Two main themes emerged: clinicians reported making frequent adjustments to patient care plans based on their awareness of patients' social contexts while expressing concerns about the adjustments, and awareness of patients' social risk factors. Clinician time, training, and experience all influenced clinician adjustments. Adjustments were made without specific guidelines or training. The authors concluded that standardization of adjustments may facilitate the contextualization of patient care through shared decisionmaking to improve outcomes.
AHRQ-funded; HS022241.
Citation: De Marchis EH, Aceves B, Razon N . Adjusting clinical plans based on social context. J Am Board Fam Med 2024 Aug 14; 37(3):466-78. doi: 10.3122/jabfm.2023.230289R1..
Keywords: Community-Based Practice, Social Determinants of Health, Disparities
Unaka N, Kahn RS, Spitznagel T
An institutional approach to equity and improvement in child health outcomes.
This advocacy case study outlines the establishment of a Health Equity Network (HEN) aimed at addressing pediatric health inequities. The HEN fosters collaboration among ten action teams to implement targeted interventions that address both medical and social determinants of health for children and adolescents. A primary focus is on reducing the equity gap in hospitalization rates between Black patients and other groups. Through monthly calls and solutions labs, the network promotes rapid learning and scaling of successful interventions, demonstrating early outcomes in enhancing equitable health care delivery.
AHRQ-funded; HS027996.
Citation: Unaka N, Kahn RS, Spitznagel T . An institutional approach to equity and improvement in child health outcomes. Pediatrics 2024 Aug 1; 54(2). doi: 10.1542/peds.2023-064994..
Keywords: Children/Adolescents, Disparities, Outcomes, Learning Health Systems
Abdus S, Selden TM
大象视频Author: Abdus S, Selden TM
Racial and ethnic disparities in attendance to well-child visit recommendations during COVID-19.
The objective of this study was to measure the impact of the COVID-19 pandemic on racial and ethnic disparities in attendance to well-child visit recommendations. Researchers used Medical Expenditure Panel Survey (MEPS) data to compare pre-pandemic (2018-2019) and pandemic (2020 and 2021) ratios of well-child visits to age-based recommendations as well as 1996-2021 MEPS data to place the pandemic changes within an historical context. The results showed that changes in disparities were large even when controlled for health status, demographic and socioeconomic characteristics, health insurance, and state of residence; magnitudes of racial and ethnic attendance disparities during the pandemic's first two years were unprecedented since before 1996. The researchers concluded that these findings highlight the need to build a more equitable healthcare system for all children.
AHRQ-authored.
Citation: Abdus S, Selden TM . Racial and ethnic disparities in attendance to well-child visit recommendations during COVID-19. Acad Pediatr 2024 Aug; 24(6):922-29. doi: 10.1016/j.acap.2024.04.003..
Keywords: Medical Expenditure Panel Survey (MEPS), Disparities, Racial and Ethnic Minorities, Children/Adolescents, COVID-19
Jacobs J, Labellart P, Margellos-Anast H
Improving Diabetes Equity and Advancing Care (IDEA) to optimize team-based care at a safety-net health system for Black and Latine patients living with diabetes: study protocol for a sequential, multiple assignment, randomized trial.
This paper describes a study protocol to randomize interventions for Black/Latine patients living with diabetes. This study will examine the implementation of diabetes self-management training (DSMT), remote glucose monitoring (RGM), and tailored support from a community health worker (CHW) to improve outcomes. This study will aim to (1) evaluate the appropriateness; (2) measure fidelity; and (3) compare the effectiveness of varying the combination and sequence of three interventions. Eligible Black and Latine patients will be recruited using patient lists extracted from an electronic medical record system. After screening and informed consent, patients will be randomized to either DSMT or RGM. After 6 months patients will complete 2 assessments and HbA1c values will be reviewed. Patients then will be categorized as 鈥渞esponders鈥 who have an HbA1c that has improved by at least one percentage point or 鈥渘onresponders鈥. Nonresponders will be randomized to either switch study arms or to work with a CHW. At 6 months the participants will complete the 2 assessments again and their HbA1c values rereviewed. Twelve patient focus groups will be formed, two for each intervention path along with staff interviews.
AHRQ-funded; HS029431.
Citation: Jacobs J, Labellart P, Margellos-Anast H . Improving Diabetes Equity and Advancing Care (IDEA) to optimize team-based care at a safety-net health system for Black and Latine patients living with diabetes: study protocol for a sequential, multiple assignment, randomized trial. Trials 2024 Jul 24; 25(1):504. doi: 10.1186/s13063-024-08346-9..
Keywords: Diabetes, Racial and Ethnic Minorities, Disparities
Cooper LA, Marsteller JA, Carson KA
大象视频Author: Boonyasai RT
Equitable care for hypertension: blood pressure and patient-reported outcomes of the RICH LIFE cluster randomized trial.
The RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) study was a 2-arm, cluster randomized trial that compared the effect on blood pressure (BP) control, patient activation, and disparities in BP control of 2 multilevel interventions, standard of care plus (SCP) and collaborative care/stepped care (CC/SC). 1820 adults with a mean age of 60.3 years with uncontrolled BP and at least one other risk factors enrolled in the study. The results showed that pairwise comparisons between racial and ethnic groups showed overall no significant differences in BP control at 12 months. Patients with coronary heart disease showed greater achievement of BP control in CC/SC than in SCP. Individuals in both arms of the trail experienced significant reductions in mean systolic BP; the difference in diastolic BP reduction between CC/SC and SCP over time was statistically significant. Patient activation did not differ between trail arms. Adding a collaborative care team to enhanced standard of care did not improve BP control but did improve patient ratings of chronic illness care.
AHRQ-authored.
Citation: Cooper LA, Marsteller JA, Carson KA . Equitable care for hypertension: blood pressure and patient-reported outcomes of the RICH LIFE cluster randomized trial. Circulation 2024 Jul 16; 150(3):230-42. doi: 10.1161/circulationaha.124.069622..
Keywords: Blood Pressure, Patient-Centered Outcomes Research, Disparities
Smith DC, Thumm EB, Anderson J
Sudden shift to telehealth in COVID-19: a retrospective cohort study of disparities in use of telehealth for prenatal care in a large midwifery service.
This study examined changes in prenatal care visit modes and predictors of telehealth use during the COVID-19 pandemic in two nurse-midwifery clinics (n = 3,172). Overall encounters increased from 15.9 to 19.5 per person, primarily driven by telehealth, with no significant change in in-person visits. Key predictors of telehealth use included English as the primary language and diagnoses of diabetes or depression. The findings suggest telehealth enhanced contact without replacing in-person care, highlighting the need to address equity and access in future prenatal care delivery.
AHRQ-funded; HS028085.
Citation: Smith DC, Thumm EB, Anderson J . Sudden shift to telehealth in COVID-19: a retrospective cohort study of disparities in use of telehealth for prenatal care in a large midwifery service. J Midwifery Womens Health 2024 Jul-Aug; 69(4):522-30. doi: 10.1111/jmwh.13601..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Disparities, Maternal Health, Women
Harrall KK, Sauder KA, Glueck DH
Using power analysis to choose the unit of randomization, outcome, and approach for subgroup analysis for a multilevel randomized controlled clinical trial to reduce disparities in cardiovascular health.
This paper discusses a proposed prevention research study which plans to use power analysis to choose the unit of randomization, outcome, and approach for subgroup analysis for a multilevel randomized controlled clinical trial to reduce disparities in cardiovascular health. The authors gave examples of three features in the design of randomized controlled clinical trials which can increase power and thus decrease sample size and costs. They considered an example multilevel trial with several levels of clustering. For a fixed number of independent sampling units, they showed that power can vary widely with the choice of the level of randomization. They demonstrated that power and interpretability can improve by testing a multivariate outcome rather than an unweighted composite outcome. Finally, they showed that using a pooled analytic approach, which analyzes data for all subgroups in a single model, improves power for testing the intervention effect compared to a stratified analysis, which analyzes data for each subgroup in a separate model. The trial will randomize adults to either telehealth (intervention) or in-person treatment (control) to reduce cardiovascular risk factors. The trial outcomes will be measures of the Essential Eight, a set of scores for cardiovascular health developed by the American Heart Association.
AHRQ-funded; HS028283.
Citation: Harrall KK, Sauder KA, Glueck DH . Using power analysis to choose the unit of randomization, outcome, and approach for subgroup analysis for a multilevel randomized controlled clinical trial to reduce disparities in cardiovascular health. Prev Sci 2024 Jul; 25(suppl 3):433-45. doi: 10.1007/s11121-024-01673-y..
Keywords: Disparities, Cardiovascular Conditions, Research Methodologies
Rivera Rivera JN, AuBuchon KE, Schubel LC
Supporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care.
This study addresses the higher incidence and mortality rates of colorectal cancer (CRC) among Black and Hispanic/Latino populations in the United States. The researchers are conducting a stepped-wedge cluster randomized trial to implement and scale a patient navigation program aimed at improving CRC screening rates in these communities. The trial involves 15 primary care clinics, with a phased introduction of the intervention over six steps, each lasting six months. Following an initial six-month baseline data collection period, clinics are randomized to join the intervention arm in groups of three every six months until all clinics have transitioned. The implementation process includes clinic training and education, electronic health record infrastructure changes, stakeholder relationship building, readiness assessment, and ongoing feedback. Guided by the Practical, Robust Implementation Sustainment Model (PRISM), the study focuses on effectiveness, reach, provider adoption, and implementation aspects. The researchers plan to document adaptations to both the patient navigation intervention and implementation strategies. To promote health equity, the study incorporates multilevel stakeholder input through interviews and a community advisory board, influencing various aspects of the project from planning to dissemination. Provider feedback will include updates on disparities in screening orders and completions. The researchers aim to understand how to tailor a patient navigation program for CRC screening across diverse primary care settings with varying baseline screening rates, payor mix, proximity to specialty care, and patient volume.
AHRQ-funded; HS029807.
Citation: Rivera Rivera JN, AuBuchon KE, Schubel LC . Supporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care. Implement Sci Commun 2024 Jun 3; 5(1):60. doi: 10.1186/s43058-024-00598-5.
Keywords: Cancer: Colorectal Cancer, Screening, Primary Care, Disparities, Racial and Ethnic Minorities
Kahn NF, Kidd KM, Hodax JK
Telemedicine-based provision of adolescent gender-affirming medical care to promote equitable access.
This study explored transgender and nonbinary (TNB) young adults' (1) interest in receiving gender-affirming medications through telemedicine before age 18 years and (2) willingness to initiate this care with primary care providers (PCPs). Data was collected from a survey of TNB young adults who had not received gender-affirming medications before age 18 years. Out of 280 respondents, 82.5% indicated interest in telemedicine and 42.0% were willing to initiate medications with their PCP. Black/African American respondents were more likely to indicate interest in telemedicine than White and multiracial respondents, and respondents from rural areas were more likely to indicate willingness to initiate medications with their PCP than those from urban areas.
AHRQ-funded; HS029028.
Citation: Kahn NF, Kidd KM, Hodax JK . Telemedicine-based provision of adolescent gender-affirming medical care to promote equitable access. Telemed J E Health 2024 Jun; 30(7):1896-900. doi: 10.1089/tmj.2023.0575..
Keywords: Telehealth, Children/Adolescents, Health Information Technology (HIT), Disparities, Access to Care
Temkin-Greener H, Hua Y, Cai S
Assisted living residents with dementia: disparities in mental health services pre and during COVID-19.
This study investigates the use of ambulatory mental health services among Medicare beneficiaries with Alzheimer's disease or related dementias (ADRD) living in assisted living (AL) communities. The research focused on both in-person and telehealth visits before and during the COVID-19 pandemic, with particular attention to racial/ethnic differences and Medicare/Medicaid dual eligibility status. The study analyzed data from a cohort of AL residents with ADRD identified in 2018, using Medicare claims from 2019-2020 to track quarterly mental health visits. The research included 102,758 fee-for-service Medicare beneficiaries with ADRD across 13,400 AL facilities. Prior to the pandemic, about one in five residents utilized mental health services. The study found that Black residents and those with dual Medicare/Medicaid eligibility were less likely to use mental health services both before and during the pandemic. Interestingly, there were no significant differences in telehealth usage based on race/ethnicity or individual dual status. However, residents in AL communities with a higher proportion of dual-eligible individuals were less likely to have mental health visits, whether in-person or via telehealth, both before and during the pandemic. The findings indicate that mental health service use among AL residents with ADRD was low and declining even before the pandemic.
AHRQ-funded; HS026893.
Citation: Temkin-Greener H, Hua Y, Cai S . Assisted living residents with dementia: disparities in mental health services pre and during COVID-19. J Am Geriatr Soc 2024 Jun; 72(6):1760-69. doi: 10.1111/jgs.18926.
Keywords: COVID-19, Disparities, Behavioral Health, Dementia, Long-Term Care, Elderly
Kasanagottu K, Anderson TS, Trivedi S
Racial and ethnic disparities in opioid prescribing on hospital discharge among older adults: a national retrospective cohort study.
This study looked at racial and ethnic disparities in opioid prescribing among Medicare beneficiaries 64 years and older using opioid prescription claims within 2 days of hospital discharge in 2016. The secondary outcome was total morphine milligram equivalents (MMEs) among adults with a filled prescription. Among 316,039 opioid beneficiaries who had not had an opioid fill in the 90 days prior to hospitalization (mean age, 76.8 years; 56.2% female), 49,131 (15.5%) filled an opioid prescription within 2 days of hospital discharge. After adjustment, Black beneficiaries were 6% less likely and Asian/Pacific Islander beneficiaries were 9% more likely to have filled an opioid prescription when compared to White beneficiaries. Among beneficiaries with a filled opioid prescription, mean total MMEs were lower among Black, Hispanic, and Asian/Pacific Islander beneficiaries when compared to White beneficiaries.
AHRQ-funded; R01 HS026215.
Citation: Kasanagottu K, Anderson TS, Trivedi S . Racial and ethnic disparities in opioid prescribing on hospital discharge among older adults: a national retrospective cohort study. J Gen Intern Med 2024 Jun; 39(8):1444-51. doi: 10.1007/s11606-024-08687-w.
Keywords: Racial and Ethnic Minorities, Opioids, Elderly, Hospital Discharge, Disparities, Medication
Richmond J, Anderson A, Cunningham-Erves J
Conceptualizing and measuring trust, mistrust, and distrust: implications for advancing health equity and building trustworthiness.
This review synthesized literature on useful ways to conceptualize, define, measure, or intervene on trust and its related constructs that have conceptual roots in racism, marginalization, and other forms of oppression. It also reviewed how trust-related constructs are associated with health outcomes, described interventions, and provided recommendations for building trust and institutional trustworthiness and for advancing health equity. The authors recommended that future efforts focus on improving the trustworthiness of public health professionals, scientists, health care providers, and systems instead of attempting to increase trust in these entities as they currently exist and behave.
AHRQ-funded; HS026122.
Citation: Richmond J, Anderson A, Cunningham-Erves J . Conceptualizing and measuring trust, mistrust, and distrust: implications for advancing health equity and building trustworthiness. Annu Rev Public Health 2024 May; 45(1):465-84. doi: 10.1146/annurev-publhealth-061022-044737..
Keywords: Disparities
Virani DA, Szatan A, Oh S
https://www.sciencedirect.com/science/article/pii/S0169814124000465
Identifying systems factors contributing to adverse events in maternal care using incident reports.
To investigate the factors contributing to negative maternal health results and racial/ethnic disparities, researchers examined 550 incident reports from maternity units at a major academic medical center over a two-year period. The analysis, which categorized incidents by race/ethnicity and utilized the SEIPS 2.0 model to code report narratives, revealed that issues related to tasks and organizational factors were most prevalent, accounting for 40% and 30% of incidents respectively. Key problems identified included omissions, inadequate staffing, poor teamwork and coordination, errors in specimen labeling, and issues with hospital protocols. These insights offer valuable information for enhancing system-wide safety measures and developing targeted strategies to promote health equity for women and birthing individuals from diverse racial and ethnic backgrounds.
AHRQ-funded; HS027680.
Citation: Virani DA, Szatan A, Oh S . Int J Ind Ergon 2024 May; 101:103590. doi: 10.1016/j.ergon.2024.103590.
Keywords: Maternal Health, Women, Racial and Ethnic Minorities, Disparities, Adverse Events

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