´óÏóÊÓƵ

U.S. flag

SHARE:

FacebookXEmail AHRQPrint

Search All Research Studies

 

´óÏóÊÓƵResearch Studies Date

Topics

´óÏóÊÓƵResearch Studies

Sign up:

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

Results

1 to 24 of 24 Research Studies Displayed
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’s 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 (1‒10 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
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
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
Squires A, Gerchow L, Ma C
A multi-language qualitative study of limited English proficiency patient experiences in the United States.
The objective of this study was to understand the experience of limited English proficiency patients with health care services in an urban setting. Individuals who spoke either Spanish, Russian, Cantonese, Mandarin, or Korean shared their experiences through semi-structured interviews. A major theme that emerged throughout all interviews was a sense that the language barrier with clinicians posed a threat to safety when receiving healthcare. Participants also identified factors they felt would improve their sense of security specific to clinician interactions. The authors concluded that these findings highlight ongoing challenges that spoken language barriers pose at multiple points of care in the US health care system.
AHRQ-funded; HS023593.
Citation: Squires A, Gerchow L, Ma C . A multi-language qualitative study of limited English proficiency patient experiences in the United States. PEC Innov 2023 Dec; 2:100177. doi: 10.1016/j.pecinn.2023.100177..
Keywords: Patient Experience, Disparities, Vulnerable Populations
Vasan A, Kyle MA, Venkataramani AS
Inequities in time spent coordinating care for children and youth with special health care needs.
The purpose of this cross-sectional study was to examine sociodemographic inequities in time spent coordinating care for children and youth with special health care needs (CYSHCN) and examine the relationship between time spent coordinating care and forgone medical care. The study utilized 2018-2020 data from the National Survey of Children's Health, which included 102,740 children across all 50 states. The researchers characterized the time spent coordinating care for children with less complex special health care needs (SHCN) (managed through medications) and more complex SHCN (resulting in functional limitations or requiring specialized therapies). Race-, ethnicity-, income-, and insurance-based differences in time spent coordinating care among CYSHCN were examined, and multivariable logistic regression was utilized to explore the relationship between time spent coordinating care and forgone medical care. The study found that over 40% of caregivers of children with more complex SHCN reported spending time coordinating their children's care each week. CYSHCN whose caregivers spent 5 hours per week or more on care coordination were disproportionately Hispanic, low-income, and publicly insured or uninsured. Increased time spent coordinating care was related with an increasing probability of forgone medical care.
AHRQ-funded; HS028555.
Citation: Vasan A, Kyle MA, Venkataramani AS . Inequities in time spent coordinating care for children and youth with special health care needs. Acad Pediatr 2023 Nov-Dec; 23(8):1526-34. doi: 10.1016/j.acap.2023.03.002..
Keywords: Children/Adolescents, Care Coordination, Vulnerable Populations, Disparities
Joyce NR, Pfeiffer MR, Zullo AR
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
Using data from the New Jersey Safety Health Outcomes data warehouse 2004-2018, the authors compared characteristics of suspended drivers, their residential census tract, as well as access to public transportation and jobs, by reason for the suspension. They found that 91% of license suspensions were for non-driving-related events, with the most common reason for a suspension being failure to pay a fine. Non-driving-related suspended drivers lived in census tracts with a lower household median income, higher proportion of black and Hispanic residents and higher unemployment rates, but also better walkability scores and better access to public transportation and jobs. They recommended additional work to determine what effect this has for the social and economic well-being of suspended drivers.
AHRQ-funded; HS022998.
Citation: Joyce NR, Pfeiffer MR, Zullo AR . Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income. J Transp Health 2020 Dec;19. doi: 10.1016/j.jth.2020.100933..
Keywords: Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations, Social Determinants of Health
Rosenberg J, Rosenthal MS, Cramer LD
Disparities in mental and behavioral health treatment for children and youth in immigrant families.
Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, the authors assessed access to MBH treatment using the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents.
AHRQ-funded; HS024332.
Citation: Rosenberg J, Rosenthal MS, Cramer LD . Disparities in mental and behavioral health treatment for children and youth in immigrant families. Acad Pediatr 2020 Nov-Dec;20(8):1148-56. doi: 10.1016/j.acap.2020.06.013..
Keywords: Children/Adolescents, Behavioral Health, Disparities, Racial and Ethnic Minorities, Vulnerable Populations, Access to Care
Luk JW, Parker EO, Richardson LP
Sexual attraction and experiences in the primary care setting: examining disparities in satisfaction with provider and health self-efficacy.
This study examines whether sexual minority adolescents report lower satisfaction with primary care providers and lower health self-efficacy compared to heterosexual males and females. Data from 535 adolescents who participated in one of two randomized clinical trials were analyzed. Both sets of adolescents reported high satisfaction with providers. Relative to heterosexual males, sexual minority males reported lower self-efficacy in reaching health goals. Sexual minority females reported lower confidence in positively impacting their own health and lower self-efficacy in setting health goals compared to heterosexual females.
AHRQ-funded; HS023383.
Citation: Luk JW, Parker EO, Richardson LP . Sexual attraction and experiences in the primary care setting: examining disparities in satisfaction with provider and health self-efficacy. J Adolesc 2020 Jun;81:96-100. doi: 10.1016/j.adolescence.2020.04.009..
Keywords: Children/Adolescents, Patient Experience, Primary Care, Clinician-Patient Communication, Vulnerable Populations, Disparities
Ruggeri K, Folke T, Benzerga A
Nudging New York: adaptive models and the limits of behavioral interventions to reduce no-shows and health inequalities.
Missed healthcare appointments (no-shows) are costly and operationally inefficient for health systems. No-show rates are particularly high for vulnerable populations, even though these populations often require additional care. The purpose of this study was to identify predictors of no-show behavior and to analyze the effects of a reminder intervention in urban FQHCs in order to design effective policy solutions to a protracted issue in healthcare.
AHRQ-funded; HS026372.
Citation: Ruggeri K, Folke T, Benzerga A . Nudging New York: adaptive models and the limits of behavioral interventions to reduce no-shows and health inequalities. BMC Health Serv Res 2020 Apr 26;20(1):363. doi: 10.1186/s12913-020-05097-6..
Keywords: Patient Adherence/Compliance, Disparities, Vulnerable Populations
Kang JX, Levanon Seligson A, Dragan KL
Identifying New York City neighborhoods at risk of being overlooked for interventions.
Public health agencies are often faced with difficult decisions about where and how to allocate funding and resources. In this study, the investigators walked readers through a process of identifying needs across different neighborhoods in New York City (NYC) by examining community district-level health outcomes using data from published Community Health Profile reports released by the NYC Department of Health and Mental Hygiene (DOHMH) in 2015.
AHRQ-funded; HS000055.
Citation: Kang JX, Levanon Seligson A, Dragan KL . Identifying New York City neighborhoods at risk of being overlooked for interventions. Prev Chronic Dis 2020 Apr 23;17:E32. doi: 10.5888/pcd17.190325..
Keywords: Public Health, Disparities, Urban Health, Vulnerable Populations
Desai AD, Zhou C, Haaland W
Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness.
This study examined associations between social disadvantage, access to care, and disparities in physical functioning among children hospitalized with acute respiratory illness. The study cohort included children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children’s hospitals for three common respiratory illnesses from July 2014 through June 2016. Surveys were completed within 2 to 8 weeks after discharge. The survey assessed social disadvantage, difficulty/delays accessing care, and baseline and follow-up health-related quality of life (HRQoL), and physical functioning using the Pediatric Quality of Life Inventory (PedsQL). A total of 1,325 patients and/or their caregivers completed both PedsQL surveys. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage (minority race/ethnicity, limited English proficiency, low education, and low income), than for patients with none. There were also disadvantage markers or difficulty/delays accessing care which were associated with lower physical functioning. However, these differences were reduced after hospital discharge.
AHRQ-funded; HS024299.
Citation: Desai AD, Zhou C, Haaland W . Social disadvantage, access to care, and disparities in physical functioning among children hospitalized with respiratory illness. J Hosp Med 2020 Apr;15(4):211-18. doi: 10.12788/jhm.3359..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization, Access to Care, Disparities, Vulnerable Populations, Quality of Life
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.
AHRQ-funded; HS022998.
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, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
Kemmick Pintor J, Call KT
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Investigators sought to measure differences in insurance by mother's documentation status among a nationally representative sample of US-born children in immigrant families and to examine the role of state-level immigrant access to prenatal coverage. They found that, in states with nonrestrictive prenatal coverage for immigrants, there were no differences in children's insurance by mother's documentation status, while large inequities were observed within states with restrictive policies.
AHRQ-funded; HS021973.
Citation: Kemmick Pintor J, Call KT . State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families. Glob Pediatr Health 2019 Sep 26;6:2333794x19873535. doi: 10.1177/2333794x19873535..
Keywords: Policy, Health Insurance, Children/Adolescents, Access to Care, Vulnerable Populations, Disparities
Grossman LV, Masterson Creber RM, Benda NC
Interventions to increase patient portal use in vulnerable populations: a systematic review.
The authors sought to systematically review the impact of interventions designed to increase portal use or predictors of use in vulnerable patient populations or to reduce disparities in use. They found that individually focused interventions have the most evidence for increasing portal use in vulnerable populations. Interventions affecting other system elements have not been sufficiently studied to draw conclusions. They recommend that research move beyond identifying disparities to systematically addressing them at multiple levels.
AHRQ-funded; HS021816.
Citation: Grossman LV, Masterson Creber RM, Benda NC . Interventions to increase patient portal use in vulnerable populations: a systematic review. J Am Med Inform Assoc 2019 Aug;26(8-9):855-70. doi: 10.1093/jamia/ocz023..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Disparities
Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al.
A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California.
This study compared the health status and healthcare experiences of Cambodian American refugees and immigrants, using data were collected via questionnaires and medical records from two community clinics in Southern California. Minimal differences in self-reported health behaviors occurred between the two groups. Refugees reported lower levels of health-related quality of life overall and self-rated health, but similar or more positive healthcare experiences than the immigrants. Refugees had higher rates of diabetes and cardiovascular disease risk, in adjusted analyses. The authors conclude that there is a need for more health promotion efforts to improve health outcomes and perceived wellbeing of Cambodian American refugees and immigrants.
AHRQ-authored.
Citation: Ngo-Metzger Q Sharif, MZ Biegler, K Mollica, et al.. A health profile and overview of healthcare experiences of Cambodian American refugees and immigrants residing in Southern California. J Immigr Minor Health 2019 Apr;21(2):346-55. doi: 10.1007/s10903-018-0736-3..
Keywords: Disparities, Health Status, Patient Experience, Quality of Life, Racial and Ethnic Minorities, Vulnerable Populations
Zuckerman RB, Wu S, Chen LM
The five-star skilled nursing facility rating system and care of disadvantaged populations.
AHRQ-funded; HS000029.
Citation: Zuckerman RB, Wu S, Chen LM . The five-star skilled nursing facility rating system and care of disadvantaged populations. J Am Geriatr Soc 2019 Jan;67(1):108-14. doi: 10.1111/jgs.15629..
Keywords: Nursing Homes, Vulnerable Populations, Medicare, Elderly, Provider Performance, Quality of Care, Hospital Discharge, Disparities
Perez Jolles M, Thomas KC
Disparities in self-reported access to patient-centered medical home care for children with special health care needs.
The purpose of this study was to examine variation in caregiver service experience concordant with care in patient-centered medical home (PCMH) over time and by the characteristics of separate groups of children with special health care needs (CSHCNs). Researchers used 2003-2012 Medical Expenditures Panel Survey data for CSHCNs for cross-sectional pooled data analysis. Their conclusions suggest that disparities remain among high-need CSHCNs. Future research that focuses on a better understanding of how clinical settings tailor this care model, particularly to provide increased access and patient-centered care, is recommended.
AHRQ-funded; HS000032.
Citation: Perez Jolles M, Thomas KC . Disparities in self-reported access to patient-centered medical home care for children with special health care needs. Med Care 2018 Oct;56(10):840-46. doi: 10.1097/mlr.0000000000000978..
Keywords: Access to Care, Children/Adolescents, Disabilities, Disparities, Medical Expenditure Panel Survey (MEPS), Patient-Centered Healthcare, Vulnerable Populations
Khubchandani JA, Shen C, Ayturk D
Disparities in access to emergency general surgery care in the United States.
This study examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. The study concluded that gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities and policy initiatives need to increase emergency general surgery capacity nationwide.

AHRQ-funded; HS022694.
Citation: Khubchandani JA, Shen C, Ayturk D . Disparities in access to emergency general surgery care in the United States. Surgery 2018 Feb;163(2):243-50. doi: 10.1016/j.surg.2017.07.026..
Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Surgery, Vulnerable Populations
Qato DM, Trivedi AN, Mor V
Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert.
The researchers compared time to discontinuation of rosiglitazone after the safety alert between black and white elderly persons, and across sociodemographic and economic subgroups. They found that white race and a history of low personal income modestly predicted later discontinuation of rosiglitazone after the FDA's safety advisory in 2007.
AHRQ-funded; HS019657.
Citation: Qato DM, Trivedi AN, Mor V . Disparities in discontinuing rosiglitazone following the 2007 FDA safety alert. Med Care 2016 Apr;54(4):406-13. doi: 10.1097/mlr.0000000000000502..
Keywords: Medication, Disparities, Elderly, Social Determinants of Health, Vulnerable Populations
Nadpara PA, Madhavan SS, Tworek C
Disparities in lung cancer care and outcomes among elderly in a medically underserved state population-a cancer registry-linked database study.
The purpose of this study was to evaluate the patterns of lung cancer care and associated health outcomes among elderly residing in a rural and medically underserved area. The authors found that delays in diagnosis and treatment varied significantly: survival outcomes significantly improved with appropriate care but did not improve with timely care. They concluded that their study highlights the critical need to address disparities in receipt of guideline-concordant lung cancer care among the elderly residing in rural and medically underserved areas.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C . Disparities in lung cancer care and outcomes among elderly in a medically underserved state population-a cancer registry-linked database study. Popul Health Manag 2016 Apr;19(2):109-19. doi: 10.1089/pop.2015.0027.
.
Keywords: Disparities, Elderly, Cancer: Lung Cancer, Outcomes, Vulnerable Populations
Higashi RT, Craddock Lee SJ, Leonard T
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
The researchers sought to better understand the health needs of a nonclinical population to inform future research and interventions. Their analysis of focus group findings led them to conclude that Crossroads Community Services clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges.
AHRQ-funded; HS022418.

Citation: Higashi RT, Craddock Lee SJ, Leonard T . Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site. Clin Transl Sci 2015 Oct;8(5):584-90. doi: 10.1111/cts.12325.

.
Keywords: Nutrition, Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations
Sofolahan-Oladeinde Y, Mullins CD, Baquet CR
Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities.
The authors proposed ways by which patient-centered outcomes research can effectively use community-based participatory research principles to engage patients in general, and specifically patients from underserved communities, in the hope that this will help to reduce and eventually eliminate health disparities.
AHRQ-funded; HS022135.
Citation: Sofolahan-Oladeinde Y, Mullins CD, Baquet CR . Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities. J Comp Eff Res 2015 Sep;4(5):515-23. doi: 10.2217/cer.15.31.
.
Keywords: Access to Care, Disparities, Evidence-Based Practice, Patient-Centered Outcomes Research, Vulnerable Populations
Moy E, Freeman W
´óÏóÊÓƵAuthor: Moy E, Freeman W
Federal investments to eliminate racial/ethnic health-care disparities.
The authors presented a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. They proposed that increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication.
AHRQ-authored.
Citation: Moy E, Freeman W . Federal investments to eliminate racial/ethnic health-care disparities. Public Health Rep 2014 Jan-Feb;129 Suppl 2:62-70. doi: 10.1177/00333549141291s212.
.
Keywords: Access to Care, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Vulnerable Populations

Related Content

Research Findings & Reports