Personal social networks and organizational affiliation of South Asians in the United States.

BACKGROUND: Understanding the social lives of South Asian immigrants in the United States (U.S) and their influence on health can inform interpersonal and community-level health interventions for this growing community. This paper describe the rationale, survey design, measurement, and network properties of 700 South Asian individuals in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) social networks ancillary study. METHODS: MASALA is a community-based cohort, established in 2010, to understand risk factors for cardiovascular disease among South Asians living in the U.S. Survey data collection on personal social networks occurred between 2014 and 2017. Network measurements included size, composition, density, and organizational affiliations. Data on participants' self-rated health and social support functions and health-related discussions among network members were also collected. RESULTS: Participants' age ranged from 44 to 84 (average 59 years), and 57% were men. South Asians had large (size=5.6, SD=2.6), kin-centered (proportion kin=0.71, SD=0.28), and dense networks. Affiliation with religious and spiritual organizations was perceived as beneficial to health. Emotional closeness with network members was positively associated with participants' self-rated health (p-value <0.001), and networks with higher density and more kin were significantly associated with health-related discussions. DISCUSSION: The MASALA networks study advances research on the cultural patterning of social relationships and sources of social support in South Asians living in the U.S. Future analyses will examine how personal social networks and organizational affiliations influence South Asians' health behaviors and outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02268513.

Health System Affiliation and 30-Day Readmission After Heart Attack in Black Men.

INTRODUCTION: Black patients who experience acute myocardial infarction and receive care in high minority-serving hospitals have higher readmission rates. This study explores how hospital system affiliation (centralized versus decentralized/independent) impacts 30-day readmissions after acute myocardial infarction in black men. METHODS: In 2018, the Healthcare Cost and Utilization Project State Inpatient Database (2009-2013) was used to observe 30-day readmission for acute myocardial infarction by race, and data from the American Hospital Association Annual Survey of Hospitals (2009-2013) to determine hospital system affiliation for the states Arizona, California, North Carolina, and Wisconsin. A series of hierarchic logistic regressions were conducted to determine if hospital system affiliation mediates the relationship between race and 30-day readmission. RESULTS: Of 63,743 hospitalizations for acute myocardial infarction among men between 2009 and 2013, black men accounted for 7.1% of hospitalizations and 8.0% of readmissions. In both models, race significantly predicted 30-day readmission (unadjusted OR=1.25, 95% CI=1.14, 1.37, p<0.001; AOR=1.13, 95% CI=1.03, 1.25, p=0.046). After controlling for system type, black men were more likely to be readmitted after acute myocardial infarction than white men in both models (unadjusted OR=1.25, 95% CI=1.14, 1.38, p<0.001; AOR=1.14, 95% CI=1.03, 1.25). There was no difference in odds of being readmitted by race and hospital system type (unadjusted OR=0.88, 95% CI=0.25, 3.07, p=0.84, AOR=1.02, 95% CI=0.21, 5.10, p=0.98). CONCLUSIONS: Black men appear to be more likely to be readmitted after acute myocardial infarction. Centralization does not appear to mediate the relationship between race and 30-day readmissions for acute myocardial infarction. SUPPLEMENT INFORMATION: This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Organizations disseminating health messages: the roles of organizational identification and HITs.

Research into the dissemination of health information now includes more focus on how various organizations (e.g., beauty shops, schools, workplaces, and churches) and health information technologies (HITs) reach and affect audiences. One relational feature of organizations is identification--the feeling of belongingness. Our study explores how it influences audiences, especially in combination with HITs such as e-mail, websites, and social media. We use social identity theory to predict how organizational identification and social media might function in health communication. Using a 3 × 2 experimental design, we find that people's identification with a message source mediates the effect of social media on outcomes. These findings improve our understanding of when organizations might be most helpful for disseminating health information.

Food, fizzy, and football: promoting unhealthy food and beverages through sport - a New Zealand case study.

BACKGROUND: High participation rates in sport and increasing recognition of how diet benefits athletic performance suggest sports settings may be ideal locations for promoting healthy eating. While research has demonstrated the effect of tobacco and alcohol sponsorship on consumption, particularly among youth, few studies have examined the extent or impact of food and beverage company sponsorship in sport. Studies using brand logos as a measure suggest unhealthy foods and beverages dominate sports sponsorship. However, as marketing goes beyond the use of brand livery, research examining how marketers support sponsorships that create brand associations encouraging consumer purchase is also required. This study aimed to identify the characteristics and extent of sponsorships and associated marketing by food and non-alcoholic beverage brands and companies through a case study of New Zealand sport. METHODS: We conducted a systematic review of 308 websites of national and regional New Zealand sporting organisations to identify food and beverage sponsors, which were then classified as healthy or unhealthy using nutrient criteria for energy, fat, sodium and fibre levels. We interviewed 18 key informants from national and regional sporting organisations about sponsorships. RESULTS: Food and beverage sponsorship of sport is not extensive in New Zealand. However, both healthy and unhealthy brands and companies do sponsor sport. Relatively few support their sponsorships with additional marketing. Interviews revealed that although many sports organisations felt concerned about associating themselves with unhealthy foods or beverages, others considered sponsorship income more important. CONCLUSIONS: While there is limited food and beverage sponsorship of New Zealand sport, unhealthy food and beverage brands and companies do sponsor sport. The few that use additional marketing activities create repeat exposure for their brands, many of which target children. The findings suggest policies that restrict sponsorship of sports by unhealthy food and beverage manufacturers may help limit children's exposure to unhealthy food marketing within New Zealand sports settings. Given the global nature of the food industry, the findings of this New Zealand case study may be relevant elsewhere.

Predictors of hospital CEO affiliation with a professional association.

Based on a 2008 cross-sectional survey of 582 hospital CEOs in the United States, this study reports the findings of two logistic regression models designed to identify CEO and hospital characteristics associated with Member and Fellow status in the American College of Healthcare Executives (ACHE). The purpose of the study was to understand the personal and organizational characteristics of those CEOs who choose to be Members and Fellows of a professional association such as ACHE. The results showed that most (74 percent) of the respondents considered ACHE to be their primary professional association. The results also revealed that a master's degree in health administration [beta = .88, t(427) = 5.35, p < .0001], male gender [beta = .59, t(427) = 3.01, p = .002], and financial incentives provided by the parent hospital [beta = .25, t(427) = 2.73, p = .006] were statistically positively linked with Member status in ACHE. A master's degree in health administration [beta = .81, t(424) = 5.79, p < .0001], male gender [beta = .39, t(424) = 2.25, p = .02], and age [beta = .02, t(424) 2.32, p = .02] were also statistically positively associated with Fellow status in ACHE. Notably, organizational factors such as size, geographic location, for-profit status, and financial strength of the hospital do not seem to play an important role in the CEOs' decision to become a Member or Fellow of ACHE. The implication of these findings is that membership and fellowship at a professional association are influenced by characteristics of the individual, and incentives provided by employers can encourage employees to get involved with their professional associations.

Integration of hospitals: is it time for similar changes in Georgia?

Health care is the most difficult and dynamic industry where the expenditure has grown almost four times during the past 20 years. Constantly, there are demands for expenditure cuts, for effectiveness, for quality improvement and evaluation of economic risks. All the precise and sophisticated strategic decisions taken by hospitals are to guarantee maximum profits from scarce resources and good service from an organization in unstable environmental conditions. From the different development alternatives, hospitals might prefer a horizontal and vertical integration. The integration of stationary hospitals into a network is convenient from a financial and economic point of view. Benefits are also expected in other areas, such as economies of scale, the improvement of human resources organization as well as the management and service offering. Consequently, expenses will be reduced and incomes will grow. However, there are some important questions about integration to be discussed in this research, including: Is Georgia's health care sector ready for reform, are the qualitative and quantitative improvements achievable, and what is the main motivation?

Consumer evaluation of complaint handling in the Dutch health insurance market.

BACKGROUND: How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. METHODS: A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. RESULTS: Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. CONCLUSIONS: Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and trust in the company to the same extent. Therefore, it is important for managers to be aware of the type of consumer satisfaction they are measuring when evaluating the handling of complaints within their company.

Long and short hospice stays among nursing home residents at the end of life.

OBJECTIVE: To identify characteristics of nursing homes and residents associated with particularly long or short hospice stays. DESIGN/SETTING: Observational study using administrative data on resident characteristics and hospice utilization from a large regional hospice linked with publicly available data on nursing home characteristics. PARTICIPANTS: A total of 13,479 residents who enrolled in hospice during 2001-2008. MEASUREMENTS: Logistic regression models of the probability of a long (>180 days) or very short (

Factors associated with increasing nursing home closures.

PURPOSE: We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures. DESIGN AND METHOD: The names of the closed facilities and dates of closure from state regulators in all 50 states were obtained. This information was linked to the Online Survey, Certification, and Reporting data, which contains information on internal, organizational, and market factors for almost all nursing homes in the United States. RESULTS: One thousand seven hundred and eighty-nine facilities closed over this time period (1999-2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. Nursing homes with higher rates of deficiency citations, hospital-based facilities, chain members, small bed size, and facilities located in markets with high levels of competition were more likely to close. High Medicaid occupancy rates were associated with a high likelihood of closure, especially for facilities with low Medicaid reimbursement rates. IMPLICATIONS: As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures.

The role of organizational factors in the adoption of healthcare information technology in Florida hospitals.

This study examines whether specific organizational characteristics, such as hospital size, geographic location (urban versus rural), system membership (stand-alone versus system-affiliated), and tax status (for-profit versus non-profit), influence adoption of healthcare information technologies (HIT) in hospitals. We hypothesize the above organizational characteristics to be related to hospitals' adoption of clinical, administrative, and strategic HIT, as well as all HIT in general. Using survey data collected from 98 Florida hospitals, we demonstrate that hospital size, system membership, and tax status, but not geographic location, are systematically related to HIT adoption, and that such factors explain about 28-41% of the adoption variance. A mixed pattern of effects emerge for clinical, administrative, and strategic HIT. For instance, hospital size appears to be less relevant for administrative HIT, where its effect is compensated by those of system membership and tax status. Implications for future HIT research and practice are discussed.

Is there gender bias in nursing research?

Using data from a consecutive sample of 259 studies published in four leading nursing research journals in 2005-2006, we examined whether nurse researchers favor females as study participants. On average, 75.3% of study participants were female, and 38% of studies had all-female samples. The bias favoring female participants was statistically significant and persistent. The bias was observed regardless of funding source, methodological features, and other participant and researcher characteristics, with one exception: studies that had male investigators had more sex-balanced samples. When designing studies, nurse researchers need to pay close attention to who will benefit from their research and to whether they are leaving out a specific group about which there is a gap in knowledge.

The challenge of merging: merger patterns, premerger status, and merger support.

Employees of merging organizations often show resistance to the merger. The employees' support depends on the companies' premerger status and on the merger pattern. Based on an intergroup perspective, three studies were conducted to investigate the influence of premerger status (high, low) and merger pattern (assimilation, integration-equality, integration-proportionality, transformation) on participants' support for a pending organizational merger. Students (Study 1) and employees (Study 2) had to take the perspective of employees of a fictitious merging organization. Study 3 investigated students' perceptions of a potentially pending university merger using a 2 (status) x 3 (merger pattern: assimilation, integration-equality, integration-proportionality) design. Across all studies, the low-status group favored integration-equality and transformation whereas the high-status group preferred integration-proportionality and assimilation. Perceived threat mediated the effects. Legitimacy was a stronger mediator for effects of the low-status group.

Hospital financial performance in the United States of America: a follow-up study.

To clarify and validate the factors that influence hospital profitability in the United States of America, we used a cross-sectional design to examine data for 1998. Several changes and government regulations introduced in the early 1990s influenced hospital performance. We included those variables to give a better understanding of the hospital payment system. Among the explanatory variables considered, geographic location, competition, hospital size and occupancy rate were identified as the main contributors to hospital profitability.

The relation between social problems and substance use in adolescent boys: an investigation of potential moderators.

This study investigated the relation between social problems and adolescent male substance use in the context of other potential moderating variables. Two hundred eighty adolescent boys completed measures of social problems, cognitive distortions, constructive thinking, affiliation with delinquent peers, and multiple aspects of substance use. Results revealed that social problems were not directly related to most substance use variables. Cognitive distortions moderated the relation between social problems and substance use in social situations, such that the relation was significant only at high levels of cognitive distortions. Constructive thinking and affiliation with delinquent peers were both related to substance use, but neither served a moderating function. It is concluded that the widely accepted relation between social difficulties and adolescent male substance use may be better understood in the context of cognitive variables.