Improving Health and Addressing Social Determinants of Health Through Hospital Partnerships.

Hospitals and health systems are forming partnerships to develop an integrated social network of services that better address the needs of their surrounding communities and their social determinants of health (SDOH). There is little research on the association of these partnered services with hospital outcomes. This study examined the association between hospital social need partnerships and activities to improve hospital and community outcomes. A secondary cross-sectional design to analyze 2021 census data of nonfederal short-term acute care hospitals in the United States was utilized. Data were obtained from the American Hospital Association. Four multilevel logistic regression models were used to analyze data from 1005 hospitals. The authors found that hospital partnership type differed in association to social need outcomes. They found that hospitals with a partnership with health insurance providers were more likely to have better health outcomes. Hospitals partnered with health insurance providers, local organizations addressing housing insecurity, local businesses, or chambers of commerce were more likely to have decreased health care costs. Hospitals partnered with health care providers, health insurance providers, local organizations providing legal assistance, or law enforcement/safety forces were more likely to have decreased utilization of hospital services. However, hospitals partnered with other local or state government or social service organizations were less likely to indicate decreased utilization of services. Many hospitals and health systems across the United States are screening for SDOH and are advancing health care delivery and improving the community's overall health and well-being by identifying unmet social needs and partnering with the community to address them.

Evaluation of a university-based community outreach weight management program.

This study tested the effectiveness of a 6-month university-based community outreach weight management program for overweight/obese adults that utilized standard guidelines from the National Heart, Lung, and Blood Institute (NHLBI). This article also provides practical observations for clinicians desirous to employ a similar program. Fifty-one overweight/obese (34.8 ± 6.6 kg/m(2)) middle-aged (46.6 ± 12.4 y) adults (42 females; 9 males) participated. Participants met weekly for 3 months to be weighed, to report weekly diet and physical activity (PA) data, and to receive instruction for weight management. Participants followed a self-selected dietary plan that included decreasing energy intake by ∼500-1000 kcal/d and consuming a combined 5 fruits and/or vegetables (FV) daily. Participants progressed to a minimum of 150 min of PA per week, wore a pedometer, and recorded daily step counts. Additionally, there was a 3-month follow-up during which participants met monthly but continued tracking FV, PA, and pedometer counts. Body weight decreased significantly (∼0.4-2.1 lbs per week; P < 0.01) during the first 3 months. Weight loss was maintained during the 3-month follow-up. Self-reported energy intake tended to increase during the first 3 months (P < 0.01). PA increased significantly (P < 0.05) beyond recommended minimums and pedometer counts increased significantly (P < 0.01). FV intake averaged below 5 per day and did not change across the study (P = 0.75). Standard treatment guidelines produce modest but consistent weight loss and improvements in PA. The NHLBI recommended approach to weight management is effective for a majority of participants and can be incorporated into a clinical program with relative ease.

One-set resistance training elevates energy expenditure for 72 h similar to three sets.

To compare the effects of an acute one versus three-set full body resistance training (RT) bout in eight overweight (mean ± SD, BMI = 25.6 ± 1.5 kg m(-2)) young (21.0 ± 1.5 years) adults on resting energy expenditure (REE) measured on four consecutive mornings following each protocol. Participants performed a single one-set or three-set whole body (10 exercises, 10 repetition maximum) RT bout following the American College of Sports Medicine (ACSM) guidelines for RT. REE and respiratory exchange ratio (RER) by indirect calorimetry were measured at baseline and at 24, 48, and 72 h after the RT bout. Participants performed each protocol in randomized, counterbalanced order separated by 7 days. There was no difference between protocols for REE or RER. However, REE was significantly (p < 0.05) elevated (~5% or ~400 kJ day(-1)) in both the protocols at 24, 48, and 72 h post RT bout compared with baseline. There was a no change in RER in both the protocols at 72 h compared to baseline. A one-set RT bout following the ACSM guidelines for RT and requiring only ~15 min to complete was as effective as a three-set RT bout (~35 min to complete) in elevating REE for up to 72 h post RT in overweight college males, a group at high risk of developing obesity. The one-set RT protocol may provide an attractive alternative to either aerobic exercise or multiple-set RT programs for weight management in young adults, due to the minimal time commitment and the elevation in REE post RT bout.

The Influence of an Environmental Cue and Exercise on Food Consumption in College Students.

The purpose of this study was to determine the effect of an environmental cue (bowl size) on food consumption and to examine the influence of exercise on that relationship. This cross-sectional study included 286 college students attending a large Midwestern University. Upon arrival at an ice cream social for university students, participants were randomly given a small (8 oz) or large (12 oz) bowl and a 4-page survey addressing exercise and eating habits. At the social, participants were invited to dish themselves as much ice cream as they wanted and the amount consumed was determined by weighing the bowl with ice cream before and after consumption using a scale that measured to the nearest tenth of a gram. Participants who were provided the 12 oz bowl scooped and consumed significantly more ice cream than the participants provided the 8 oz bowl. Regular exercisers consumed more ice cream than non-regular exercisers regardless of statistical control for bowl size and body weight. Those participants who reported exercising previously that day also consumed significantly more ice cream than those not previously exercising; however, the difference was no longer significant after controlling for bowl size and body weight. Environment cues significantly influence food consumption and exercise may also influence subsequent food consumption but further research is needed.

Aquatics, health-promoting self-care behaviours and adults with brain injuries.

PRIMARY OBJECTIVE: To determine the effect of an aquatic programme on the health promoting behaviours of adults with brain injuries. MAIN OUTCOMES AND RESULTS: Eighteen individuals participated in the programme and were randomly assigned to an experimental (n = 9) or control group (n = 9). Health promoting behaviours, physical self-concept and self-esteem were measured pre- and post-intervention. Significant differences and large effect sizes were found between scores for the experimental group only, indicating an increase in health promoting behaviours, physical self-concept and self-esteem. CONCLUSIONS: Results have useful implications for health professionals as exercise prescription may enhance health promoting behaviours and decrease health care costs after a brain injury.

Evaluation of an aquatics programme on fitness parameters of individuals with a brain injury.

The primary objective was to determine the effect of an aquatic exercise programme on the physical fitness of people with a brain injury. A pre-test-post-test randomized-groups design was conducted. Sixteen outpatients with a brain injury were included in the study. Eight participants were assigned to an aquatic exercise group and eight to a control group. The components of physical fitness measured included cardiovascular endurance, body composition, muscular strength and endurance and flexibility. Measurements were taken pre- and post-programme. Results indicated an increase in components of physical fitness for the experimental group but not the control group. Increases in fitness were reported as having a positive impact on the functional capacity of individuals in the exercise group as well as enhancing the individual's ability to complete activities of daily living successfully. Results indicate that aquatic exercise may positively impact the primary and secondary physical injuries caused by a brain injury.

An investigation of the relation between religion and exercise motivation.

The present study sought to investigate whether traditional secular or faith-based program factors were more responsible for motivating women (N = 220, M age = 44.6 yr.) to participate in Christian exercise programs. Based on the results of a pilot study, the Christian Exercise Program Questionnaire was developed and mailed to the study participants. The internal reliability of the questionnaire was excellent as indicated by Cronbach coefficient alpha. As expected, those aspects of the exercise program that were faith-based, e.g., modest clothing, noncompetitive, and worshipful atmosphere. were considered more important than traditional secular factors, e.g., personal trainers and childcare, in the decision to enroll in the program (t219 = 9.23, p < .001). The findings suggest exercise programs that incorporate faith-based practices may appeal to a segment of the population and provide an alternative strategy for improving participation rates in physical activity.