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Our objective was to characterize the relationship between public housing residents' diet/exercise habits with similar behaviors among their social network. We conducted a cross-sectional survey of randomly selected households in Baltimore, Maryland, from August 2014 to August 2015. Adult heads of household completed questions on diet, exercise, and perceived habits among network members. Our dependent variables were high added sugar intake (≥39.9 teaspoons/day), high fruit/vegetable intake (≥6.1 servings/day), and being physically active (≥moderately activity). Our network exposures were proportion of members perceived to daily consume (1) sugar-sweetened beverages, (2) sweets, (3) fruits, and (4) vegetables, as well as to weekly exercise (1) vigorously or (2) moderately. We used multivariate logistic regression to examine associations between habits with relevant network exposures. Our sample included 266 adults with mean age of 44.5 years, 86.1% women and 95.5% African American. We found a statistically significant association between study participants' high daily intake of added sugar with perceived network exposure to daily sugar-sweetened beverages (odds ratio [OR] = 1.10, 95% confidence interval [CI] [1.02, 1.20]) and daily sweets (OR = 1.10, 95% CI [1.02, 1.20]). Greater network exposure to weekly vigorous exercise was significantly associated with personally being physically active (OR = 1.15, 95% CI [1.04, 1.28]), but not network exposure to weekly moderate exercise. Among public housing residents, associations exist between individuals' and perceived networks' lifestyle habits of high added sugar foods consumption and vigorous exercise, which may hold promise for future social network interventions.

Health systems in the USA have received a mandate to improve quality while reining in costs. Several opportunities have been created to stimulate this transformation. This paper describes the design, early implementation and lessons learned for the behavioural components of the John Hopkins Community Health Partnership (J-CHiP) programme. J-CHiP is designed to improve health outcomes and reduce the total healthcare costs of a group of high healthcare use patients who are insured by the government-funded health insurance programmes, Medicaid and Medicare. These patients have a disproportionately high prevalence of depression, other psychiatric conditions, and unhealthy behaviours that could be addressed with behavioural interventions. The J-CHiP behavioural intervention is based on integrated care models, which include embedding mental health professionals into primary sites. A four-session behaviour-based protocol was developed to motivate self-efficacy through illness management skills. In addition to staff embedded in primary care, the programme design includes expedited access to specialist psychiatric services as well as a community outreach component that addresses stigma. The progress and challenges involved with developing this programme over a relatively short period of time are discussed.