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Purpose of the Study: Care challenges have been described for hospitalized morbidly obese (MO) patients. These challenges likely persist post discharge. As a result, nursing homes (NHs) may be reluctant to admit these patients, potentially leaving them “stranded in hospitals”. This study identified issues NHs consider in admission decisions for MO patients transitioning from hospitals. Design and Method: Approved surveys were mailed to nursing directors at federally-certified NHs in Arkansas (n = 234) and Pennsylvania (n = 710) to collect NH experience in the admission of patients weighing ≥325 pounds. Analyses included descriptive and inferential statistics to summarize and identify predictors of MO patient admission decisions. Results: In total, 360 surveys were returned (38.1% response rate). Although two-thirds of respondents reported patient size as an admission barrier, only 6% reported that MO patients were always refused admission. Adjusted analysis showed that NHs with adequate staff were significantly (p = .04) less likely to report obesity as an admission barrier whereas NHs reporting concerns about availability of bariatric equipment were significantly (p < .0001) more likely to report obesity as a barrier. Implications: Lack of staff and bariatric equipment in NHs appears to negatively affect the transition of MO patients out of the hospital to NHs. Additional research, including examination of current regulations and reimbursement policies, should be undertaken to understand NH staffing and equipment acquisition decisions in light of the current obesity epidemic. Such research has implications for the optimal care of obese individuals during times of transition. [ABSTRACT FROM AUTHOR]

Senior centers are ideal locations to deliver evidence-based health promotion programs to the rapidly growing population of older Americans to help them remain healthy and independent in the community. However, little reported research is conducted in partnership with senior centers; thus, not much is known about barriers and facilitators for senior centers serving as research sites. To fill this gap and potentially accelerate research within senior centers to enhance translation of evidence-based interventions into practice, the present study examined barriers and facilitators of senior centers invited to participate in a cluster-randomized controlled trial. Primary barriers to participation related to staffing and perceived inability to recruit older adult participants meeting research criteria. The primary facilitator was a desire to offer programs that were of interest and beneficial to seniors. Senior centers are interested in participating in research that provides benefit to older adults but may need assistance from researchers to overcome participation barriers. [ABSTRACT FROM PUBLISHER]

Community health workers (CHWs) have long been engaged by organizations to assist underserved populations with unmet health-related needs. CHWs' roles in effectively addressing service and health barriers--for example, through navigation and health promotion--are well established. Few published studies address how the skills and roles of CHWs are applied to support research, though similar barriers exist. To address this gap, we surveyed CHW programs about the extent and type of CHW involvement supporting research. [ABSTRACT FROM AUTHOR]

This study compared the effectiveness of two Diabetes Prevention Program (DPP) interventions on weight loss among overweight and obese Marshallese adults. The study was a two-arm cluster randomized controlled trial conducted in 30 churches in Arkansas and Oklahoma. Marshallese adults with a body mass index ≥25 kg/m 2 were eligible for the study. The study sample included 380 participants. Participants received either a faith-based adaptation of the DPP or a family-focused adaptation of the DPP, each delivered over 24 weeks. The primary outcome was weight change from baseline. Secondary outcomes included changes in Hemoglobin A 1c , blood pressure, dietary intake, family support for healthy behaviors, and physical activity. Outcomes were examined longitudinally using general linear mixed effects regression models, adjusting for baseline outcomes, sociodemographic covariates, and clustering of participants within churches. Reductions in weight were small for both groups. Overall, only 7.1% of all participants lost 5% or more of their baseline body weight. There were no significant differences in weight loss between the 2 arms at 6 months ( P  = .3599) or at 12 months ( P  = .3207). Significant differences in systolic and diastolic blood pressure were found between the 2 arms at 6 months ( P  = .0293; P  = .0068, respectively). Significant within-arm changes were found for sugar-sweetened beverage consumption and family support for both arms at both follow-ups. Both interventions achieved a modest weight loss. While even modest weight loss can be clinically significant, future research is needed to identify chronic disease prevention interventions that can successfully reduce weight for this at-risk population.

Objectives: A lack of knowledge is one of the key barriers that hinders the use of Periodic Health Examinations (PHEs). This study aimed to investigate the knowledge of PHE among adults residing in Al-Jouf region, KSA, and determine characteristics associated with such knowledge., Methods: A cross-sectional survey targeting adults (≥18 years) residing in Al-Jouf region, KSA, was conducted to gather information relating to their sociodemographic characteristics, needs for healthcare, and knowledge about and practices toward PHE. Comparative statistics and multivariate linear regression analysis were conducted to determine the key characteristics associated with knowledge about PHE., Results: A total of 624 respondents completed the survey and participated in this study. Among the participants, the mean PHE knowledge score was 5.26 (SD = 0.05) with a range of 0-7. Regression analysis showed that the PHE knowledge score was significantly higher among females, respondents with a college degree, and those worked in the healthcare field when compared to their counterparts., Conclusion: Analysis revealed a relatively high overall knowledge score for PHE among surveyed adults in KSA although knowledge score varied in males, those with lower educational levels and those who did not work in the healthcare field; these cohorts were significantly less knowledgeable about PHE than their peers even after controlling for other characteristics that may affect knowledge levels. Research to address knowledge of other health topics and health behaviors, including the utilization of health services, may provide guidance to those in KSA to improve the knowledge and use of PHE overall and within specific groups., (© 2022 [The Author/The Authors].)

Too often, populations experiencing the greatest burden of disease and disparities in health outcomes are left out of or ineffectively involved in academic-led efforts to address issues that impact them the most. Community-based participatory research (CBPR) is an approach increasingly being used to address these issues, but the science of CBPR is still viewed by many as a nascent field. Important to the development of the science of CBPR is documentation of the partnership process, particularly capacity building activities important to establishing the CBPR research infrastructure. This paper uses a CBPR Logic Model as a structure for documenting partnership capacity building activities of a long-term community-academic partnership addressing public health issues in Arkansas, U.S. Illustrative activities, programs, and experiences are described for each of the model's four constructs: context, group dynamics, interventions, and outcomes. Lessons learned through this process were: capacity building is required by both academic and community partners; shared activities provide a common base of experiences and expectations; and creating a common language facilitates dialogue about difficult issues. Development of community partnerships with one institutional unit promoted community engagement institution-wide, enhanced individual and partnership capacity, and increased opportunity to address priority issues.

The Affordable Care Act of 2010 builds on earlier efforts to expand home and community-based alternatives to institutional long-term care. Identifying people living in the community who have unmet long-term care needs and who may be at risk for entering nursing homes may be crucial to these efforts. The Arkansas Community Connector Program used specially trained community health workers to identify such people in three disadvantaged counties and connect them to Medicaid home and community-based services. The result was a 23.8 percent average reduction in annual Medicaid spending per participant during the period 2005-08. Net three-year savings to the Arkansas Medicaid program equaled $2.619 million. Similar interventions may help other localities achieve cost-saving and equitable access to publicly funded long-term care options other than institutional care.

The development of family planning services is considered one of the ten greatest achievements in public health in the United States (US) during the 20th century, enabling women to improve birth spacing and control family size. Arkansas Medicaid has expanded eligibility for family planning services to women of childbearing age with income at or below 200% of the federal poverty level (FPL). This paper describes the impact the family planning waiver has had on birth-related and economic outcomes. It also provides information that every physician should know regarding scope of services, client eligibility and provider enrollment.

Rural residents often have poorer health than their urban counterparts. Many factors, including the availability of rural health care providers, contribute to their poorer health status. The Arkansas Southern Rural Access Program offers innovative strategies for improving health care in rural areas of the state including assisting with recruitment and retention, developing rural health networks, nurturing rural health leaders, and facilitating the availability of development capital to enhance the rural health care infrastructure. This paper describes the program, its components and successes, as well as how these resources can be accessed by health care providers around the state.