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This article discusses a student-led refugee initiative called the PSCOM Refugee Initiative (RI) that aims to address the lack of awareness about health disparities among medical trainees. The initiative began in 2016 and initially focused on providing tutoring services and food security to resettled Syrian refugee families in Harrisburg, PA. However, due to the COVID-19 pandemic, the program faced new challenges and had to adapt its services. The article highlights the benefits of community relationships and interdisciplinary teamwork in understanding and addressing social determinants of health (SDH) and health disparities. The authors also discuss lessons learned from their experience and suggest integrating key lessons into medical curricula to benefit all students. The article concludes by emphasizing the importance of constant evaluation and innovation in improving similar refugee initiatives and enhancing the competency of graduating medical students in applying SDH in their future medical practice. [Extracted from the article]

Academic Health Centers and nonprofit hospitals are exploring strategies to meet Affordable Care Act mandates requiring tax-exempt institutions to address community health needs, which commonly include major chronic illnesses. We explore the implications of this regulatory landscape, describing methods that nonprofit health care institutions are using to undertake community health needs assessments and showing how value has been found in addressing needs through the implementation of nutrition-related Health Education initiatives that aim to prevent or delay the onset of major chronic diseases. We then share and evaluate approaches we have undertaken at Penn State Hershey Medical Center involving 2 nutrition-focused initiatives--a hospital-affiliated farmers' market and a community garden--and argue for why such investments may be valuable assets to other nonprofit institutions that must demonstrate community benefit by addressing major chronic diseases.

Abstract Background High rates of physical inactivity compromise the health status of populations globally. Social networks have been shown to influence physical activity (PA), but little is known about how best to engineer social networks to sustain PA. To improve procedures for building networks that shape PA as a normative behavior, there is a need for more specific hypotheses about how social variables influence PA. There is also a need to integrate concepts from network science with ecological concepts that often guide the design of in-person and electronically-mediated interventions. Therefore, this paper: (1) proposes a conceptual model that integrates principles from network science and ecology across in-person and electronically-mediated intervention modes; and (2) illustrates the application of this model to the design and evaluation of a social network intervention for PA. Methods/Design A conceptual model for engineering social networks was developed based on a scoping literature review of modifiable social influences on PA. The model guided the design of a cluster randomized controlled trial in which 308 sedentary adults were randomly assigned to three groups: WalkLink+: prompted and provided feedback on participants’ online and in-person social-network interactions to expand networks for PA, plus provided evidence-based online walking program and weekly walking tips; WalkLink: evidence-based online walking program and weekly tips only; Minimal Treatment Control: weekly tips only. The effects of these treatment conditions were assessed at baseline, post-program, and 6-month follow-up. The primary outcome was accelerometer-measured PA. Secondary outcomes included objectively-measured aerobic fitness, body mass index, waist circumference, blood pressure, and neighborhood walkability; and self-reported measures of the physical environment, social network environment, and social network interactions. The differential effects of the three treatment conditions on primary and secondary outcomes will be analyzed using general linear modeling (GLM), or generalized linear modeling if the assumptions for GLM cannot be met. Discussion Results will contribute to greater understanding of how to conceptualize and implement social networks to support long-term PA. Establishing social networks for PA across multiple life settings could contribute to cultural norms that sustain active living. Trial registration ClinicalTrials.gov NCT01142804

Background: Fruit and vegetable prescription (FVRx) programs provide "prescriptions" for produce, but increased access to nutritional food may be insufficient for long-term behavior change. Purpose: We integrated nutritional education into an FVRx program at a farmers' market and community garden at Penn State Medical Center by pairing medical student "mentors" with 4 families with overweight/obese children. Methods: Each head of household completed a presurvey that included basic demographic information, as well as a question about barriers to healthy eating. Families made up to 4 visits to the market with mentors, during which students discussed and documented produce utilization. A 1-hour focus group with mentors was conducted and transcribed. Thematic analysis was performed on qualitative data. Results: Two families completed all visits. On average, families spent 32 minutes at the market/garden per visit, had expenditures of $40.68, and reported one weekly produce item going unused. Families valued on-site mentoring, and students felt that it provided opportunities for professional development and improved self-care while also benefiting vendors. Discussion: Integrating medical student nutritional mentoring into an FVRx program was feasible and conferred benefits to participating families, students, and vendors. Translation to Health Education Practice: Educators should consider pairing access to nutritional foods with mentoring.

In response to Finch and Burstein's provocative argument that the advanced dementias may result from environmental toxins and lifestyle factors associated with post-industrial societies, we call for a more rigorous historical approach, emphasizing the importance of situating ancient texts more fully in their historical and cultural context. Such an approach would also entail consideration of the declining relative rates of dementia in Western countries, which have been linked to population health-level factors and policies that appear to have reduced the risk of dementia by directly and indirectly influencing the social determinants of brain health. [ABSTRACT FROM AUTHOR]

The development of disease concepts for conditions such as Alzheimer's disease (AD) is an ongoing social process that evolves over time. The biomedical paradigm about AD that has informed our culture's understanding of brain aging for the past several decades is currently undergoing a major and timely renovation in the early 21st century. This evolution is reflected in new guidelines issued by the National Institute on Aging and Alzheimer's Association (NIA/AA) for the diagnosis of AD and related conditions that aim at helping researchers identify and eventually treat AD in its presymptomatic stages. The purpose of this article is to offer the scientific, clinical, and ethics communities a critical analysis of the implications of proposed guidelines and prompt deeper reflection about the lessons learned from these new efforts both in terms of their actual content and the cultural context in which they were issued and will be used. From a social-constructivist perspective, we explore the gradual 100-year evolution of AD and summarize the proposed NIA/AA guidelines within this historical context, enumerating what we see as their main benefits and limitations. We then consider the potential implications of these guidelines in the clinical setting, and explore shifts in our cultural paradigm about brain aging that might be engendered by the logic of the guidelines.

In the therapeutic void created by over 20 failed Alzheimer's disease drugs during the past decade, a new marketplace of "brain fitness" technology products has emerged. Ranging from video games and computer software to mobile phone apps and hand-held devices, these commercial products promise to maintain and enhance the memory, concentration, visual and spatial skills, verbal recall, and executive functions of individual users. It is instructive to view these products as sociocultural objects deeply imbued with the values and ideologies of our age; consequently, this article offers a critique of the brain fitness technology marketplace while identifying limitations in the capacity of commercial products to realistically improve cognitive health. A broader conception of brain health is presented, going beyond the reductionism of the commercial brain fitness marketplace and asking how our most proximate relationships and local communities can play a role in supporting cognitive and psychosocial well-being. This vision is grounded in recent experiences at The Intergenerational School in Cleveland, OH, a multigenerational community-oriented learning environment that is implementing brain fitness technology in novel ways.

Purpose: To evaluate whether medical student participation in TimeSlips (TS), a creative group-based storytelling program, with persons affected by dementia would improve student attitudes toward this patient population. Design and Methods: Fifteen fourth-year medical students from Penn State College of Medicine participated in a month-long regimen of TS sessions at a retirement community. Student course evaluations were analyzed at the conclusion of the program to examine perceived qualitative changes in attitude. Findings: Qualitative data revealed insights into the manner in which student attitudes toward a geriatric patient population became more positive. Implications: This is the first known pilot study to suggest that participation in a creative group-based storytelling program might improve medical student attitudes toward persons with dementia.

Introduction: Health professionals are working in an era of social technologies that empower users to generate content in real time. This article describes a 3-part continuing education minicourse called "Friending Facebook?" undertaken at Penn State Hershey Medical Center that aimed to model the functionality of current technologies in health care and encourage discussion about how health professionals might responsibly utilize social media. Methods: Fifteen health professionals participated in the course and provided written evaluation at its conclusion. The course instructor took field notes during each of the 3 classes to document emergent themes. Results: The course received uniformly positive evaluations, and participants identified several current tools perceived as being potentially useful in their professional lives, including news aggregators, Google Alerts, and--if used responsibly--social networking sites such as Facebook. Discussion: Developing innovative and appropriate programming that teaches to emerging social media technologies and ideologies will be crucial to helping the health professions adapt to a new, networked era. Medical institutions would do well to foster interprofessional--and perhaps even intergenerational--conversations to share not only the dangers and risks of social media, but also the opportunities that are emerging out of a rapidly evolving online world. (Contains 2 tables.)