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The article presents results of primary researches of information field of non-profit medical organizations in Russia, carried out from January 01 to December 31 2019 in Yandex search engine and Medialogia media database. The analysis of results of the study with measurements of beginning and end of 2019 was carried out. The results are one of parts of a panel study of image of medical non-profit organizations in Russia and can be used in future by interested structures with purpose of its adjustment.

Introduction: Organizations in the "ecosystem of recovery"-most often non-profits led and staffed by individuals with lived substance use disorder (SUD) experience-offer peer services, group counseling, and a wide variety of programs to help those struggling with SUD. The efforts of such organizations are effective in transitioning those suffering from SUD into long-term recovery. Despite well-established evidence depicting inequitable access to SUD treatment between BIPOC and non-Hispanic White Americans, there has been no empirical undertaking of whether organizations in the ecosystem of recovery face barriers to fund their operations based on the racial and ethnic composition of their community members., Methods: In this 2022 needs assessment, "Optimizing Recovery Funding," we combined the results of quantitative and qualitative data for a mixed methods analytic approach. The study employs bivariate descriptive statistics and inferences along with thematic analyses. From an initial list of 537 organizations across U.S. states and territories, 145 leaders of these organizations comprise our survey analytic sample. A total of 85 leaders participated in one of 16 focus groups, with 10 based on geography and 6 based on population identity. This needs assessment produced comprehensive data on the operations of organizations in the ecosystem of recovery., Results: A lack of training and existing organizational funding, as well as non-inclusive language in funding requests for proposals contributed to some organizations' decisions not to pursue certain grants and funding mechanisms. There were no statistical differences in applying for, nor success in receiving, federal and state funding between organizations serving predominantly BIPOC community members and those serving mostly non-Hispanic White community members. However, there were key instances of-at times inexplicable-inequity in funding outcomes., Conclusions: All leaders of organizations in the ecosystem of recovery who participated in the needs assessment made it clear that there are fundamental issues to accessing peer recovery operational and programmatic funding. Innovative strategies for developing inclusive and culturally responsive funding approaches that prioritize organizations predominantly serving historically marginalized communities are needed., Competing Interests: Declaration of competing interest The authors do not have any conflicts of interest, or competing interests, to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Housing is a critical social determinant of health that can be addressed through hospital-supported community benefit programming., Objectives: To explore the prevalence of hospital-based programs that address housing-related needs, categorize the specific actions taken to address housing, and determine organizational and community-level factors associated with investing in housing., Research Design: This retrospective, cross-sectional study examined a nationally representative dataset of administrative documents from nonprofit hospitals that addressed social determinants of health in their federally mandated community benefit implementation plans. We conducted descriptive statistics and bivariate analyses to examine hospital and community characteristics associated with whether a hospital invested in housing programs. Using an inductive approach, we categorized housing investments into distinct categories., Measures: The main outcome measure was a dichotomous variable representing whether a hospital invested in one or more housing programs in their community., Results: Twenty percent of hospitals invested in one or more housing programs. Hospitals that addressed housing in their implementation strategies were larger on average, less likely to be in rural communities, and more likely to be serving populations with greater housing needs. Housing programs fell into 1 of 7 categories: community partner collaboration (34%), social determinants of health screening (9%), medical respite centers (4%), community social determinants of health liaison (11%), addressing specific needs of homeless populations (16%), financial assistance (21%), and targeting high-risk populations (5%)., Conclusions: Currently, a small subset of hospitals nationally are addressing housing. Hospitals may need additional policy support, external partnerships, and technical assistance to address housing in their communities., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Biomedical research in the United States has contributed enormously to science and human health and is conducted in several thousand institutions that vary widely in their histories, missions, operations, size, and cultures. Though these institutional differences have important consequences for the research they conduct, the organizational taxonomy of US biomedical research has received scant systematic attention. Consequently, many observers and even participants are surprisingly unaware of important distinguishing attributes of these diverse institutions. This essay provides a high-level taxonomy of the institutional ecosystem of US biomedical research; illustrates key features of the ecosystem through portraits of eight institutions of varying age, size, culture, and missions, each representing a much larger class exhibiting additional diversity; and suggests topics for future research into the research output of institutional types that will be required to develop novel approaches to improving the function of the ecosystem.

Importance: Care of adults at profit vs nonprofit dialysis facilities has been associated with lower access to transplant. Whether profit status is associated with transplant access for pediatric patients with end-stage kidney disease is unknown., Objective: To determine whether profit status of dialysis facilities is associated with placement on the kidney transplant waiting list or receipt of kidney transplant among pediatric patients receiving maintenance dialysis., Design, Setting, and Participants: This retrospective cohort study reviewed the US Renal Data System records of 13 333 patients younger than 18 years who started dialysis from 2000 through 2018 in US dialysis facilities (followed up through June 30, 2019)., Exposures: Time-updated profit status of dialysis facilities., Main Outcomes and Measures: Cox models, adjusted for clinical and demographic factors, were used to examine time to wait-listing and receipt of kidney transplant by profit status of dialysis facilities., Results: A total of 13 333 pediatric patients who started receiving maintenance dialysis were included in the analysis (median age, 12 years [IQR, 3-15 years]; 6054 females [45%]; 3321 non-Hispanic Black patients [25%]; 3695 Hispanic patients [28%]). During a median follow-up of 0.87 years (IQR, 0.39-1.85 years), the incidence of wait-listing was lower at profit facilities than at nonprofit facilities, 36.2 vs 49.8 per 100 person-years, respectively (absolute risk difference, -13.6 (95% CI, -15.4 to -11.8 per 100 person-years; adjusted hazard ratio [HR] for wait-listing at profit vs nonprofit facilities, 0.79; 95% CI, 0.75-0.83). During a median follow-up of 1.52 years (IQR, 0.75-2.87 years), the incidence of kidney transplant (living or deceased donor) was also lower at profit facilities than at nonprofit facilities, 21.5 vs 31.3 per 100 person-years, respectively; absolute risk difference, -9.8 (95% CI, -10.9 to -8.6 per 100 person-years) adjusted HR for kidney transplant at profit vs nonprofit facilities, 0.71 (95% CI, 0.67-0.74)., Conclusions and Relevance: Among a cohort of pediatric patients receiving dialysis in the US from 2000 through 2018, profit facility status was associated with longer time to wait-listing and longer time to kidney transplant.

Community-based organizations (CBOs) are integral to achieving the goal of Ending the HIV epidemic (EHE). Their familiarity with and proximity to communities position them to effectively implement strategies necessary to address determinants of health through their formal and informal medical and social services. However, structural inequities have contributed to the demise of many organizations that were instrumental in early responses to the HIV epidemic. We define structural inequities for HIV CBOs as systems in which policies, institutional practices, organizational (mis)representations, and other norms work to produce and maintain inequities that affect CBOs' ability to survive and thrive. In this discussion, we describe the organizational threats to grassroots HIV CBOs and the risks to livelihood and longevity, including examples. The invaluable role of HIV CBOs in EHE and their role in responding to existing and novel infectious diseases like COVID-19 should not be overlooked. Recommendations to promote structural equity are offered. ( Am J Public Health . 2022;112(3):417-425. https://doi.org/10.2105/AJPH.2021.306688).

Proper health knowledge and adequate motivation for health activities are key factors that influence an individual to adopt a healthy behavior. Health promotion positively influences progressive behaviors that seek to advance health potential, to continuously improve one's lifestyle. There are many health promotion indications constantly encouraging people to eat healthier food. Based on the successful experience of a non-profit organization promoting a healthier vegetarian diet, this research identifies the operating factors that lead to the success of health promotion. The formulation and implementation of the health promotion strategy must be combined with the key success factors in order to accomplish the objectives. This study assessed seven factors, evaluated using the proposed method. The proposed Decision Making Trial and Evaluation Laboratory (DEMATEL) method constructs the cause and effect model of health promotion, and places forward suggestions and strategies for improvement based on the evaluation of the results. This research compared the original DEMATEL with a Modified DEMATEL (M-DEMATEL) to identify the success factors of health promotion. According to the results of both methods, "leadership", "communication channel" and "budget" are the most important and influential factors when promoting healthy diets. The results have shown the connection and the difference between the two methods. The main purpose of this research is not to determine which method is the best method, instead, to derive the combined effect of both methods., Competing Interests: The authors have declared that no competing interests exist.

Background: Philanthropy in plastic surgery supports research, clinical care, academic infrastructure, and education in the United States and internationally. Plastic surgeons have opportunities to innovatively address unmet needs in their local and global communities by forming philanthropic nonprofit organizations., Methods: The authors queried three national philanthropic databases (Charity Navigator, Guidestar, and ProPublica) for Internal Revenue Service 990 form tax return information related to philanthropic plastic surgery organizations. The authors analyzed the financial information publicly available about current plastic surgery philanthropic organizations and their funding sources., Results: Seventy-three federally tax-exempt groups identified plastic surgery as their primary area of work to the Internal Revenue Service in 2019, and 52 of those organizations said they engaged in clinical and/or educational philanthropy.3 In 2017, a total of $158.5 million was donated to these groups in cash and noncash donations including equipment and time. Analyses of 6 years (2013 to 2018) of tax records from groups that provide plastic surgery clinical, research, or educational philanthropy reveal that government grants provide very little funding for this work. Eighty-six percent of money raised for these groups in 2017 was collected by means of direct donations. Money obtained from fundraising events contributed 2 percent to their total monies raised in 2017 on average and 8 percent came from noncash gifts., Conclusions: A broad body of academic research is reviewed here that guides best practices and measuring a group's impact and outcomes. The details of a philanthropic group's organization and finances directly influence the impact of their work and, as such, are worthy of our sustained attention., (Copyright © 2021 by the American Society of Plastic Surgeons.)

The article is devoted to the study of the process of transformation of the activities of Russian children's public organizations in the face of the threat of the spread of coronavirus infection COVID-19 and the opening of new opportunities for non-profit organizations to work in this situation. The paper uses the results of a survey conducted from March 18 to 23, 2020 by experts of the Charitable Foundation for the Development of Philanthropy, which covered 232 organizations operating in the non-profit sector. The results of the study allowed us to conclude that the period of self-isolation contributed to the stimulation of children's public organizations to actively implement information technologies in their activities, find new opportunities for remote interaction in their work, and develop online projects.

Objectives: Hospitals are on the front lines of the opioid epidemic, seeing patients who overdose or have complicated infections, but the extent of services offered or whether services are evidence-based is not known. The objective of our study was to assess the extent to which nonprofit hospitals are addressing opioid abuse, a critical public health issue, through their community benefit work and to identify which evidence-based strategies they adopt., Methods: We reviewed community benefit documents from January 1, 2015, through December 31, 2018, for a sample (N = 446) of all nonprofit hospitals in the United States. We classified hospital opioid-related strategies into 9 categories. Using logistic regression, we predicted the likelihood of hospitals adopting various strategies to address opioid abuse., Results: Of the 446 nonprofit hospitals in our sample, 49.1% (n = 219) adopted ≥1 clinical strategy to address opioid use disorder in their community. Approximately one-quarter (26.5%; n = 118) of hospitals adopted a strategy related to treatment services for substance use disorder; 28.2% (n = 126) had ≥1 program focused on connecting patients to a primary care medical home, and 14.6% (n = 65) focused on caring for patients with opioid-related overdoses in the emergency department. We also identified factors that predicted involvement in programs that were less common than clinical strategies, but potentially effective, such as harm reduction and prescriber initiatives (both 6.3% of hospitals)., Conclusions: Evidence-based prevention and treatment require strong collaboration between health care and community institutions at all levels. Effective policy interventions may exist to encourage various types and sizes of nonprofit hospitals to adopt evidence-based interventions to address opioid abuse in their communities.

This article examines the relationship between hospital profitability and efficiency. A cross-section of 1317 U.S. metropolitan, acute care, not-for-profit hospitals for the year 2015 was employed. We use a frontier method, stochastic frontier analysis, to estimate hospital efficiency. Total margin and operating margin were used as profit variables in OLS regressions that were corrected for heteroskedacity. In addition to estimated efficiency, control variables for internal and external correlates of profitability were included in the regression models. We found that more efficient hospitals were also more profitable. The results show a positive relationship between profitability and size, concentration of output, occupancy rate and membership in a multi-hospital system. An inverse relationship was found between profits and academic medical centers, average length of stay, location in a Medicaid expansion state, Medicaid and Medicare share of admissions, and unemployment rate. The results of a Hausman test indicates that efficiency is exogenous in the profit equations. The findings suggest that not-for-profit hospitals will be responsive to incentives for increasing efficiency and use market power to increase surplus to pursue their objectives.

Objective: To provide guidance about management of psoriatic disease during the coronavirus disease 2019 (COVID-19) pandemic., Study Design: A task force (TF) of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was convened. The TF was supplemented by nonvoting members, which included fellows and National Psoriasis Foundation (NPF) staff. Clinical questions relevant to the psoriatic disease community were informed by questions received by the NPF. A Delphi process was conducted., Results: The TF approved 22 guidance statements. The average of the votes was within the category of agreement for all statements. All guidance statements proposed were recommended, 9 with high consensus and 13 with moderate consensus., Limitations: The evidence behind many guidance statements is limited in quality., Conclusion: These statements provide guidance for the management of patients with psoriatic disease on topics ranging from how the disease and its treatments impact COVID-19 risk and outcome, how medical care can be optimized during the pandemic, what patients should do to lower their risk of getting infected with severe acute respiratory syndrome coronavirus 2 and what they should do if they develop COVID-19. The guidance is intended to be a living document that will be updated by the TF as data emerge., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Aims: To describe how new public management practices, a global public service management trend, and a provincial community of practice, a group of people who learn from each other by interacting on an ongoing basis, affected a group of 240 community-based organisations., Methods: We conducted a holistic single case study of 240 grassroots, community-based organisations called Family Resource Centres in the province of Québec, Canada. Data was collected from 36 research interviews, 6 years of participant observation, institutional documents and a research journal, and analysed qualitatively., Results: New public management practices foster social injustice and endanger the integrity of the community-based organisations, whereas the provincial community of practice empowered them to fight back deleterious new public management practices and reclaim their identity., Conclusion: A provincial community of practice allowed 240 independent community-based organisations in Québec, Canada to become empowered on a macro level while remaining faithful to their small scale community orientation. We hope this model can serve as an example of alternatives to current (new public) management practices., (© 2020 Wiley Periodicals LLC.)

Retaining productive volunteers is an essential issue nonprofit organizations face, as volunteers help extend nonprofits' services to their target populations. The current study examined two facets of communication, perception of voice (i.e., upward communication) and satisfaction with communication (i.e., downward communication), as well as training, as important volunteer management practices with respect to facilitating volunteer engagement and commitment using both psychological contract and social exchange theories as the framework. One-hundred and seventy-one volunteers from two nonprofit organizations were surveyed to assess their satisfaction with the communication processes at their respective agencies, as well as their level of engagement, commitment, and perception of the training they received for their volunteer roles. Volunteer perceptions of both upward and downward communication were found to be indirectly related to organizational commitment through engagement. In addition, results indicated that volunteer training practices moderated the effects of upward and downward communication on engagement and commitment. Findings suggested that upward and downward communication are important predictors of volunteer engagement and commitment. Furthermore, providing training may help to strengthen these indirect effects., (© 2020 Wiley Periodicals LLC.)

An extremely useful theoretical approach to understanding the nature of work, health, and wellbeing is the job demand-control (JDC) model and the job demand-control-support (JDCS) model. In order for professional workers in the nongovernmental organization (NGO) sector to do their job, it is necessary for them to have a feeling of wellbeing. Despite this, in Europe, studies regarding the effects of the JDCS model in relation to workers' wellbeing have not been carried out. This study is expected to fill this important gap in research by analyzing the relationship of wellbeing with work demands, work control, and social support. In order to corroborate the proposed hypotheses, an analysis of these constructs in employees in European nongovernmental organizations (NGOs) was developed and, using structural equation models, these relationships were tested. The results confirm the main hypothesis of the job demand-control-support (JDCS) model and the causal relationship among physical and psychological demands, work control, and support from supervisors and colleagues with the level of employee wellbeing.

Context: Addressing the opioid epidemic requires a coordinated community response; yet, the role that nonprofit hospitals play in these efforts has not been systematically examined., Objective: To explore hospital-initiated strategies to address opioid use in urban communities most affected by the opioid epidemic., Design: We conducted content analysis of publicly available community health needs assessments (CHNAs) and accompanying implementation strategies of 140 nonprofit hospitals. We employed a qualitative approach using open coding methods to explore the extent to which hospitals identified opioid use as a community health need and engaged in interventions to address opioid use in their communities. We also conducted bivariate analysis to compare organizational and community characteristics of hospitals that did and did not engage in strategies to address opioid use., Setting: One hundred forty nonprofit hospitals in urban areas with high opioid death rates across 25 states., Results: Almost 70% of CHNAs identified opioid use as a community health need, and 63% of implementation strategies included at least 1 hospital-initiated activity to address this need. More than 90% of these implementation strategies involved providing additional capacity for and access to treatment. Bivariate analysis showed that hospitals that engaged in activities to address opioid use did not differ meaningfully from hospitals that did not engage in such activities, with 2 exceptions. Hospitals that relied on consultants to prepare the CHNA were more likely to engage in activities to address opioid use as were hospitals located in Medicaid expansion states., Conclusions: Nonprofit hospitals are taking action to address the opioid epidemic in their communities, most commonly by providing additional treatment capacity for patients with opioid use. While an important contribution, hospitals need incentives to develop a more comprehensive response to the opioid epidemic that extends beyond medical care to include the social and economic determinants of this crisis.

Background: Patient-centred care is an essential component of quality of health care. We hypothesize that integration of a mental health care package into versatile first-line health care services can strengthen patient participation, an important dimension of patient-centred care. The objective of this study is to analyse whether consultations conducted by providers in facilities that integrated mental health care score higher in terms of patient participation., Methods: This study was conducted in Guinea in 12 not-for-profit health centres, 4 of which had integrated a mental health care package (MH+) and 8 had not (MH-). The study involved 450 general curative consultations (175 in MH+ and 275 in MH- centres), conducted by 18 care providers (7 in MH+ and 11 in MH- centres). Patients were interviewed after the consultation on how they perceived their involvement in the consultation, using the Patient Participation Scale (PPS). The providers completed a self-administered questionnaire on their perception of patient's involvement in the consultation. We compared scores of the PPS between MH+ and MH- facilities and between patients and providers., Results: The mean PPS score was 24.21 and 22.54 in MH+ and MH- health centres, respectively. Participation scores depended on both care providers and the health centres they work in. The patients consulting an MH+ centre were scoring higher on patient participation score than the ones of an MH- centre (adjusted odds ratio of 4.06 with a 95% CI of 1.17-14.10, p = 0.03). All care providers agreed they understood the patients' concerns, and patients shared this view. All patients agreed they wanted to be involved in the decision-making concerning their treatment; providers, however, were reluctant to do so., Conclusion: Integrating a mental health care package into versatile first-line health services can promote more patient-centred care.

Background: Community Health Representatives (CHRs) overcome health disparities in Native communities by delivering home care, health education, and community health promotion. The Navajo CHR Program partners with the non-profit Community Outreach and Patient Empowerment (COPE), to provide home-based outreach to Navajo clients living with diabetes. COPE has created an intervention (COPE intervention) focusing on multiple levels of improved care including trainings for CHRs on Motivational Interviewing and providing CHRs with culturally-appropriate education materials. The objective of this research is to understand the participant perspective of the CHR-COPE collaborative outreach through exploring patient-reported outcomes (PROs) of clients who consent to receiving the COPE intervention (COPE clients) using a qualitative methods evaluation., Methods: Seven COPE clients were selected to participate in semi-structured interviews one year after finishing COPE to explore their perspective and experiences. Qualitative interviews were recorded, transcribed, and coded to identify themes., Results: Clients revealed that health education delivered by CHRs facilitated lifestyle changes by helping them understand key health indicators and setting achievable goals through the use of accessible material and encouragement. Clients felt comfortable with CHRs who respected traditional practices and made regular visits. Clients also appreciated when CHRs educated their family members, who in turn were better able to support the client in their health management. Finally, CHRs who implemented the COPE intervention helped patients who were unable to regularly see a primary care doctor for critical care and support in their disease management., Conclusion: The COPE-CHR collaboration facilitated trusting client-CHR relationships and allowed clients to better understand their diagnoses. Further investment in materials that respect traditional practices and aim to educate clients' families may foster these relationships and improve health outcomes., Trial Registration: clinicaltrials.gov: NCT03326206. Registered 9/26/2017 (retrospectively registered).

Quality or performance management capabilities allow agencies to identify effective practices in routine care, implement new practices, and learn to adapt practices as contexts change. Within child-serving human service systems there is not a dominant model of quality management capabilities and how they are deployed. Quality management capabilities and their development were explored at nine different child serving agencies. Agency respondents described four emergent core quality management capabilities: generating shared goals, managing information, routinizing problem-solving, and propagating a culture of quality. None of the nine agencies we studied excelled at all four. Each capability is described and implications for research, policy and practice are discussed.

Background and Objectives: Nursing homes (NHs) in the United States face increasing pressures to admit Medicare postacute patients, given higher payments relative to Medicaid. Changes in the proportion of residents who are postacute may initiate shifts in care practices, resource allocations, and priorities. Our study sought to determine whether increases in Medicare short-stay census have an impact on quality of care for long-stay residents., Research Design and Methods: This study used panel data (2005-2010) from publicly-available sources (Nursing Home Compare, Area Health Resource File, LTCFocus.org) to examine the relationship between a 1-year change in NH Medicare census and 14 measures of long-stay quality among NHs that experienced a meaningful increase in Medicare census during the study period (N = 7,932). We conducted analyses on the overall sample and stratified by for- and nonprofit ownership., Results: Of the 14 long-stay quality measures examined, only one was shown to have a significant association with Medicare census: increased Medicare census was associated with improved performance on the proportion of residents with pressure ulcers. Stratified analyses showed increased Medicare census was associated with a significant decline in performance on 3 of 14 long-stay quality measures among nonprofit, but not for-profit, facilities., Discussion and Implications: Our findings suggest that most NHs that experience an increase in Medicare census maintain long-stay quality. However, this may be more difficult to do for some, particularly nonprofits. As pressure to focus on postacute care mount in the current payment innovation environment, our findings suggest that most NHs will be able to maintain stable quality., (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Leadership at the board and executive levels across the nonprofit sector remains predominantly composed of white individuals, despite an increasingly diverse society. Research documents distinct benefits associated with diversity and inclusion, but efforts to move the dial have fallen short. This article explores how voluntary associations can prioritize racial/ethnic equity in their governance and provides specific steps for the examination of culture, practices, and processes required to operationalize change. There are a variety of professional societies and associations, also known as business leagues, established under the Internal Revenue Code. To be exempt, these organizations must be devoted to improving an industry or profession, as distinguished from performing particular services for individuals, and when successful they serve to improve the economic and social well-being of the entire nation., (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Physical inactivity has been identified as a leading risk factor for premature mortality globally, and adolescents, in particular, have low physical activity levels. Schools have been identified as a setting to tackle physical inactivity. Economic evidence of school-based physical activity programmes is limited, and the costs of these programmes are not always collected in full. This paper describes a micro-costing and cost-consequence analysis of the 'Girls Active' secondary school-based programme as part of a cluster randomised controlled trial (RCT). Micro-costing and cost-consequence analyses were conducted using bespoke cost diaries and questionnaires to collect programme delivery information. Outcomes for the cost-consequence analysis included health-related quality of life measured by the Child Health Utility-9D (CHU-9D), primary care General Practitioner (GP) and school-based (school nurse and school counsellor) service use as part of a cluster RCT of the 'Girls Active' programme. Overall, 1,752 secondary pupils were recruited and a complete case sample of 997 participants (Intervention n = 570, Control n = 427) was used for the cost-consequence analysis. The micro-costing analysis demonstrated that, depending upon how the programme was delivered, 'Girls Active' costs ranged from £1,054 (£2 per pupil, per school year) to £3,489 (£7 per pupil, per school year). The least costly option was to absorb 'Girls Active' strictly within curriculum hours. The analysis demonstrated no effect for the programme for the three main outcomes of interest (health-related quality of life, physical activity and service use).Micro-costing analyses demonstrated the costs of delivering the 'Girls Active' programme, addressing a gap in the United Kingdom (UK) literature regarding economic evidence from school-based physical activity programmes. This paper provides recommendations for those gathering cost and service use data in school settings to supplement validated and objective measures, furthering economic research in this field. Trial registration: -ISRCTN, ISRCTN10688342., Competing Interests: MJD has acted as consultant, advisory board member and speaker for Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca and Janssen, an advisory board member for Servier and as a speaker for Mitsubishi Tanabe Pharma Corporation and Takeda Pharmaceuticals International Inc. MJD has received grants in support of investigator and investigator initiated trials from Novo Nordisk, Sanofi-Aventis, Lilly, Boehringer Ingelheim and Janssen. This does not alter our adherence to PLOS ONE policies on sharing data and materials. KK has served as a speaker/consultant for Amgen, AstraZeneca, Bayer, NAPP, Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Roche, Berlin-Chemie AG / Menarini Group, Sanofi-Aventis and Servier. KK has received grants in support of investigator and investigator initiated trials from AstraZeneca, Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim and Merck Sharp & Dohme. KK has served on advisory boards for Amgen, AstraZeneca, Bayer, NAPP, Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Roche, Berlin-Chemie AG / Menarini Group, Sanofi-Aventis and Servier. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Outside of the submitted work, JMC and RTE report funding from Public Health Wales during the conduct of the study. CE reports grants from National Institute for Health Research Public Health Research during the conduct of the study. DHB, TG, DMH, LS and TY all have nothing to declare.

Objective: The Society for Vascular Surgery (SVS) is a not-for-profit medical society, whose goal is to further advance in vascular health on a global scale. With its 10th anniversary in sight, we were interested in analyzing the impact of a specific scholarship given under the SVS, the International Scholars Program. Our goal was to examine the awardees' characteristics and academic productivity., Materials and Methods: We measured the number of peer-reviewed articles, before and after the program, using PubMed ® and Google Scholar ® (2008-2018) of the scholarship recipients. Editorials, book chapters, letter to editor, and oral/poster presentations were excluded. A survey was sent out to assess the awardees' current status., Results: The average number of applicants/year was 15.4 (standard deviation ± 6.69), with 17.5% females and a mean age of 37 ± 3.37 years, with 5.6 ± 2.30 years status post vascular fellowship. Brazil had the highest number of recipients (n = 5; 18.5%) followed by China (n = 4; 14.8%). No significant difference was noted between each country in terms of publications ( P = .45), nor with after the SVS scholarship program compared to before ( P = .14, 1.84 vs 2.76). The survey concluded 33% had attended a subsequent SVS meeting after the program, with 27% having presented their research (n = 15). The recipients noted the program helped adopt new practices in clinical management (n = 13, 87%), learn new procedures (n = 10, 67%), gain local/regional leadership (n = 9, 60%), and improve technical skills (n = 8, 53%). The most visited clinical sites were Massachusetts General Hospital and Mayo Clinic (n = 4, 27%). The program was given a 9.1/10 rating., Conclusion: The program was successful in maintaining academic productivity by continuing to publish research even after the scholarship, while teaching recipients skills to further improve their career goals. The award remains a competitive process that selects highly skilled recipients and still has much growth and progress to look forward to over the next decade.

Background: By 2030, an additional 1.27 million surgeons, anaesthesiologists, and obstetricians (SAO) are needed by 2030 to reach the Lancet Commission on Global Surgery's target of 20 SAO providers per 100,000 population. Inclusion of future generations of health workers early in global surgery discussions and interventions is critical to scale-up access to surgical and anaesthesia care and ensure lasting change., Method: InciSioN, the International Student Surgical Network, is an innovative nonprofit organization by and for students, residents, and young doctors around the world. Through advocacy efforts, capacity building, educational events, international research collaboratives, and unique virtual internships, InciSioN contributes to the development of future generations of global SAO across the globe., Results: Since the formal establishment of the organization in 2016, InciSioN has grown to unite over 5000 members in over 75 countries and 31 formally established National Working Groups across all world regions. Through a system of virtual internships, members of the network have contributed to the World Development Indicators surgical data collection 2016 for the World Bank. InciSioN has created the standardized capacity-building curriculum Training Global Surgery Advocates, and established the annual Global Surgery Day on May, 25th as a global awareness day on surgical care around the world., Conclusion: The rapid global expansion of the organization and its increasingly loud voice in the worldwide global surgery discourse highlight the importance of including the future of the OR in global health discussions and shifting existing short-term paradigms to more sustainable, long-term thinking., (Copyright © 2019 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Background: In U.S. hospitals, boards of directors (BODs) have numerous governance responsibilities including overseeing hospital activities and guiding strategic decisions. BODs can help hospitals adapt to changes in their markets including those stemming from a shift from fee-for-service to value-based purchasing. The recent increase in market turbulence for hospitals has brought renewed attention to the work of BODs., Purpose: The aim of the study was to examine trends in hospital BOD structure and activities and determine whether these changes are commensurate with approaches designed to respond to market pressures., Methodology/approach: We examined hospital level data from The Governance Institute Survey (2009, 2011, 2013, and 2015) and corresponding years of the American Hospital Association Annual Survey in a pooled, cross-sectional design. We conducted individual multivariate models with adjustments for hospital and market characteristics, comparing the changes in BOD structures, demographics, and activities over time., Findings: The sample included 1,811 hospital-year observations, including 682 unique facilities. We found that BODs in 2015 had less internal management (β = -2.25, p < .001) and fewer employed and nonemployed physicians (β = -8.28, p < .001) involved on the BOD. Moreover, compared to 2009, racial and ethnic minorities (2013 β = 2.88, p < .001) and women (2013 β = 1.60, p = .045; 2015 β = 2.06, p = .049) on BODs increased over time. In addition, BODs were significantly less likely to spend time on the following activities in 2015, as compared to 2009: discussing strategy and setting policy (β = -5.46, p = .002); receiving reports from management, board committees, and subsidiaries (β = -29.04, p < .001); and educating board members (β = -4.21, p < .001). Finally, BODs had no changes in the type of committees reported over time., Practice Implications: Our results indicate that hospital BODs deploy various strategies to adapt to current market trends. Hospital decision-makers should be aware of the potential effects of board structure on organization's position in the changing health care market.

Using multilevel data from the national evaluation of Boys and Girls Clubs of America (BGCA), this study examined associations among programmatic structures, workplace and workforce characteristics, and relational practices of program staff as they relate to young people's ratings of their experience attending local clubs. The sample included 57,710 members and 5,231 staff members at 740 BGCA sites throughout the United States. Staff relational practices-including establishing caring relationships, setting high expectations, positive behavior management, encouraging youth input and agency, and cultural sensitivity-explained associations between staffing and organizational functioning and youths' perceptions of the quality of their clubs. Findings suggest a central role of staff relational practices in establishing conditions that youth experience positively, and that staffing and organizational processes, including community engagement and teamwork and efficiency can be viewed as foundations for establishing a culture of positive adult-youth interaction, which in turn can contribute to the promotion of positive youth development. Further, identification with the experiences of youth had a direct association with youths' perceptions of club quality. These results underscore the importance of staff workforce development initiatives as key to improving youth experiences in after-school programs., (© 2019 Society for Community Research and Action.)

Publicly (mainly Medicaid) funded long-term care (LTC) services have evolved from a nursing home dominated system of service to a much more balanced system including home- and community-based services (HCBS) programs over the last 30 years. The HCBS programs have been largely administered by the state and local level nonprofit aging networks (ANs) consisting of Area Agencies on Aging and thousands of service providers. Over the last decade, however, for-profit HMOs administered primarily by large insurance companies have begun to displace AN organizations. State policymakers have embraced for-profit privatizations under the rationale that this approach will generate greater savings, efficiencies, and higher quality outcomes than the traditional public or private nonprofit models of program administration. As we show here, there is very little evidence for this rationale; yet, this lack of evidence has not prevented the continuing growth of for-profit managed LTC programs supported more by an ideology of market fundamentalism than empirical evidence. We also describe six possible consequences of the trend toward corporate control of public LTC services in the years ahead., (© The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Many markets maintain a nontrivial mix of both nonprofit and for-profit firms, particularly in health care industries such as hospice, nursing homes, and home health. What are the effects of coexistence vs. dominance of one ownership type? We show how the presence of both ownership types can lead to greater diversity in consumer types served, even if both firms merely profit-maximize. This is the case where firms serve consumers for multiple consumption durations, but where donations are part of a nonprofit firm objective function and happen after services have been provided. This finding is strengthened if the good or service has value beyond immediate consumption or the direct consumer. We show these predictions empirically in the hospice industry, using data containing over 90 percent of freestanding U.S. hospices, 2000-2008. Nonprofit and for-profit providers split the patient market according to length of stay, leading to a wider range of patients being served than in the absence of this coexistence., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Newborn screening programs rely on understanding the benefits and harms of screening, but the rarity of conditions hampers generation of high-quality data. The Early Check study, a partnership between North Carolina nonprofit, academic, and state organizations, is filling this gap by screening for conditions not included in standard newborn screening., (©2019 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.)

The goal of this study was to understand whether Appalachian Ohio hospitals prioritized substance abuse in their IRS-mandated community health needs assessments (CHNAs) and if not, what factors were important in this decision. Analysis of CHNA reports from all 28 hospitals in the region supplemented interview data from in-depth phone interviews, with 17 participants tasked with overseeing CHNAs at 21 hospitals. The CHNA reports show that hospitals in this region prioritize substance abuse and mental health less often than access to care and obesity. Interviews suggest 4 reasons: lack of resources, risk aversion, concern about hospital expertise, and stigma related to substance abuse. Hospitals are playing a larger role in public health as a result of CHNA requirements but resist taking on challenging problems such as substance abuse. The report concludes by summarizing concrete steps to ensure that community benefit efforts address pressing health problems. The implications of this study are manifest in concrete recommendations for encouraging hospitals to address pressing health problems in their community benefit efforts.

Noklus is a non-profit quality improvement organization that focuses to improve all elements in the total testing process. The aim is to ensure that all medical laboratory examinations are ordered, performed and interpreted correctly and in accordance with the patients' needs for investigation, treatment and follow-up. For 25 years, Noklus has focused on point-of-care (POC) testing in primary healthcare laboratories and has more than 3100 voluntary participants. The Noklus quality system uses different tools to obtain harmonization and improvement: (1) external quality assessment for the pre-examination, examination and postexamination phase to monitor the harmonization process and to identify areas that need improvement and harmonization, (2) manufacturer-independent evaluations of the analytical quality and user-friendliness of POC instruments and (3) close interactions and follow-up of the participants through site visits, courses, training and guidance. Noklus also recommends which tests that should be performed in the different facilities like general practitioner offices, nursing homes, home care, etc. About 400 courses with more than 6000 delegates are organized annually. In 2017, more than 21,000 e-learning programs were completed.

This study examined Bolivian women's decisions to stay with or leave their violent partners. The theory of planned behavior (TPB) was used as the theoretical framework. One hundred thirty-four women were assessed 3 times over 6 months. The TPB constructs were measured at T1 and T2; relationship status was assessed at T3. At T2, attitudes about staying and leaving predicted the intention to leave. Intention to leave at T2 but not at T1 predicted relationship status at T3. These results suggest that the decision to leave was consolidated between T1 and T2, and attitudes toward staying were most relevant to this decision.

Background: Faith-based non-profit (FBNP) providers have had a long-standing role as non-state, non-profit providers in the Ghanaian health system. They have historically been considered to be important in addressing the inequitable geographical distribution of health services and towards the achievement of universal health coverage (UHC), but in changing contexts, this contribution is being questioned. However, any assessment of contribution is hampered by the lack of basic information about their comparative presence and coverage in the Ghanaian health system. In response, since the 1950s, there have been repeated calls for the 'mapping' of faith-based health assets., Methods: A historically-focused mixed-methods study was conducted, collecting qualitative and quantitative data and combining geospatial mapping with varied documentary resources (secondary and primary, current and archival). Geospatial maps were developed, providing a visual representation of changes in the spatial footprint of the Ghanaian FBNP health sector., Results: The geospatial maps show that FBNPs were originally located in rural remote areas of the country but that this service footprint has evolved over time, in line with changing social, political and economic contexts., Conclusion: FBNPs have had a long-standing role in the provision of health services and remain a valuable asset within national health systems in Ghana and sub-Saharan Africa more broadly. Collaboration between the public sector and such non-state providers, drawing on the comparative strengths and resources of FBNPs and focusing on whole system strengthening, is essential for the achievement of UHC.

Background: A case study was prepared examining government resource contributions (GRCs) to private-not-for-profit (PNFP) providers in Uganda. It focuses on Primary Health Care (PHC) grants to the largest non-profit provider network, the Uganda Catholic Medical Bureau (UCMB), from 1997 to 2015. The framework of complex adaptive systems was used to explain changes in resource contributions and the relationship between the Government and UCMB., Methods: Documents and key informant interviews with the important actors provided the main sources of qualitative data. Trends for GRCs and service outputs for the study period were constructed from existing databases used to monitor service inputs and outputs. The case study's findings were validated during two meetings with a broad set of stakeholders., Results: Three major phases were identified in the evolution of GRCs and the relationship between the Government and UCMB: 1) Initiation, 2) Rapid increase in GRCs, and 3) Declining GRCs. The main factors affecting the relationship's evolution were: 1) Financial deficits at PNFP facilities, 2) advocacy by PNFP network leaders, 3) changes in the government financial resource envelope, 4) variations in the "good will" of government actors, and 5) changes in donor funding modalities. Responses to the above dynamics included changes in user fees, operational costs of PNFPs, and government expectations of UCMB. Quantitative findings showed a progressive increase in service outputs despite the declining value of GRCs during the study period., Conclusions: GRCs in Uganda have evolved influenced by various factors and the complex interactions between government and PNFPs. The Universal Health Coverage (UHC) agenda should pay attention to these factors and their interactions when shaping how governments work with PNFPs to advance UHC. GRCs could be leveraged to mitigate the financial burden on communities served by PNFPs. Governments seeking to advance UHC goals should explore policies to expand GRCs and other modalities to subsidize the operational costs of PNFPs.

Purpose: This study assessed the critical aspect of individual staff attitudes and readiness for change within staff at a non-profit human service organization in Anchorage, Alaska, committed to adopting trauma-informed care (TIC). Organizational research has highlighted that staff attitudes and readiness impact the success of change efforts., Method: An online survey was used to measure staff knowledge about trauma, attitudes toward TIC, and readiness for change., Results: A significant finding was that attitudes favorable toward TIC were positively associated with higher readiness for change., Discussion: Human service organizations have sought to become more responsive to the needs of clients that have experienced trauma by adopting TIC. Prior to change efforts, it is critical that organizations consider staff readiness., Conclusion: As awareness about the prevalence and impact of trauma is increasing, these significant findings have implications for other agencies adopting TIC.