To examine perceived infection risk of COVID-19 and the health and related behavior changes among people with diabetes, compared with people without diabetes, and to examine factors associated with self-reported health during the national quarantine period in China. Methods: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media across China. A national sample of 10,545 adults in all 31 provinces in mainland China provided data on sociodemographic characteristics, awareness, attitudes towards COVID-19, lifestyle factors, and health outcomes during the quarantine. Regression models tested associations among study variables adjusting for covariates. Results: Among the 9,016 total participants (42.6% men and 57.4% women), 585 reported having diagnosed diabetes and 8,431 had no diabetes. Participants with diabetes perceived themselves to be at higher risk and were more worried about being infected with COVID-19 when compared to non-diabetic individuals (p < 0.001). During the COVID-19 pandemic, participants with diabetes were more likely to experience food and drug shortages and to increase their physical activity, compared to their counterparts. Among diabetic respondents, a high proportion of current smokers (74.1%) and drinkers (68.5%) reported increased
Objective:
This systematic review examined and synthesized peer-reviewed research studies that reported the process of integrating social determinants of health (SDOH) or social needs screening into electronic health records (EHRs) and the intervention effects in the United States.
Methods:
Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, a systematic search of Scopus, Web of Science Core Collection, MEDLINE, and Cochrane Central Register of Clinical Trials was performed. English language peer-reviewed studies that reported the process of integrating SDOH or social needs screening into EHRs within the U.S. health systems and published between January 2015 and December 2021 were included. The review focused on process measures, social needs changes, health outcomes, and health care cost and utilization.
Results:
In total, 28 studies were included, and half were randomized controlled trials. The majority of the studies targeted multiple SDOH domains. The interventions vary by the levels of intensity of their approaches and heterogeneities in outcome measures. Most studies (82%,
n
=23) reported the findings related to the process measures, and nearly half (43%,
n
=12) reported outcomes related to social needs. By contrast, only 39% (
n
=11) and 32% (
n
=9) of the studies reported health outcomes and impact on health care cost and utilization, respectively. Findings on patients' social needs change demonstrated improved access to resources. However, findings were mixed on intervention effects on health and health care cost and utilization. We also identified gaps in implementation challenges to be overcome.
Conclusion:
Our review supports the current policy efforts to increase U.S. health systems' investment toward directly addressing SDOH. While effective interventions can be more complex or resource intensive than an online referral, health care organizations hoping to achieve health equity and improve population health must commit the effort and investment required to achieve this goal.
Recreational facility availability has been shown to associate positively with youth physical activity levels. Nonetheless, little is known about additional facility characteristics affecting their use for physical activity as well as differences between private and public facilities. This study examines (1) perceptions and use of public and private recreational facilities and (2) environmental and individual-level correlates of both facility use and physical activity among urban adolescents. Physical activity was assessed using accelerometry, objective measures of facility availability were obtained using Geographical Information Systems data, and facility use and perceptions were measured with a survey (N = 327). Adolescents were more likely to use public than private facilities despite perceiving that private facilities were of higher quality. Adolescents' use of both public and private facilities was associated with perceived (but not objective) availability, perceived quality, and use by friends and family. Public, but not private, facility use was associated with physical activity. This study reveals the importance of public facilities to the physical activity of urban youth.
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