Future research should examine these interactions in the college context in order to further our understanding of potential interventions or environmental modifications that support healthy eating and PA.

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BackgroundWorksite obesity prevention interventions using an ecological approach may hold promise for reducing typical weight gain. The purpose of this study was to examine the effectiveness of Go!, an innovative 12-month multi-component worksite obesity prevention intervention.MethodsA quasi-experimental non-equivalent control group design was utilized; 407 eligible hospital employees (intervention arm) and 93 eligible clinic employees (comparison arm) participated. The intervention involved pedometer distribution, labeling of all foods in the worksite cafeteria and vending machines (with calories, step equivalent, and a traffic light based on energy density signaling recommended portion), persuasive messaging throughout the hospital, and the integration of influential employees to reinforce healthy social norms. Changes in weight, BMI, waist circumference, physical activity, and dietary behavior after 6 months and 1 year were primary outcomes. Secondary outcomes included knowledge, perceptions of employer commitment to employee health, availability of information about diet, exercise, and weight loss, perceptions of coworker support and frequency of health discussions with coworkers. A process evaluation was conducted as part of the study.ResultsRepeated measures ANCOVA indicated that neither group showed significant increases in weight, BMI, or waist circumference over 12 months. The intervention group showed a modest increase in physical activity in the form of walking, but decreases in fruit and vegetable servings and fiber intake. They also reported significant increases in knowledge, information, perceptions of employer commitment, and health discussions with peers. Employees expressed positive attitudes towards all components of the Go! intervention.ConclusionsThis low-intensity intervention was well-received by employees but had little effect on their weight over the course of 12 months. Such results are consistent with other worksite obesity prevention studies using ecological approaches. Implementing low-impact physical activity (e.g., walking, stair use) may be more readily incorporated into the worksite setting than more challenging behaviors of altering dietary habits and increasing more vigorous forms of physical activity.Trial RegistrationThis study was registered with clinicaltrials.gov (NCT01585480) on April 24, 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2828-0) contains supplementary material, which is available to authorized users.

Purpose Rural communities have unique economic and social structures, different disease burdens, and a more patchworked healthcare delivery system compared to urban counterparts. Yet research into addressing social determinants of health has focused on larger, urban, integrated health systems. Our study sought to understand capacities, facilitators, and barriers related to addressing social health needs across a collaborative of independent provider organizations in rural Northeastern Minnesota and Northwestern Wisconsin. Methods We conducted qualitative, semi-structured interviews with a purposive sample of 37 key informants from collaborative members including 4 stand-alone critical access hospitals, 3 critical access hospitals affiliated with primary care, 1 multi-clinic system, and 1 integrated regional health system. Findings Barriers were abundant and occurred at the organizational, community and policy levels. Rural providers described a lack of financial, labor, Internet, and community-based social services resources, a limited capacity to partner with other organizations, and workflows that were less than optimal for addressing SDOH. State Medicaid and other payer policies posed challenges that made it more difficult to use available resources, as did misaligned incentives between partners. While specific payer programs and organizational innovations helped facilitate their work, nothing was systemic. Relationships within the collaborative that allowed sharing of innovations and information were helpful, as was the role leadership played in promoting value-based care. Conclusions Policy change is needed to support rural providers in this work. Collaboration among rural health systems should be fostered to develop common protocols, promote value-based care, and offer economies of scale to leverage value-based payment. States can help align incentives and performance metrics across rural health care entities, engage payers in promoting value-based care, and bolster social service capacity.

BackgroundThe potential for social capital to influence health outcomes has received significant attention, yet few studies have assessed the temporal ordering between the two. Even less attention has been paid to more vulnerable populations, such as low-income women with children. Our objective was to explore how different dimensions of social capital impact future health status among this population.MethodsThis study uses data from the Fragile Families and Child Well-Being (FFCWB) Study, which has followed a cohort of children and their families born in large U.S. cities between 1998 and 2000 to mostly minority, unmarried parents who tend to be at greater risk for falling into poverty. Four separate measures of social capital were constructed, which include measures of social support and trust, social participation, perceptions of neighborhood social cohesion, and perceptions of neighborhood social control. The temporal effect of social capital on self-reported health (SRH) is investigated using logistic regression and we hypothesize that higher levels of social capital are associated with higher levels of self-rated health.ResultsAfter controlling for socioeconomic and demographic factors related to social capital and self-rated health, social support and trust, perceptions of neighborhood social cohesion and control at an earlier point in time were positively associated with higher levels of health four-years later. Social participation was not related to increased health. The empirical results appear robust.ConclusionHigher levels of social capital are predictive of improved health over a four-year time frame. These results suggest that policy initiatives supporting increasing the social capital available and accessible by low-income, urban, minority women are viable for improving health. Such policies may have the potential to reduce socioeconomic health disparities.