Patient-centered care innovations by accountable care organizations: Lessons from leaders.

Although there is a widespread belief that ACOs must be patient-centered to be successful, evidence to guide them in achieving that goal has been lacking. This case report examines four ACO innovators in patient-centered care that together represent urban, suburban and rural populations with a broad range of economic, racial, ethnic and geographic diversity. Seven patient-centeredness strategies emerged: transform primary care practices into patient-centered medical homes; move upstream to address social and economic issues; use both high-tech and high-touch to identify and engage high-risk patients; practice a whole-person orientation; optimize patient-reported measures; treat patients like valued customers; and incorporate patient voices into governance and operations.

Manager support for work-family issues and its impact on employee-reported pain in the extended care setting.

Objective: Supervisor-level policies and the presence of a manager engaged in an employee's need to achieve work-family balance, or "supervisory support," may benefit employee health, including self-reported pain.

Methods: We conducted a census of employees at four selected extended care facilities in the Boston metropolitan region (n = 368). Supervisory support was assessed through interviews with managers and pain was reported by employees.

Depressive symptoms in extended-care employees: children, social support, and work-family conditions.

To examine the relation between having a child aged 18 years and under in the home and employee depressive symptoms, we analyzed cross-sectional data from four extended care facilities in Boston, MA (n = 376 employees). Results show that having a child is associated with slightly higher depressive symptoms. The strength of this relationship in our models is attenuated with the inclusion of social support at home (β = 1.

A review of state regulations to promote physical activity and safety on playgrounds in child care centers and family child care homes.

Background: As interventions increasingly emphasize early child care settings, it is necessary to understand the state regulatory context that provides guidelines for outdoor physical activity and safety and sets standards for child care environments.

Methods: Researchers reviewed regulations for child care facilities for 50 states, the District of Columbia and the Virgin Islands. We compared state regulations with national standards for 17 physical activity- and safety-related items for outdoor playground settings outlined in Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs (CFOC).

Social ties in relation to health status of low-income Brazilian women.

Background: Social support resources are thought to buffer stressful life events and have been associated with numerous health outcomes in industrialized countries. Because the nature of supportive relationships varies by culture and social class, we studied the relationship of informal social support and networks to self-rated health among low-income women in northeastern Brazil.

Methods: Participants included 595 randomly sampled mothers from nine low-income communities in Teresina, Piauí, Brazil.