Browsing by Author "Mangum, Joshua"

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    Association of Socio-Demographic Factors and Social Determinants of Health with Physical Activity Level in Patients with Disabilities
    (2025-04-25) Clark, Austin; Mangum, Joshua; Muvuka, Baraka; Guerrero, Jonathan
    Background: Regular exercise has been shown to improve health outcomes and an important component of preventative medicine. The CDC has shown that patients with disabilities get less regular exercise than patients without disabilities. Identifying groups with low physical activity levels, such as patients with disabilities, and the barriers to physical activity can guide policy and decision making to improve health outcomes. This study examined associations between social determinants of health (SDOH) and physical activity levels. Methods: This retrospective study focused on patients with disabilities admitted at 3 urban hospitals in Northwest Indiana between January 2021 and April 2024. SDOH were screened and participants were selected based on CDC’s disability categories (Cognitive, Mobility, Vision, Hearing, Independent Living, and Self Care). Physical activity level was based on exercise minutes per week: Inactive (IA)=0 minutes, Insufficiently Active (ISA)=<150 minutes, and Sufficiently Active (SA)=150+ minutes. Results: 705 patients with disabilities with recorded physical activity levels were identified. No significant differences were found in physical activity levels between disability categories. The IA group differed significantly from both SA and ISA groups in Age Group, Social Connections Risk, and Length of Stay (p=<0.01). The SA and ISA groups showed significant difference in Financial Resource Risk (p=.045). Regression Analysis showed an increased risk for physical inactivity as Age increased (p=<.001), as well as patients with public insurance compared to private (p=0.02). Conclusion: Age is a common risk factor for reduced physical and the association of lower physical activity with Financial Resource Risk and Social Connections Risk is not novel, but further studies using larger samples may offer insight for future interventions. Future research would benefit from more specific physical activity data from patients with disabilities that may also give insight into adaptive interventions to improve exercise levels in this population.
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    Association of Socio-Demographic Factors, Social Determinants of Health and Weekly Physical Activity in an Urban Hospital in Northwest Indiana
    (2023-07) Gad, Wael; Chandler, Brianna; Jones, Brendan; Mangum, Joshua
    Background: Engaging in regular physical activity has been proven to have beneficial health effects such as preventing chronic diseases and improving mental health. Recent studies have demonstrated correlations between socio-demographic factors and physical activity levels. This study determined the associations between socio-demographic factors, social determinants of health and the amount of weekly physical activity in patients occupying an urban underserved area. Methods: This study retrospectively analyzed a dataset generated by St. Mary Medical Center from EPIC™ with demographic characteristics and physical activity levels partitioned by time per week for adult inpatient visits from January 2021 to March 2023. Patients were stratified into physical activity levels based upon published guidelines: inactive (no physical activity), insufficiently active (<150 minutes per week) or sufficiently active (≥150 minutes per week). Data analysis was conducted in SPSS 28.0 using tests of association including Kruskal Wallis H and multivariate ordinal regression model. This study was exempted by Indiana University Human Research Protection Program (IRB # 14040). Results: The sample of individuals from the dataset who answered physical activity questions was comprised of 1498 patients. There was a statistically significant difference in physical activity level by age group (p<0.001), sex (p<0.05), insurance category (p<0.001), and social connections risk score (p<0.001); with race (p=0.057) and language (p=0.054) approaching significance. Multivariate analysis showed that age was the only significant factor when accounting for all variables, with higher age groups reporting lower proportions of physically active individuals. Conclusion: Determining how socio-demographic factors influence physical activity levels will direct efforts to form and implement new interventions in the Northwest Indiana urban area and support community health initiatives. This data makes it possible to inform practitioners of the demographics that are at risk of being insufficiently active and having them direct those patients to programs in place to help bridge the lapse.
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    Social, Demographic, and Behavioral Determinants of Prolonged Hospital Stay and Readmissions of Postoperative Complications in an Urban Acute Care Hospital
    (2025-04-25) Dres, Alexis; Thompson, Skyler; Sullivan, Maggie; Muvuka, Baraka; Guerrero, Jonathan; Mangum, Joshua; Gosporadek, Kyle
    Background and Hypothesis The correlation between postoperative complications and social determinants of health (SDOH) is a prominent focus in medical literature due to its implications for healthcare quality and hospital outcomes. In evaluating hospital performance, extended hospital stays (LOS) and readmissions (RA) are critical indicators, prompting initiatives like the Hospital Readmission Reduction Program. Despite efforts, disparities affecting surgical outcomes among urban patients remain underexplored. This study aims to investigate how SDOH influence readmissions and prolonged hospital stays among urban patients experiencing postoperative complications. Conducted through a Community-Based Participatory Research (CBPR) collaboration between Indiana University School of Medicine (IUSM) and Power Health in Northwest Indiana, the research addresses gaps in understanding healthcare disparities in urban settings. Methods This retrospective study analyzed a dataset sourced from SMMC via EPIC™, focusing on SDOH, demographic profiles, health behaviors, and outcomes of adult inpatients who experienced prolonged hospital stays or 30-day readmissions after surgical procedures at an urban hospital between January 2021 and April 2024. Data analysis utilized SPSS 29.0, employing methods like frequency analysis, Chi-Square tests (p<0.05), binary logistic regression (p<0.05), and linear logistic regression (p<0.05) tailored to the study population. The study received exemption from the Indiana University Human Research Protection Program (IRB # 14040) on 1/28/2022. Results The study included data from over 900 patients, with 565 readmissions (RA) and 337 extended LOS cases, primarily adults over 50 years old (81.8% RA, 81.4% LOS), White (69.4% RA, 86.3% LOS), and publicly-insured (74.8% RA, 74.7% LOS). Bivariate analysis revealed significant associations between postoperative complications and age (p < 0.001 for RA, p < 0.011 for LOS), veteran status (p = 0.022 for RA, p = 0.058 for LOS), insurance type (p < 0.001 for RA), smoking tobacco use (p < 0.001 for RA, p = 0.026 for LOS), and BMI (p = 0.002 for RA). Multivariate analysis showed that former smoking (OR = 2.144, p < 0.001), underweight BMI (OR = 4.131, p = 0.006), and publicly-insured status (OR = 3.295, p < 0.001) remained significant across all readmission durations. Specifically for 30-day readmission, public insurance (OR = 2.844, p = 0.021) and former smoking (OR = 1.875, p = 0.037) were significant factors. Potential Impact This research highlights various SDOH and health behaviors associated with increased risks of prolonged hospital stays and readmissions following postoperative complications among urban patients. Policy interventions addressing these factors before and after surgery could potentially mitigate readmissions and extended hospital stays due to procedural complications, thereby improving healthcare outcomes and reducing disparities in urban healthcare settings.