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Summary: Background & Aims: Age-related changes in body composition and the apparent protective effects of being overweight suggest that specific guidance is required for the clinical management of overweight and obesity for older adults (≥65 years). This study aimed to synthesise content on older adults from clinical practice guidelines for the management of overweight and obesity in adults. Methods: Twenty-three clinical practice guidelines on the management of overweight and obesity in the general adult population were identified from a recent scoping review. These guidelines were analysed for content relating to older adults. Data extraction focused on the assessment, diagnosis, and management of overweight and obesity in older adults, and specific guidance/recommendations on the management of overweight and obesity in older adults. Data were synthesised narratively. Results: Of the 23 guidelines, nine included text specific for older adults. Of these guidelines, four contained cautions regarding relevance of body mass index (BMI) cutoffs for older adults, and an additional two guidelines contained statements that BMI is a poor predictor of mortality. Information on waist circumference was inconsistent across five guidelines. Five guidelines cautioned against pursuing weight loss goals with older adults. Age-related considerations for diet, exercise, use of pharmacological interventions for weight management, and bariatric surgery were identified in several guidelines. Guidance to encourage older adults to participate in diet and exercise interventions was the most common recommendation. Recommendations on pharmacological interventions for weight management and bariatric surgery were inconsistent. Conclusions: Few guidelines incorporate content and recommendations for older adults, and there are inconsistencies between guidelines regarding the management of overweight and obesity. With evidence showing body composition and mortality risk associated with overweight change with age, there is a need to provide recommendations for older adults within clinical practice guidelines for the management of overweight and obesity.

BackgroundCompleting aggregate food and food-related waste audits in hospital foodservices is an intense practice, however they can demonstrate problem areas that require attention to reduce waste. Identifying interventions to facilitate and improve the implementation of these audits can be guided by behavior change science. The aims of this study were to use behavior change theories and frameworks to (1) describe the drivers of behavior to complete food and food-related waste audits and (2) identify possible interventions that support the implementation and uptake of these audits.MethodsPurposive sampling was used to recruit participants from hospitals in Victoria, Australia who worked in their foodservice system. Semi-structured interviews sought knowledge of participant’s perceived barriers and enablers to completing food and food-related waste audits. Deductive analysis using the Theoretical Domains Framework (TDF) and Capability Opportunity Motivation Behavior theory (COM-B) identified dominant drivers of behavior. TDF domains were then matched to their corresponding intervention functions according to the Behavior Change Wheel framework (BCW) to identify relevant strategies that may support audit implementation.ResultsData from 20 interviews found the dominant COM-B constructs (TDF domains) were psychological capability (knowledge, skills), physical opportunity (environmental context and resources), and reflective motivation (social/professional role and identity, beliefs about capabilities). These dominant domains come from narratives that participants shared about foodservice staffs’ lack of knowledge, labor, time, and the hospital avoiding responsibility for audit completion. Corresponding intervention functions that could have the most potential for implementing waste audits were education, training, environmental restructuring, modeling, and enablement. Participants’ shared perspectives of audit enablers resembled these: for example, obtaining staff buy-in, reinforcing behavior through incentives and installing an audit champion.ConclusionTo transition toward regular food and food-related waste auditing practices in hospital foodservices these findings may help identify practice and policy change that delivers standardized auditing activities to encourage long term behavior change. Interventions to support audit completion should address each behavioral construct and relevant domain, as individual hospital sites will experience unique contextual factors and expectations influencing audit outcomes. A co-design process that includes staff and stakeholders of hospital foodservices is recommended to enable engagement and practical solutions to audit implementation.

BackgroundFoodservice in hospitals contributes to the environmental footprint of healthcare delivery. There is little known about the role of policy in supporting environmentally sustainable foodservices. The aim of the study was to explore policy in exemplar environmentally sustainable hospital foodservices from the perspective of hospital staff, toward what makes a policy effective, the limitations of policy, and the influential levels and types of policy.MethodsA generic qualitative inquiry approach was utilized. Staff involved in foodservices were interviewed about the role of policy during 2020–2021 from 14 hospitals across nine countries. Data were analyzed using framework and thematic analysis.ResultsPolicies spanned across high level policies at the level of the healthcare organization, local hospital procedures and protocols, as well as public policy from local, state/provincial and national government. Internal organizational policy was used to embed practices within the organization in the long term and help to build a shared vision and goal where public policy had lacked guidance. The creation, content and methods of communication and creating accountability made internal organizational policy successful. Public policy was most effective when it was mandatory, had clearly defined targets and funding to assist implementation. These exemplar hospitals also demonstrated attributes of policy entrepreneurs by engaging with policy makers to share their stories and lobby government for policy change.DiscussionPolicy from within the healthcare organization is an important mechanism for enabling hospitals to deliver and maintain environmentally sustainable foodservice. Public policy must be designed considering the unique implementation challenges hospitals face to ensure they are successful.

Abstract Low skeletal muscle mass is known to be associated with poor morbidity and mortality outcomes in cancer, but evidence of its impact on health‐related quality of life (HRQOL) is less established. This systematic review and meta‐analysis was performed to investigate the relationship between skeletal muscle mass and HRQOL in adults with cancer. Five databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus, Scopus, and PsycInfo) were systematically searched from 1 January 2007 until 2 September 2020. Studies reporting on the association between measures of skeletal muscle (mass and/or radiodensity) derived from analysis of computed tomography imaging, and a validated measure of HRQOL in adults with cancer, were considered for inclusion. Studies classifying skeletal muscle mass as a categorical variable (low or normal) were combined in a meta‐analysis to investigate cross‐sectional association with HRQOL. Studies reporting skeletal muscle as a continuous variable were qualitatively synthesized. A total of 14 studies involving 2776 participants were eligible for inclusion. Skeletal muscle mass classified as low or normal was used to dichotomize participants in 10 studies (n = 1375). Five different cut points were used for classification across the 10 studies, with low muscle mass attributed to 58% of participants. Low muscle mass was associated with poorer global HRQOL scores [n = 985 from seven studies, standardized mean difference −0.27, 95% confidence interval (CI) −0.40 to −0.14, P 0.05). Five studies examined the cross‐sectional relationship between HRQOL and skeletal muscle mass as a continuous variable and found little evidence of an association unless non‐linear analysis was used. Two studies investigated the relationship between longitudinal changes in both skeletal muscle and HRQOL, reporting that an association exists across several HRQOL domains. Low muscle mass may be associated with lower global and physical functioning HRQOL scores in adults with cancer. The interpretation of this relationship is limited by the varied classification of low muscle mass between studies. There is a need for prospective, longitudinal studies examining the interplay between skeletal muscle mass and HRQOL over time, and data should be made accessible to enable reanalysis according to different cut points. Further research is needed to elucidate the causal pathways between these outcomes.

Background Autologous stem cell transplant is a common procedure for people with haematological malignancies. While effective at improving survival, autologous stem cell transplant recipients may have a lengthy hospital admission and experience debilitating side-effects such as fatigue, pain and deconditioning that may prolong recovery. Prehabilitation comprising exercise and nutrition intervention before stem cell transplant aims to optimise physical capacity before the procedure to enhance functional recovery after transplant. However, few studies have evaluated prehabilitation in this setting. We aim to explore preliminary efficacy of improving physical capacity of prehabilitation for people undergoing autologous stem cell transplant. Methods The PIRATE study is a single-blinded, parallel two-armed pilot randomised trial of multidisciplinary prehabilitation delivered prior to autologous stem cell transplantation. Twenty-two patients with haematological malignancy waitlisted for transplant will be recruited from a tertiary haematology unit. The intervention will include up to 8 weeks of twice-weekly, supervised tailored exercise and fortnightly nutrition education delivered via phone, in the lead up to autologous stem cell transplant. Blinded assessments will be completed at week 13, approximately 4 weeks after transplant and health service measures collected at week 25 approximately 12 weeks after transplant. The primary outcome is to assess changes in physical capacity using the 6-minute walk test. Secondary measures are time to engraftment, C-reactive protein, physical activity (accelerometer), grip strength, health-related quality of life (EORTC QLQ-C30 and HDC29 supplement), self-efficacy and recording of adverse events. Health service data including hospital length of stay, hospital readmissions, emergency department presentations and urgent symptom clinic presentation at will also be recorded. Discussion This trial will inform design of a future definitive randomised controlled trial and implementation of prehabilitation for people receiving autologous stem cell transplant by providing data on efficacy and safety. Trial registration The PIRATE Trial has been approved by the Eastern Health Human Research Ethics Committee (E20/003/61055) and is funded by the Eastern Health Foundation. This trial is registered with the Australian New Zealand Clinical Trials Registry ACTRN12620000496910. Registered April 20, 2020.

BackgroundDesigning a food waste audit tool for novel hospital foodservice practice does not guarantee uptake. Intended users must be consulted to understand the tool’s feasibility and face validity. This study aimed to identify the perspectives of staff involved in the operation of hospital foodservices on (1) how an evidenced based consensus pathway food waste audit tool is perceived to translate into practice, and (2) to determine the factors that influence the completion of food and food-related waste audits within this setting.Materials and methodsPurposeful sampling was used to recruit staff with knowledge on the operation/governance of foodservices within hospitals in Victoria, Australia. Semi-structured interviews (n = 20) were conducted via Zoom to explore barriers and enablers to completing food and food-related waste audits and a previously published food waste audit tool. NVivo was used for inductive thematic analysis.ResultsThree factors determined the completion of food and food-related waste audits in hospital foodservices, and each factor could be a barrier or an enabler; (1) capacity: the availability of time, labour and materials to complete an audit (2) change: staff resistance to audit procedures and how to gain their buy-in (3) processes, governance, and leadership: the opportunity for high level support, policy and structure to encourage waste audits if present. The consensus tool appeared to have face validity. Planning audit operations, conducting stakeholder meetings, providing education/training to foodservice team members, and facilitating communication between managers and staff were described to support consensus tool use and audit completion.ConclusionThe consensus tool can be used to support hospital foodservices to complete food and food-related waste audits, although it may need to be customised to be fit for purpose. Optimising the capacity, change management and processes, governance and leadership of the foodservice department may improve the experience and success of a food and food-related waste audit.

BackgroundThe cultural-cognitive, normative and regulative pillars of institutions influence the ability of hospitals to change how they function at an organizational and operational level. As more hospitals and their foodservices instigate changes to address their environmental footprint and impact on food systems, they move through the “sustainability phase model” from no response through to high level action and leadership. The aim of this study was to describe and compare the pillars of institutions between hospitals in different stages of achieving environmentally sustainable foodservices (business-as-usual vs. exemplar hospitals).MethodsFor this qualitative inquiry study, interviews were conducted with 33 hospital staff from 3 business-as-usual hospitals in Melbourne, Australia and 21 hospital staff from 14 exemplar hospitals across 9 countries. Participants were asked questions about their perspectives on environmental sustainability in foodservices and the barriers, enablers and drivers they experienced. Each data set was analyzed thematically and then compared.FindingsThere was a clear and distinct difference in responses and behaviors within each pillar between the exemplar and business-as-usual hospitals. The cultural-cognitive pillar identified a similarity in personal belief in the importance of addressing environmental impacts of foodservices, but difference in how staff saw and acted on their responsibility to drive change. The normative pillar uncovered a supportive culture that encouraged change in exemplar hospitals whilst business-as-usual hospital staff felt disheartened by the difficult processes and lack of support. The regulative pillar reflected business-as-usual hospital staff feeling restricted by government policy vs. exemplar hospital participants who were motivated to internalize government policy in different ways and work with other hospitals to advocate for better policy.InterpretationThese findings highlight strategies related to each of the three pillars of institutions that can be used to drive effective, sustainable long term change within hospitals. This includes staff education and training, revisiting hospital culture and values around environmental sustainability, embedding sustainable foodservices in internal policies, and a comprehensive government policy approach to sustainable healthcare.

Local food procurement by public institutions such as hospitals offers multiple benefits including stimulating the local economy, creating jobs, and building resilience within the food supply. Yet no published study has attempted to quantify the local food purchase by hospitals. This baseline is needed to identify gaps, set targets, and monitor change. The objective of this study was to investigate the origin of food supplied to a metro tertiary public hospital and to describe the proportion of food budget spent on items with ingredients grown in Australia and “locally” within the state of Victoria. Food procurement data were collected and analyzed during October 2020-April 2021. All items purchased by the cook fresh kitchen supplying meals to inpatients and two childcare centres during an 8-day menu cycle period were audited. Following an inspection of food packaging labels to determine country of origin, data on the proportion of Victorian content were collected from manufacturers and suppliers of foods containing Australian ingredient. Almost 80% of the food budget (AU $17,748 and 200 items) was spent on items containing significant (at least 75%) Australian content, while 11% was spent on entirely imported foods. The specific geographic origins of 55% of the budget spent on “Australian” food remain unknown as information from manufacturers and suppliers was not available. Where data were available, 3% of food budget was attributed to entirely Victorian grown foods, including fresh fruit, vegetables, and poultry. A considerable proportion of Australian grown foods are purchased by this hospital, but it is largely unknown whether these are local, from the state of Victoria, or not. Tracing and sharing of food origin data, a clear definition for “local” food, and an understanding of Victorian food growing industries are needed to progress the “local food to hospital” agenda.

Increased resting systemic anti-inflammatory responses have previously been reported after a period of progressive resistance training (PRT) with daily consumption of a high-protein dairy beverage. The study aimed to investigate the independent and combined effects of consuming a high protein dairy milk beverage with or without a PRT on markers of intestinal epithelial integrity and selected systemic inflammatory responses in active older (≥50 yrs) adults. Thirty two (males n = 24, females n = 8) active older adults [mean (SD): Age 62 (7) years, weight 74.2 (14.0) kg, height 1.73 (10.0) cm, BMI 24.9 (4.0) kg/m2, and body fat mass: 25.8 (9.1)%)], that reported exercising ≥3/week (211 (91) min/week) were randomly allocated into one of four groups: dairy milk (DM), exercise and dairy milk (EX+DM), exercise alone (EX), and control (CON). Groups with EX underwent 12-weeks whole-body PRT program (x3 sessions/week), groups with DM consumed the beverage twice daily (30g protein/day), and CON was required to carry out their ad libitum dietary and exercise habits. Plasma concentrations of CRP, IL-1ß, IL-1ra, LBP, and sCD14 were determined by ELISA from samples collected at weeks 0, 6, and 12. Data were analyzed (SPSS v25.0) for group and time differences using a two-way repeated-measures ANOVA with post hoc analysis. No significant differences were observed for any of the measured plasma biomarkers. The previously observed increase in anti-inflammatory cytokine response is likely due to a muscular cellular response and not an indication of intestinal epithelial integrity disturbance and/or subsequent translocation of luminal originated pathogenic bacterial compounds.

Background: Hospital foodservices have the potential to positively contribute to the local food system and planetary healthcare. Understanding the factors contributing to the success of “exemplar hospitals” with environmentally sustainable foodservices gives an opportunity to reimagine foodservices and guide strategic planning. The aim of this study was to identify the drivers of sustainable hospital foodservices.Methods: For this qualitative multiple case study, purposive sampling was used to identify exemplar hospitals internationally. Semi-structured interviews were conducted with staff with extensive knowledge of their foodservices to explore the drivers of sustainable practices. Relevant documents provided background on the case. These documents and interview data were analyzed using the framework and thematic analysis.Findings: There were 21 participants from 14 hospitals recruited across nine countries. Sustainable foodservice practices included local and organic food procurement, gardens onsite, vegetarian menus, re-serving unopened portion-controlled items, traditional foods, and food waste composting. Four themes were identified: initiating drivers, supporting enablers, challenges, and influence. Initiating drivers that “sparked” sustainable practices included the values of individuals or the hospital (e.g., community, environmental, or religious values), logical solutions to a problem, or government requirements. Enablers that facilitated success included motivated individuals, dedicated personnel, supportive leadership, internal protocols, and perceived benefits. External enablers included being part of member organizations, government requirements, and learning from other hospitals. Exemplar hospitals had broader influence, including educating the hospital community, supporting other hospitals, and influencing government policies/targets. Common challenges were staff resistance and inadequate policy directive.Interpretation: These findings examine the successful international cases of sustainable hospital foodservices to provide a global overview to assist with strategic planning both within hospitals and within governing bodies.

Population ageing and climate change are issues of global concern. Subsequently, the need for healthy and sustainable food systems to meet the increasing demands for health and aged care is evident. This review aimed to systematically identify studies reporting new or innovative foods, drinks and snack products in health and aged care, and describe health and environmental sustainability considerations where reported. Methods were guided by the Joanna Briggs Institute guidelines for scoping reviews and reported against the PRISMA-ScR guidelines. Eligible studies were conducted in an inpatient healthcare setting or aged care facility where a new or innovative food, drink or snack product was evaluated with outcomes of product use, acceptability, cost, appropriateness for the population, and clinical or environmental sustainability outcomes in the last decade. Three databases were searched using a replicable strategy, with five publications of four studies included in the final library. Product innovations were led at the facility level and included testing dewaxed brown rice, talbinah, and an apple/pear juice fibre solution. Results suggest that food industry suppliers are operating in parallel with foodservices within hospital and aged care. Future intersection would be transformative for both industry sectors.

The study aimed to investigate the independent and combined effects of consuming a high-protein dairy milk beverage, twice daily, with or without a progressive resistance training (PRT) program on outcomes of age-related sarcopenia, in healthy active older (≥50 years) adults. In this 12-week, 2 × 2 factorial study, participants were randomly allocated into one of four groups: dairy milk beverage (DM), exercise and dairy milk beverage (EX+DM), exercise alone (EX), and control (CON). The EX group underwent a 12-week whole-body PRT schedule (three sessions/week) and a high-protein dairy milk beverage (DM) was consumed twice daily (30 g protein/day). At weeks 0, 6, and 12, body composition (iDXA), strength [one-repetition maximum (1RM): leg press, chest press, lateral (lat) pull-down, and handgrip], power (countermovement jump), cardiorespiratory fitness (VO2), and physical performance (gait speed) were measured. Before measurements, blood samples were collected to determine the immune (i.e., leukocyte trafficking and inflammatory cytokines) and hormonal (i.e., insulin, cortisol, IGF-1, testosterone, and estradiol) profiles. Participants (n = 37) completed the study within the controlled experimental conditions. Protein intake increased in the EX+DM [mean ± SD, 1.2 ± 0.2 to 1.8 ± 0.4 g/kg body mass (BM) per day−1] and DM (1.3 ± 0.5 to 1.8 ± 0.6 g kg−1 BM day−1) groups during the intervention. Absolute fat-free mass increased in the EX+DM [mean (95% confidence interval) = 0.65 (0.25–1.0) kg] and EX [0.49 (−0.44 to 1.40) kg] groups (P < 0.001) compared to DM [−0.54 (−1.6 to 0.05) kg]. Relative fat mass decreased (group*time, P = 0.018) in DM [−1.8% (−3.3 to −0.35%)] and EX+DM [−1.3% (−2.3 to −0.31%)], which was a greater reduction than that in the CON [0.10% (−0.80 to 1.0%)] group (P < 0.01). Relative maximal strength increased in both the EX and EX+DM (≥35%, P < 0.05) groups, but not in the DM and CON groups. The change in 1RM strength outcomes was higher in EX+DM compared to all other groups (53–78%, P < 0.01). There was an increase in resting plasma IL-10 concentration in EX+DM (88%), compared to all the other groups (P = 0.016). No other differences in systemic inflammatory cytokines were observed. There were no significant changes in all hormone concentrations measured among all groups. In conclusion, a high-protein dairy milk beverage providing additional protein did not further enhance the effects of PRT on outcomes of fat-free mass, power, or physical performance. However, there was a significant augmentative effect for high-protein dairy milk consumption on changes to maximal strength outcomes during PRT in healthy active older adults.

We compared the impact of two different, but commonly consumed, beverages on integrative markers of exercise recovery following a 2 h high intensity interval exercise (i.e., running 70–80% V̇O2max intervals and interspersed with plyometric jumps). Participants (n = 11 males, n = 6 females) consumed a chocolate flavored dairy milk beverage (CM: 1.2 g carbohydrate/kg BM and 0.4 g protein/kg BM) or a carbohydrate-electrolyte beverage (CEB: isovolumetric with 0.76 g carbohydrate/kg BM) after exercise, in a randomized-crossover design. The recovery beverages were provided in three equal boluses over a 30 min period commencing 1 h post-exercise. Muscle biopsies were performed at 0 h and 2 h in recovery. Venous blood samples, nude BM and total body water were collected before and at 0, 2, and 4 h recovery. Gastrointestinal symptoms and breath hydrogen (H2) were collected before exercise and every 30 min during recovery. The following morning, participants returned for performance assessment. In recovery, breath H2 reached clinical relevance of >10 ppm following consumption of both beverages, in adjunct with high incidence of gastrointestinal symptoms (70%), but modest severity. Blood glucose response was greater on CEB vs. CM (P < 0.01). Insulin response was greater on CM compared with CEB (P < 0.01). Escherichia coli lipopolysaccharide stimulated neutrophil function reduced on both beverages (49%). p-GSK-3β/total-GSK-3β was greater on CM compared with CEB (P = 0.037); however, neither beverage achieved net muscle glycogen re-storage. Phosphorylation of mTOR was greater on CM than CEB (P < 0.001). Fluid retention was lower (P = 0.038) on CEB (74.3%) compared with CM (82.1%). Physiological and performance outcomes on the following day did not differ between trials. Interconnected recovery optimization markers appear to respond differently to the nutrient composition of recovery nutrition, albeit subtly and with individual variation. The present findings expand on recovery nutrition strategies to target functionality and patency of the gastrointestinal tract as a prerequisite to assimilation of recovery nutrition, as well as restoration of immunocompetency.

This study aimed to determine the effects of flavored dairy milk based recovery beverages of different nutrition compositions on markers of gastrointestinal and immune status, and subsequent recovery optimisation markers. After completing 2 h high intensity interval running, participants (n = 9) consumed a whole food dairy milk recovery beverage (CM, 1.2 g/kg body mass (BM) carbohydrate and 0.4 g/kg BM protein) or a dairy milk based supplement beverage (MBSB, 2.2 g/kg BM carbohydrate and 0.8 g/kg BM protein) in a randomized crossover design. Venous blood samples, body mass, body water, and breath samples were collected, and gastrointestinal symptoms (GIS) were measured, pre- and post-exercise, and during recovery. Muscle biopsies were performed at 0 and 2 h of recovery. The following morning, participants returned to the laboratory to assess performance outcomes. In the recovery period, carbohydrate malabsorption (breath H2 peak: 49 vs. 24 ppm) occurred on MBSB compared to CM, with a trend toward greater gut discomfort. No difference in gastrointestinal integrity (i.e., I-FABP and sCD14) or immune response (i.e., circulating leukocyte trafficking, bacterially-stimulated neutrophil degranulation, and systemic inflammatory profile) markers were observed between CM and MBSB. Neither trial achieved a positive rate of muscle glycogen resynthesis [−25.8 (35.5) mmol/kg dw/h]. Both trials increased phosphorylation of intramuscular signaling proteins. Greater fluid retention (total body water: 86.9 vs. 81.9%) occurred on MBSB compared to CM. Performance outcomes did not differ between trials. The greater nutrient composition of MBSB induced greater gastrointestinal functional disturbance, did not prevent the post-exercise reduction in neutrophil function, and did not support greater overall acute recovery.

Abstract Background Increasing population lifespan necessitates a greater understanding of nutritional needs in older adults (65 year and over). A synthesis of total energy expenditure in the older population has not been undertaken and is needed to inform nutritional requirements. We aimed to establish the extent of the international evidence for total energy expenditure (TEE) using doubly-labelled water (DLW) in older adults (65 years and over), report challenges in obtaining primary data, and make recommendations for future data sharing. Methods Four databases were searched to identify eligible studies; original research of any study design where participant level TEE was measured using DLW in participants aged ≥65 years. Once studies were identified for inclusion, authors were contacted where data were not publicly available. Results Screening was undertaken of 1223 records; the review of 317 full text papers excluded 170 records. Corresponding or first authors of 147 eligible studies were contacted electronically. Participant level data were publicly available or provided by authors for 45 publications (890 participants aged ≥65 years, with 248 aged ≥80 years). Sixty-seven percent of the DLW data in this population were unavailable due to authors unable to be contacted or declining to participate, or data being irretrievable. Conclusions The lack of data access limits the value of the original research and its contribution to nutrition science. Openly accessible DLW data available through publications or a new international data repository would facilitate greater integration of current research with previous findings and ensure evidence is available to support the needs of the ageing population. Trial registration The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016047549.

Importance: Readmission to the hospital can lead to poorer patient outcomes and increased health care costs. The effect of occupational therapy interventions for adult hospitalized patients on readmission rates has not been previously evaluated., Objective: To systematically examine the published literature to determine the effects of occupational therapy interventions for adult hospitalized patients on readmission rates., Data Sources: Systematic search of five electronic databases was performed from database inception until May 2020, supplemented by citation and reference list searches. Study Selection and Data Collection: This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered prospectively; methodological quality of the included studies was assessed using the Downs and Black checklist. Meta-analyses were conducted with clinically homogeneous data; the overall body of evidence was graded for quality., Findings: Meta-analysis of 7 studies with 16,718 participants provided low-quality evidence that 1-mo readmission rates were reduced when adult patients hospitalized for general medical and surgical care received additional occupational therapy interventions compared with standard care. Subgroup analysis of 4 studies provided moderate-quality evidence that interventions focusing on the transition from hospital to the community were effective in reducing 1-mo readmissions to hospitals compared with standard care., Conclusions and Relevance: Occupational therapy interventions can be effective in reducing readmissions among some adult hospitalized patient populations, including those admitted for surgery or management of acute medical conditions, with stronger evidence to support transitional care interventions. What This Article Adds: Occupational therapy interventions can be effective in reducing readmissions among adult hospitalized patients. There is a continued need for occupational therapy practitioners to understand their value and contribution to reducing avoidable readmissions to hospitals., (Copyright © 2022 by the American Occupational Therapy Association, Inc.)