Advancing Lifestyle Medicine in New York City’s Public Health Care System

Mayo Clinic proceedings. Innovations, quality & outcomes Pub Date : 2024-05-21 DOI:10.1016/j.mayocpiqo.2024.01.005

John S. Babich BS , Michelle McMacken MD , Lilian Correa MA, MPH, RDN , Krisann Polito-Moller BS, NBC-HWC , Kevin Chen MD, MHS , Eric Adams MPA , Samantha Morgenstern MS, RD, CDN , Mitchell Katz MD , Theodore G. Long MD, MHS , Shivam Joshi MD , Andrew B. Wallach MD , Sapana Shah MD, MPH , Rebecca Boas MD, MBA

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Abstract

Chronic diseases are the leading cause of death and disability in the United States, and much of this burden can be attributed to lifestyle and behavioral risk factors. Lifestyle medicine is an approach to preventing and treating lifestyle-related chronic disease using evidence-based lifestyle modification as a primary modality. NYC Health + Hospitals, the largest municipal public health care system in the United States, is a national pioneer in incorporating lifestyle medicine systemwide. In 2019, a pilot lifestyle medicine program was launched at NYC Health + Hospitals/Bellevue to improve cardiometabolic health in high-risk patients through intensive support for evidence-based lifestyle changes. Analyses of program data collected from January 29, 2019 to February 26, 2020 demonstrated feasibility, high demand for services, high patient satisfaction, and clinically and statistically significant improvements in cardiometabolic risk factors. This pilot is being expanded to 6 new NYC Health + Hospitals sites spanning all 5 NYC boroughs. As part of the expansion, many changes have been implemented to enhance the original pilot model, scale services effectively, and generate more interest and incentives in lifestyle medicine for staff and patients across the health care system, including a plant-based default meal program for inpatients. This narrative review describes the pilot model and outcomes, the expansion process, and lessons learned to serve as a guide for other health systems.

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在纽约市公共医疗保健系统中推广生活方式医学

慢性疾病是导致美国人死亡和残疾的主要原因，而这一负担的大部分可归因于生活方式和行为风险因素。生活方式医学是一种预防和治疗与生活方式有关的慢性疾病的方法，以循证生活方式调整为主要方式。纽约市健康与医院是美国最大的市级公共医疗保健系统，是在全系统范围内推行生活方式医学的全国先驱。2019 年，纽约市健康 + 医院/贝尔维尤分院启动了一项生活方式医学试点计划，通过强化对循证生活方式改变的支持，改善高风险患者的心脏代谢健康。对 2019 年 1 月 29 日至 2020 年 2 月 26 日期间收集的计划数据进行的分析表明，该计划具有可行性，服务需求量大，患者满意度高，并且在临床和统计上显著改善了心脏代谢风险因素。该试点项目正在扩展到纽约市健康与医院（NYC Health + Hospitals）的 6 个新站点，覆盖纽约市的所有 5 个行政区。作为扩展工作的一部分，已实施了许多改革，以加强最初的试点模式，有效扩大服务规模，并在整个医疗保健系统中激发员工和患者对生活方式医学的兴趣和动力，包括为住院患者提供以植物为基础的默认膳食计划。这篇叙述性综述介绍了试点模式和成果、扩展过程和经验教训，为其他医疗系统提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy

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审稿时长

49 days