Genevieve N. Healy, Ana D. Goode, Lucy Campbell, Amit Sikder, Denis Giguere, Sjaan R. Gomersall
{"title":"Barriers and Enablers to Maintaining Behaviour Changes Following a Lifestyle Intervention for Adults With Type 2 Diabetes","authors":"Genevieve N. Healy, Ana D. Goode, Lucy Campbell, Amit Sikder, Denis Giguere, Sjaan R. Gomersall","doi":"10.1177/15598276241262721","DOIUrl":"https://doi.org/10.1177/15598276241262721","url":null,"abstract":"AimTo explore short-term barriers and enablers to maintaining behaviour changes in adults with type 2 diabetes who had completed a lifestyle behaviour change program.MethodsFocus groups with 44 participants identified barriers and enablers at the end-of-program (n = 8 groups: anticipated); and, 1-month post-program (n = 6 groups: experienced). Thematic inductive analysis was undertaken independently by two authors, discussed, then deductively grouped according to the Capability (physical, psychological), Opportunity (physical, social), Motivation (automatic, reflective) – Behaviour (COM-B) model.ResultsNine barriers were identified: two anticipated, one experienced, and six common to both timepoints. Key barriers related to physical capability (health ability), physical opportunity (difficulty accessing and using resources), social opportunity (unwillingness to invest in social networks), and reflective motivation (lack of internal drive). Eleven enablers were identified: all across both timepoints. Key enablers related to psychological capability (knowledge), physical opportunity (access and use of program resources), social opportunity (sense of belonging and safety within the program), automatic motivation (beliefs and awareness around perceived risk; monitoring of progress), and reflective motivation (committed to change).DiscussionFindings suggest diabetes management programs should enable ongoing access to their resources. Investing in mechanisms to scaffold program graduates into suitable community-based activities may also be beneficial.","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"72 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141782903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediabetes, Physical Activity, and Primary Care Providers","authors":"Bryant J. Webber","doi":"10.1177/15598276241264739","DOIUrl":"https://doi.org/10.1177/15598276241264739","url":null,"abstract":"","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"225 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141782902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blake M. Hauser, Matthew Parsons, Besmira Alija, Christine Kim, Andrew Nguyen, Joy Moses, Sierra Tseng, Christopher Alba, Kniya Dédé, Megan Gimmen, Evelyn Lemus Silva, Diviya Rajesh, Lily Mirfakhraie, Alan Z. Yang, Meghan Ariagno, Kelly Moutsioulis, Erin Reilly, Reza Askari, Nancy L. Cho, Amy Evenson, Arundhati Ghosh, Sophia McKinley, Roy Phitayakorn, Beth Frates
{"title":"Improving Medical Student Access to Nutrition During the Core Surgery Clerkship","authors":"Blake M. Hauser, Matthew Parsons, Besmira Alija, Christine Kim, Andrew Nguyen, Joy Moses, Sierra Tseng, Christopher Alba, Kniya Dédé, Megan Gimmen, Evelyn Lemus Silva, Diviya Rajesh, Lily Mirfakhraie, Alan Z. Yang, Meghan Ariagno, Kelly Moutsioulis, Erin Reilly, Reza Askari, Nancy L. Cho, Amy Evenson, Arundhati Ghosh, Sophia McKinley, Roy Phitayakorn, Beth Frates","doi":"10.1177/15598276241261646","DOIUrl":"https://doi.org/10.1177/15598276241261646","url":null,"abstract":"The rigorous demands of medical education create circumstances that can make it challenging to maintain a healthy diet. Evaluations from students at an urban medical school in the northeast U.S. regarding their surgery clerkship highlighted the difficulty of finding healthy snacks or meals between operations and patient care obligations. In response, we implemented the Nutritional Wellness Initiative, a pilot program designed to offer accessible, healthy snacks to medical students during their surgery clerkship. We conducted a 3-month pilot program at three hospital sites and surveyed participants. Responses were compared to controls who completed their surgery rotation before initiation of the pilot program. Both groups emphasized the importance of having access to food during the workday for student wellness, with less than 50% of students in either group eating lunch daily during the surgery rotation. Of students who participated in the pilot program, 63% used the provided snacks at least once per week. This model offers one approach to improving student access to nutritious snacks during the busy surgery workday. To improve our program going forward, we have engaged the Director of Lifestyle Medicine and Wellness in the Department of Surgery to help optimize nutritional delivery and to create student education resources regarding healthy snacking habits and choices.","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"64 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prescribe Movement Outside","authors":"John La Puma","doi":"10.1177/15598276241265282","DOIUrl":"https://doi.org/10.1177/15598276241265282","url":null,"abstract":"","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"77 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Regular Physical Activity: A Key to Healthy Living and an Indispensable Pillar of Lifestyle Medicine","authors":"James M. Rippe","doi":"10.1177/15598276241263790","DOIUrl":"https://doi.org/10.1177/15598276241263790","url":null,"abstract":"Individuals who choose to be inactive accept the same increased risk of heart disease as individuals who smoke a pack of cigarettes a day! Unfortunately, between 11%-15% of the adult population still smoke a pack of cigarettes a day, whereas, 60%-80% of adults are either not adequately active or completely inactive. Thus, inactivity carries the same risk as smoking a pack of cigarettes per day and is between 4-5 times more prevalent!","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"42 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abd Moain Abu Dabrh, Kavitha Reddy, Bettina M. Beech, Margaret Moore
{"title":"Health & Wellness Coaching Services: Making the Case for Reimbursement","authors":"Abd Moain Abu Dabrh, Kavitha Reddy, Bettina M. Beech, Margaret Moore","doi":"10.1177/15598276241266784","DOIUrl":"https://doi.org/10.1177/15598276241266784","url":null,"abstract":"In 2020, a consortium composed of three national coach credentialing organizations, four medical societies, and 72 healthcare organizations led by National Board for Health and Wellness Coaching (NBHWC) was formed to advocate for the reimbursement of Health and Wellness Coaching (HWC) services in the U.S. healthcare system. Building on that, the NBHWC and the Veterans Health Administration (VHA) initiated a pivotal collaboration in 2023, with a target audience comprised influential reimbursement policymakers, notably the American Medical Association’s Current Procedural Terminology (CPT®) Panel and the Centers for Medicare & Medicaid Services (CMS). This concerted effort led to CMS announcing the temporary inclusion of HWC services on the 2024 Medicare Telehealth list. This ongoing advocacy work is crucial while understanding its key components is imperative for wider participation. This paper aims to distill the essence of the advocacy to date into a coherent narrative. By doing so, we seek to share with stakeholders—health and wellness coaches, medical professionals, healthcare organizations, patient advocates, and policy experts—a robust framework to support advocacy for reimbursement to both government and private insurers, at local and national levels. This initiative marks a significant milestone in healthcare policy, reflecting a growing recognition and impact of HWC.","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"32 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Milestone: 2024 Marks the 20th Anniversary of the Founding of the American College of Lifestyle Medicine","authors":"Susan Benigas","doi":"10.1177/15598276241246728","DOIUrl":"https://doi.org/10.1177/15598276241246728","url":null,"abstract":"","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"31 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141547901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter re: Food is Medicine: Take a Lesson From the Past","authors":"Deborah Kennedy","doi":"10.1177/15598276241264269","DOIUrl":"https://doi.org/10.1177/15598276241264269","url":null,"abstract":"","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"12 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141506643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benno Krachler, Anna Söderholm, Fanny Ekman, Frida Lindberg, Joakim Lindbäck, Johan Nilsson Sommar, Eva-Lotta Glader, Bernt Lindahl
{"title":"Intensive Lifestyle Intervention for Cardiometabolic Prevention Implemented in Healthcare: Higher Risk Predicts Premature Dropout","authors":"Benno Krachler, Anna Söderholm, Fanny Ekman, Frida Lindberg, Joakim Lindbäck, Johan Nilsson Sommar, Eva-Lotta Glader, Bernt Lindahl","doi":"10.1177/15598276241259961","DOIUrl":"https://doi.org/10.1177/15598276241259961","url":null,"abstract":"AimsPatient characteristics and treatment setting are potential predictors of premature dropout from lifestyle interventions, but their relative importance is unknown.MethodsFrom the quality registry of the unit for behavioral medicine, Umeå University hospital, we identified 2589 patients who had been enrolled in a multimodal lifestyle intervention for cardiometabolic risk reduction between 2006 and 2015. Baseline characteristics predicting dropout before 1-year follow-up were selected by a stepwise logistic regression algorithm.ResultsBetter physical health and older age predicted full participation, with odds ratios for premature dropout (ORs) of .44 (95% confidence interval (CI) .31-.63), and .47 (95% CI .34-.65) in the highest compared to the lowest quartile, respectively. Odds of premature dropout were also lower among female participants, .71 (95% CI .58-.89). Premature dropout was predicted by higher BMI, snuffing tobacco, and smoking, with ORs of 1.53 (95% CI 1.13-2.08) in the highest compared to the lowest quartile of BMI, 1.37 (95% CI 1.03-1.81) comparing snuff user with non-users and 2.53 (95% CI 1.79-3.61) comparing smokers with non-smokers. Odds ratio for premature dropout among inpatients compared with outpatients was .84 (95% CI .68-1.04).ConclusionHigher risk at baseline predicts premature dropout.","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"25 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141529441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Akash Sharma, Velmurugan Anbu Ananthan, Hamza Yousaf
{"title":"Evaluating the Factors Associated With Increased Risk of Self-Reported Ischemic Heart Disease in Patients With Arthritis","authors":"Akash Sharma, Velmurugan Anbu Ananthan, Hamza Yousaf","doi":"10.1177/15598276241254329","DOIUrl":"https://doi.org/10.1177/15598276241254329","url":null,"abstract":"Introduction. Arthritis has increased systematic repercussions either by extra-articular manifestations or due to limited activities. Methods. In this study, we used the 2020 and 2021 Behavioral Risk Factor Surveillance System (BRFSS), a large, nationally representative, cross-sectional telephone survey. The data was divided into the participants having arthritis and no arthritis. Results represented as an odds ratio (OR) with a 95% confidence interval (CI). We used a multivariate-adjusted logistic regression model to analyze the results. Fisher’s t-test was used to compare between 2 groups. P-value < 0.05 was considered significant. Results. BRFSS survey results led to 835,452 participants included in the final analysis. Of the included participant, 267020 has arthritis, and 568432 do not. In the arthritis group, 38.7% were males, and 61.3% were females. We found that patients with arthritis have a higher prevalence of diabetes and stroke. Adjusted logistic regression analysis showed that patients with arthritis have higher odds of reporting ischemic heart disease (IHD) (OR = 1.05, 95% CI 1.05-1.05, p-value < 0.001). Also, poor health status (mental, general, and physical) patients are more likely to report IHD. Conclusion. Patients with arthritis are more likely to report IHD, which further increases in patients with poor health status.","PeriodicalId":47480,"journal":{"name":"American Journal of Lifestyle Medicine","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141062572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}