Background Primary care is the ideal place to implement behaviour change interventions for weight management. However, most primary care physicians are not managing patient weight as a standard of care due to lack of knowledge, skills and reimbursement. Generating more physicians who are familiar and comfortable with providing weight management is essential in leveraging a global change. In our university free clinic, medical students provide healthy lifestyle counselling using shared decision making to each patient at every clinic visit. Objective Improve the efficacy of behaviour change interventions via increased patient responsiveness and adherence. Methods The needs assessment demonstrated a subpar patient response rate to check-ins regarding behavioural change goals. In the first and second interventions, check-in message structure and contact schedule were varied to maximize patient responsiveness and goal achievement. Results In the needs assessment, 58% of patients responded to follow-ups and 58% of patients accomplished their goal. The first intervention cycle resulted in an improvement of responsiveness to 70% and accomplishment of goals to 59%. The second intervention cycle resulted in an improvement of responsiveness to 78% and accomplishment of goals to 74%. Conclusions Messages that were frequent, unique, succinct and delivered within 4 weeks after the clinic visit resulted in the highest response rate and goal attainment. Other primary care clinics can use these interventions to increase patient completion of implemented behaviour changes for a healthier lifestyle.

Introduction and Objective The Mini-Jupette has been successfully used concomitantly with inflatable penile prostheses (IPP) to treat erectile dysfunction (ED), climacturia and stress urinary incontinence (SUI) secondary to radical prostatectomy (RP). This is the largest single surgeon report of the original Andrianne Mini-Jupette sling and IPP placements in men with ED and climacturia, mild SUI and/or foreplay incontinence. Methods This was a retrospective study on a prospectively managed database of 32 patients who underwent IPP and Mini-Jupette placement using Tutoplast® cadaver pericardium graft by a single surgeon between July 2016 and February 2020. Patients were surveyed pre- and post-operatively and asked to score the severity of their foreplay incontinence (FI), climacturia, and SUI from 0 (“dry”), 1 (“1 drop”), 2 (“few drops”), 3 (“small dribble”), or 4 (“squirt of urine”). Patient surveys were compared pre- to post-operation using Fisher's exact test. Results Of the 32 men, 27 (84%) had FI, 26 (81%) with climacturia, and 27 (27%) with SUI (Table 1). At a mean follow-up of 17.9 months, FI (p<0.001), climacturia (p<0.001), and SUI (p<0.001) all significantly improved (Table 2). FI improved in 78.9% (15/19) and resolved in 47.4% (9/19); climacturia improved in 82.3% (14/17) and resolved in 64.7% (11/17); SUI improved in 71.4% (15/21) and resolved in 57.1% (12/21). Sexual Health Inventory for Men (SHIM) scores significantly improved from 5.0 to 23.8 (p<0.001) for the entire group. Three patients (9.4%) required an artificial urethral sphincter (AUS) for the management of persistent incontinence. One patient underwent IPP revision due to foreskin irritation and another experienced pump-related issues. Conclusions The Mini-Jupette in tandem with an IPP is a safe and effective treatment option for men with severe ED experiencing sexually related incontinence as well as SUI post-RP. This is the first report of IPP placement with a Mini-Jupette sling successfully treating foreplay incontinence. Disclosure Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Antares Pharma, Clarus Therapeutics, Coloplast, Promescent, Viome).

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