Group Medical Visits 2.0: The Open Source Wellness Behavioral Pharmacy Model

Emmert-Aronson, Benjamin O.; Grill, Katherine B.; Trivedi, Zalak; Markle, Elizabeth; Chen, Steven

doi:10.1089/acm.2019.0079

Cited by 23 publications

(24 citation statements)

References 42 publications

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“…Therefore, data from 31 participants were included in our analyses. Of these, 77.4% (24) were female and 71.0% (22) Percent change reduction from preintervention to postintervention was 2.1% for BMI, 7.4% for systolic blood pressure, 10.0% for total cholesterol, 10.6% for LDL, and 5.9% for HDL. For subgroup comparisons, participants with clinically normal preintervention BMI or metabolic markers ranged from 0% (0/31) for systolic blood pressure to 61% (19/31) for HDL (Table 2).…”

Section: Resultsmentioning

confidence: 98%

“…Studies have shown increased consumption of fruits and vegetables and improved metabolic markers as a result of these programs. 24,25 Although evidence suggests benefits from the WFPB diet, [12][13][14][15][16][17][18][19][20] interventions advocating a transition to this diet are uncommon at FQHCs because of their perceived cost. There may also be a perception that such interventions are irrelevant to FQHC patients.…”

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confidence: 99%

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Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community

Bansal

Connolly

Harder

2021

American Journal of Lifestyle Medicine

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The current study evaluated the impact of a whole-foods, plant-based nutrition intervention on metabolic markers of patients with chronic disease in an underserved community setting. A retrospective analysis of metabolic biomarkers preintervention and postintervention was conducted on 31 patients with metabolic disease who attended an Eating for Life group visit series. Significant decreases were found for body mass index (BMI; −0.66 [−0.91 to −0.40] kg/m2), systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol (−20 [−29 to −10] mg/dL), low-density lipoprotein (LDL; −11.6 [−17.5 to −5.5] mg/dL), and high-density lipoprotein (HDL; −3.2 [−5.7 to −0.7] mg/dL, all Ps < .01). In participants with clinically abnormal preintervention data, the mean (95% CI) change significantly decreased for overweight (−0.45 [−0.85 to −0.05]) and obese (−0.76 [−1.13 to −0.39]) BMI, systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol −22 [−40 to −4] mg/dL), and LDL (−15.6 [−23.8 to −7.4] mg/dL, all Ps ≤ .03). In conclusion, the Eating for Life model showed significant improvement in BMI, diastolic blood pressure, total cholesterol, and LDL in a federally qualified health center population. Group visits advocating for a whole-foods, plant-based diet may be effective in reducing chronic disease burden in underserved communities.

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Section: Resultsmentioning

confidence: 98%

mentioning

confidence: 99%

Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community

Bansal

Connolly

Harder

2021

American Journal of Lifestyle Medicine

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“…Emmert-Aronson and colleagues [ 22 ] evaluated Open Source Wellness, a 16-week behavioral pharmacy that prescribes physical activity, healthy meals (by way of vouchers), social support, and stress reduction within a federally qualified health center. They demonstrated increased fruit and vegetable consumption and significant reductions in BMI (b = 0.31, p < 0.01) and systolic BP (b = -4.04, p < 0.01) in a predominantly African American population.…”

Section: Discussionmentioning

confidence: 99%

A nutrition and lifestyle-focused shared medical appointment in a resource-challenged community setting: a mixed-methods study

et al. 2022

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Background In order to address disparities in preventable chronic diseases, we adapted a nutrition and lifestyle-focused shared medical appointment (SMA) program to be delivered in an underserved community setting. The objective was to evaluate a community-based nutrition and lifestyle-focused SMA as it relates to acceptability and health and behavior-related outcomes. Methods A mixed-methods study was performed to evaluate pre-post changes in wellness indices, biometrics, self-efficacy, and trust in medical researchers as part of a community-based SMA. To understand program acceptability including barriers and facilitators for implementation and scalability, we conducted two participant focus groups and five stakeholder interviews and used content analysis to determine major themes. Results Fifteen participants attended 10 weekly sessions. The majority were older adult, African American women. There were pre-post improvements in mean [SD] systolic (-10.5 [7.7] mmHg, p = 0.0001) and diastolic (-4.7 [6.7] mmHg, p = 0.17) blood pressures and weight (-5.7 [6.3] pounds, p = 0.003) at 3 months though these were not significant at 6 months. More individuals reported improvements in health status, daily fruit and vegetable intake, and sleep than at baseline. There were no significant pre-post changes in other wellness indices, self-efficacy, trust in medical researchers, hemoglobin A1c, insulin, or LDL cholesterol. Participants discussed positive health changes as a result of the SMA program, program preferences, and facilitators and barriers to continuing program recommendations in focus groups. SMA implementation was facilitated by clinical staff who adjusted content to a low health literacy group and partnership with a trusted community partner. Sustainability barriers include heavy personnel time and in-kind resources to deliver the program. Conclusions Nutrition and lifestyle-focused SMAs in a resource-challenged community setting may be an acceptable intervention for underserved patients.

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“…They did not report findings on stress specifically. 35 Affirmation and coping interventions. Two articles (11%) were classified as affirmation and coping interventions.…”

Section: Lifestyle Modification Interventionsmentioning

confidence: 99%

“…30 Using a non-randomized, uncontrolled-single arm design, Emmert-Aronson et al implemented a "behavioral pharmacy" approach that engaged multiple social determinants of health to engage patients at a federally qualified health center (FHQC) with conditions that can be managed through behavioral intervention. 35 The "behavioral pharmacy" approach was rooted in four components: physical activity, nutrition, social support, and stress reduction. This study's approach incorporated comprehensive lifestyle changes while also including a meditation aspect for the stress reduction component.…”

Section: Lifestyle Modification Interventionsmentioning

confidence: 99%

Stress interventions and hypertension in Black women

Kalinowski

Kaur

Newsome-Garcia

et al. 2021

Womens Health (Lond Engl)

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Hypertension is a risk factor for cardiovascular disease. Black women have high rates of hypertension compared to women of other racial or ethnic groups and are disproportionately affected by psychosocial stressors such as racial discrimination, gender discrimination, and caregiving stress. Evidence suggests that stress is associated with incident hypertension and hypertension risk. Stress management is associated with improvements improved blood pressure outcomes. The purpose of this review is to synthesize evidence on effects of stress management interventions on blood pressure in Black women. A comprehensive search of scientific databases was conducted. Inclusion criteria included studies that were: (1) primary research that tested an intervention; (2) in the English language; (3) included African-American women; (4) incorporated stress in the intervention; (5) included blood pressure as an outcome; and (6) were US based. Eighteen studies met inclusion criteria. Ten (56%) studies tested meditation-based interventions, two (11%) tested coping and affirmation interventions, and six (33%) tested lifestyle modification interventions that included stress management content. Thirteen of the studies were randomized controlled trials. Reductions in blood pressure were observed in all of the meditation-based interventions, although the magnitude and statistical significance varied. Comprehensive lifestyle interventions were also efficacious for reducing blood pressure, although the relative contribution of stress management versus behavior modification could not be evaluated. Coping and affirmation interventions did not affect blood pressure. Most of the reviewed studies included small numbers of Black women and did not stratify results by race and gender, so effects remain unclear. This review highlights the urgent need for studies specifically focusing on Black women. Given the extensive disparities in cardiovascular disease morbidity and mortality, whether stress management can lower blood pressure and improve primary and secondary cardiovascular disease prevention among Black women is an important question for future research.

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Group Medical Visits 2.0: The Open Source Wellness Behavioral Pharmacy Model

Cited by 23 publications

References 42 publications

Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community

Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community

A nutrition and lifestyle-focused shared medical appointment in a resource-challenged community setting: a mixed-methods study

Stress interventions and hypertension in Black women

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