Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care—A Pilot Feasibility Project

Abstract

Introduction:Diseases linked to obesity such as cardiovascular disease, diabetes, degenerative joint disease, gastroesophageal reflux, and sleep apnea constitute a large portion of primary care visits. Patients with these conditions often lack knowledge, skills, and support needed to maintain health. Shared medical appointments (SMAs) that include culinary skills and nutrition education offer a novel, cost-effective way to address these diseases in primary care.Methods:Adult patients in a primary care practice at a large academic hospital in Boston, Massachusetts, who had at least 1 cardiovascular risk factor were invited to participate in SMAs that included cooking demonstrations and teaching about nutrition in addition to medical management of their conditions. Sessions were conducted by a physician and an assistant in a conference room of a traditional primary care practice as part of a pilot feasibility project.Results:Seventy patients, contributing a total of 156 patient visits, attended 17 nutrition-focused SMAs over a 4-year period. Patients were surveyed after each visit and indicated that they enjoyed the SMAs, would consider alternating SMAs with traditional one-on-one visits, and would recommend SMAs to others. Half would pay out of pocket or a higher copay to attend SMAs. Financially, the practice broke even compared with traditional one-onone office visits.Conclusion:In this feasibility study, chronic disease SMAs conducted with a culinary/nutrition focus were feasible, cost-effective, and well received by patients. Follow-up studies are needed to evaluate short- and long-term outcomes of this SMA model on obesity-related diseases.

Ten things to know about ten cardiovascular disease risk factors

“… [63] Another barrier includes a lack of education regarding the purchase and preparation of healthful foods, which may be facilitated by shared culinary medical appointments (i.e., including nutrition and cooking lessons with cardiac rehabilitation appointments). [64] Methods to implement healthful nutrition include educating patients regarding evidenced-based meal plans and dietary practice guidelines, [4] and referring patients to a dietitian nutritionist to implement medical nutrition therapy to help manage CVD risk factors and reduce CVD risk. [65 , 66] Sentinel guidelines and references 2019 A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention [4] 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guideline [6] 2018 Clinician's Guide for Trending Cardiovascular Nutrition Controversies: Part II [3] 2017 Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association [67] …”

Three-year review of a capacity building pilot for a sustainable regional network on food, nutrition and health systems education in India

“…There is evidence detailing the use of hands on methods of teaching to provide nutrition education in a number of different settings, but the use in poorly educated marginalised communities has not to date been documented. [15][16][17][18][19][20] The kitchen continues to develop, and following its initial educational intervention it was planned to visit at least monthly for continued engagement, but in fact it has grown beyond this as can be seen through activities including a microenterprise model, selling food and providing education to members of the public in Kolkata through the participants originally educated in the marginalised communities. 21 Our review depicts the journey and development of those involved from NNEdPro in establishing the project, using the data and details collected through 3 years of work.…”

Shape-Up and Eat Right Families Pilot Program: Feasibility of a Weight Management Shared Medical Appointment Model in African-Americans With Obesity at an Urban Academic Medical Center

“…As a result, it becomes more essential to evaluate novel effective obesity-care delivery models among various populations. In regards to chronic diseases and obesity, shared medical appointments (SMAs) are innovative, patient-receptive, cost-effective methods of clinical practice ( 13 – 16 ) with a family-based approach particularily utilized for pediatric interventions, such as in childhood obesity ( 17 , 18 ). SMAs are a redesign of chronic care models where groups of patients (8–20) are seen by a multidisciplinary team in 1 h in efforts to improve clinic throughput and efficiency and have shown improved cardiovascular benefit and quality improvement in diabetes management ( 19 ).…”

“…SMAs are a redesign of chronic care models where groups of patients (8–20) are seen by a multidisciplinary team in 1 h in efforts to improve clinic throughput and efficiency and have shown improved cardiovascular benefit and quality improvement in diabetes management ( 19 ). These group-based patient visits address the gaps in knowledge, skills, and support necessary to maintain overall health and well-being, while increasing the time allocated to discuss lifestyle modification and healthy behaviors, especially in the context of a busy clinical practice where an individual visits may last only 15–20 min ( 13 ). Moreover, in an effort to increase accessibility to care and address disparities, SMAs have been adopted as novel methods to address those needs among healthcare systems ( 20 ).…”