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Privilege, social justice and the goals of medicine: Towards a critically conscious professionalism of solidarity [Editorial]

Razack, Saleem; de Carvalho Filho, Marco Antonio; Merlo, Gia; Agbor-Baiyee, William; de Groot, Janet; Reynolds, P Preston
PMID: 35254652
ISSN: 2212-277x
CID: 5181662

Physician Burnout: A Lifestyle Medicine Perspective

Merlo, Gia; Rippe, James
Physician burnout, as described in North America, is a multidimensional work-related syndrome that includes emotional exhaustion, depersonalization, and a low sense of accomplishment from work. More than 50% of physicians were reporting symptoms of burnout prior to the COVID-19 pandemic. This silent epidemic of burnout is bound to become less silent as the pandemic continues. Lifestyle medicine is an evidence-based discipline that describes how daily habits and health practices can affect overall health and well-being of individuals. Lifestyle Medicine can potentially play a significant role in preventing and ameliorating physician burnout. This article explores the burnout process, including the historical context, international definitions, symptoms, and imprecision of the clinical diagnosis. The systemic etiological issues are discussed, and the psychological underpinnings are explored, including physicians' personal vulnerabilities contributing to burnout. The stress response and lifestyle medicine's role in healthy coping are described. A prevention model for risk factor reduction is proposed, focusing on primordial, primary, secondary, and tertiary prevention. Lifestyle medicine clinicians' role in prevention, treatment, and advocacy to ameliorate the potential for burnout is discussed along with specific recommendations.
PMID: 33790702
ISSN: 1559-8284
CID: 4830932

MPRO: A Professionalism Curriculum to Enhance the Professional Identity Formation of University Premedical Students

Merlo, Gia; Ryu, Hanjun; Harris, Toi B; Coverdale, John
Limited opportunities exist for university premedical students to gain exposure to the realities of clinical practice through physician shadowing or through a formal curriculum. Medical Professionalism and Observership utilizes didactics, reflective writing, small- and large- group discussions, and clinical observerships to enhance the process of professional identity formation during a critical developmental window of late- adolescence. The pilot semester included a sample of 135 students, all in their sophomore, junior, or senior years of study at Rice University. Students were selected through an application process and paired with physicians at Houston Methodist Hospital based on specialty preference and availability. Students were required to participate in biweekly lectures and discussions and to submit a weekly reflection on topics discussed in the course and their shadowing experiences. Student evaluations were administered to survey changes in students' knowledge and perceptions of the curriculum. Selected reflections were read for evidence of professional identity formation. Lectures increased students' exposure to core competencies within the medical profession and influenced their desire to become physicians. Reflective writings demonstrated integration of these core competencies into the professional identity of students. Structured reflection and didactics, when coupled with physician shadowing, appear to promote integration of the values, beliefs, and attitudes of medical professionalism. Future studies should seek to demonstrate how such a curriculum affects professional identity formation through established measures, and to assess whether such a curriculum may influence students' preparedness for medical training and practice as they progress along their careers.
PMID: 33606590
ISSN: 1087-2981
CID: 4787302

Personal and Planetary Health-The Connection With Dietary Choices

Shah, Urvi A; Merlo, Gia
PMID: 37155189
ISSN: 1538-3598
CID: 5496472

LM Initiative Success at the Institutional Level Through the RE-AIM Approach: 12 Tips and Implementation Science Strategies

Ortega, Hugo; Tache, Christina; Bachtel, Gabrielle; Merlo, Gia
Transforming research into practice via implementation science may improve institution-wide implementation success rates for lifestyle medicine (LM). Implementation science (IS) is the study of methods that facilitate the uptake of evidence-based practice and research into regular use by practitioners and policymakers. Multiple IS frameworks, such as the Reach, Effectiveness, Adoption, Implementation, Maintenance/Practical Robust Implementation Strategy Model (RE-AIM/PRISM) model, Exploration, Preparation, Implementation, Sustainment (EPIS) model, and Consolidated Framework for Implementation Research (CFIR) model, have been developed. IS frameworks provide a strong yet adaptable foundation for launching initiatives, minimizing barriers by challenging implementers to identify and address problems that impede implementation, and promoting long-term sustainability and positive outcomes. The trouble-shooting tips provided in this article are strategically aligned with the RE-AIM/PRISM model of IS to maximize the likelihood of implementation success within the LM space. These tips provide guidance on how to effectively implement interventions, sustain their delivery, and avoid or overcome barriers to implementation. This article presents 12 tips intended as a list of options to facilitate the implementation phases of an initiative, as opposed to offering an all-or-nothing approach to implementation strategy. Current IS priorities emphasize system change and sustainability, which are essential components of successful implementation of LM initiatives.
ISSN: 1559-8276
CID: 5549582


Chapter by: Merlo, Gia; Bachtel, Gabrielle
in: Routledge International Handbook of Positive Health Sciences: Positive Psychology and Lifestyle Medicine Research, Theory and Practice by
[S.l.] : Taylor and Francis, 2023
pp. 24-42
ISBN: 9781032456928
CID: 5662592

Nutrition in Lifestyle Psychiatry

Chapter by: Merlo, Gia; Bachtel, Gabrielle
in: Lifestyle Psychiatry: Through the Lens of Behavioral Medicine by
[S.l.] : CRC Press, 2023
pp. 230-252
ISBN: 9781032230993
CID: 5631162

Posttraumatic Stress Disorder

Chapter by: Young, Allison; Merlo, Gia
in: Lifestyle Psychiatry: Through the Lens of Behavioral Medicine by
[S.l.] : CRC Press, 2023
pp. 342-353
ISBN: 9781032230993
CID: 5631152

Trauma Considerations

Chapter by: Merlo, Gia; Sugden, Steven G.
in: Lifestyle Psychiatry: Through the Lens of Behavioral Medicine by
[S.l.] : CRC Press, 2023
pp. 63-70
ISBN: 9781032230993
CID: 5631142

Lifestyle Psychiatry: Through the Lens of Behavioral Medicine

Merlo, Gia; Fagundes, Christopher P.
[S.l.] : CRC Press, 2023
Extent: 1 v.
ISBN: 9781032230993
CID: 5631132