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Patient-Reported Outcomes from a Pilot Plant-Based Lifestyle Medicine Program in a Safety-Net Setting

Massar, Rachel E; McMacken, Michelle; Kwok, Lorraine; Joshi, Shivam; Shah, Sapana; Boas, Rebecca; Ortiz, Robin; Correa, Lilian; Polito-Moller, Krisann; Albert, Stephanie L
ISSN: 2072-6643
CID: 5519482

Patient-Reported Outcomes from a Pilot Plant-Based Lifestyle Medicine Program in a Safety-Net Setting

Massar, Rachel E; McMacken, Michelle; Kwok, Lorraine; Joshi, Shivam; Shah, Sapana; Boas, Rebecca; Ortiz, Robin; Correa, Lilian; Polito-Moller, Krisann; Albert, Stephanie L
Lifestyle medicine interventions that emphasize healthy behavior changes are growing in popularity in U.S. health systems. Safety-net healthcare settings that serve low-income and uninsured populations most at risk for lifestyle-related disease are ideal venues for lifestyle medicine interventions. Patient-reported outcomes are important indicators of the efficacy of lifestyle medicine interventions. Past research on patient-reported outcomes of lifestyle medicine interventions has occurred outside of traditional healthcare care settings. In this study, we aimed to assess patient-reported outcomes on nutrition knowledge, barriers to adopting a plant-based diet, food and beverage consumption, lifestyle behaviors, self-rated health, and quality-of-life of participants in a pilot plant-based lifestyle medicine program in an urban safety-net healthcare system. We surveyed participants at three time points (baseline, 3 months, 6 months) to measure change over time. After 6 months of participation in the program, nutrition knowledge increased by 7.2 percentage points, participants reported an average of 2.4 fewer barriers to adopting a plant-based diet, the score on a modified healthful plant-based diet index increased by 5.3 points, physical activity increased by 0.7 days per week while hours of media consumption declined by 0.7 h per day, and the percentage of participants who reported that their quality of sleep was "good" or "very good" increased by 12.2 percentage points. Our findings demonstrate that a lifestyle medicine intervention in a safety-net healthcare setting can achieve significant improvements in patient-reported outcomes. Key lessons for other lifestyle medicine interventions include using a multidisciplinary team; addressing all pillars of lifestyle medicine; and the ability for patients to improve knowledge, barriers, skills, and behaviors with adequate support.
PMID: 37447186
ISSN: 2072-6643
CID: 5535302

Change in cardiometabolic risk factors in a pilot safety-net plant-based lifestyle medicine program

Albert, Stephanie L; Massar, Rachel E; Correa, Lilian; Kwok, Lorraine; Joshi, Shivam; Shah, Sapana; Boas, Rebecca; Alcalá, Héctor E; McMacken, Michelle
INTRODUCTION/UNASSIGNED:Interventions emphasizing healthful lifestyle behaviors are proliferating in traditional health care settings, yet there is a paucity of published clinical outcomes, outside of pay-out-of-pocket or employee health programs. METHODS/UNASSIGNED:We assessed weight, hemoglobin A1c (HbA1c), blood pressure, and cholesterol for 173 patients of the Plant-Based Lifestyle Medicine Program piloted in a New York City safety-net hospital. We used Wilcoxon signed-rank tests to assess changes in means, from baseline to six-months, for the full sample and within baseline diagnoses (i.e., overweight or obesity, type 2 diabetes, prediabetes, hypertension, hyperlipidemia). We calculated the percentage of patients with clinically meaningful changes in outcomes for the full sample and within diagnoses. FINDINGS/UNASSIGNED:The full sample had statistically significant improvements in weight, HbA1c, and diastolic blood pressure. Patients with prediabetes or overweight or obesity experienced significant improvements in weight and those with type 2 diabetes had significant improvements in weight and HbA1c. Patients with hypertension had significant reductions in diastolic blood pressure and weight. Data did not show differences in non-high-density lipoprotein cholesterol (non-HDL-C), but differences in low-density lipoprotein cholesterol (LDL-C) were approaching significance for the full sample and those with hyperlipidemia. The majority of patients achieved clinically meaningful improvements on all outcomes besides systolic blood pressure. CONCLUSION/UNASSIGNED:Our study demonstrates that a lifestyle medicine intervention within a traditional, safety-net clinical setting improved biomarkers of cardiometabolic disease. Our findings are limited by small sample sizes. Additional large-scale, rigorous studies are needed to further establish the effectiveness of lifestyle medicine interventions in similar settings.
PMID: 37153909
ISSN: 2296-861x
CID: 5519462

Addressing Psychosocial Stressors through a Community-Academic Partnership between a Museum and a Federally Qualified Health Center: A Qualitative Study

Liou, Kevin T; Boas, Rebecca; Murphy, Shannon; Leung, Peggy; Boas, Samuel; Card, Andrea; Asgary, Ramin
Psychosocial stressors are prevalent and linked to worse health outcomes, but are less frequently addressed than physically apparent medical conditions at primary care visits. Through a community-academic partnership between an art museum and a federally qualified health center, we developed an innovative museum-based intervention and evaluated its feasibility and acceptability among diverse, underserved patients and its perceived effects on psychosocial stressors. Guided by experiential learning and constructivist approaches, the intervention consisted of a single, three-hour session that incorporated group discussions and interactive components, including art-viewing, sketching, and object-handling. We used post-intervention focus groups to elicit feedback qualitatively. From July 2017 to January 2018, 25 patients participated. Focus groups revealed that the intervention exhibited therapeutic qualities, fostered self-reflection, catalyzed social connectivity, and functioned as a gateway to community resources. These findings can guide future research and development of community-based interventions to target the growing burden of psychosocial stressors among the underserved.
PMID: 34120976
ISSN: 1548-6869
CID: 4911262


Ito, Timothy; Boas, Rebecca; Han, Justin S; Kheterpal, Emil; Wysock, James S; Stifelman, Michael D; Huang, William C; Taneja, Samir S; Shah, Ojas
ISSN: 0022-5347
CID: 1872322


Ito, Timothy; Kheterpal, Emil; Han, Justin S; Marien, Tracy; Boas, Rebecca; Stifelman, Michael D; Taneja, Samir S; Huang, William C; Shah, Ojas
ISSN: 0892-7790
CID: 2166062