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Lifestyle Medicine
for Preventive Medicine Residents
Shark Tank 2015
Sajida Chaudry MD MPH MBA
Associate Program Director
General Preventive Medicine Residency
Program
Family Physician at JHCP Odenton
Agenda
• Why this is important
• What will we do: LPTL
• How will we prove it worked
• What will we do with the money
What is Lifestyle Medicine?
“Lifestyle Medicine (LM) is the use of lifestyle
interventions in the treatment and management of
disease.
Such interventions include:
Diet (nutrition)
Exercise
Stress Management
Smoking Cessation
A variety of other non-drug modalities”
•Growing burden of chronic disease
•Limited resources
•Growing interest from patients
•Low tech and low cost
•Few side effects
•Patient centered
•Fun for clinicians
•Health promotion and prevention
Why is lifestyle medicine important?
This is what the residents will do
in the lifestyle medicine
curriculum.
• Learn
• Practice
• Teach
• Lead
Learn: Enhance existing curriculum
1. Introduction to Lifestyle Medicine (Eddie Phillips, MD)
2. Introduction to Behavior Change Models (Mellisa Poulsen,
JHSPH)
3. Behavior Health Coaching (Deborah Linehan, RD, LDN, CIC
and Tara McDonald)
4. The Role of the Physician in Health Behavior Change:
Interpersonal Communication (Debra Roter, DrPH, MPH)
5. Stress Management I and II (Delia Chiaramonte, MD)
6. Diet (Dechen Surkhang, RD and Diane Blahut, RD)
7. Motivational Interviewing (Mary Catherine Beach, MD)
8. Using Mindfulness Based Stress Reduction
Learn: What we will add
• Patient Care Curriculum
- Lifestyle medicine interview
- Lifestyle specific assessment and plan
• Self-Awareness Practicum
• Work with co-residents
• Assess themselves (resiliency, well-being
and flourishing scales)
Practice: 2 yr. Clinical Experience
• Weekly 4 hour clinic sessions
– 4-5 patients; 2-3 phone follow-ups
– Referrals from JHCP clinicians (and residents)
• Lifestyle Medicine Interview:• Nutrition, Exercise, Sleep, Mood, Social support,
Substance use
• Care plans & team care
Teach: Patients & Colleagues
• Patient Education:
– Lifestyle medicine
– Resiliency
– Well-being
– Flourishing
• Colleagues
– Model lifestyle medicine
Brief Resilience Scale
1. I tend to bounce back quickly after hard times.
2. I have a hard time making it through stressful
events.
3. It does not take me long to recover from a stressful
event.
4. It is hard for me to snap back when something bad
happens.
5. I usually come through difficult times with little
trouble.
6. I tend to take a long time to get over set-backs in my
life.
Smith, B. W., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J (2008). The brief resilience scale: assessing the
ability to bounce back. International journal of behavioral medicine, 15(3), 194-200.
WHO Wellbeing Index
1. I have felt cheerful in good spirits.
2. I have felt calm and relaxed.
3. I have felt active and vigorous.
4. I woke up feeling fresh and rested.
5. My daily life has been filled with things that interest
me.
Regional Office for Europe WHO. Use of Well-Being Measures in Primary Health Care - The DepCare Project.
Health for All, Target 12, 1998 [http://www.who.dk/document/e60246.pdf]
Bech P. Measuring the dimensions of psychological general well-being by the WHO-5. QoL Newsletter 2004; 32: 15-16.
Short Flourishing Scale
1. I lead a purposeful and meaningful life...
2. My social relationships are supportive and
rewarding...
3. I am engaged and interested in my daily activities...
4. I actively contribute to the happiness and well-being
of others...
5. I am competent and capable in the activities that are
important to me...
6. I am a good person and live a good life...
7. I am optimistic about my future...
8. People respect me...
Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D. W., Oishi, S., & Biswas-Diener, R. (2010). New well-being
measures: Short scales to assess flourishing and positive and negative feelings. Social Indicators Research, 97(2),
143-156.
Teach: Precepting and Mentoring
• Provide preceptorship and mentorship from LM experts
– LM rotation core faculty precept weekly clinics
– Bi monthly sessions with Subject Matter Experts and
co- residents to review case and approaches
Linda Lee, Anastasia Rowland-Seymour
and Annie Umbricht
• Bi-monthly resident self reflection on lifestyle changes
• Culminates in 2 year data evaluation and presentation of
findings
– resident and patient lifestyle medicine changes, care plans, scales
Summary
Resident Teaching Assessment
and Plan
Evaluation
of Scales
2 yr Journal
review
Resident A
Resident B
Patient Teaching Assessment
and Plan
Evaluation
of Scales
2 yr chart
and care
plans
Patient A
Patient B
Lead
• Develop Preventive Medicine and
Lifestyle Medicine leaders
• Dissemination
• Residents will share with others
Evaluation
• Resident:
– ACGME competencies (23) and milestones
– Resiliency/self-efficacy/flourishing
– LM knowledge
– Lifestyle medicine changes
• Program: ACGME competencies, milestones,
replication
• Patient
– Self-care plans in EMR meet MU criteria
– Resiliency/self-efficacy/flourishing
– Patient outcomes in terms of lifestyle medicine
changes
Budget
• $10,000
– Curriculum development $2,500
– Faculty support and online meetings
$2,500
– Statistical analysis $2,500
– Dissemination $2,500
Lifestyle Medicine at Hopkins
• Leadership in an emerging field
Thank you