How to Improve Clinical Practice and Medical Education About Nutrition

Katz, David L.

doi:10.1001/amajethics.2018.994

Cited by 12 publications

(2 citation statements)

References 9 publications

(6 reference statements)

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“…Recent estimations show that dietary counseling by physicians occurs in only 20-40% of patient visits [4][5][6]. Consistent failure to address diet in a clinical context has been described as an ethical lapse [7]. Considering the potency of dietary influences on health, many in the medical and public health fields agree that doctors should be trained and supported to assist patients with initiating positive lifestyle changes-specifically those involving diet and exercise.…”

Section: Introductionmentioning

confidence: 99%

Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy

Brennan,

Beals,

Burns

et al. 2023

Nutrients

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Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated the impact of an interprofessional CM course for medical and health professional students who experienced the hands-on cooking component in person or a in mixed-mode format (in-person and via Zoom) at the University of Utah from 2019–2023 (n = 84). A factorial ANOVA assessed differences between educational environment and changes between pre- and post-course survey responses related to diet and lifestyle counseling, interprofessional communication, and health behaviors and advocacy. Qualitative comments from post-course surveys were analyzed on a thematic level. Students rated themselves as having greater confidence and competence in diet and lifestyle counseling (p < 0.05) and increased ability to prepare eight healthy meals (p < 0.05). Additionally, a Mann–Whitney two-sample rank-sum test was used to compare data from exit survey responses from medical students who took the CM course (n = 48) and did not take the CM course (n = 297). Medical students who took CM were significantly more likely to agree that they could counsel patients about nutrition (p < 0.05) and physical activity (p < 0.05). CM courses may improve students’ confidence to provide diet and lifestyle counseling.

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Section: Introductionmentioning

confidence: 99%

Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy

Brennan,

Beals,

Burns

et al. 2023

Nutrients

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“…In 2017, the American Medical Association House of Delegates emphasized the importance of LM treatment by passing a resolution supporting providers to prescribe healthy lifestyle behaviors [ 18 ]. Despite these advances, adoption in clinical practice is slow [ 12 , 13 , 19 - 21 ], and additional research is needed to better understand the barriers and facilitators to implement this approach in health care settings [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Lifestyle Medicine Implementation in 8 Health Systems: Protocol for a Multiple Case Study Investigation

Ames,

Karlsen,

Sundermeir

et al. 2024

JMIR Res Protoc

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Background Lifestyle medicine (LM) is the use of therapeutic lifestyle changes (including a whole-food, plant-predominant eating pattern; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection) to prevent and treat chronic illness. Despite growing evidence, LM is still not widely implemented in health care settings. Potential challenges to LM implementation include lack of clinician training, staffing concerns, and misalignment of LM services with fee-for-service reimbursement, but the full range of factors facilitating or obstructing its implementation and long-term success are not yet understood. To learn important lessons for success and failure, it is crucial to understand the experiences of different LM programs. Objective This study aims to describe in depth the protocol used to identify barriers and facilitators impacting the implementation of LM in health systems. Methods The study team comprises team members at the American College of Lifestyle Medicine (ACLM), including staff and researchers with expertise in public health, LM, and qualitative research. We recruited health systems that were members of the ACLM Health Systems Council. From among 15 self-nominating health systems, we selected 7 to represent a diversity of geographic location, type, size, expertise, funding, patients, and LM services. Partway through the study, we recruited 1 additional contrasting health system to serve as a negative case. For each case, we conducted in-depth interviews, document reviews, site visits (limited due to the COVID-19 pandemic), and study team debriefs. Interviews lasted 45-90 minutes and followed a semistructured interview guide, loosely based on the Consolidated Framework for Implementation Research (CFIR) model. We are constructing detailed case narrative reports for each health system that are subsequently used in cross-case analyses to develop a contextually rich and detailed understanding of various predetermined and emergent topics. Cross-case analyses will draw on a variety of methodologies, including in-depth case familiarization, inductive or deductive coding, and thematic analysis, to identify cross-cutting themes. Results The study team has completed data collection for all 8 participating health systems, including 68 interviews and 1 site visit. We are currently drafting descriptive case narratives, which will be disseminated to participating health systems for member checking and shared broadly as applied vignettes. We are also conducting cross-case analyses to identify critical facilitators and barriers, explore clinician training strategies to facilitate LM implementation, and develop an explanatory model connecting practitioner adoption of LM and experiences of burnout. Conclusions This protocol paper offers real-world insights into research methods and practices to identify barriers and facilitators to the implementation of LM in health systems. Findings can advise LM implementation across various health system contexts. Methodological limitations and lessons learned can guide the execution of other studies with similar methodologies. International Registered Report Identifier (IRRID) DERR1-10.2196/51562

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Food as Medicine: A Pilot Nutrition and Cooking Curriculum for Children of Participants in a Community-Based Culinary Medicine Class

Marshall

Albin

2020

Matern Child Health J

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How to Improve Clinical Practice and Medical Education About Nutrition

Cited by 12 publications

References 9 publications

Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy

Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy

Lifestyle Medicine Implementation in 8 Health Systems: Protocol for a Multiple Case Study Investigation

Food as Medicine: A Pilot Nutrition and Cooking Curriculum for Children of Participants in a Community-Based Culinary Medicine Class

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