Transcultural Lifestyle Medicine

Nieto-Martínez, Ramfis; González-Rivas, Juan P.

doi:10.1007/978-3-030-48088-2_19

Cited by 4 publications

(4 citation statements)

References 111 publications

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“…Validation efforts are underway to provide evidence corroborating the distinctness of each cell in the three-dimensional tCMBCD model based on specific stages, drivers, and populations [ 32 – 35 ]. Interventions are considered as preventive in nature, focusing on early stages (e.g., stages 1 and 2), and therefore centered on lifestyle change [ 27 , 36 ]. Endpoints are mitigation of development and progression of tCMBCD stages, in terms of physiological, economic, and quality of life metrics.…”

Section: The Importance Of Culturally Adapted Interventions For Migra...mentioning

confidence: 99%

Telehealth and cardiometabolic-based chronic disease: optimizing preventive care in forcibly displaced migrant populations

Nieto-Martínez,

De Oliveira-Gomes,

Gonzalez-Rivas

et al. 2023

J Health Popul Nutr

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The number of migrants, which includes forcibly displaced refugees, asylum seekers, and undocumented persons, is increasing worldwide. The global migrant population is heterogeneous in terms of medical conditions and vulnerability resulting from non-optimal metabolic risk factors in the country of origin (e.g., abnormal adiposity, dysglycemia, hypertension, and dyslipidemia), adverse travel conditions and the resulting stress, poverty, and anxiety, and varying effects of acculturation and access to healthcare services in the country of destination. Therefore, many of these migrants develop a high risk for cardiovascular disease and face the significant challenge of overcoming economic and health system barriers to accessing quality healthcare. In the host countries, healthcare professionals experience difficulties providing care to migrants, including cultural and language barriers, and limited institutional capacities, especially for those with non-legal status. Telehealth is an effective strategy to mitigate cardiometabolic risk factors primarily by promoting healthy lifestyle changes and pharmacotherapeutic adjustments. In this descriptive review, the role of telehealth in preventing the development and progression of cardiometabolic disease is explored with a specific focus on type 2 diabetes and hypertension in forcibly displaced migrants. Until now, there are few studies showing that culturally adapted telehealth services can decrease the burden of T2D and HTN. Despite study limitations, telehealth outcomes are comparable to those of traditional health care with the advantages of having better accessibility for difficult-to-reach populations such as forcibly displaced migrants and reducing healthcare associated costs. More prospective studies implementing telemedicine strategies to treat cardiometabolic disease burden in migrant populations are needed.

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Section: The Importance Of Culturally Adapted Interventions For Migra...mentioning

confidence: 99%

Telehealth and cardiometabolic-based chronic disease: optimizing preventive care in forcibly displaced migrant populations

Nieto-Martínez,

De Oliveira-Gomes,

Gonzalez-Rivas

et al. 2023

J Health Popul Nutr

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“…By adopting this paradigm, culturally adapted preventive care is applied at earlier stages . 33,34 The DBCD model aims to resolve the controversy around insulin resistance and the diagnosis of prediabetes incorporating them as specific DBCD stages in the progression of dysglycemia and incorporating them as an actionable entity for early prevention. When other metabolic drivers (e.g., abnormal adiposity [adiposity-based chronic disease; ABCD], hypertension [hypertension-based chronic disease; HBCD], and dyslipidemia [lipid-based chronic disease; LBCD] are configured along the 4 stages, a 2 × 2 matrix arises and depicts the 2-dimensional CMBCD framework.…”

Section: Lifestyle Medicine At Ldhmentioning

confidence: 99%

“…45 In other words, to better incorporate transcultural components so the precision of screening and lifestyle interventions can be maximized. 34 The LDH programs are culturally competent and therefore recognize and include cultural aspects to improve the interactions between patients and HCPs, and consequently the effectiveness of healthcare delivery. 45 Considering that the Hispanic and African American populations represent 83% of adults and 95% of youth patients, 90% of the LDH personnel is bilingual (i.e., English and Spanish speaking).…”

Section: Lifestyle Medicine At Ldhmentioning

confidence: 99%

Lifestyle Medicine in Diabetes Care: The Lifedoc Health Model

Nieto-Martínez

Neira

Oliveira

et al. 2022

American Journal of Lifestyle Medicine

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Introduction The relevance of lifestyle medicine in diabetes treatment is now incorporated in clinical practice guidelines but finding an exemplar for the creation of a Lifestyle Medicine Program (LMP) is a difficult task. Aim To use Lifedoc Health (LDH) as a LMP exemplar by describing their multidisciplinary team (MDT) approach to diabetes care along with tactics to address sustainability challenges. Results The LDH model facilitates early activation of patients with diabetes and other cardiometabolic risk factors, MDT approaches, and protocols/policies that are able to overcome barriers to equitable healthcare in the community. Specific programmatic targets are clinical outcomes, effective dissemination, economic viability, and sustainability. Infrastructure centers on patient-driven problem-based visits, shared medical appointments, telemedicine, and patient tracking. Further discussions on program conceptualization and operationalization are provided. Conclusion Even though strategic plans for LMPs that specialize in diabetes care are well represented in the literature, implementation protocols, and performance metrics are lacking. The LDH experience provides a starting point for those healthcare professionals interested in translating ideas into action.

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“…66 The transcultural approach recognizes and addresses these differences and the influence of cultural factors on various aspects of cardiometabolic risk, including lifestyle, diagnosis cutoffs, response to interventions, and cardiometabolic phenotypes and outcomes. 67 If precise prescriptions/recommendations are sought, then individualized biological and cultural factors should be considered. Transcultural medicine is a component of precision medicine that should be part of every encounter between a healthcare professional and patient.…”

Section: Transculturalizing the Cmbcd Modelmentioning

confidence: 99%

Cardiometabolic risk: New chronic care models

Nieto-Martínez

González-Rivas

Mechanick

2021

J Parenter Enteral Nutr

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Cardiometabolic risk factors, and the chronic cardiovascular diseases (CVDs) that result from them, are highly prevalent in the US and amenable to clinical nutrition interventions. This creates an urgency to develop comprehensive care models that incorporate prevention-based actions by improving lifestyle routines. Such care models should account for social determinants of health, ethnocultural variables, and challenges to sustainability. The relevance of these newly designed chronic care models is to inform and facilitate early intervention, primarily consisting of lifestyle changes and healthy nutrition, which mitigates progression from one stage to subsequent, higher morbidity stages to a greater extent than late intervention. In this article, the mechanistic drivers and ethnocultural validation of the Cardiometabolic-Based Chronic Disease (CMBCD) model are reviewed. Main findings are that in CMBCD, primary (genetics, environment, and behavior) and metabolic (obesity as Adiposity-Based Chronic Disease [ABCD], type 2 diabetes as Dysglycemia-Based Chronic Disease [DBCD], hypertension, and dyslipidemia) drivers initiate and perpetuate the progression of CVD. Epidemiological findings and molecular mechanisms support intra-ABCD/DBCD, as well as ABCD to DBCD stage progression culminating in CVD. The ABCD definition overcomes weight stigma and body mass index underperformance by considering adiposity amount, distribution, and function; and the DBCD definition overcomes criticisms of prediabetes and an exclusive glucocentric approach by considering insulin resistance and residual vascular risk along a clinical spectrum. In conclusion, clinicians should approach patients using the CMBCD model to incorporate lifestyle changes as early as possible to optimally mitigate the burden of CVD.

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Transcultural Lifestyle Medicine

Cited by 4 publications

References 111 publications

Telehealth and cardiometabolic-based chronic disease: optimizing preventive care in forcibly displaced migrant populations

Telehealth and cardiometabolic-based chronic disease: optimizing preventive care in forcibly displaced migrant populations

Lifestyle Medicine in Diabetes Care: The Lifedoc Health Model

Cardiometabolic risk: New chronic care models

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