Using the SMART-EST Goals in Lifestyle Medicine Prescription

White, Nicole D.; Bautista, Vicki; Lenz, T.; Cosimano, Amy

doi:10.1177/1559827620905775

Cited by 19 publications

(10 citation statements)

References 9 publications

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“…[14][15][16]28 In particular, the use of the SMART technique is encouraged, where participants choose goals which are specific, measurable, achievable, relevant, and time-bound. 35 While there has been limited research in evaluating the effect of CTs in the adult primary care setting in the US, this study showed that there were a number of participants who found the CT to be helpful in achieving either a specific health goal or HRSN. However, many agreed that it was not enough to have a significant impact.…”

Section: Discussionmentioning

confidence: 75%

Insights Into Patients’ Perceptions of Health-Related Social Needs and the Role of the Adult Primary Care Clinic

Meltzer

Rhodes

Morgan

et al. 2023

J Prim Care Community Health

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Introduction/Objectives: While it is well established that unmet healthrelated social needs (HRSN) adversely affect health outcomes, there has been limited evaluation in adult primary care of patients’ perceptions of how these needs impact their health and the role of the primary care provider (PCP). The objective of this study is to identify patients’ perceptions of HRSN and how PCPs could help address them. Secondary objectives include exploring the impact of goal setting and a 1-time cash transfer (CT). Methods: This qualitative study used semi-structured baseline and follow-up interviews with patients in internal medicine clinics. Adult primary care patients were included if they screened positive as having 1 of 3 HRSN: financial resource strain, transportation needs, or food insecurity. All participants completed an initial interview about their HRSN and health, and were asked to set a 6-month health goal. At enrollment, participants were randomized to receive a $500 CT or a $50 participation reward. At 6-months, patients were interviewed again to investigate progress toward meeting their health goals, [when applicable] how the CT helped, and their beliefs about the role of PCPs in addressing HRSN. Results: We completed 30 initial and 25 follow-up interviews. Participants identified their HRSN, however most did not readily connect identified needs to health. Although participants were receptive to HRSN screening, they did not feel it was their PCP’s responsibility to address these needs. Verbal goal-setting appeared to be a useful tool, and while the CTs were appreciated, patients often found them inadequate to address HRSN. Conclusions: Given the importance of identifying the social conditions that shape patients’ health, providers, and health systems have an opportunity to re-evaluate their role in helping patients address these barriers. Future studies could examine the effect of more frequent disbursement of CTs over time.

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Section: Discussionmentioning

confidence: 75%

Insights Into Patients’ Perceptions of Health-Related Social Needs and the Role of the Adult Primary Care Clinic

Meltzer

Rhodes

Morgan

et al. 2023

J Prim Care Community Health

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“…Based on review of the narrative feedback by authors SJ and JA, students valued having formal nutrition education, recognising its clinical relevance. They appreciated learning how to approach conversations about diet in a non‐judgemental manner and specific strategies to use during counselling, including 24‐hour diet recalls and SMART goals 14,15 . For course improvement, students desired additional didactics on specific evidence‐based diets, more opportunities to practice counselling with standardised patients and spacing out the curriculum to engage with learning materials throughout the 6‐week clerkship.…”

Section: Discussionmentioning

confidence: 99%

Empowering learners to provide dietary counselling

Jain

Higashi

Bonnema

et al. 2022

The Clinical Teacher

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Background: Despite calls to increase dietary counselling by physicians to help address the epidemic of lifestyle-related chronic disease, medical education does not equip future physicians with the training to provide effective dietary counselling. In addition to the multiple barriers that clinician educators face in implementing clinically relevant nutrition education curricula, evaluation modalities in the nutrition education literature that assess student skills and behaviour remain limited.Approach: We implemented a brief, virtual nutrition education intervention in a US medical school during the outpatient clinical clerkship and assessed how our curriculum influenced students' development of dietary counselling skills.Evaluation: Student feedback revealed appreciation for learning how to approach conversations about diet in a non-judgmental manner and specific strategies to use during counselling. We thematically analysed the free-text responses from 81 dietary counselling encounter forms submitted by students. Three emergent themes

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“…After further meeting specific content (see Supplement Table 1 for details) was shared, the SMART approach to goal setting was explained so that participants could develop goals which were specific, measurable, attainable, relevant, and time-bound [ 18 ]. Participants then broke into pairs and were given 10 minutes to share with one another: (1) The steps they had taken so far in adopting a WFPB diet, (2) Setting their own personal goals to implement by the next meeting (using the SMART methodology), and (3) Possible obstacles which they might encounter.…”

Section: Methodsmentioning

confidence: 99%

Implementation of a Whole Food Plant Based Diet in a Food as Prevention Program in a Resource Constrained Environment

Ganguli

Russell

Tsoi

2022

JLM

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Background:The efficacy of a Whole Food Plant-based (WFPB) diet has been shown in randomized controlled trials in diabetes, cardiovascular disease and obesity. However, it's effectiveness in routine clinical settings is less well documented. This study describes the implementation and outcomes of a "Food as Prevention" program run by a single clinician.Methods: Participants were referred to a "Food as Prevention" program run by a single gastroenterologist at an academic teaching center. The program included 5 physician-led discussion and small group educational sessions. Data collected included demographics, weight and biochemical measurements before and after completion of the program. Statistical analysis included paired t-test and Pearson correlation coefficients were used to assess differences before and after WFPB implementation.Results: A total of 17 participants (age 59 years; 59% female) with an average weight of 90.0 kg attended a median of 3 group sessions. Majority of patients had hyperlipidemia (71%) followed by hypertension (47%) and coronary artery disease (35%), fatty liver disease (35%) and diabetes mellitus (29%). Adoption of a WFPB diet led to significant decreases in weight (4.3 kg; p ＜ 0.01), total cholesterol (0.72 mmol/L; p = 0.046), and triglycerides (0.53 mmol/L; p = 0.005) with an increase in high-density lipoprotein (HDL) (0.10 mmol/L; p = 0.01).Conclusions: Implementation of the WFPB diet in this novel pilot program led to weight loss and improvement in biochemical markers of disease. Future studies are needed to implement this model on a larger scale.

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Using the SMART-EST Goals in Lifestyle Medicine Prescription

Cited by 19 publications

References 9 publications

Insights Into Patients’ Perceptions of Health-Related Social Needs and the Role of the Adult Primary Care Clinic

Insights Into Patients’ Perceptions of Health-Related Social Needs and the Role of the Adult Primary Care Clinic

Empowering learners to provide dietary counselling

Implementation of a Whole Food Plant Based Diet in a Food as Prevention Program in a Resource Constrained Environment

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