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Health & Wellness Coaching Services: Making the Case for Reimbursement 健康与保健指导服务:为报销提供依据
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-19 DOI: 10.1177/15598276241266784
Abd Moain Abu Dabrh, Kavitha Reddy, Bettina M. Beech, Margaret Moore
In 2020, a consortium composed of three national coach credentialing organizations, four medical societies, and 72 healthcare organizations led by National Board for Health and Wellness Coaching (NBHWC) was formed to advocate for the reimbursement of Health and Wellness Coaching (HWC) services in the U.S. healthcare system. Building on that, the NBHWC and the Veterans Health Administration (VHA) initiated a pivotal collaboration in 2023, with a target audience comprised influential reimbursement policymakers, notably the American Medical Association’s Current Procedural Terminology (CPT®) Panel and the Centers for Medicare & Medicaid Services (CMS). This concerted effort led to CMS announcing the temporary inclusion of HWC services on the 2024 Medicare Telehealth list. This ongoing advocacy work is crucial while understanding its key components is imperative for wider participation. This paper aims to distill the essence of the advocacy to date into a coherent narrative. By doing so, we seek to share with stakeholders—health and wellness coaches, medical professionals, healthcare organizations, patient advocates, and policy experts—a robust framework to support advocacy for reimbursement to both government and private insurers, at local and national levels. This initiative marks a significant milestone in healthcare policy, reflecting a growing recognition and impact of HWC.
2020 年,由国家健康与保健教练委员会(NBHWC)领导的三个国家教练认证组织、四个医学协会和 72 个医疗保健组织组成了一个联盟,倡导在美国医疗保健系统中对健康与保健教练(HWC)服务进行报销。在此基础上,NBHWC 和退伍军人健康管理局 (VHA) 于 2023 年启动了一项关键性合作,目标受众包括有影响力的报销政策制定者,特别是美国医学协会的现行程序术语 (CPT®) 小组和医疗保险和医疗补助服务中心 (CMS)。通过共同努力,CMS 宣布将 HWC 服务暂时纳入 2024 年医疗保险远程医疗清单。这项持续的宣传工作至关重要,而了解其关键组成部分则是更广泛参与的当务之急。本文旨在将迄今为止宣传工作的精髓提炼成一个连贯的叙述。通过这样做,我们希望与利益相关者--健康和保健教练、医疗专业人士、医疗机构、患者权益倡导者和政策专家--分享一个强大的框架,以支持在地方和国家层面向政府和私人保险公司倡导报销。该倡议标志着医疗保健政策的一个重要里程碑,反映出人们对健康与保健教练的认可度和影响力在不断提高。
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引用次数: 0
A Milestone: 2024 Marks the 20th Anniversary of the Founding of the American College of Lifestyle Medicine 里程碑:2024 年标志着美国生活方式医学学院成立 20 周年
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-03 DOI: 10.1177/15598276241246728
Susan Benigas
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引用次数: 0
Letter re: Food is Medicine: Take a Lesson From the Past 关于 "食物是药 "的信以史为鉴
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-24 DOI: 10.1177/15598276241264269
Deborah Kennedy
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引用次数: 0
Intensive Lifestyle Intervention for Cardiometabolic Prevention Implemented in Healthcare: Higher Risk Predicts Premature Dropout 在医疗机构中实施强化生活方式干预以预防心脏代谢:高风险预示过早退出
IF 1.9 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-20 DOI: 10.1177/15598276241259961
Benno Krachler, Anna Söderholm, Fanny Ekman, Frida Lindberg, Joakim Lindbäck, Johan Nilsson Sommar, Eva-Lotta Glader, Bernt Lindahl
AimsPatient characteristics and treatment setting are potential predictors of premature dropout from lifestyle interventions, but their relative importance is unknown.MethodsFrom the quality registry of the unit for behavioral medicine, Umeå University hospital, we identified 2589 patients who had been enrolled in a multimodal lifestyle intervention for cardiometabolic risk reduction between 2006 and 2015. Baseline characteristics predicting dropout before 1-year follow-up were selected by a stepwise logistic regression algorithm.ResultsBetter physical health and older age predicted full participation, with odds ratios for premature dropout (ORs) of .44 (95% confidence interval (CI) .31-.63), and .47 (95% CI .34-.65) in the highest compared to the lowest quartile, respectively. Odds of premature dropout were also lower among female participants, .71 (95% CI .58-.89). Premature dropout was predicted by higher BMI, snuffing tobacco, and smoking, with ORs of 1.53 (95% CI 1.13-2.08) in the highest compared to the lowest quartile of BMI, 1.37 (95% CI 1.03-1.81) comparing snuff user with non-users and 2.53 (95% CI 1.79-3.61) comparing smokers with non-smokers. Odds ratio for premature dropout among inpatients compared with outpatients was .84 (95% CI .68-1.04).ConclusionHigher risk at baseline predicts premature dropout.
目的患者特征和治疗环境是生活方式干预过早退出的潜在预测因素,但它们的相对重要性尚不清楚。方法我们从于默奥大学医院行为医学科的质量登记册中确定了2589名患者,这些患者在2006年至2015年间参加了降低心脏代谢风险的多模式生活方式干预。结果较好的身体健康状况和较大的年龄预示着完全参与,最高四分位数与最低四分位数相比,过早退出的几率比(ORs)分别为.44(95% 置信区间 (CI) .31-.63)和.47(95% CI .34-.65)。女性参与者过早辍学的几率也较低,为 0.71 (95% CI .58-.89)。预测过早辍学的因素包括较高的体重指数、吸食烟草和吸烟,与体重指数最低的四分位数相比,体重指数最高的四分位数的OR值为1.53(95% CI 1.13-2.08),吸食烟草者与非吸食者的OR值为1.37(95% CI 1.03-1.81),吸烟者与非吸烟者的OR值为2.53(95% CI 1.79-3.61)。住院患者与门诊患者相比,过早辍学的风险比为 0.84 (95% CI 0.68-1.04)。
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引用次数: 0
Evaluating the Factors Associated With Increased Risk of Self-Reported Ischemic Heart Disease in Patients With Arthritis 评估关节炎患者自述缺血性心脏病风险增加的相关因素
IF 1.9 Q2 Medicine Pub Date : 2024-05-18 DOI: 10.1177/15598276241254329
Akash Sharma, Velmurugan Anbu Ananthan, Hamza Yousaf
Introduction. Arthritis has increased systematic repercussions either by extra-articular manifestations or due to limited activities. Methods. In this study, we used the 2020 and 2021 Behavioral Risk Factor Surveillance System (BRFSS), a large, nationally representative, cross-sectional telephone survey. The data was divided into the participants having arthritis and no arthritis. Results represented as an odds ratio (OR) with a 95% confidence interval (CI). We used a multivariate-adjusted logistic regression model to analyze the results. Fisher’s t-test was used to compare between 2 groups. P-value < 0.05 was considered significant. Results. BRFSS survey results led to 835,452 participants included in the final analysis. Of the included participant, 267020 has arthritis, and 568432 do not. In the arthritis group, 38.7% were males, and 61.3% were females. We found that patients with arthritis have a higher prevalence of diabetes and stroke. Adjusted logistic regression analysis showed that patients with arthritis have higher odds of reporting ischemic heart disease (IHD) (OR = 1.05, 95% CI 1.05-1.05, p-value < 0.001). Also, poor health status (mental, general, and physical) patients are more likely to report IHD. Conclusion. Patients with arthritis are more likely to report IHD, which further increases in patients with poor health status.
导言。由于关节外表现或活动受限,关节炎的系统性影响越来越大。研究方法在这项研究中,我们使用了 2020 年和 2021 年行为风险因素监测系统(BRFSS),这是一项具有全国代表性的大型横断面电话调查。数据分为有关节炎和无关节炎的参与者。结果以几率比(OR)和 95% 置信区间(CI)表示。我们使用多变量调整逻辑回归模型来分析结果。两组间的比较采用费雪 t 检验。P值为0.05为显著。结果BRFSS 调查结果导致 835 452 名参与者被纳入最终分析。在纳入的参与者中,267020 人患有关节炎,568432 人没有关节炎。在关节炎组中,男性占 38.7%,女性占 61.3%。我们发现,关节炎患者的糖尿病和中风患病率较高。调整后的逻辑回归分析显示,关节炎患者报告缺血性心脏病(IHD)的几率更高(OR = 1.05,95% CI 1.05-1.05,p 值为 0.001)。此外,健康状况(精神、一般和身体状况)较差的患者更有可能报告 IHD。结论关节炎患者更有可能报告患有心肌缺血,而健康状况差的患者更有可能报告患有心肌缺血。
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引用次数: 0
Evaluation of a Medical Fitness Referral Program at a Single Institution From 2015 to 2022 2015 至 2022 年单一机构的体格检查转诊计划评估
IF 1.9 Q2 Medicine Pub Date : 2024-05-13 DOI: 10.1177/15598276241254305
Zhen Arthur Lu, Craig Ziegler, Elise Tharp, Darby Cole, James Price
Purpose: To assess whether biometric data of participants (i.e., weight, body mass index (BMI), body fat percentage (BFP), heart rate, and blood pressure) would be statistically different from pre- to post-program assessments after completion of a single institution medical fitness referral program. Methods: This is a retrospective analysis of randomly selected participants from August 2015 to December 2022. Analysis of variance was performed for each outcome with groups separated by gender, age, and time period relative to COVID. Results: Analysis included 984 participants, 653 (66%) were female, mean age was 55.5 years (SD = 14.9) with 297 (30%) of participants ≥65, and 747 (76%) completed the program prior to COVID. Significant mean reductions from pre- to post-program were seen for BMI (−.43, SD = 1.16), weight (-2.69 pounds, SD = 7.44), BFP (.44%, SD = 2.35%), systolic blood pressure (3.33 mmHg, SD = 14.58), and diastolic blood pressure (2.18 mmHg, SD = 8.65). Additional significant interactions identified: weight difference for participants less than age 65 (−3.16, SD = 8.31) vs participants ≥65 (−1.60, SD = 4.66), P = .003. Conclusions: In this analysis, participants of the program from August 2015 to December 2022 were seen to have statistically significant reductions in the delineated biometric parameters. However, due to limitations, specific conclusions regarding causation cannot be drawn.
目的:评估参与者的生物测量数据(即体重、体重指数 (BMI)、体脂百分比 (BFP)、心率和血压)在完成单一机构医疗健身转介计划后,与计划前和计划后的评估结果是否存在统计学差异。方法:这是对 2015 年 8 月至 2022 年 12 月期间随机抽取的参与者进行的回顾性分析。对每项结果进行方差分析,按性别、年龄和相对于 COVID 的时间段进行分组。结果:分析包括 984 名参与者,其中 653 人(66%)为女性,平均年龄为 55.5 岁(SD = 14.9),297 人(30%)≥65 岁,747 人(76%)在 COVID 之前完成了该计划。从计划前到计划后,BMI(-.43,SD = 1.16)、体重(-2.69 磅,SD = 7.44)、BFP(.44%,SD = 2.35%)、收缩压(3.33 mmHg,SD = 14.58)和舒张压(2.18 mmHg,SD = 8.65)的平均值均有显著降低。发现的其他重要交互作用:65 岁以下参与者的体重差异(-3.16,SD = 8.31)与≥65 岁参与者的体重差异(-1.60,SD = 4.66),P = .003。结论:在这项分析中,2015 年 8 月至 2022 年 12 月期间参加该计划的人员在统计意义上显著降低了规定的生物测量参数。然而,由于条件限制,无法得出具体的因果关系结论。
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引用次数: 0
Health-Related Benefits and Adherence for Multiple Short Bouts of Aerobic Physical Activity Among Adults 成人进行多次短期有氧体育锻炼对健康的益处和坚持性
IF 1.9 Q2 Medicine Pub Date : 2024-05-11 DOI: 10.1177/15598276241253160
Nashira I. Brown, Jazmin Henderson, Marilyn Stern, Tiffany L. Carson
Most adults do not adhere to established aerobic physical activity (PA) guidelines due in part to various barriers. PA snacks, or periodic short bouts of activity (<10 minutes) offer a potential strategy to overcoming such barriers and increasing PA. Previous efforts have been focused on eliciting the health benefits of PA and exercise snacks, yet adherence to this concept has not been examined. The purpose of this review is to summarize the current literature assessing adherence to PA snacks and health-related outcomes associated with PA snacks. PubMed, CINAHL, and SPORTDiscus were searched for literature published between January 2018-September 2023. Studies investigating adherence and/or the health-related outcomes of PA snacks were included. Of 4201 articles identified, 12 studies were included in the review. Most of the studies were randomized (n = 10), focused on adults with a chronic disease/life-long condition or exhibited a sedentary lifestyle (n = 8), and reported positive health outcomes (n = 12; e.g., improvements in cardiometabolic markers and body composition). Five studies reported adherence to supervised and unsupervised PA snack interventions, with high rates ≥92%. This review supports and extends the previously reported health-related benefits of PA snacks. It also shows promise for increasing overall PA and adherence to the PA guidelines.
大多数成年人没有遵守既定的有氧体育锻炼(PA)指南,部分原因在于各种障碍。运动零食或周期性的短时间活动(10 分钟)为克服这些障碍和增加运动量提供了一种潜在的策略。以往的工作主要集中在宣传运动锻炼和运动零食对健康的益处,但尚未对这一概念的坚持情况进行研究。本综述的目的是总结目前评估坚持食用运动量零食以及与运动量零食相关的健康结果的文献。我们检索了 PubMed、CINAHL 和 SPORTDiscus 上 2018 年 1 月至 2023 年 9 月间发表的文献。纳入了调查 PA 零食的依从性和/或健康相关结果的研究。在确定的 4201 篇文章中,有 12 项研究被纳入综述。大多数研究都是随机的(n = 10),重点关注患有慢性疾病/终身疾病或表现出久坐不动生活方式的成年人(n = 8),并报告了积极的健康结果(n = 12;例如,心血管代谢指标和身体成分的改善)。五项研究报告了在有监督和无监督的情况下坚持运动量零食干预的情况,坚持率高达≥92%。本综述支持并扩展了之前报道的 PA 零食对健康的益处。它还显示了增加整体 PA 和遵守 PA 指南的前景。
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引用次数: 0
Physical Activity in Natural Settings: An Opportunity for Lifestyle Medicine 自然环境中的体育活动:生活方式医学的机遇
IF 1.9 Q2 Medicine Pub Date : 2024-05-11 DOI: 10.1177/15598276241253211
Jay E. Maddock, Howard Frumkin
Physical activity is a well-known behavior for promoting health and preventing a variety of chronic diseases. Despite widespread knowledge of the benefits of physical activity, most Americans do not engage in sufficient physical activity. Over the past decade, there has been increasing recognition of the health benefits of spending time in nature, mediated in part through physical activity. This has led to new partnerships across health, parks and recreation, public lands, and environmental organizations to increase time spent, and physical activity, in natural settings. This review assesses the current evidence around physical activity in natural settings (PANS), strategies for promoting PANS including health professional engagement, and current gaps in the research literature.
体育锻炼是一种众所周知的促进健康和预防各种慢性疾病的行为。尽管人们普遍了解体育锻炼的益处,但大多数美国人并没有参加足够的体育锻炼。在过去的十年中,人们越来越认识到在大自然中度过的时间对健康的益处,这部分是通过体育锻炼来实现的。这促使健康、公园与娱乐、公共土地和环保组织之间建立了新的合作关系,以增加在自然环境中的时间和体育活动。本综述评估了当前有关自然环境中的体育活动(PANS)的证据、促进自然环境中的体育活动(PANS)的策略(包括卫生专业人员的参与)以及当前研究文献中存在的差距。
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引用次数: 0
Healthy Lifestyle Behaviors Among First-Year College Students Attending a University in Mississippi 密西西比州一所大学一年级学生的健康生活方式
IF 1.9 Q2 Medicine Pub Date : 2024-05-08 DOI: 10.1177/15598276241249951
Hannah Horaist, Mayantoinette Watson
IntroductionThe promotion of healthy lifestyle behaviors among college students is a significant interest for public health, especially in Mississippi where 1 in 4 individuals have inadequate access to food supply. A study at a major Mississippi university found that 45% of their students reported food insecurity. More recently, research has highlighted a higher risk of unhealthy lifestyle habits among college students in the Southeastern US.MethodsThis study utilized a descriptive quantitative study design to survey first-year college students (n = 196) enrolled at a University in Southern Mississippi. The relationship between lifestyle and health among first-year college students was measured using the Fantastic Lifestyle Checklist. Data were analyzed utilizing bivariate analysis to determine significant correlations.ResultsOnly 19% of the students reported eating a balanced diet regularly, while 54% reported being active less than twice a week. Although 91% of the students perceived themselves as having an overall healthy lifestyle, 79% reported feelings of sadness or depression. The Fantastic Lifestyle Checklist correlated significantly ( P < .05) with gender out of all demographic variables.ConclusionsInterventions promoting healthy lifestyle behaviors should be encouraged among first-year college students who are vulnerable to contributing factors that can increase health risks. Interventions such as evaluation of risks, health promotion resources, and health promotion behavior awareness should be brought to bear in an effort to improve healthy lifestyle habits among students.
导言:在大学生中推广健康的生活方式行为是公共卫生领域的一项重要工作,尤其是在密西西比州,每 4 人中就有 1 人无法获得充足的食物供应。密西西比州一所重点大学的一项研究发现,该校 45% 的学生报告称食物无保障。本研究采用描述性定量研究设计,调查了密西西比州南部一所大学的一年级新生(n = 196)。使用 "奇妙生活方式清单 "测量了大学一年级学生的生活方式与健康之间的关系。结果只有 19% 的学生表示经常均衡饮食,54% 的学生表示每周活动少于两次。虽然 91% 的学生认为自己拥有整体健康的生活方式,但 79% 的学生表示有悲伤或抑郁情绪。在所有人口统计学变量中,"美妙生活方式清单 "与性别显著相关(P <.05)。结论应鼓励对大学一年级学生采取促进健康生活方式行为的干预措施,因为他们很容易受到会增加健康风险的因素的影响。应采取风险评估、健康促进资源和健康促进行为意识等干预措施,努力改善学生的健康生活习惯。
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引用次数: 0
Improvement in Nutritional Knowledge Confidence and Food-Agency: Outcomes of the First French-Speaking Culinary Medicine Courses Among Medical Students 提高营养知识信心和食品代理能力:医科学生首届法语烹饪医学课程的成果
IF 1.9 Q2 Medicine Pub Date : 2024-05-08 DOI: 10.1177/15598276241252612
Sylvie Dodin, Catherine Bégin, Michel Lucas
BackgroundMedical students often lack sufficient nutrition education, leading to confidence gaps and an inability to address this healthcare aspect. Culinary Medicine (CM) courses offer an innovative solution.MethodsWe tested the first French-speaking CM courses among 2 groups of second-third year medical students, compared to a control group (CG). The objectives were to assess if an optional CM course could enhance their confidence in both nutritional knowledge and providing nutritional advice, and improve their food agency (CAFPAS: Cooking and Food Provisioning Action Scale). The analysis examines changes in scores by comparing post-session to pre-session questionnaire measurements.ResultsOf the 22 CM students and 6 in CG, predominantly aged 20-25 years, Caucasian, and female, the majority (CG = 100%, CM = 86.4%) reported <5 hours of nutrition education. Almost all expressed dissatisfaction with nutrition education provided in medicine, both quantitatively and qualitatively. CM students reported significantly increased confidence in their knowledge and ability to advise about nutrition during the sessions. We also observed improvements in their CAFPAS scores, which measure food agency, while the control group exhibited no change in confidence or CAFPAS scores.ConclusionThe findings highlight CM as practical strategy for integrating nutrition education into medical curricula, offering insights for enhancing future physicians’ knowledge.
背景医科学生往往缺乏足够的营养教育,导致信心不足,无法解决这一医疗保健方面的问题。烹饪医学(CM)课程提供了一种创新的解决方案。方法我们在两组二年级至三年级的医学生中测试了首个讲法语的烹饪医学课程,并与对照组(CG)进行了比较。我们的目标是评估选修 CM 课程是否能增强学生对营养知识和提供营养建议的信心,并提高他们的食物代理能力(CAFPAS:烹饪和食物供应行动量表)。通过比较课后与课前的问卷测量,分析了得分的变化。结果在 22 名 CM 学生和 6 名 CG 学生中,大多数(CG = 100%,CM = 86.4%)表示接受过 5 个小时的营养教育。无论是从数量上还是质量上看,几乎所有学生都对医学营养教育表示不满。中医学学生表示,在课程期间,他们对营养知识和建议能力的信心明显增强。我们还观察到他们的 CAFPAS 分数(衡量食物代理能力)有所提高,而对照组的信心或 CAFPAS 分数均无变化。
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引用次数: 0
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American Journal of Lifestyle Medicine
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