1. EXPERIENCES WITH AN OFFICE BASED HEALTHY EATING CLASS
Kinder Fayssoux, MD
Kathleen A Hill, RN, CRNP
Crozer Keystone Family Medicine Residency Program
INTRODUCTION
DISCUSSION
In this limited small group study, patients appeared to benefit from the group interactive class
Weight measurement was not a part of the class, but because all participants were patients of the practice, we were able to review pre-class and post-class weights and noted a decrease in weight of between 2 and 7 pounds, maintained for the 6 week follow-up period
There was no blinding on post-surveys-participants may have responded favorably to “be nice”
There were no objective measurements
It was a very small size group, and included only women.
One class of 8 participants that has been held since included one male,and also included patients who were not in our practice. This group did include pre-and post-formal weights. Participants in this group missed many classes, and verbalized dislike of the weigh-ins. Only 2 participants presented for the last class, which was to include the final weigh in.
Poor eating habits and activity behaviors contribute to multiple chronic health issues including diabetes, hyperlipidemia and hypertension
Patients often present seeking advice regarding healthier eating and getting started with physical activity
Providers verbalize a lack of time and insufficient knowledge as barriers to providing this counseling.
Patients are bombarded with multiple choices regarding supplements and programs.
An office-based program with a primary focus on healthier eating with increased physical activity would be convenient for patients and result in an increased competence in these areas.
RESULTS
Healthy Eating Class in Progress…
Responses to the follow-up questions at 4-6 weeks demonstrated:
5/5 still applying concepts learned in class to their daily life
4/5 still assessing hunger and eating accordingly (the 5th was a diabetic who was eating on timed schedule)
4/5 preparing more meals at home
5/5 maintaining increased activity level since completing the series
5/5 reported the contents of their kitchen more healthy than prior to classes
4/5 felt that the “Wheel of Life” goal setting exercises were an important part of the classes
METHODS
CONCLUSIONS
We decided to limit the participation in classes to patients within the medical practice.
Patients were recruited in person by providers within the practice and also were encouraged to self-refer through posted advertisements.
Of the 60 people who expressed interest, 20 were able to come on the selected days, and 6 people paid the charge of $25 for the 5 classes.
The 2 hour classes were held on 5 successive Monday evenings and were taught by a 3rd year Family medicine resident and a CRNP with additional training in nutrition and physical activity.
Each class had 5 segments: nutrition education, hunger recognition, psychological aspects of eating, physical activity and hands-on cooking classes. Classes were highly interactive
Pre- and Post-class feedback forms were given to assess learning, perceived value, satisfaction, and intention to change.
Patients had improved health behaviors 6 weeks after the completion of classes
Patients verbalized that classes were enjoyable with one comment of “life-changing” received
Weight assessment was not an integral assessment of the original class, and based on experiences of subsequent class, will likely not be included in future classes
The classes were very labor intensive as the curriculum had to be developed, but once clearly developed should be much less so
The classes did fill a need for both patients and providers within the office
Single night “refreshers” would be worthwhile for both patient retention and also for subsequent data collection
ACKNOWLEGEMENTS:
Am I Hungry? What To Do When Diets Don't Work
by Michelle May, M.D., with Lisa Galper, Psy.D. and Janet Carr, M.S., R.D
The Wheel of Life
(picture of wheel of life omitted due to copyright)
Perceived rating of “How healthy is my life”:
Before Classes: 20%
After Classes: 60%