Greer Deborah M, Hill Dawn C
Cardiovascular Services, LLC, Inverness, Florida, USA.
J Am Acad Nurse Pract. 2011 Feb;23(2):76-83. doi: 10.1111/j.1745-7599.2010.00585.x. Epub 2011 Jan 11.
To develop and implement a pilot program designed as a shared medical group visit targeting metabolic syndrome prevention in two ethnically diverse patient populations.
The Cooperative Health Care Clinics (CHCC) module was utilized for group sessions to focus on interactive discussions following the L.E.A.R.N. format in order to encourage healthy lifestyle changes. Participants completed a pre- and postknowledge base test that encompassed information on healthy lifestyle changes in addition to disease processes associated with metabolic syndrome. Each didactic session was evaluated using mean ± standard deviation for the knowledge tests. Analysis of variance was used in determining body mass index (BMI) and weight measured at weeks 1, 5, and 10. Participants completed a 5-point Likert scale satisfaction survey on week 10. Independent means t-test compared clinic results along with the Satterthwaite approximate t-test because of unequal sample sizes to evaluate differences in means.
There were no significant statistical differences in mean weight or BMI on weeks 1 and 5. However, on week 10, there was a statistically significant difference for waist circumference in both clinics (p= .0466). Knowledge base improved in both clinics with a premean (0 score = 87 ± 18) and postmean (0 score = 93 ± 14). Both sites received high scores for patient satisfaction.
The shared medical group visits program implemented in both clinic sites demonstrated that this is an effective model in which to provide intensive patient education, foster peer support, and facilitate health-related behavioral changes. Peer support, self-management, and continuity appear to be important factors in behavior change and improved knowledge.