Popescu Dominique L, Mace Ryan A, Baggett Anna, Mirsky Jacob B
Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Prev Med Rep. 2025 Apr 7;53:103059. doi: 10.1016/j.pmedr.2025.103059. eCollection 2025 May.
To better understand patient engagement in a Lifestyle Medicine Shared Medical Appointment.(LMSMA) program with Health and Wellness Coaching (HWC).
From July 2022 to June 2023, adult patients were referred to the Massachusetts General Hospital Healthy Lifestyle Program by primary care providers or self-referred in LMSMAs and HWC, both virtual programs supporting lifestyle behavior change. Demographic and clinical data extracted from electronic medical records were analyzed to assess associations with engagement using independent samples -test, Chi-squared, Fisher exact-test, and odds ratios.
In total, 1315 patients enrolled in LMSMAs and 947 (72.0 %) attended at least one session. Also, 151 patients (15.9 %) attended at least one HWC session. For LMSMAs, age was associated with higher enrollment (OR = 1.02, CI = 1.01-1.03) and attendance (OR = 1.02, CI = 1.01-1.02), male sex was associated with lower enrollment (OR = 0.64, CI = 0.48-0.87) but higher attendance (OR = 1.46, CI = 1.04-2.06). Lower education was associated with lower attendance (OR = 0.42, CI = 0.21-0.83). For HWC enrollment, male sex was associated with higher enrollment (OR = 1.96, CI = 1.19-3.41). Black race (OR = 2.90, CI = 1.36-7.60), Hispanic ethnicity (OR = 2.05, CI = 1.07-4.44), and lower education (OR = 1.71, CI = 1.20-2.46) were associated with higher HWC enrollment.
Primary care provider- and self-referred patients both attend LMSMAs and HWC. Both LMSMAs and HWC may reach a racially and educationally diverse subset of patients. Research is needed to better understand the role that age, sex, race, and ethnicity play in LMSMA and HWC participation.
更好地了解患者在生活方式医学共享医疗预约（LMSMA）计划与健康与 Wellness 指导（HWC）中的参与情况。
2022 年 7 月至 2023 年 6 月，成年患者由初级保健提供者转介至麻省总医院健康生活方式计划，或在 LMSMA 和 HWC 中自我转介，这两个虚拟计划均支持生活方式行为改变。从电子病历中提取的人口统计学和临床数据进行分析，以使用独立样本 t 检验、卡方检验、Fisher 精确检验和比值比评估与参与度的关联。
共有 1315 名患者参加了 LMSMA，其中 947 名（72.0%）至少参加了一次课程。此外，151 名患者（15.9%）至少参加了一次 HWC 课程。对于 LMSMA，年龄与更高的注册率（OR = 1.02，CI = 1.01 - 1.03）和出勤率（OR = 1.02，CI = 1.01 - 1.02）相关，男性与较低的注册率（OR = 0.64，CI = 0.48 - 0.87）相关，但出勤率较高（OR = 1.46，CI = 1.04 - 2.06）。较低的教育程度与较低的出勤率相关（OR = 0.42，CI = 0.21 - 0.83）。对于 HWC 注册，男性与更高的注册率相关（OR = 1.96，CI = 1.19 - 3.41）。黑人种族（OR = 2.90，CI = 1.36 - 7.60）、西班牙裔（OR = 2.05，CI = 1.07 - 4.44）和较低的教育程度（OR = 1.71，CI = 1.20 - 2.46）与更高的 HWC 注册率相关。
初级保健提供者转介和自我转介的患者都参加了 LMSMA 和 HWC。LMSMA 和 HWC 都可能覆盖种族和教育背景多样的患者群体。需要进行研究以更好地了解年龄、性别、种族和民族在 LMSMA 和 HWC 参与中所起的作用。
