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Frates B, Ortega HA, Freeman KJ, Co JPT, Bernstein M. Lifestyle Medicine in Medical Education: Maximizing Impact. Mayo Clin Proc Innov Qual Outcomes 2024; 8:451-474. [PMID: 39263429 PMCID: PMC11387546 DOI: 10.1016/j.mayocpiqo.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/19/2024] [Accepted: 07/01/2024] [Indexed: 09/13/2024] Open
Abstract
The relationship between lifestyle behaviors and common chronic conditions is well established. Lifestyle medicine (LM) interventions to modify health behaviors can dramatically improve the health of individuals and populations. There is an urgent need to meaningfully integrate LM into medical curricula horizontally across the medical domains and vertically in each year of school and training. Including LM content in medical and health professional curricula and training programs has been challenging. Barriers to LM integration include lack of awareness and prioritization of LM, limited time in the curricula, and too few LM-trained faculty to teach and role model the practice of LM. This limits the ability of health care professionals to provide effective LM and precludes the wide-reaching benefits of LM from being fully realized. Early innovators developed novel tools and resources aligned with current evidence for introducing LM into didactic and experiential learning. This review aimed to examine the educational efforts in each LM pillar for undergraduate and graduate medical education. A PubMed-based literature review was undertaken using the following search terms: lifestyle medicine, education, medical school, residency, and healthcare professionals. We map the LM competencies to the core competency domains of the Accreditation Council for Graduate Medical Education. We highlight opportunities to train faculty, residents, and students. Moreover, we identify available evidence-based resources. This article serves as a "call to action" to incorporate LM across the spectrum of medical education curricula and training.
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Affiliation(s)
- Beth Frates
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charleston, MA
- American College of Lifestyle Medicine, Chesterfield, MO
- Harvard Medical School, Boston, MA
| | - Hugo A Ortega
- Albert Einstein College of Medicine, Bronx, NY
- Montefiore Moses/Weiler Internal Medicine Residency, Bronx, NY
| | - Kelly J Freeman
- Department of Practice Advancement/Workforce Development, American College of Lifestyle Medicine, Chesterfield, MO
| | - John Patrick T Co
- Graduate Medical Education, Mass General Brigham, Boston, MA
- Department of Pediatrics, Boston, MA
- Harvard Medical School, Boston, MA
| | - Melissa Bernstein
- Department of Nutrition, College of Health Professions, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, IL
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Hoenders R, Ghelman R, Portella C, Simmons S, Locke A, Cramer H, Gallego-Perez D, Jong M. A review of the WHO strategy on traditional, complementary, and integrative medicine from the perspective of academic consortia for integrative medicine and health. Front Med (Lausanne) 2024; 11:1395698. [PMID: 38933107 PMCID: PMC11201178 DOI: 10.3389/fmed.2024.1395698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.
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Affiliation(s)
- Rogier Hoenders
- Dutch Consortium for Integrative Care and Health, Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands and Faculty of Religion, Culture and Society, University of Groningen, Groningen, Netherlands
| | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health and Department of Medicine on Primary Care, Faculty of Medicine Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caio Portella
- Brazilian Academic Consortium for Integrative Health and Universidade de São Paulo, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, São Paulo, Brazil
| | - Samantha Simmons
- Academic Consortium for Integrative Medicine and Health, Lake Oswego, OR, United States
| | - Amy Locke
- Academic Consortium for Integrative Medicine and Health and Department of Family and Preventive Medicine University of Utah Health, Salt Lake City, UT, United States
| | - Holger Cramer
- Academic Consortium for Traditional & Integrative Medicine and Health, Germany and Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany and Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Daniel Gallego-Perez
- Physical Medicine and Rehabilitation Department University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Miek Jong
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Patja K, Huis in ‘t Veld T, Arva D, Bonello M, Orhan Pees R, Soethout M, van der Esch M. Health promotion and disease prevention in the education of health professionals: a mapping of European educational programmes from 2019. BMC MEDICAL EDUCATION 2022; 22:778. [PMID: 36369021 PMCID: PMC9652036 DOI: 10.1186/s12909-022-03826-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health professionals face barriers in carrying out effective health promotion and disease prevention. To indicate what are the needs for curriculum development in educational programmes, this study aims to provide an overview of how various health professionals are currently trained in health promotion and disease prevention at different educational levels. METHODS In 2019, a descriptive mapping exercise was performed focusing on European programmes for different health and healthcare professionals at the three levels of education (undergraduate, postgraduate, and continuous professional development [CPD]). Data were collected by a self-developed online survey that was distributed using a modified snowball method. RESULTS A total of 186 educational programmes of 17 different health professionals were analysed, implemented in 31 countries (60% were undergraduate, 30% postgraduate and 10% CPD programmes). Nearly all programmes indicated that expected outcomes were defined on knowledge (99%), skills (94%) and behaviours/attitudes (89%) regarding health promotion and disease prevention. A multidisciplinary approach was reported to be applied by 81% of the programmes. Traditional teaching methods such as lectures (97%) and assignments (81%) were dominant, while e-learning was less frequently used (46%). Digitalization in health promotion and digital health coaching were the least addressed topics in most programmes. CONCLUSIONS Health promotion and disease prevention are reported at all surveyed levels of education for a broad spectrum of health professionals. Educational programmes cover contents on knowledge, skills, and behaviours. There is a need for capacity building and joint development in health promotion education. Specifically, there is a need to include digitalisation and novel teaching in the educational programmes of health promotion and disease prevention.
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Affiliation(s)
- Kristiina Patja
- Department of Public Health, Medical Faculty, University of Helsinki, PO BOX 20 (Tukholmankatu 8 B), 00014 Helsinki, Finland
| | | | - Dorottya Arva
- Department of Public Health, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary
- MTA-PTE Innovative Health Pedagogy Research Group, University of Pécs, Pécs, Hungary
| | - Marjorie Bonello
- Department of Occupational Therapy, Faculty of Health Sciences, University of Malta, Msida, MSD 2090 Malta
| | - Rana Orhan Pees
- European Medical Students’ Association (EMSA), c/o CPME, Rue Guimard 15, 1040 Brussels, Belgium
- Association of Schools of Public Health in the European Region (ASPHER), UM Brussels Campus, Av de Tervueren 153, BE-1150 Brussels, Belgium
| | - Marc Soethout
- Department of Public and Occupational Health, Amsterdam University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Martin van der Esch
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Weesperzijde 190, 1097 DZ Amsterdam, The Netherlands
- Reade, Center for Rehabilitation and Rheumatology, J. van breemenstraat 2, 1056 AB Amsterdam, The Netherlands
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Wang F, Bíró É. Determinants of sleep quality in college students: A literature review. Explore (NY) 2020; 17:170-177. [PMID: 33246805 DOI: 10.1016/j.explore.2020.11.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/12/2020] [Accepted: 11/15/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To review the various determinants of sleep quality among college students. METHODS The PubMed, Web of Science and Cochrane Library databases were searched with the search string "sleep quality" AND "college students" for articles published between January 2007 and October 2017. Articles were excluded if they (1) examined sleep quality as a risk factor for other outcomes or (2) involved inpatients or participants under medical care. RESULTS The 112 identified studies were classified into categories according to the investigated determinants and their effect on sleep quality. Physical activity and healthy social relations improved sleep quality, while caffeine intake, stress and irregular sleep-wake patterns decreased sleep quality. Less consistent results were reported regarding eating habits and sleep knowledge, while proper napping during the day might improve overall sleep quality. CONCLUSIONS College students are vulnerable to different risk factors for sleep quality. When designing interventions to improve sleep quality among college students, the main determinants need to be taken into consideration.
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Affiliation(s)
- Feifei Wang
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, Eötvös Loránd University ELTE, 1075 Budapest, Kazinczy u. 23-27, Hungary.
| | - Éva Bíró
- Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4028 Debrecen Kassai út 26, Hungary
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Lee JS, Kang MA, Lee SK. Effects of the e-Motivate4Change Program on Metabolic Syndrome in Young Adults Using Health Apps and Wearable Devices: Quasi-Experimental Study. J Med Internet Res 2020; 22:e17031. [PMID: 32729838 PMCID: PMC7426802 DOI: 10.2196/17031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/22/2020] [Accepted: 06/14/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The health behaviors of young adults lag behind those of other age groups, and active health management is needed to improve health behaviors and prevent chronic diseases. In addition, developing good lifestyle habits earlier in life could reduce the risk of metabolic syndrome (MetS) later on. OBJECTIVE The aim of this study is to investigate the effects of the e-Motivate4Change program, for which health apps and wearable devices were selected based on user needs. The program was developed for the prevention and management of MetS in young adults. METHODS This experimental study used a nonequivalent control group. In total, 59 students from 2 universities in Daegu, Korea participated in the study (experimental group n=30; control group n=29). Data were collected over 4 months, from June 1 to September 30, 2018. The experimental group received a 12-week e-Motivate4Change program intervention, and the control group received MetS education and booklets without the e-Motivate4Change program intervention. RESULTS After the program, the experimental group had significantly higher scores for health-related lifestyle (t=3.86; P<.001) and self-efficacy (t=6.00; P<.001) than did the control group. Concerning BMI, there were significant effects by group (F=1.01; P<.001) and for the group × time interaction (F=4.71; P=.034). Concerning cholesterol, there were significant main effects for group (F=4.32; P=.042) and time (F=9.73; P<.001). CONCLUSIONS The e-Motivate4Change program effectively improved participants' health-related lifestyle scores and self-efficacy, and significantly reduced their BMI and cholesterol levels. The program can be used to identify and prevent MetS among young adults.
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Affiliation(s)
- Ji-Soo Lee
- Keimyung University, Daegu, Republic of Korea
| | - Min-Ah Kang
- Keimyung University, Daegu, Republic of Korea
- Gyeongnam Center for Infectious Disease Control and Prevention, Changwon, Republic of Korea
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McGrady A, Badenhop D, Lynch D. Effects of a Lifestyle Medicine Elective on Self-Care Behaviors in Preclinical Medical Students. Appl Psychophysiol Biofeedback 2019; 44:143-149. [PMID: 30826911 DOI: 10.1007/s10484-019-09431-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to explore the impact of a lifestyle medicine elective on medical students' self-care behaviors. From fall, 2015, through spring, 2017, a lifestyle medicine elective was offered to first and second year medical students. Acquisition of data was approved by the IRB. Students attended four group sessions, two at the beginning and two at the end of the elective. At the first session, information about the effects of lifestyle on mental and physical health was presented. Students completed screening instruments to assess their own physical activity, nutrition, anxiety, and depression. At the next class, students received their scores. They chose one of three focus groups: nutrition, physical activity or stress management and set a specific goal in that area. At the end of the elective, students attended two group sessions, which focused on patient cases. They again completed the screening instruments, and received their scores. They also evaluated the course. Sixty-three students signed the consent form and provided data. Comparison of baseline scores by gender revealed that women had statistically significant higher scores on the depression screener than men, and lower physical activity scores than men. Pre and post elective comparison in the whole group showed statistically significant improvements in nutrition, depression, and anxiety (all p < .05). Further analysis in the focus groups demonstrated that the stress management group's scores on anxiety were significantly improved. The nutrition group significantly lowered their fat consumption and increased their intake of fruits and vegetables (all p < .05). The physical activity group did not significantly increase their daily physical activity, although this analysis was limited by missing data and wide variability. Student evaluations of the course were positive. Medical students are able to make improvements in their own lifestyle behaviors while acquiring information that may be useful in later patient care.
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Affiliation(s)
- Angele McGrady
- Department of Psychiatry, University of Toledo Medical Center, Mail Stop 1190 3000 Arlington Ave., Toledo, OH, 43614, USA.
| | - Dalynn Badenhop
- Department of Medicine, University of Toledo Medical Center, Mail Stop 1190 3000 Arlington Ave., Toledo, OH, 43614, USA
| | - Denis Lynch
- Department of Psychiatry, University of Toledo Medical Center, Mail Stop 1190 3000 Arlington Ave., Toledo, OH, 43614, USA
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