A Lifestyle Management Group within a Safety Net Primary Care Practice and Its Effect on Mood and Obesity

Background: Research has shown lifestyle modifications that include weight management, regular physical activity, and stress reduction are associated with improved chronic disease risk factors and overall improvement in general health. A lifestyle management group (LMG) was initiated in a safety net, faculty-resident internal medicine practice that provides care to approximately 12,000 patients. Many patients have been diagnosed with obesity, mental health issues, and chronic diseases. An internal referral process was developed for providers or patients could self-refer with provider clearance. The LMG included a 2-hour, bi-weekly class for 6 months. Each class incorporated a short provider visit to establish and review health goals, group exercises modified to adapt all fitness levels, and various educational topics presented by multidisciplinary staff within the clinic. Patients were encouraged to attend as many sessions as able to achieve their goals and benefit from the program.

Purpose: This program was developed and implemented in an attempt to improve chronic health conditions in a vulnerable population through an affordable onsite lifestyle management program. The established patient outcomes focused on weight reduction and quality-of-life metrics (physical function, pain, and mood). A group setting offered structure, motivation, and socialization, along with accountability to keep patients moving toward their desired goals.

Results/outcomes: 64 patients were referred to the program; 13 (20.3%) attended at least 1 class, and 8 (12.5%) attended at least 3 of more classes. In order to determine the value of the LMG program, weight and patient-reported outcomes measurement information system metrics were evaluated according to physical function, pain, and mood. Although weight loss was not clinically significant (5 –10% reduction in body weight), more than half of the patients lost weight at program completion. Improvement in mood was both clinically and statistically significant and may be related to the positive benefits of participating in a group setting.

Conclusions: LMG has demonstrated weight reduction and an improvement in mood for attendees. Goals for subsequent LMGs may include weekly sessions to increase patient engagement and achieve personal goals, as well as staff education and participation to increase patient referrals. In addition, an “alumni group” has been designed to continue ongoing efforts and to facilitate utilization of community resources.

Purpose: This program was developed and implemented in an attempt to improve chronic health conditions in a vulnerable population through an affordable onsite lifestyle management program. The established patient outcomes focused on weight reduction and quality-of-life metrics (physical function, pain, and mood). A group setting offered structure, motivation, and socialization, along with accountability to keep patients moving toward their desired goals.

Results/outcomes: 64 patients were referred to the program; 13 (20.3%) attended at least 1 class and 8 (12.5%) attended at least 3 of more classes. In order to determine the value of the LMG program, weight and patient–reported outcomes measurement information system metrics were evaluated according to physical function, pain, and mood. Although weight loss was not clinically significant (5 –10% reduction in body weight), more than half of the patients lost weight at program completion. Improvement in mood was both clinically and statistically significant and may be related to the positive benefits of participating in a group setting.

Conclusions: LMG has demonstrated weight reduction and an improvement in mood for attendees. Goals for subsequent LMGs may include weekly sessions to increase patient engagement and achieve personal goals, as well as staff education and participation to increase patient referrals. In addition, an “alumni group” has been designed to continue ongoing efforts and to facilitate utilization of community resources.