Education strategies to facilitate lifestyle medicine practice within health systems: a multiple case study of US health systems

促进医疗系统内生活方式医学实践的教育策略:美国医疗系统的多案例研究

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Abstract

BACKGROUND: Lifestyle medicine (LM) is an evidence-based field of medicine that is effective in treating and preventing leading causes of morbidity and mortality. Despite demonstrated impact, few physicians and other healthcare professionals regularly implement LM. Continuing education may be an effective avenue for improving practitioner knowledge, confidence, and practice of LM, but there is a gap in the understanding of how educational content and strategies can be utilized to effectively increase LM adoption. The purpose of this study is to identify educational strategies that facilitate the implementation of LM in health systems (HS). METHODS: Eight US HSs participated in this multiple case study. We conducted in-depth, semi-structured interviews (n = 68 total; 6-8 within each HS) with HS employees leading and delivering LM programs. Interviews included questions about LM implementation and educational strategies. Transcripts were analyzed following the framework analysis approach. Strength of endorsement was assessed through quantitative and qualitative analysis. RESULTS: Four topic areas were identified as critical content for effective continuing education in LM. The need for further education in behavior change counseling received the strongest endorsement. Other topics included LM definition and evidence, referral opportunities, and business development skills. Ten types of continuing educational strategies were identified that facilitate LM. There was the strongest endorsement for pilot programs, employee wellness, and interpersonal educational activities, including peer-learning, communities-of-practice, and supervisor-learning/mentorship. CONCLUSION: Continuing education can facilitate LM implementation in HSs. Educational strategies should emphasize training that builds skills in behavior change counseling, leverages employee wellness pilot programs, and nurtures interpersonal learning.

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