Abstract
CONTEXT: Metabolic syndrome, includes elevated fasting glucose, high triglycerides, hypertension, low HDL & abdominal obesity, affects 35% of adults in the United States. People with metabolic syndrome are at high risk for diabetes and cardiovascular disease and have higher all-cause mortality. Usual treatment for metabolic syndrome is weight loss through diet and exercise. Evidence supports the use of mindfulness as a strategy for effective weight management. OBJECTIVE: Are group visits for mindful eating and healthy nutrition education feasible and acceptable across different primary care settings for patients, staff and clinicians? STUDY DESIGN: Pilot/feasibility study. SETTING: Needham Wellesley Family Medicine PC, a physician-owned family medicine practice in Wellesley, MA and UC Health Integrative Medicine Center in Denver, CO. POPULATION STUDIED: 3 primary care clinicians (1 in MA, 2 in CO), 3 mindfulness teachers (1 RN in MA, 2 clinical psychologists in CO); 15 patients 18+ years with obesity/overweight and metabolic syndrome or diabetes, cardiovascular disease, hypertension. actively enrolled in MA; able to consent, understand procedures; Patient exclusions: lack cognitive capacity, unable/unwilling to consent or complete study. INTERVENTION: Group visits with mindful eating, healthy nutrition for adults with metabolic syndrome and related conditions. Curriculum: evidence-based principles of mindful eating, healthy nutrition, and activity to improve management of metabolic syndrome and related conditions. The curriculum seeks to foster sustainable lifestyle change related to eating behaviors, nutrition choices, activity, self-efficacy, goal setting. Physician, mindfulness teacher, patients meet for 13 weekly group visits during 3 months. OUTCOME MEASURES: survey questions, semi-structured interviews for physicians and mindfulness teachers. feasibility & acceptability to clinicians learning and leading the curriculum. RESULTS: Clinicians report: (5=best) helped patients acquire new skills 4.8/5; clinicians enjoyed leading the program 4.2/5; time to explore difficult issues more deeply, curriculum was very interesting. CHALLENGES: learning complex curriculum, charting medical records for a group of patients; staffing/scheduling/locating group visits. CONCLUSIONS: Mindful eating healthy nutrition group visits are feasible. Clinicians report acceptability for leading group visits to enhance healthier eating & lifestyle change.