000			03888nam a22005297a 4500
008			190724s20192019 xxu||||| |||| 00| 0 eng d
022			_a1075-5535
024			_a10.1089/acm.2019.0091 [doi]
040			_aOvid MEDLINE(R)
099			_a31314556
245			_aFresh and Savory: Integrating Teaching Kitchens with Shared Medical Appointments.
251			_aJournal of Alternative & Complementary Medicine. 25(7):709-718, 2019 Jul.
252			_aJ Altern Complement Med. 25(7):709-718, 2019 Jul.
253			_aJournal of alternative and complementary medicine (New York, N.Y.)
260			_c2019
260			_fFY2020
265			_sppublish
266			_d2019-07-24
520			_a<b>Objectives:</b> In the fall of 2017, Fresh and Savory, a Culinary and Lifestyle Medicine Teaching Kitchen (TK) program proved systematically feasible as a Shared Medical Appointment (SMA). A portable TK complemented physician consultations, interactive didactic presentations, nutritious cooking, and mind-body exercises. A series of SMAs were launched to develop a system for physicians to address patients' nutritional and lifestyle needs. <b>Interventions:</b> MedStar Health implemented three TK SMA programs to improve patients culinary and lifestyle skills and improve relevant habits. Two cohorts were recruited from Internal Medicine and Cardiology (Internal Medicine/Cardiology I and II) and completed an 8-week program leveraging a culinary and lifestyle medicine curriculum. One cohort (Sports Performance) was held with young, elite athletes completing a 4-week program regarding athlete's nutrition and lifestyle. Feasibility was assessed through patient surveys, staff program operation assessments, and reimbursement. <b>Results:</b> Fifty-three unique patients attended SMA programs, 4-18 patients per weekly session; 223 appointments billed in 2018. E&M code 99213 was billed at _157 and reimbursed, on average, at _116 per patient encounter. During a 4- to 8-week SMA program, changes in patient vitals were statistically insignificant, yet habit changes showed clinical significance. Patients noted increased knowledge of plant-based meals, importance of sleep, and adding mindfulness and exercise to their weekly routine. <b>Conclusions:</b> This exploration investigated the feasibility to implement TK SMA programs at MedStar Health. Developing financial and operational infrastructure for TK SMAs requires financial, staffing, location, and population considerations. TK SMAs proved patient demand for opportunities to develop healthy behaviors. However, sufficient time is required to recruit patients. Vital signs may not acutely improve over an 8-week period, however, small habit changes may improve health outcomes longitudinally and additional exploration is required to assess longitudinal patient outcomes. Financially, SMAs suggest a sustainable and effective approach to integrative medicine in health care.
546			_aEnglish
650			_a*Cooking
650			_a*Health Promotion/mt [Methods]
650			_a*Integrative Medicine
650			_a*Nutritional Sciences/ed [Education]
650			_a*Shared Medical Appointments
650			_aAdolescent
650			_aAdult
650			_aAged
650			_aAged, 80 and over
650			_aFeasibility Studies
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aMind-Body Therapies
650			_aYoung Adult
651			_aMedStar Institute for Innovation
657			_aJournal Article
700			_aHwang, Ellie
700			_aImamura, Anthony
700			_aKakareka, Renee
700			_aPlsek, Paul
700			_aStone, Theresa A
790			_aHwang E, Imamura A, Kakareka R, Plsek P, Stone TA
856			_uhttps://dx.doi.org/10.1089/acm.2019.0091 _zhttps://dx.doi.org/10.1089/acm.2019.0091
942			_cART _dArticle
999			_c4455 _d4455