PRP169: Team-based, Virtual Group Medical Visits to Promote Healthy Lifestyle Behaviors During Pandemic
Annie Chern, MD
Context: Covid-19 has caused great stressors on the medical system. Patients are hesitant to seek “routine care" for chronic medical conditions, with adverse health consequences. To address this, we partnered with Open Source Wellness (OSW) to establish a virtual group visit. The OSW curriculum focuses on 4 pillars - diet, exercise, social connection, and stress reduction - to promote healthy lifestyle changes as treatment for chronic disease. Objective: Establish a virtual group visit model that serves as a peer-based support system to promote healthy behaviors during this socially isolating time. Setting: Online group visit to be administered via HIPAA-compliant Zoom platform; lead physician will be based at Family Medicine Associates, a full-spectrum family medicine clinic in San Jose, CA. Population: Primary care patients at Family Medicine Associates. Intervention: 16 week group visit curriculum, led by health coaches from OSW (www.opensourcewellness.org), a community-based “Behavioral Pharmacy." Curriculum focuses on Nourishment, Movement, Social Connection, and Stress Reduction. Each group visit includes exercise, stress reduction, and health coaching with patient goal setting. One-on-one physician-patient visits will occur during the group visit setting every 4 weeks to review medical prescriptions, labs, and medical follow-up. All visits will be administered through HIPAA-compliant ZOOM platform. Study Design and Analysis: May - June 2020: Patient recruitment via email invitation in EMR (complete). June 5, 2020 - October 5, 2020: Monthly enrollment of patients in 16-week group visit curriculum. Pre-Intervention questionnaires: 2 item fruit and vegetable intake, Exercise as a vital sign, WHO-5 Wellbeing Index, UCLA 3-item Loneliness Scale, PHQ-9, CD-RISC-10, Qualitative interviews with patients regarding logistics of virtual format. Monthly assessment with above measures to assess change during and after the program. Multi-level linear modelling used to account for longitudinal data and missing data, and to maximize analytic power. Expected Outcomes: Virtually administered, team-based approach to healthy lifestyle behavior will promote measurable increases in healthy behaviors and reduce the social isolation created by the current Covid-19 pandemic. The novel virtual format will prove feasible and welcome for patients during this time of shelter-in-place, and can be applied for scalability and accessibility, even as shelter-in-place is lifted.