Moving From In-Person to Telehealth Group Visits for a Mindful-Eating Healthy Nutrition Program.
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ABSTRACT:
SUBMITTER: Carroll JK
PROVIDER: S-EPMC8437556 | biostudies-literature | 2021 Sep-Oct
REPOSITORIES: biostudies-literature
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Moving From In-Person to Telehealth Group Visits for a Mindful-Eating Healthy Nutrition Program.
Carroll Jennifer K JK Finn Leonard L Scharer Kirsten K Kiel Lauren L Kiel Ashley A Callen Elisabeth E Callister Erin E Campbell Ina I Anderson Emma E Grossman Lauren L Landin Carrie C Nederveld Anne A
Annals of family medicine 20210901 5
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Project description:ObjectiveTo estimate how incentives that encourage healthy eating among Supplemental Nutrition Assistance Program (SNAP) participants impact intra-monthly variation in fruit and vegetable spending.DesignWe used transaction data from three Alabama grocery stores participating in a programme that offered dollar-matching coupons for fresh produce. For each store, we calculated daily spending on fresh produce out of SNAP benefits and daily incentive coupon redemptions. We compared total daily spending on fresh produce and daily coupon redemptions on days over which SNAP benefits are distributed in Alabama with spending and redemption on days at the end of the month with no SNAP distribution.SettingSNAP and incentive transactions in three Alabama grocery stores.ParticipantsSNAP participants purchasing fruit and vegetables April 2023-July 2023.ResultsDaily spending with SNAP on produce dropped by 38% at the end of the month. Incentive coupon redemption did not significantly drop at the end of the month. The share of total SNAP spending going to fresh fruits and vegetables increased by two percentage points and the share of fresh fruits and vegetables spending coming from redemptions increased by ten percentage points at the end of the month.ConclusionsSNAP households may use incentive coupons to smooth drops in produce consumption at the end of the month. These findings also highlight trade-offs inherent in different delivery mechanisms for SNAP incentives.
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Project description:BackgroundThe rise of telemedicine has brought significant changes to patient care, especially regarding the experience of empathy and connection during consultations. Understanding how telemedicine compares to in-person visits in terms of patient-physician interactions and the perception of empathy is crucial for optimizing telehealth services.ObjectivesThis study aims to compare patient-physician interaction ratings between telemedicine and in-person visits across the 10 items of the Consultation and Relational Empathy (CARE) measure. Additionally, it seeks to identify any significant differences in interaction ratings between male and female patients within these contexts.MethodsA cross-sectional study was conducted involving 320 participants who had either telemedicine or in-person consultations. Participants were assigned to the telehealth or in-person group based on the type of consultation they experienced. The CARE measure was utilized to capture patient's perspective of the quality of the interaction. Statistical analyses were performed to compare the ratings between the two groups.ResultsThe study found no significant differences in overall CARE measure ratings between telemedicine and in-person visits. However, male patients reported higher satisfaction with telemedicine on several items compared to in-person visits, whereas female patients showed no significant differences in their ratings.ConclusionsTelemedicine is as effective as in-person visits in maintaining high-quality patient-physician interactions. The findings also suggest gender-specific preferences that could inform the optimization of telemedicine practices. Further research is recommended to explore these differences in more diverse populations.
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Project description:PurposeWe designed and pilot-tested a reimbursable lifestyle change program delivered via telehealth that was initiated during the COVID-19 pandemic.MethodsThe program (IM Healthy) focused on increasing physical activity, improving nutrition, and facilitating stress management and healthy behavior change. Retrospective chart review was used to collect data on IM Healthy participants from the period of Sept 2021 to Aug 2022. The program was offered three days each week with the same topic presented each day. Patients chose which day they attended. Meetings were primarily led by a health psychologist, with intermittent weeks led by a dietitian or physical therapist. Chart review provided demographics, group attendance, ESAS-FS, PROMIS10, weight, and BMI. Patient feedback regarding the telehealth program was collected approximately 6 months following the data collection period.ResultsPatients (N = 50) mostly women (90%) with mean 57.9 years old (SD = 11.2) attended at least one group with an average of 13.1 (SD = 10.8; range = 1-45) attended sessions. Frequency of individual psychology sessions decreased after starting IM Healthy (z = - 2.17, p = 0.03). Overall, patients provided positive feedback including feelings of connectedness and physical and psychological benefit. Patients endorsed moderate to high perceived success in physical activity, nutrition, and stress management.ConclusionsWe demonstrate that a reimbursable lifestyle change group program can be tailored to telehealth and is well-received and beneficial to cancer survivors.
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Project description:BackgroundThe feasibility of remote visits following abdominal colorectal surgery has not been studied in relation to efficacy, patient satisfaction, and surgeon satisfaction. This study aims to assess reliability and satisfaction with a web-based questionnaire for post-operative visits following abdominal colorectal surgery.MethodsThis was a prospective single-arm cohort study at single-tertiary care center during admission for abdominal colorectal surgery. Using a web-based patient portal, patients completed a questionnaire 48 h prior to their scheduled in-person follow-up visits and submitted photographs of their incisions. Surgeons reviewed patient-entered data and responded within 24 h. Following the subsequent in-person visit, surgeons completed questionnaires to compare the accuracy of the web-based vs. in-person evaluations. Lastly, patients and surgeons completed separate satisfaction surveys after the in-person visits.ResultsA total of 33 patients were enrolled, of which 30 (90.9%) successfully completed the web questionnaire. Providers reported the online questionnaire to be concordant with the in-person visit in 90% of cases. Of the patients who completed the study, only half found the survey alone to be acceptable for follow-up. Patients spent significantly less time completing the online questionnaire (≤ 10 min) than in-person visits, including travel time (75 min, IQR 50-100). Only 12 patients (40%) uploaded photographs of their incisions. During in-person visits, management changes were employed in four patients (13.3%), of which 3 required treatment of superficial surgical site infections (10%).ConclusionThis asynchronous web-based visit format was acceptable to colorectal surgeons but was only embraced by half of patients, despite considerable time savings. While patients preferred in-person visits, there may be opportunities to expand TeleHealth acceptance that focus on patient selection and education.Clinicaltrialsgov: NCT05084131.
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Project description:BackgroundBlack and Latinx adults experience disproportionate asthma-related morbidity and limited specialty care access. The severe acute respiratory syndrome coronavirus 2 pandemic expanded telehealth use.ObjectiveTo evaluate visit type (telehealth [TH] vs in-person [IP]) preferences and the impact of visit type on asthma outcomes among Black and Latinx adults with moderate-to-severe asthma.MethodsFor this PREPARE trial ancillary study, visit type preference was surveyed by e-mail or telephone post-trial. Emergency medical record data on visit types and asthma outcomes were available for a subset (March 2020 to April 2021). Characteristics associated with visit type preferences, and relationships between visit type and asthma outcomes (control [Asthma Control Test] and asthma-related quality of life [Asthma Symptom Utility Index]), were tested using multivariable regression.ResultsA total of 866 participants consented to be surveyed, with 847 respondents. Among the participants with asthma care experience with both visit types, 42.0% preferred TH for regular checkups, which associated with employment (odds ratio [OR] = 1.61; 95% confidence interval [CI], 1.09-2.39; P = .02), lower asthma medication adherence (OR = 1.06; 95% CI, 1.01-1.11; P = .03), and having more historical emergency department and urgent care asthma visits (OR = 1.10 for each additional visit; 95% CI, 1.02-1.18; P = .02), after adjustment. Emergency medical record data were available for 98 participants (62 TH, 36 IP). Those with TH visits were more likely Latinx, from the Southwest, employed, using inhaled corticosteroid-only controller therapy, with lower body mass index, and lower self-reported asthma medication adherence vs those with IP visits only. Both groups had comparable Asthma Control Test (18.4 vs 18.9, P = .52) and Asthma Symptom Utility Index (0.79 vs 0.84, P = .16) scores after adjustment.ConclusionTH may be similarly efficacious as and often preferred over IP among Black and Latinx adults with moderate-to-severe asthma, especially for regular checkups.Trial registrationClinicalTrials.gov Identifier: NCT02995733.
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Project description:BackgroundTelehealth rapidly expanded since the outbreak of the COVID-19 pandemic. This study aims to understand how telehealth can substitute in-person services by 1) estimating the changes in non-COVID emergency department (ED) visits, hospitalizations, and care costs among US Medicare beneficiaries by visit modality (telehealth vs. in-person) during the COVID-19 pandemic relative to the previous year; 2) comparing the follow-up time and patterns between telehealth and in-person care.MethodsA retrospective and longitudinal study design using US Medicare patients 65 years or older from an Accountable Care Organization (ACO). The study period was April-December 2020, and the baseline period was March 2019 - February 2020. The sample included 16,222 patients, 338,872 patient-month records and 134,375 outpatient encounters. Patients were categorized as non-users, telehealth only, in-person care only and users of both types. Outcomes included the number of unplanned events and costs per month at the patient level; number of days until the next visit and whether the next visit happened within 3-, 7-, 14- and 30-days at the encounter level. All analyses were adjusted for patient characteristics and seasonal trends.ResultsBeneficiaries who used only telehealth or in-person care had comparable baseline health conditions but were healthier than those who used both types of services. During the study period, the telehealth only group had significantly fewer ED visits/hospitalizations and lower Medicare payments than the baseline (ED 13.2, 95% CI [11.6, 14.7] vs. 24.6 per 1,000 patients per month and hospitalization 8.1 [6.7, 9.4] vs. 12.7); the in-person only group had significantly fewer ED visits (21.9 [20.3, 23.5] vs. 26.1) and lower Medicare payments, but not hospitalizations; the both-types group had significantly more hospitalizations (23.0 [21.4, 24.6] vs. 17.8). Telehealth was not significantly different from in-person encounters in number of days until the next visit (33.4 vs. 31.2 days) or the probabilities of 3- and 7-day follow-up visits (9.2 vs. 9.3% and 21.8 vs.23.5%).ConclusionsPatients and providers treated telehealth and in-person visits as substitutes and used either depending on medical needs and availability. Telehealth did not lead to sooner or more follow-up visits than in-person services.
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Project description:To ensure the adequate supply of nutrients, a model food ration (MFR) should be used for planning the menu. The purpose of the study was to determine the effects of the nutrition education program on the compliance with MFR in 231 preschools. The average supply of food products (per child/day) with reference to the MFR was examined on the baseline and 3 to 6 months after education on the basis of 10-day menus and daily inventory reports (4620 in total). According to the recommendations, preschool should implement 70⁻75% of the recommended daily intake standards. Examined menus had too high content of meat and meat products, whereas vegetables, milk and fermented milk beverages, cottage cheese and eggs were served in scarce. Education significantly reduced the amount of meat (47.7 vs. 44.5 g), processed meat (16.2 vs. 14.4 g), sugar and sweets (15.9 vs. 14.4 g) and increased the amount of cereals, groats, rice (17.7 vs. 18.5 g), vegetables (164.3 vs. 170.8 g), milk and fermented milk beverages (200.3 vs. 209.5 g) but the compliance with the MFR remained poor. The evaluation of menus stressed the need for further modifying their composition. Education can positively affect the quality of nutrition; however, introduction of the legal nutritional regulations should be recommended.
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