Characterizing primary care patient referrals and attendance patterns for virtual lifestyle medicine shared medical...

To better understand patient engagement in a Lifestyle Medicine Shared Medical Appointment.(LMSMA) program with Health and Wellness Coaching (HWC).

From July 2022 to June 2023, adult patients were referred to the Massachusetts General Hospital Healthy Lifestyle Program by primary care providers or self-referred in LMSMAs and HWC, both virtual programs supporting lifestyle behavior change. Demographic and clinical data extracted from electronic medical records were analyzed to assess associations with engagement using independent samples t-test, Chi-squared, Fisher exact-test, and odds ratios.

In total, 1315 patients enrolled in LMSMAs and 947 (72.0 %) attended at least one session. Also, 151 patients (15.9 %) attended at least one HWC session. For LMSMAs, age was associated with higher enrollment (OR = 1.02, CI = 1.01-1.03) and attendance (OR = 1.02, CI = 1.01-1.02), male sex was associated with lower enrollment (OR = 0.64, CI = 0.48-0.87) but higher attendance (OR = 1.46, CI = 1.04-2.06). Lower education was associated with lower attendance (OR = 0.42, CI = 0.21-0.83). For HWC enrollment, male sex was associated with higher enrollment (OR = 1.96, CI = 1.19-3.41). Black race (OR = 2.90, CI = 1.36-7.60), Hispanic ethnicity (OR = 2.05, CI = 1.07-4.44), and lower education (OR = 1.71, CI = 1.20-2.46) were associated with higher HWC enrollment.

Primary care provider- and self-referred patients both attend LMSMAs and HWC. Both LMSMAs and HWC may reach a racially and educationally diverse subset of patients. Research is needed to better understand the role that age, sex, race, and ethnicity play in LMSMA and HWC participation.