Predictors of Patient Engagement With an Interprofessional Lifestyle Medicine Program

Abstract

Background: Changes in lifestyle habits can reduce morbidity and mortality, but not everyone who can benefit from lifestyle intervention is ready to do so.

Purpose: To describe characteristics of patients who did and did not engage with a lifestyle medicine program, and to identify predictors of engagement.

Methods: This was a single-center, retrospective cohort study of 276 adult patients who presented for consultation to a goal-directed, individualized, interprofessional lifestyle medicine program. The primary outcome was patients' extent of engagement. Candidate predictors considered in multivariable multinomial logistic regression models included baseline sociodemographic, psychological, and health-related variables.

Results: A predictor of full engagement over no engagement was having private or Medicare insurance (rather than Medicaid, other, or no insurance) (OR 4.2 [95% CI 1.3-14.2], P = .021). A predictor of partial engagement over no engagement was having a primary goal to lose weight (OR 3.1 [1.1-8.4], P = .026).

Conclusions: System-level efforts to support coverage of lifestyle medicine services by all insurers may improve equitable engagement with lifestyle medicine programs. Furthermore, when assessing patients' readiness to engage with a lifestyle medicine program, clinicians should consider and address their goals of participation.

Keywords: engagement; goals; insurance; lifestyle medicine; resource utilization.

Figure 1.

Inclusion flowsheet.

Figure 2.

Candidate predictors of (A) Full vs no engagement, (B) Partial vs no engagement, and (C) Full vs partial engagement with an interprofessional lifestyle medicine program (N = 276). Multivariable odds ratios are presented, and error bars represent 95% confidence intervals.