JMIR Publications

ABSTRACT

Background:

Despite growing evidence supporting its effectiveness to prevent and treat chronic illness, lifestyle medicine (LM) is still not widely integrated into medical practice. Potential challenges include lack of clinician training, staffing concerns, and misalignment of LM services with fee-for-service reimbursement; but the full range of factors facilitating or obstructing its implementation and long-term success are not yet understood. It is crucial to understand the experiences of different LM programs, in order to learn important lessons for success and failure.

Objective:

The purpose of this paper is to describe the protocol of Lifestyle Medicine Integration in Health Systems: A Case Study Project.

Methods:

From among 15 self-nominating health systems, eight were selected to represent a diversity of geographic location, type, size, expertise, funding, patients, and LM services. For each case, in-depth interviews, document review, site visits, and study team debriefs are conducted and used to construct a detailed case narrative report for each health system. These reports are subsequently used to conduct cross-case analyses to develop a contextually rich and detailed understanding of various pre-determined and emergent topics, such as billing, care delivery models, clinician training, leadership support/buy-in, intervention content, workplace culture, and burnout. We will disseminate findings through deidentified case reports shared with participating health systems and academic publication.

Results:

The study team has completed data collection for five health systems and three are in progress.

Conclusions:

This protocol paper offers real-world insights into research methods and practices that can guide the execution of other studies with similar methodologies. Limitations and lessons learned are discussed.