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Just as lifestyle medicine is the necessary foundation for true health care reform, lifestyle medicine competencies should be the foundation for health education. Although lifestyle medicine education may benefit a health professional at any stage in their education or career, evidence-based undergraduate lifestyle medicine education for future health professionals shifts the perspective of health and health care delivery. Educating health preprofessionals in associate, bachelor’s, master’s, and other preprofessional healthcare training programs is of paramount importance due to the interdisciplinary nature of lifestyle medicine. To accomplish this, American College of Lifestyle Medicine (ACLM) members can work collaboratively through committees, projects, and working groups—becoming leadership champions of change. An ACLM Pre-Professional Member Interest Group (LMPP) was created in 2018. LMPP has been working to build a national collaborative effort to amass, create, and distribute resources for educators in this pre-professional arena. Educating college students planning to become professionals outside the medical sphere, for example, lawyers, business people, artists, and engineers, will also benefit the field by introducing the power of nutrition, exercise, sleep, social connection, and stress resiliency during this formative state of career development. Pre-professional educational programs provide learners the opportunity to personally experience the power of lifestyle medicine.

Background The actual causes of the preponderance of non-communicable chronic diseases are related to unhealthy behaviours, such as poor nutrition, physical inactivity and tobacco use. Our goal was to evaluate the feasibility of training in lifestyle medicine (LM) for family physicians, which could be included in ‘Healthy Israel 2020’, a national initiative created to enhance the health of Israelis. Methods Twenty-six providers participated in a 1-year certificate of completion in LM. A control group included 21 providers who participated in a similar musculoskeletal training programme. Pre/post data were collected in both groups of participants' attitudes and self-efficacy to prescribe LM and personal health behaviours. Mid/post feedback was collected in the study group participants. Results Physicians in the LM training represented a nationwide distribution and attended >80% of the programmes' meetings. They reported positive outcomes in most areas after the intervention compared with baseline. Five variables reached statistical significance: potential to motivate patients to improve exercise behaviours (p Conclusions A training programme in LM appears feasible and could have a positive impact on interested family physicians' attitudes and confidence in prescribing LM. Thus, ‘Healthy Israel 2020’ and other programmes worldwide, which aim to improve health behaviours and decrease the impact of chronic diseases, might consider including family physicians training.

Objective The objectives of this study were twofold: to develop and psychometrically test a questionnaire to measure health profession students' knowledge of aging in older adults and to assess comparative professional geriatric knowledge in pharmacy, nursing, and physician assistant (PA) students. Design An interdisciplinary team of faculty with clinical geriatric expertise and experience in item scale development designed a scale, termed the Geriatric Knowledge Assessment Scale (GKAS), to measure health profession students' geriatric knowledge in the areas of aging disease, physical activity, drug therapy, and nutrition. Upon development of the scale, the psychometric properties of the GKAS were analyzed. The tool was administered to pharmacy, nursing, and PA students in the final semester of their professional education programs. Results A total of 412 students participated in the test and 408 completed the questionnaire with health profession responses as follows: pharmacy students ( n = 159), nursing students ( n = 162), and PA students ( n = 87). PA students scored at a significantly higher level on the GKAS than both pharmacy and nursing students ( p p = 0.05). Overall, 65% of students agreed or strongly agreed on a five-point Likert scale that the gerontological content in their professional education adequately prepared them to address the health care needs of older adults. Conclusion Further research and utilization of the GKAS in geriatric health care education is required. Our findings also support ongoing evaluation of geriatrics education and training within all health professions.

Introduction Sub-optimal nutrition is a leading factor in all-cause mortality, the preponderance of non-communicable chronic diseases, and various health conditions that are treated by physiatrists, such as stroke and musculoske-letal disorders. Furthermore, patients with chronic pain have a high prevalence of nutritional deficiencies, and malnutrition has been associated with limited rehabilitation outcomes in elderly patients with hospital-associated deconditioning. Thus, physiatrists may find it valuable to include nutrition in their patient services. However, discussion of nutritional counselling in the physiatry literature is rare. Objective To inform physiatrists about including nutritional counselling as part of the treatment they provide. Methods The paper reviews recommended communication skills, behavioural change strategies, and opportunities for inter-professional collaboration. Further resources to educate physiatrists both in nutritional prescription and in improving their own personal health behaviours are provided. Conclusion Training physiatrists to address nutrition is a step-wise process, described here.

There is a need for effective continuing medical education (CME) programs to increase healthcare providers' knowledge and skills in lifestyle medicine so that healthcare providers are better equipped to assist patients in adopting and maintaining healthier lifestyle behaviors.To evaluate the impact of five live face-to-face CME programs in lifestyle medicine on providers' barriers, knowledge, confidence, and professional counseling behaviors.200 participants completed researcher-generated surveys before and 90 days after each CME program. Paired t-tests measured significant changes for all outcome variables, and regression analyses assessed predictors of these changes.Barriers that were targeted during the programs, i.e. lack of knowledge/skills, lack of materials, and perceived poor patient compliance showed highly significant improvement. Participants also reported significant changes in knowledge, confidence, and counseling behaviors in the areas of exercise and stress management. Some improvements occurred in areas that the CME programs did not target as much, i.e. nutrition, smoking, and weight management. The greatest predictor of change was the baseline level of scores. Those participants who could most benefit from change did show the largest improvements.Live CME programs can be effective in educating healthcare providers about topics within the rapidly expanding field of lifestyle medicine.

Recognizing the importance of interprofessional education, we developed a pilot interprofessional education course at our institution that included a total of 10 nursing, BS health psychology, premedical, and pharmacy students. Course goals were for students to: 1) learn about, practice, and enhance their skills as members of an interprofessional team, and 2) create and deliver a community-based service-learning program to help prevent or slow the progression of cardiovascular disease in older adults. Teaching methods included lecture, role-play, case studies, peer editing, oral and poster presentation, and discussion. Interprofessional student teams created and delivered two different health promotion programs at an older adult care facility. Despite barriers such as scheduling conflicts and various educational experiences, this course enabled students to gain greater respect for the contributions of other professions and made them more patient centered. In addition, inter-professional student teams positively influenced the health attitudes and behaviors of the older adults whom they encountered.

Objective To determine the prevalence of eating disorders in a sample of infertile women. Design A descriptive comparative two-group design in which collected data were compared with a published community sample. Setting Private infertility center. Patient(s) Eighty-two participants beginning their first gonadotropin/intrauterine insemination (IUI) treatment cycle completed self-report measures that assessed eating disorder pathology and exercise habits. Each subject was telephone-administered the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) Module H (Eating Disorders) and a demographic questionnaire. Intervention(s) None. Main Outcome Measure(s) Past or current diagnosis of an eating disorder. Result(s) Seventeen participants (20.7%) met criteria for a past or current eating disorder, which is five times higher than the U.S. lifetime prevalence rate. None of the participants who met the criteria for an eating disorder had disclosed their past or current diagnosis to their reproductive endocrinologist. Conclusion(s) Infertility clinics are likely to be treating women with a past or current eating disorder history. Therefore, an eating disorder screening tool should be included in the initial intake, because these patients may be at a higher risk for negative maternal and fetal outcomes than non–eating disorder patients. Additionally, patients with a past or current eating disorder may not disclose this information to reproductive health care providers, which may limit providers' ability to provide appropriate medical and psychologic referrals.

Unhealthy nutrition is a leading factor in various rehabilitation diagnoses such as stroke and several musculoskeletal complications. Further, the association between nutrition, pain management, and brain plasticity support the importance of having rehabilitation patients follow healthy nutrition guidelines. The goal of this brief report is to emphasize the importance of nutritional counseling to physiatrists and to briefly describe recommended communication skills, behavioral change strategies, and opportunities for interprofessional collaborations. Potential next steps aimed at prescribing nutrition within physiatry clinics are provided. Incorporating healthy nutrition in the physiatrist's personal and professional life presents an opportunity for a meaningful change. Physiatrists can lead the way one bite at a time. The time for a healthy approach to food is now.

Strategies for exercise maintenance of vigorous (n=54) and moderate (n=38) regular women exercisers were compared using the Processes of Change (Marcus, Rossi et al., 1992) and Self-Efficacy scales (Marcus, Selby et al., 1992). Both groups reported highest utilization of Counterconditioning, Self-liberation, Self-reevaluation, and Reinforcement Management, as well as a high degree of exercise self-efficacy. Vigorous exercisers indicated greater utilization of Counterconditioning (p=.004) and a higher degree of self-efficacy (p=.009), whereas moderate exercisers reported higher utilization of Environmental Reevaluation (p=.028). In follow-up interviews with vigorous exercisers (n=4) and moderate exercisers (n=4), all participants reported psychological benefits of physical activity, high exercise self-efficacy, and exercising to meet personal needs. Reported differences between the two groups include physical experiences while exercising, the development of exercise behavior patterns, and social influences. Based upon this study we suggest that similarities outweigh differences in the maintenance of vigorous and moderate exercise, but certain mode-specific interventions may be warranted to enhance adherence.

Background The emerging field, Lifestyle Medicine (LM), is the evidence-based practice of assisting individuals and families to adopt and sustain behaviors that can improve health. While competencies for LM education have been defined, and undergraduate curricula have been published, there are no published reports that address graduate level fellowship in LM. This paper describes the process of planning a LM fellowship curriculum at a major, academic teaching institution. Methods In September 2012 Harvard Medical School Department of Physical Medicine and Rehabilitation approved a “Research Fellowship in Lifestyle Medicine”. A Likert scale questionnaire was created and disseminated to forty LM stakeholders worldwide, which measured perceived relative importance of six domains and eight educational experiences to include in a one-year LM fellowship. Statistical procedures included analysis of variance and the Wilcoxon signed-rank test. Results Thirty-five stakeholders (87.5%) completed the survey. All domains except smoking cessation were graded at 4 or 5 by at least 85% of the respondents. After excluding smoking cessation, nutrition, physical activity, behavioral change techniques, stress resiliency, and personal health behaviors were rated as equally important components of a LM fellowship curriculum (average M = 4.69, SD = 0.15, p = 0.12). All educational experiences, with the exception of completing certification programs, research experience and fund raising, were graded at 4 or 5 by at least 82% of the responders. The remaining educational experiences, i.e. clinical practice, teaching physicians and medical students, teaching other health care providers, developing lifestyle interventions and developing health promotion programs were ranked as equally important in a LM fellowship program (average M = 4.23, SD = 0.11, p = 0.07). Conclusions Lifestyle fellowship curricula components were defined based on LM stakeholders’ input. These domains and educational experiences represent the range of competencies previously noted as important in the practice of LM. As the foundation of an inaugural physician fellowship, they inform the educational objectives and future evaluation of this fellowship.

To examine how motives discriminate 3 physical activity levels of inactive, active, and sustained maintainers.Six hundred forty-five adults (M age = 63.8) completed stage-of-change and Exercise Motivations Inventory (EMI-2) scales. Exploratory factor analysis established psychometric properties of the EMI-2 suitable for older adults.Six factors emerged in the EMI-2: health and fitness, social/emotional benefits, weight management, stress management, enjoyment, and appearance. Enjoyment contributed most to differentiating activity levels. Moderators of age and gender were delineated.Intrinsic motivation and self-determined extrinsic motivation distinguish older adults' activity levels.