Applying a Medical Wellness Group Visit Model to a Community Setting Yielding Weight Loss and Improved Laboratory Results

Abstract

Purpose: To determine the feasibility of applying a medical wellness group (WG) model to a community setting to improve cardiometabolic health. Design: This quasi-experiment was designed to compare individuals participating in the WG to participants in the control group who received general lectures on nutrition, physical activity, and sleep. Setting: A suburb north of Boston, Massachusetts. Participants: Forty-five adults were in the WG and 10 in the control group. Intervention: Fourteen weekly 90-minute sessions, led by a physician and dietitian, focusing on nutrition, physical activity, and sleep, compared to controls receiving two 30-minute general wellness lectures provided within 3 months. Measures: Pre- and postweight, waist circumference, hemoglobin A1C (HbA1c), and serum lipids; a survey measuring beliefs, attitudes, and intentions related to behavioral change. Analysis: T tests examined the mean change in biometric measurements. The Wilcoxon test was used to compare the ordinal questions in baseline and final survey results. The Mann-Whitney test was used to compare final survey results between groups. Results: The WG demonstrated desirable difference-in-difference between groups in weight ( P < .001), waist circumference ( P < .001), and total cholesterol ( P = .03) compared to the control group. Mean change of HbA1c and triglycerides was not different between groups. Survey results showed that attitudes, perceived behavioral control, and feeling supported about wellness behaviors significantly improved from baseline to final visit in the WG ( P = .002; P = .019, P = .006, respectively), but not among controls. Conclusion: Wellness groups are feasible and provide high levels of support and accountability that empower people to make behavioral changes to improve health.