title: Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care-A Pilot Feasibility Project.
abstract: BACKGROUND
  Diseases linked to obesity such as cardiovascular disease, diabetes, degenerative joint disease, gastroesophageal reflux, and sleep apnea constitute a large portion of primary care visits. Patients with these conditions often lack knowledge, skills, and support needed to maintain health. Shared medical appointments (SMAs) that include culinary skills and nutrition education offer a novel, cost-effective way to address these diseases in primary care.
  
  
  METHODS
  Adult patients in a primary care practice at a large academic hospital in Boston, Massachusetts, who had at least 1 cardiovascular risk factor were invited to participate in SMAs that included cooking demonstrations and teaching about nutrition in addition to medical management of their conditions. Sessions were conducted by a physician and an assistant in a conference room of a traditional primary care practice as part of a pilot feasibility project.
  
  
  RESULTS
  Seventy patients, contributing a total of 156 patient visits, attended 17 nutrition-focused SMAs over a 4-year period. Patients were surveyed after each visit and indicated that they enjoyed the SMAs, would consider alternating SMAs with traditional one-on-one visits, and would recommend SMAs to others. Half would pay out of pocket or a higher copay to attend SMAs. Financially, the practice broke even compared with traditional one-onone office visits.
  
  
  CONCLUSIONS
  In this feasibility study, chronic disease SMAs conducted with a culinary/nutrition focus were feasible, cost-effective, and well received by patients. Follow-up studies are needed to evaluate short- and long-term outcomes of this SMA model on obesity-related diseases.
authors.affiliation: Massachusetts General Hospital and Harvard Medical School, Boston (Dr Delichatsios), United States.
authors.forename: Helen K
authors.initials: HK
authors.lastname: Delichatsios
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, and San Mateo Medical Center, Fair Oaks Health Center, Redwood City, California (Dr Hauser), United States.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Hauser
authors.affiliation: Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire (Mr Burgess), United States.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Burgess
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts (Dr Eisenberg), United States.
authors.forename: David M
authors.initials: DM
authors.lastname: Eisenberg
keywords: Shared medical appointments; culinary education; nutrition; pilot study