ABSTRACT
Introduction Inflammatory Bowel Disease (IBD) homes have been shown in academic settings to improve patient outcomes and decrease health care utilization, resulting in an overall improvement in healthcare quality. Scarce information is available demonstrating their utility in a community practice setting where economic drivers and available resources may differ significantly from academic institutions. The value of these integrated care model homes is often achieved by implementing basic health maintenance initiatives that are lacking with traditional care, which is largely focused on primary disease management. This study seeks to define the baseline compliance of required health maintenance screenings and vaccinations in patients enrolled in a community based IBD Home. Methods We conducted a retrospective analysis of IBD patients enrolling in the IBD Home program of a large community based practice from January 2021 to January 2022. The multidisciplinary team comprised of a gastroenterologist, physician's assistant, dietician, nurse and social worker. No specific education was provided regarding health maintenance requirements to collect baseline compliance. Data collection included patient compliance with bone density scans, dermatologic exams, annual pap smears and receipt of pneumonia, Hepatitis A, Hepatitis B, influenza, and COVID -19 vaccines. Results There were 51 IBD patients enrolled in the IBD Home program with 63% female. of the total cohort, 100% of patients lacked in one or more of the recommended health maintenance guidelines. Specifically, only 27% were current with bone density scans, 29% with routine dermatologic screening, and 16% with PAP smears (HPV vaccination status unknown). Regarding vaccinations, 78% had received influenza, 33% pneumonia, 27% hepatitis A, 43% hepatitis B and 60% for Covid 19 (two doses). Conclusions The analysis of these elements provided key insights into the factors contributing to the low levels of health maintenance compliance noted in these IBD patients. Many community-based gastroenterologists refer patients to their primary care physicians who are not aware of the specific IBD health maintenance guidelines. Further, many gastroenterologists educate patients about the guidelines but lack mechanisms to easily implement the recommendations and to closely monitor patient compliance. Enrolling patients into an integrated IBD medical home provides the resources needed to facilitate heath maintenance issues, although our study illustrates a need to intervene further to effectively impact compliance.
ABSTRACT
Background: Due to the rising number of positive COVID-19 cases in the US, a national emergency was declared on March 13, 2020, and Tarrant County issued a stay-at- home order on March 24, 2020 to limit the spread of the new novel virus. The purpose of this study was to assess lifestyle changes across various categories of nutrition knowledge and BMI classifications in response to the global pandemic. Methods: For this mixed-methods cross-sectional study, 150 undergraduate students (n = 75 had not taken a nutrition class;n = 75 taken at least 1 nutrition class, mean age 20.8 ± 4.1yrs) completed a 59-question survey (∼29.9 ± 121.0min). The survey was adapted from the validated, shortened version of REAPS (Rapid Eating Assessment for Participants) and PLifeCOVID-19, and it included two open-ended questions. Results: Majority of participants reported a healthy BMI (56%), while 30% of individuals were overweight. The mean weight change in those who took nutrition classes was 0.55 ± 2.89kg, and the mean change in those with no nutrition classes was 0.65 ± 1.13kg. Of those that completed one or more nutrition class(es), 45% indicated they rarely or never skipped breakfast, alcohol consumption increased by 37% and 12% decreased the amount of moderative activity they were doing. Of those participants who had no nutrition classes, 28% skipped breakfast rarely or never skipped breakfast, alcohol consumption increased in 24% of participants, and 19% reduced the amount of moderate activity they were doing. Conclusions: The COVID-19 pandemic has differentially impacted health behaviors of college students, some for the better and some for the worse.