The Design and Impact of a Clinic-Based Community Program on Food Insecurity, Healthy Eating Behaviors, and Mood.

Food insecurity is a national issue that disproportionately impacts Louisiana citizens, contributing to the state's poor health outcomes. We know that the Supplemental Nutrition Assistance Program (SNAP) and food pantries improve access to food, but we have limited data on what interventions improve food insecurity. The Geaux Get Healthy Clinical Program at Our Lady of the Lake (GGHOLOL) is a clinic-based community program that leverages community partnerships and a clinical setting to provide education and access to resources for individuals with food insecurity. This prospective study examines the impact of GGHOLOL on food insecurity as a pre-post survey evaluation over a two-year period. A total of 57 research participants with food insecurity completed the program. Mean food security scores improved at completion of GGHOLOL, and these scores further improved 6 months after enrollment. Furthermore, participants demonstrated sustainable improvements in healthy eating, cooking, and shopping behaviors. Lastly, participants improved their overall depression scores at the completion of the program with sustainable improvement at 6 months. With the improvement in GGHOLOL on food insecurity and nutrition behaviors, GGHOLOL may serve as a model for other programs addressing food insecurity in the future.

Integrating Problem-Based Learning Into an Internal Medicine Residency Curriculum.

Background: Problem-based learning (PBL) is a form of constructivist learning that allows learners to use higher order thinking by promoting learners to construct their own knowledge and understanding. PBL is prevalent in medical school education, but literature on PBL in graduate medical education (GME) is lacking. Because of the limited amount of data on PBL curricula in GME and the need for young physicians to develop critical thinking, lifelong self-directed learning, and problem-solving skills, we sought to incorporate PBL into the curriculum for our internal medicine residency program in a university-based community hospital setting. Methods: The PBL committee created 4 cases derived from actual patient encounters that address common chief complaints encountered in the hospital and served as a crash course curriculum for interns in internal medicine. The success of the PBL curriculum was measured using a 39-question survey created by PBL leadership to assess the learners' satisfaction with case content, likeability/design, feasibility, effectiveness, and motivation/self-learning. Additional questions asked for ways to improve PBL sessions in the future. Results: Overall, interns felt the content was clinically relevant, challenged them to think critically, and aided in the medical management of their patients. They also found PBL to be more effective and more enjoyable than the traditional lecture-style curriculum. Conclusion: Implementing a PBL curriculum in a residency program is possible. Although PBL has associated challenges such as scheduling, it is well received when supported by the program.

Effectiveness of a Patient-Centered Dietary Educational Intervention.

Background: A healthy diet is an important component of preventive medicine. With the changing landscape of medicine, physicians are encountering more challenges in educating patients about a healthy diet, so finding innovative ways to educate patients is imperative. This study investigated the effectiveness of an innovative educational intervention based on the United States Department of Agriculture-recommended MyPlate diet. Methods: Based on the assessed need for dietary education, patients were exposed to an educational video and received a handout on the MyPlate diet. The educational video was created to be culturally relevant with patient-informed edits. The handout was taken from www.ChooseMyPlate.gov. The patients who received the intervention were compared to those who were not exposed to the intervention. Data were collected in a primary care clinic for an underserved population in fall 2018 and analyzed in spring 2019 through patient-completed surveys and physician reporting on patient interactions. Data were analyzed using descriptive statistics, t tests, chi-squared models, and repeated measures analysis of variance. Results: Among 320 patients, 169 patients were exposed to the educational intervention. Intervention patients had better knowledge of the MyPlate diet (P=0.009), felt it would be easier to change their diet (P=0.03), and were more motivated to have conversations about diet with their physician (P=0.04) compared to those who were not exposed. Patients also enjoyed the video overall. Conclusion: This study shows that using multiple modalities including a patient-centered video and handouts to educate patients about diet is enjoyable to patients and effective in teaching, motivating change, and encouraging communication between patients and physicians.