Group medical visit innovations improve access & advance integrative heath equity

Group medical visits are exceptional methods delivering critical components of integrative health care for treating and reducing the risk of a wide variety of chronic diseases, particularly in underserved populations. A Special Focus Issue on Innovation in Group-Delivered Services is published in JACM (The Journal of Alternative and Complementary Medicine), a peer-reviewed publication from Mary Ann Liebert, Inc., publishers, dedicated to paradigm, practice, and policy advancing integrative health.

The Special Issue was developed in partnership with Integrative Medicine for the Underserved (IM4US) and Centering Healthcare Institute. The issue was led by Guest Editors Paula Gardiner, MD, MPH, University of Massachusetts Medical School (Worcester), Maria Chao, DrPH, MPA, University of California San Francisco, and Marena Burnett, Centering Healthcare Institute (Boston, MA).

The Special Issue on Innovation in Group-Delivered Services includes two editorials, four commentaries, a systematic review and eight original research articles. The broad diversity of contexts that are conducive to review are featured, from applications in federally qualified health centers to integrative oncology, and with themes ranging from the growing movement for community acupuncture to a commentary exploring the special ingredient that group brings.

A broad-sweeping review by Gardiner and colleagues from University of Massachusetts Medical School and Boston Medical Center includes in-depth data from 55 unique published studies on the characteristics of medical group visits for multiple chronic health conditions. Integrative modalities are well-represented components with mindfulness, meditation, and yoga being the most common. Detailed findings are published in the article entitled "Characteristics and Components of Medical Group Visits for Chronic Health Conditions: A Systematic Scoping Review."

Researchers Inger Burnett-Zeigler et al., from Feinberg School of Medicine, Northwestern University (Chicago, IL), coauthored the article "A Mindfulness-Based Intervention for Low-Income African American Women with Depressive Symptoms Delivered by an Experienced Instructor Versus a Novice Instructor." They describe a streamlined protocol for training staff at federally qualified health centers to provide mindfulness to patients and compare outcomes in groups led by an experienced instructor or an instructor who underwent streamlined training. They reported comparable positive outcomes on measures of depressive symptoms, stress, functioning, and well-being.

Can teaching kitchens be used to deliver an effective lifestyle program as part of shared medical appointments? The feasibility of this approach was the focus of an article by Theresa Stone, MD, et al. entitled "Fresh and Savory: Integrating Teaching Kitchens with Shared Medical Appointments." In this study, the teaching kitchen complemented other modalities, including physician consultations and mind-body exercises. Their findings led the researchers to suggest what such a weekly program could achieve to improve patient health and chronic disease risk.

Guest Editor Chao notes that "our editorial team was struck by the heterogeneity of integrative group visits for a range of health conditions, serving diverse patients across the life course and implemented in varied healthcare settings. A unifying theme is the potential for integrative group visits to address unmet needs of underserved and vulnerable patients. In many ways, group visits serve as a critical model towards integrative health equity."

JACM Editor-in-Chief John Weeks, johnweeks-integrator.com, Seattle, WA, states: "The fit of the group delivery model with addressing both what ails us as a people and how adults learn and change provokes wonder—as I do in my editorial—whether a reformed healthcare system will be characterized by putting group services closer to the center rather than the periphery of care planning."