Wellness and prevention activities play a critical role in a patient’s overall health, shifting the focus from reactive “sick care” to proactive health management. Factors like healthy eating and exercise can help patients manage chronic conditions, help them feel better, and enable them to live longer, healthier lives.
For several years, Butler Health System (BHS), a health system with hospitals in Butler and Clarion County, Pennsylvania, has offered an evidence-based Lifestyle Coaching (LC) program to the rural communities it serves. The program’s classes help patients, community members, and BHS employees prevent and manage diseases like hypertension, diabetes, and heart disease.
“Butler’s LC program touches over 1,000 lives annually,” said Patti Kuniak, RD, LDN, Lifestyle Coaching program manager. Kuniak shared how BHS transformed the program from an in-person model to a virtual experience, then to a hybrid format that combines the best of both worlds and allows her team to meet patients where they are — at home or in person.
Q: How did the COVID-19 pandemic change the program experience?
Kuniak: Prior to COVID-19, the LC program was solely in-person. We covered many rural communities and traveled to various sites to provide instruction and cooking demos.
Starting in March 2020, in-person delivery was no longer an option and we converted all programming to virtual sessions via Zoom. The downside is that we lost the ability to conduct cooking demos and taste healthy food, which was an important aspect of “buy-in” for our participants — healthy food actually tastes great!
When pandemic restrictions loosened, we decided to start a hybrid program, offering in-person cooking demos at various sites before or after hosting the live feed of our seminar or class on Zoom.
Q: What is the impact of this new hybrid approach?
Kuniak: This hybrid approach allows us to use Zoom technology to continue to reach a large geographic area and target in-person cooking demos to reconnect with our clients in person. It provides the best of both worlds, allowing us to engage in person through cooking demos while at the same time offering programs virtually. We are hoping to recapture people that may have been lost to technology with the hybrid classes but reach our larger virtual community at the same time.
Q: What benefits have patients and staff experienced?
Kuniak: Participants like the fact that they don’t have to travel, especially those who are not close to the hospitals where in-person programs were conducted. Participation in rural areas has increased. Our most popular program is likely the ongoing Volumetrics weight management series. We have a large enrollment and this group has really developed into a support group type setting with participants sharing ideas, successes, and struggles.
It has also been beneficial from a staffing perspective as we can now reach many communities over our large geographic area at the same time. We are currently at pre-pandemic levels of participation with fewer staffing hours because staff members don’t need to travel.
Q: What other positive outcomes have you seen as a result of the LC program?
Kuniak: Data collected from participants after completion of our programs show that 98% strongly agree or agree that attending the program was a good use of their time, 100% reported that they would use the information they learned, and 98% strongly agree or agree that they would recommend the program to others.
Outcome data for the diabetes and weight management programs identify positive lifestyle changes as a result of attending the program. For example, when asked what foods they ate less of since attending the program, more than 50% of participants indicated they consume fewer sugary desserts, highly processed foods, fatty or fried meats, and high-sodium foods. When asked what foods they ate more of since attending the program, more than 50% said they consumed more fruits, vegetables, whole grains, nuts, and seeds.
Q: What are your plans for further improving or expanding upon the program experience?
Kuniak: Being able to record sessions is becoming increasingly important. A portion of our participants are hospital employees who work shifts and are requesting recorded programs, and many participants want the convenience of on-demand content. We may add additional course offerings via Zoom.
Q: What format or content do you think contributes to a successful program?
Kuniak: It is helpful that participants can ask questions and we are able to screen share and visit various websites for additional education and resources during our Zoom meetings. We provide a follow-up email with handouts and website links for each seminar.
Q: What advice would you give to other healthcare organizations looking to implement similar virtual or hybrid programs for their patient community?
Kuniak: Start small and build upon your success. I would also recommend collaborating with providers to identify needs and invite participation from experts from within your organization. When I first started, I was the creator and instructor for all content. As the program became more popular, it was easy to recruit other health professionals and pull from existing staff for support. Now, we have health professionals throughout our organization who support our programs – a physician assistant, diabetes care and education specialist, registered dietitian, and social worker team up for our diabetes LC series, a physical therapist teaches our Reducing Barriers to Physical Activity seminar, and so on.