Introduction: Lifestyle medicine focuses on six key behaviors (physical activity, plant-forward eating, sleep, avoiding risky substances, social connection, and stress management) to prevent and treat chronic disease like cardiovascular (CV) disease. However, integrating lifestyle medicine into cardiology clinics can be difficult due to lack of infrastructure for sustained behavior change support. Hypothesis: We hypothesized that the HeartBeet Clinic lifestyle medicine intervention could be feasibly delivered via virtual groups or a self-paced online course. Methods: This randomized pilot feasibility trial enrolled 60 adults with at least one CV risk factor from a preventive cardiology clinic within a large integrated health system. Participants (62% female, 33% male, 5% other gender; M age = 54.1 years, SD = 11.7; 82% White, 10% Black, 8% other race) were randomized to either a virtual group-based program or a self-paced online course. Both programs lasted 16 weeks and covered the six pillars of lifestyle medicine. In the group-based program, participants initially had a group visit with a cardiology physician assistant, followed by weekly virtual small-group meetings with a health coach. The self-paced group accessed the same educational content online. Pre- and post-intervention assessments included vitals (blood pressure, weight), laboratory measures (glucose and lipids), and surveys of lifestyle behaviors. Feasibility was evaluated through retention and intervention completion rates. Intervention plausibility was assessed using the Life’s Essential 8 (LE8) CV health measure (scale 0-100) and by determining whether individual risk factors improved to a clinically significant degree. Results: Retention rates were similar between the self-paced course and the group-based program (87% v. 77%, p = .32). In the self-paced program, 57% fully and 17% partially completed the online course. In the group-based program, 70% attended at least half of the sessions. Both groups showed comparable improvements in CV health scores (LE8 mean change: group = 6.6 units; self-paced = 7.2 units) over 16 weeks, with >80% improving at least one risk factor to a clinically significant degree. Conclusions: Delivering the HeartBeet Clinic through both virtual group and self-paced formats was feasible and associated with meaningful improvements in CV health. Future studies could consider tailoring delivery methods or adopting a stepped-care approach for optimal resource use.
Stephanie Hooker (Tue,) studied this question.