The Design and Implementation of a Weight Management Program in Underserved Communities: A Medical Student-Led Initiative

Margaret Koester; Lauren Hucko; Laila Elias; Rebecca Shakour; Dayana Hano; Erin Marcus; Gisela Alvarez; Shirin Shafazand

doi:10.59586/jsrc.v11i1.469

Margaret Koester, MD, MPH University of Miami
Lauren Hucko, MD, MPH University of Miami
Laila Elias, MD, MPH University of Miami
Rebecca Shakour, MD, MPH University of Miami
Dayana Hano, MD, MPH University of Miami
Erin Marcus, MD, MPH University of Miami
Gisela Alvarez, RDN, LDN Jackson Health System
Shirin Shafazand, MD, MS University of Miami

DOI: https://doi.org/10.59586/jsrc.v11i1.469

Keywords: diabetes mellitus, obesity, program evaluation, patient education

Abstract

Background: Lifestyle change programs, like the Diabetes Prevention Program (DPP), are successful at addressing obesity and related comorbidities; however, they are often inaccessible. We describe our experience developing and implementing Healthier Together (HT), a medical student-led condensed adaptation of the DPP designed for low-income adults within Miami.

Methods: Participants, both English- and Spanish-speaking, are referred via various community partners to participate in the year-long program. Run by medical students as Lifestyle Coaches (LC), participants attend an initial 1:1 interview with their LC, six, group-based, nutrition and activity sessions, a 1:1 exit interview, followed by one year of monthly phone check-ins. Metrics such as weight, blood pressure, attendance, pre- and post-lesson quiz scores, and four standardized surveys are measured throughout the program. A 22-question Knowledge Attainment Survey measured medical student nutrition knowledge and feelings of self-efficacy with patient interactions gained through leading the program.

Results: From 2020-2023, HT has completed five cohorts consisting of 23 1:1 interviews, 17 enrolled individuals, and 17 exit interviews among 45 participant referrals, with 20 additional referrals for future cohorts. The mean attendance rate across was 70%. Overall mean program satisfaction was a 5 ± 0 (1=very dissatisfied, 5=very satisfied) (n=8). Eleven medical students have led the program, with a mean of 14 ± 3 hours of hands-on experience. Medical student Knowledge Attainment mean score increased from 61% to 81%.

Conclusions: The implementation of HT demonstrates the feasibility of a medical student adaptation of the DPP for both community members and medical student facilitators.