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ALTERNATIVETHERAPIESjulaug2011VOL.17NO.439markersfordiseaserisk.Furthermorerecentstudieshaveshownthatalternativeapproachestostressreductionsuchasyoga1718andmeditation19-21canlikewiseinEuencechronicdiseaserisk.Researchhasshownthatimprovinghealthbehaviorscanleadtoimprove-mentinoverallhealthandwell-beinghoweverindividualsdesir-ingtobettertheirhealthoftenfaceobstacleswhenitcomestoinitiatingandmaintainingchangesinbehavior.Anintegrativehealthmodelmayhelpovercomethesehurdlesthroughsupport-ivepatientpartnershipsthatfocusonidentifyingandimplement-inglifestylechangesbaseduponpersonalvaluesandgoals.Integrativehealthprofessionalstrainedincoachingcansupportandpromotethisprocessbybuildingtrustingrelationshipswithpatientsthatencouragepersonalgrowthenhancemotivationandpromoteself-efDcacy.22Therehasbeenonlylimitedinvestigationintotheeffectivenessofapatient-centeredprogramthatcombinesmultiplestrategiesintoawhole-personparadigmfordiseaseriskreduction.2324Accordinglytheaimofthecurrentstudywastoevaluatepatientoutcomesfromanintegrativehealthprogramdesignedtoprovideholisticpatient-centeredcareandincorporateconventionalandcomplementarymedicineapproachesforthereductionofchronicdiseaserisk.METHODSStudyx0Designx0AprospectiveobservationalstudydesignwasusedtoassesschangesinmodiDablediseaseriskpatientactivationandbehavior-alandpsychosocialmeasuresafteranintegrativemedicinehealthprogram.Thisprogramincludedtwoprincipalcomponentsa3-dayhealthimmersionphaseconductedatanacademicintegra-tivemedicinefacilityandasupportphaseconsistingoftelephonichealthcoachingandmonthlydidacticsessionsonhealthtopics.TheresearchprotocolwasapprovalbytheDukeUniversityMedicalCenterInstitutionalReviewBoard.ParticipantsParticipantsincluded63individuals33maleand30femalewhoprovidedwritteninformedconsentandattendedadiscountedself-paid3-dayhealthimmersionprogramatDukeIntegrativeMedicine.ParticipationwaslimitedtomembersandemployeesofanearlyretirementcommunityinSouthCarolinaallliterateinEnglishand18yearsofageorolder.IndividualswereexcludediftheywerepregnanthadseverepsychiatricdiseaseacognitiveimpairmentegdementiaAlzheimerx19sdiseaseorothercondi-tionsthatwouldlimittheirabilitytoprovideinformedconsent.Interventionx0Phasex0Ix03-dayx0Healthx0Immersion.Duringthehealthimmer-sionparticipantsspent3daysattheIntegrativeMedicinecenterparticipatinginavarietyofconventionalandcomplementarythera-piesincludingnutritionalcounselingacupuncturemassageexer-cisetrainingyogaandmind-bodytherapyTable1.ClassesandindividualconsultationsfocusedontopicsidentiDedontheDukeIntegrativeMedicineIMWheelofHealthFigure1.25Thismodelcentersonmindfulnessandincludestopicsrelatedtobothprofes-sionalcareegpharmaceuticalssupplementspreventivemedi-cineandconventionalCAMtreatmentsandself-careegmind-bodyconnectionmovementexercisenutritionphysicalenvironmentrelationshipsandpersonalgrowthspirituality.Ateamofhealthcareprovidersworkedwitheachparticipantindivid-uallytodevelopapersonalizedhealthplan26correspondingtothe10integralareasofhealthidentiDedontheWheelofHealthFigure1.Duringthe3daysparticipantsalsometwithhealthcoachestoreEectonpersonalgoalsandvaluesaswellastoreDneandimple-mentthehealthplan.Thusbytheendoftheimmersionpartici-pantshadestablishedacomprehensivemultimodalplanforimplementinglifestylechanges.Phasex0IIx0Supportx0Phase.Aftercompletingthehealthimmer-sionparticipantswereprovidedwithfollow-upintegrativehealthcoachingIHCbytelephone.IHCisarelativelyrecentadditiontotheDeldofcoaching.22TheIHCmodelbuildsuponelementsoflifecoachingsuchasappreciativeinquiry27andmotivationalinterview-ing28andinadditionhelpspatientsexploremotivationtomovetowardwhole-personhealthasconceptualizedbytheWheelofHealthFigure1.SpeciDcallyIHCstrivestolinkdesiredlifestylechangeswithpersonalvaluesandmission.Masters-levelprofessionalstrainedinIHCperformedtheDiseaseRiskImprovesWithIntegrativeImmersionModelTABLE1DukeIntegrativeMedicineThree-dayHealthImmersionProgram1.IntroductiontoIntegrativeMedicineinformationontheThree-dayHealthImmersionprogramdescriptionofpersonalizedhealthplanningandexplanationoftheDukeIntegrativeMedicineWheelofHealth2.IndividualintegrativephysicianconsultationsNewpatientconsultationonday180minFollow-upconsultationonday330min3.HealthcoachingThreegroupcoachingsessions50mineachoroneindividualcoachingsessionviaphone90min4.IndividualDtnessassessment60min5.IndividualmanualtherapiesAcupunctureoracupressure60minMassage60min6.GroupmovementclassesYoga60minQigong60min7.NutritionconsultationandeducationIndividualintegrativenutritionconsultwithregistereddietician60minNutritionclassInSearchoftheOptimalDiet60min8.Healthfulcookingclass60min9.Individualmindbodyconsultation60min10.GroupmindfulnessclassesIntroductiontomindfulness-basedmeditation60minMindful-eatinglunch60min11.ProgramconclusionandDnalreEectiongroupsettingAllsubjectsparticipatedintheabovehealth-relatedactivitiesduringa3-dayperiodbetweenJanuaryandMarch2008.