Spotlight On: Lifestyle SMAs

How can I change my lifestyle to be more heart healthy?

If you’ve ever tried to change a habit, you know how difficult it can be – especially if it relates to your health. This month, we turn to Anne Hedelt, a nurse practitioner with the Club Red Clinic, to learn about a new type of medical appointment designed to help you make changes and stick to them.

Q. What are lifestyle shared medical appointments? How are they different from other shared medical appointments?

A. As the name implies, a lifestyle shared medical appointment (SMA) focuses on modifying your lifestyle to manage or reduce your risk of heart disease. They differ from traditional shared medical appointments, which focus on acute medical needs like managing high blood pressure or high cholesterol with medication. Lifestyle management is also known in the medical journals as therapeutic lifestyle counseling (TLC) and promotes behavior change related to aspects of your health like diet, physical activity, tobacco use, alcohol consumption and maintaining a healthy weight.

Q. What happens in a lifestyle SMA?

A. A lifestyle SMA is similar to a traditional SMA in that it is a 90-minute medical appointment conducted in a group setting where the same confidentiality rules apply. The big difference is that lifestyle SMAs are more interactive. Rather than just talk about exercise, participants actually go to the cardiac rehab gym and work with an exercise physiologist. Participants learn how to progress through a workout, how hard they should exercise, and how best to stretch and strengthen muscles. They also learn about proper posture on the equipment and pace on the treadmill.

We tackle nutrition issues in the same way. We actually look at food labels and talk about what it is you need to do to meet your healthy weight goal. Recently, we made a fruit parfait for a morning appointment and then compared its nutritional make-up to that of a bacon and egg breakfast.

Our goal in a lifestyle SMA is to make behavior changes come to life through real world examples that you can incorporate in your daily routine.

Q. How can I benefit from participating?

A. Lots of ways. Many people understand that they need to live a healthier lifestyle in order to improve their health, but they often get stuck at the point of incorporating change into their daily lives. At a lifestyle SMA, staff members provide tools, encouragement and will help hold you accountable to the personal behavioral goals you set for yourself. That accountability comes in the form of setting goals and keeping track of your progress. At each visit, participants are asked to grade themselves on how they did in sticking to their plan last month. The energy and support of a group is very important in motivating and encouraging each participant.

Q. How often do I need to attend a lifestyle SMA?

A. For weight loss, therapeutic lifestyle counseling works best with monthly visits, research shows. Some patients choose more frequent visits initially to establish the goal-setting and behavior change skills and then reduce the frequency of visits to every other month. It is important to remember that lifestyle change is not short-term and it may take a year to establish new healthy habits. While the process takes time and energy, research shows that it is well worth it. In fact, up to 80% of heart disease can be prevented and 90% of diabetes can be prevented through lifestyle modification alone.

Q. Are they covered by insurance?

A. Yes, shared medical appointments, both traditional and lifestyle, are covered by insurance. The same co-pay applies that you would normally pay when seeing a specialty physician, like a cardiologist. While lifestyle SMAs are focused on behavior change, the provider will address any medical needs that come up, including writing a prescription or scheduling a diagnostic test.