Community-Engaged Lifestyle Medicine: Building Health Equity Through Preventive Medicine Residency Training

Vulnerable populations in the U.S. experience persistent disparities in chronic disease and associated lifestyle-based risk factors. Because of environmental, cultural, and health systems barriers affecting vulnerable populations, lifestyle medicine interventions may miss those at highest risk for chronic disease. Numerous reports suggest that graduate medical education (GME) inadequately prepares physicians to promote healthy lifestyles and health equity in vulnerable groups. General Preventive Medicine/Public Health (GPM/PH), the medical specialty dedicated to health promotion and disease prevention in populations, can fill this gap. However, virtually no published reports describe health equity-oriented GPM/PH residency programs. The authors describe implementation of the novel Community-Engaged Lifestyle Medicine at the University of Texas Rio Grande Valley GPM/PH residency program between 2017 and 2018. Community-Engaged Lifestyle Medicine applies community engagement principles to lifestyle medicine practice, training residents in multilevel, intersectoral approaches promoting behavior change and health equity. Community-Engaged Lifestyle Medicine is described in the context of health equity and the local border community, along with associated curricular objectives and experiences. In 2017, the authors assessed first-year Community-Engaged Lifestyle Medicine process outcomes, fidelity to health equity mechanisms, and feasibility in a GPM/PH residency, by mapping Community-Engaged Lifestyle Medicine activities to American Council of Graduate Medical Education and the American College of Lifestyle Medicine competencies. The Community-Engaged Lifestyle Medicine framework was successfully implemented in 2017, meets all American Council of Graduate Medical Education competency domains, and demonstrates fidelity to mechanisms of community engagement, health equity, and the practice of lifestyle medicine. Community-Engaged Lifestyle Medicine represents a feasible and valid framework to promote health equity via GPM/PH and GME training and practice. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.