Efficacy of the Doctor Interactive Group Medical Appointment : examining patient behavioral and attitudinal changes attributed to an integrated healthcare model

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Title: Efficacy of the Doctor Interactive Group Medical Appointment : examining patient behavioral and attitudinal changes attributed to an integrated healthcare model
Author: Westheimer, Joshua Mark
Abstract: The Doctor Interactive Group Medical Appointment (DIGMA ) is a group health intervention that combines the services of behavioral health and primary care . The DIGMA was first invented by Edward Noffsinger in 1996 , in response to his own difficulties with the overtaxed primary care system at Kaiser Permanente in California (Noffsinger , 1999 ) . Integrating healthcare services in this way has practical implications such as efficient use of resources , treating multiple complaints at once , and beginning to view the mind and body as one (Noffsinger , 1999 ; Engel , 1977 ) . The DIGMA at the Austin Veterans Outpatient Clinic was designed to address the specific needs of veterans with hypertension . It consists of 4 sessions of 1 .5 hours each and addresses such varied topics as exercise , stress -management , nutrition , and medication adherence . These topics are discussed in a group format with the tenets of group psychotherapy (Yalom & Leszcz , 2005 ) as a backdrop . An exploratory study was warranted to determine whether programs of this sort would be effective on a broad scale . A pretest /posttest design was utilized to determine if the DIGMA was effective at reducing symptoms of hypertension ; improving health promoting behavior ; increasing self -efficacy to manage hypertension ; and increasing internal health locus of control while decreasing chance and powerful others health locus of control . Groups were conducted over a period of seven months with a total of 73 male veterans enrolled in the study . The final n was 58 . Findings indicated that both systolic and diastolic blood pressure readings were reduced significantly from pretest to posttest . Health promoting behavior increased significantly ; hypertension self efficacy increased significantly ; and locus of control did not change significantly from pretest to posttest . The exploratory study concluded that the DIGMA may be efficacious for a variety of aspects of the management of hypertension . It is suggested that further research be conducted but that integrating services in this way can lead to improved patient outcomes and can also be cost -effective .
URI: http : / /hdl .handle .net /2152 /6821
Date: 2010-01-13

Citation

Efficacy of the Doctor Interactive Group Medical Appointment : examining patient behavioral and attitudinal changes attributed to an integrated healthcare model. Doctoral dissertation, The University of Texas at Austin. Available electronically from http : / /hdl .handle .net /2152 /6821 .

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