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Lifestyle Medicine

Competencies
  • Lifestyle Medicine Home Page




    This Lifestyle Medicine introductory course provides a foundation of theoretical and practical knowledge and skills, as well as an opportunity to plan strategies and practice techniques for assisting patients with positive health behavior changes. All parts of this training are free, including registration, learning, testing, and a certificate of completion. This course is intended for primary-care physicians, nurses, and allied health professionals in training and in practice.

    This Lifestyle Medicine course was developed in partnership with Bar-Ilan University, the Brookfield Centre for Lifestyle Medicine, the European Lifestyle Medicine Organization, the Institute of Lifestyle Medicine at Harvard, the Israeli Society of Family Medicine - Lifestyle Medicine Section, the Lifestyle Medical Education Collaborative, and the USC School of Medicine Greenville.  Like all NextGenU.org courses, the course is competency-based; this course utilizes competencies from the Lifestyle Medicine Program Curriculum Outline of the American College of Lifestyle Medicine and the Israeli Society of Family Medicine - Lifestyle Medicine Section. In addition, the Lifestyle Medicine course uses resources from accredited world-class organizations, including the American College of Lifestyle Medicine, the American College of Preventive Medicine, the American College of Sports Medicine, the U.S. Centers for Disease Control and Prevention, the U.S. National Institutes of Health, and the World Health Organization. The course developer is Lilach Malatskey, MD, MHA, Chairman of the Israeli Society of Lifestyle Medicine of the Family Physicians Association, who received substantial input from the Executive Members of the Israeli Society of Family Medicine, Lifestyle Medicine Section. Significant feedback was also received from our Advisory Group members, Ioannis Arkadianos, MD; Erica Frank, MD, MPH; Ioan Hanes, MD; Jenny Lee, MD, PhD, MPH; Dr. Ifeoma Monye, MBBS, DCH, DFFP, DRCOG, FRCGP;  Edward M. Phillips, MD; Verena Rossa-Roccor, MD; Mary Rudolf, MB, BS, BSc, FRCPCH, FAAP; Jennifer Trilk, PhD; and Stefania Ubaldi, MD, PhD.

          

    For a publication on this course’s efficacy, see “NextGenU.org’s Free, Globally Available Online Training in Lifestyle Medicine,” (2017), American Journal of Lifestyle Medicine, https://doi.org/10.1177/1559827616682444; see also “Building Public Health Capacity through Online Global Learning,” (2018), Open Praxis, https://openpraxis.org/index.php/OpenPraxis/article/view/746/427; to see more research related to NextGenU.org’s educational model, click on NextGenU.org’s publication page.

    There are two components to this course. 

    The first component involves completing the modules and which provide: 

    • An introduction to the principles of lifestyle medicine, and an understanding of the effects of physical activity, nutrition, sleep, stress, and sexuality on health; 
    • Overviews of smoking cessation and alcohol use disorders; 
    • Skills to develop and implement action plans for lifestyle medicine in both clinical and personal settings.

    In order to receive a certificate of completion, you will need to also complete the second, skills-based component of the course, which requires you to identify a person (could be a patient or an acquaintance) who would like to make one or more lifestyle changes. During this course, you will meet with this person 3 times and practice strategies you have learned to help others make behavioral changes. You may meet in person or via video conferencing. You will also need to identify a mentor with professional health care training at least at the bachelor’s level (a college degree), and with a certificate or other specific training in Lifestyle Medicine, who can provide you with feedback on the assignments you submit about your relationship with your patient. 

    The results of your assessments will be provided to you, and we can report your testing information and share your work with anyone you request (school, employer, etc.). The evaluation you provide at the course’s conclusion will help us improve the training for future students. We hope you find this Lifestyle Medicine course a wonderful learning experience!

    Approximate time for completion of this course is 49 hours at an average reading rate of 144 words/minute.

    Before you begin the course, please take a moment to take the short knowledge Pre-test below. It allows us to assess various aspects of the course itself and is mandatory to receive your certificate upon completion of the course. 

    The course requires the completion of peer and mentored activities. At the end of each lesson, there is a practice quiz. At the end of the course, after you’ve completed each lesson, quiz, and activity, you’ll have access to a final exam, and a chance to assess the training. Once you’ve passed that last test, you will be able to download a certificate of completion from NextGenU.org and our course’s co-sponsoring organizations (listed above). We keep all of your personal information confidential, never sell any of your information, and only use anonymized data for research purposes, and we are also happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request. We hope that you will find this a rewarding learning experience, and we count on your feedback to help us improve this training for future students.

    Engaging with this Course

    You may browse this course for free to learn for your personal enrichment; there are no requirements.

    To obtain a certificate
    • Show in the registration fields that you have the appropriate prerequisites to be certified. This course requires the learner to have already obtained a college-level degree. 
    • Take the brief pre-test.
    • Complete all the reading requirements.
    • Complete all quizzes and pass with a 70% with unlimited attempts.
    • Complete 1 peer activity and associated certification quizzes.
    • Find a mentor and complete the 8 required mentor activities.
    • Successfully complete the final exam with a minimum of 70%  and a maximum of 3 attempts.
    • Complete the self and course evaluation forms.

    To obtain credit 
    • Complete all requirements listed above for the certificate. 
    • Your learning institution or workplace should approve the partner-university-sponsored NextGenU.org course for educational credit, as they would for their learner taking a course anywhere.  
    • NextGenU.org is happy to provide your institution with:
      • a link to and description of the course training, so they can see all its components, including the cosponsoring universities and other professional organization cosponsors;
      • your grade on the final exam;
      • your work products (e.g. peer and mentored activities), and any other required or optional shared materials that you produce and authorize to share with them;  
      • your evaluations -- course, self, peer, and mentor assessments;
      • a copy of your certificate of completion, with the co-sponsoring universities and other organizations listed.

    To obtain a degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think that your institution might be interested in offering a degree with NextGenU.org contact us


    We hope that you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.

    Next Steps

    • Take the short knowledge pre-test below. It allows us to assess various aspects of the course itself.
    • Complete the registration form.
    • Complete the survey on your health practices, as this will allow us to study any personal behavioral changes that happened during the time you took this behavioral change course.
    • Begin the course with Module 1: Introduction to Lifestyle Medicine. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.

    Lifestyle Medicine Home Page
    • Course Registration Questionnaire
    • Health Behaviors Survey Questionnaire
    • Pre-Test Quiz
    • Announcements Forum
    • Lifestyle Medicine Mentored Activities Page
    • LM Course Files Folder
    • Peer activities Page
  • Module 1: Introduction to Lifestyle Medicine

    Module 1: Introduction to Lifestyle Medicine

    Before starting this first module, please take a moment to take the short knowledge Pre-test above. It allows us to assess various aspects of the course itself and is mandatory to receive your certificate upon completion of the course.

    First, do no harm. — Hippocratic oath 

    Competencies covered in this module:
    1. Introduction to lifestyle medicine
    2. The role of physician health
    3. Environmental lifestyle factors and their impact on non-communicable diseases

    Click here for the brief module introduction

    Module 1: Introduction to Lifestyle Medicine
    • This module acts as a foundation for the rest of the course, providing an introduction to the principles of lifestyle medicine (LM) and an understanding of LM as an evidence-based practice. You will learn the definition of LM and how LM plays a unique role in the prevention and treatment of non-communicable diseases. By understanding both the health advantages and disadvantages of lifestyle behaviors, you will comprehend primary healthcare's important role in screening, diagnosing, and monitoring lifestyle-related conditions. By the end of this module, you will appreciate that a physician's healthy lifestyle influences a patient's health behavior outcome. You are invited to examine your personal lifestyle and identify a health habit you would like to improve upon (and subsequently maintain) while taking this course.

      This module requires you identify a mentor with whom you would like to work.  Your mentor should be someone who has worked as a primary-care physician for five years or more, with a particular interest in LM. Your mentor will serve as your main consultant and educator on new material and will help you understand application of these lessons in clinical practice.

      Upon completion of this module, students should be able to perform the following:

      • Define lifestyle medicine (LM) and describe the unique role of LM
      • Describe the LM core competencies as identified by a national consensus panel
      • Cite the scientific evidence that demonstrates the association of risk conditions (from unhealthy behaviors) as key to health outcomes
      • Understand the importance of LM in treating the world's lifestyle disease burden
      • Cite scientific data supporting that physicians who practice healthy lifestyles are more likely to offer counseling and improve patient outcomes
      • Understand environmental lifestyle-related factors and their impact on non-communicable diseases
  • Module 1 : Lesson 1: Definition, Role, and Evidence Base for Lifestyle Medicine

    Module 1 : Lesson 1: Definition, Role, and Evidence Base for Lifestyle Medicine

    Learning Objectives
    • Define lifestyle medicine (LM) and describe the unique role of LM
    • Describe the LM core competencies as identified by a national consensus panel
    • Cite the scientific evidence that demonstrates the association of risk conditions (from unhealthy behaviors) as key to health outcomes
    SmokingApproximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    7 URLs
    Module 1 : Lesson 1: Definition, Role, and Evidence Base for Lifestyle Medicine
    • Required Learning Resources and Activities

    • Define lifestyle medicine (LM) and describe the unique role of LMLearning Objectives Icon

    • Lifestyle Medicine: Treating the Causes of Disease URL

      Watch the video.  If necessary, download a transcript of the video by clicking on the link titled ʺView Transcriptʺ.

    • Lifestyle Medicine - Evidence Review URL

      Read pages 2-5.

    • Learning Objectives IconDescribe the LM core competencies as identified by a national consensus panel

    • Lifestyle Medicine Competencies for Primary Care Physicians URL

      Read the entire article.

    • Learning Objectives IconCite the scientific evidence that demonstrates the association of risk conditions (from unhealthy behaviors) as key to health outcomes

    • Lifestyle Medicine - Evidence Review URL

      Read pages 14-43, and page 70.

    • Quiz: Module 1: Lesson 1
      Restricted Not available unless:
      • The activity Course Registration is marked complete
      • The activity Health Behaviors Survey is marked complete
      • The activity Pre-Test is marked complete

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • TEDxMindStreamAcademy - Dr. David Katz - The Road to Health URL

      Watch the video.

    • Lifestyle Medicine Competencies URL

      Read the web page.

    • Noncommunicable diseases country profiles 2018 URL

      Scroll down through the list and click on links to access the fact sheets for United States of America, Australia, Sweden, United Kingdom, and Germany.  Read those fact sheets and the fact sheets of any other high-income country of your choice.  Learn about the prevalence of non-communicable diseases in high-income countries.

  • Module 1 : Lesson 2: The Importance of Lifestyle Medicine in Treating the World's Lifestyle Disease Burden

    Module 1 : Lesson 2: The Importance of Lifestyle Medicine in Treating the World's Lifestyle Disease Burden

    Obesity
    Learning Objectives:
    • Understand the importance of LM in treating the world's lifestyle disease burden
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    3 URLs, 1 Quiz
    Module 1 : Lesson 2: The Importance of Lifestyle Medicine in Treating the World's Lifestyle Disease Burden
    • Required Learning Resources and Activities

    • Learning Objectives IconUnderstand the importance of LM in treating the nation's lifestyle disease burden

    • Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community URL

      Read the entire article.

    • Lifestyle Medicine URL

      Read the entire web page.

    • Quiz: Module 1: Lesson 2

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Lifestyle medicine: The importance of considering all the causes of disease URL

      Read the entire article.

  • Module 1 : Lesson 3: The Role of Physician Health and Physician Advocacy

    Module 1 : Lesson 3: The Role of Physician Health and Physician Advocacy

    Obesity
    Learning Objectives:
    • Cite scientific data supporting that physicians who practice healthy lifestyles are more likely to offer counseling and improve patient outcomes
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    3 URLs, 1 Quiz, 1 Assignment
    Module 1 : Lesson 3: The Role of Physician Health and Physician Advocacy
    • Required Learning Resources and Activities

    • Learning Objectives IconCite scientific data supporting that physicians who practice healthy lifestyles are more likely to offer counseling and improve patient outcomes

    • Lifestyle Medicine - Evidence Review URL

      Read from the section titled "Physician Responsibility" (page 9) to the section titled "A. Prevalence of Lifestyle-related Conditions" (page 10).

    • Physicians' health practices strongly influence patient health practices URL

      Read the entire article.

    • Quiz: Module 1: Lesson 3

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • How to Exercise at Your Desk URL

      Practice the recommended exercises at your desk, as outlined in the images at the bottom of the web page.

    • Enrichment Activity (optional): The Blue Zones Project Assignment
  • Module 1 : Lesson 4: Environmental Lifestyle Factors and Their Impact on Non-communicable Diseases

    Module 1 : Lesson 4: Environmental Lifestyle Factors and Their Impact on Non-communicable Diseases

    Figure searching garbage dumpster for food
    Learning Objectives:
    • Understand environmental lifestyle-related factors and their impact on non-communicable diseases
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    2 URLs, 1 Quiz
    Module 1 : Lesson 4: Environmental Lifestyle Factors and Their Impact on Non-communicable Diseases
    • Required Learning Resources and Activities

    • Learning Objectives IconUnderstand environmental lifestyle-related factors and their impact on non-communicable diseases

    • Global Health Risk - Mortality and burden of disease attributable to selected major risks URL

      Read "Summary" (page v), along with "2.6 Environmental risks" and "2.7 Occupational and other risks" (pages 23-27).

    • Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes URL

      Read the entire article.

    • Quiz: Module 1: Lesson 4

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

  • Module 2: Fundamentals of Health Behavior Change

    Module 2: Fundamentals of Health Behavior Change

    Knowing is not enough—we must apply. Willing is not enough—we must do. — Johann Wolfgang von Goethe

    MOODY AIR FORCE BASE, Ga. -- Airmen use different types of cardiovascular machines Jan. 5. Cardiovascular exercises develop your heart and lungs; many consider it to be the most important component in a workout program. (U.S. Air Force photo/Senior Airman Stephanie Mancha)(RELEASED) Competency covered in this module:

    1. Fundamentals of health behavior change

    Click here for the brief module introduction

    Module 2: Fundamentals of Health Behavior Change
    • Adoption of a healthy lifestyle is reached through changes in perception and habits. This module provides you with knowledge of the change process, equipping you with tools to support individuals willing to change their health behavior.

      This module requires that you identify a patient with lifestyle health-related issues who you will accompany in his/her lifestyle health behavior change. Throughout the course, you will be asked to meet with your patient and practice the use of key materials and behavioral methods. By the end of this module, you should feel comfortable using practical tools that support your patients with their health behavior changes.

      Upon completion of this module, students should be able to perform the following:

      • Understand the role of behavioral determinants on positive and negative health outcomes
      • Demonstrate key elements of conducting patient readiness assessment and stage matched responses
      • Understand the gap between clinical guidelines and patient behavior; know how to apply the transtheoretical model of health behavior change
      • Apply motivational interviewing, cognitive behavioral, and positive psychology techniques
      • Describe the process of building effective relationships with patients
      • Describe strategies for helping patients maintain healthy behaviors

       

  • Module 2 : Lesson 1: Introduction to Behavior Change

    Module 2 : Lesson 1: Introduction to Behavior Change

    Learning Objectives:
    • Understand the role of behavioral determinants on positive and negative health outcomes
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    1 URL, 1 Quiz
    Module 2 : Lesson 1: Introduction to Behavior Change
    • Stages of Health Behavior Change


      Required Learning Resources and Activities


    • Learning Objectives IconUnderstand the role of behavioral determinants on positive and negative health outcomes

    • Why behavior change is hard - and why you should keep trying URL

      Read the entire article.

    • Quiz: Module 2: Lesson 1

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

  • Module 2 : Lesson 2: Tools for Health Behavior Change

    Module 2 : Lesson 2: Tools for Health Behavior Change

    Image of the seven domains of wellness, which are: Spiritual, Emotional, Intellectual, Physical, Social, Environmental, and Financial
    Learning Objectives
    • Demonstrate key elements of conducting patient readiness assessment and stage matched responses
    • Understand the gap between clinical guidelines and patient behavior; know how to apply the transtheoretical model of health behavior change
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    3 URLs, 1 Forum, 1 Quiz
    Module 2 : Lesson 2: Tools for Health Behavior Change
    • Required Learning Resources and Activities

    • Learning Objectives IconDemonstrate key elements of conducting patient readiness assessment and stage matched responses

    • The Stages of Change Model, and Treatment Planning URL

      Read slides 8-29.

    • Learning Objectives IconUnderstand the gap between clinical guidelines and patient behavior; know how to apply the transtheoretical model of health behavior change

    • Influencing Patient Adherence to Treatment Guidelines URL

      Read the entire article.

    • Enhancing Motivation for Change in Substance Abuse Treatment: Treatment Improvement Protocol (TIP) Series, No. 35 URL

      Scroll down and in Chapter 1 click on the link titled "A Transtheoretical Model Of the Stages of Change" and read the content of that section. For more information, read Chapter 8, "Measuring Components of Client Motivation" (optional reading).

    • Peer Activity 1: Tools for Behavior Change Forum

      In this activity you will work with your peer to explore tools for health behavior change. Set a time to meet with your peer (between 30-40 minutes). Set this meeting up like a role play: first, you are the “patient” and your peer the physician; then switch. Go through the following steps: 



      1. Review relevant medical records, and, if indicated, perform a physical on each other, with an emphasis on lifestyle risk factors.


      1. The wellness-health wheel: Replace the wheel titles with health issues such as exercise, healthy nutrition, stress, sleep, smoking, social life and relationships, career satisfaction, etc.  You can download a picture of the “health wheel” online or draw one for your own use. Fill in your degree of satisfaction (1 - low, 10 - high) for each of these health issues. Here is a resource regarding the health wheel that you may find useful: https://www.uky.edu/hr/sites/www.uky.edu.hr/files/wellness/documents/Balance-Wheel.pdf


      1. Discuss with your peer: How do the findings on the wheel make you feel about your health? Which health achievement provides the most satisfaction? Investigate your success with Appreciative Inquiry Questions. Then discuss what you would like to change, as this personal decision predicts a higher adherence to the process of change.


      1. Prepare an Action Plan according to S.M.A.R.T. principles: Use materials from the module, for example from the Centre for Excellence in Primary Care and the University of California, San Francisco.  Remember to choose one small step at a time. Do not attempt large steps, as this will increase the probability of failure. Fill in the worksheet below accordingly (you can print it or upload it on your desktop as a constant reminder of your plan to improve your health).

      2. Assess ‘Importance’ and ‘Confidence’.


      1. Share your action plan in a discussion post below by clicking "add new discussion topic".


      1. Comment on at least one of your peer’s posts. Encourage each other by using motivational interview tools such as Open-ended questions, Affirmations,  Reflective listening, etc., in order to enhance the probability of success.






      Personal Health Behavior Change Worksheet


      Please fill in your vision on your health improvement and specify your goal.

      My personal vision is:

      Measuring Success and Challenges

      My Goal:

      weekly action steps

      Week



      1



      2



      3



      4



      5



      6



      7



      8



      9



      10



    • Quiz: Module 2: Lesson 2

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

  • Module 2 : Lesson 3: Techniques for Health Behavior Change

    Module 2 : Lesson 3: Techniques for Health Behavior Change

    Two people, seated at a table, talking, as indicated by speech bubbles.
    Learning Objectives

    Upon completion of the first lesson of Module 2, students should be able to:

    • Apply motivational interviewing, cognitive behavioral, and positive psychology techniques
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    8 URLs, 1 Quiz, 1 Assignment
    Module 2 : Lesson 3: Techniques for Health Behavior Change
    • Required Learning Resources and Activities

    • Learning Objectives IconApply motivational interviewing, cognitive behavioral, and positive psychology techniques

    • Health Goals URL

      Read the entire document that outlines how to set S.M.A.R.T. health goals.

    • Encouraging Patients to Change Unhealthy Behaviors with Motivational Interviewing URL

      Read the entire article.

    • CCNC Motivational Interviewing (MI) Resource Guide URL

      Read pages 5-6, 21, and 28-30.

    • Positive psychology in practice URL

      Read down to the section "Resources".

    • 5 A’s Behavior Change Model Adapted for Self-Management Support Improvement URL

      Read the entire document.

    • Cognitive Behavioral Therapy for Treatment of Adult Obesity URL

      Read the entire article.

    • Quiz: Module 2: Lesson 3

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Mentored Activity: Apply Techniques for Health Behavior Change Assignment
    • Additional Learning Options

    • Motivational interviewing techniques: Facilitating behaviour change in the general practice setting URL

      Read the entire article.

    • The 10 Building Blocks of Primary Care - My Action Plan URL

      Read the entire text.

  • Module 2 : Lesson 4: Building Effective Relationships with Patients

    Module 2 : Lesson 4: Building Effective Relationships with Patients

    Patient Consultation
    Learning Objectives
    • Describe the process of building effective relationships with patients
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    2 URLs, 1 Quiz
    Module 2 : Lesson 4: Building Effective Relationships with Patients
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe the process of building effective relationships with patients

    • The Effective Physician: Motivational Interviewing Demonstration URL

      Watch the entire video.

    • The Ineffective Physician: Non-Motivational Approach URL

      Watch the entire video.

    • Quiz: Module 2: Lesson 4

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

  • Module 2 : Lesson 5: Maintain Healthy Behaviors

    Module 2 : Lesson 5: Maintain Healthy Behaviors

    Figure searching garbage dumpster for food
    Learning Objectives
    • Describe strategies for helping patients maintain healthy behaviors

    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    3 URLs, 1 Quiz
    Module 2 : Lesson 5: Maintain Healthy Behaviors
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe strategies for helping patients maintain healthy behaviors

    • Making lifestyle changes that last URL

      Read the web page.

    • Tips for Making Healthy Behavior Changes Last URL

      Read the entire document.

    • Quiz: Module 2: Lesson 5

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Supporting Self-management in Patients with Chronic Illness URL

      Read down to the section "Motivational Interviewing".

  • Module 3: Physical Activity

    Module 3: Physical Activity

    Those who think they have no time for bodily exercise will sooner or later have to find time for illness. — Edward Stanley, Earl of Derby (1873)

    Competency covered in this module:

    1. Physical activity science and prescription

    Click here for the brief module introduction

    Module 3: Physical Activity
    • “Physical inactivity is a fast-growing public health problem and contributes to a variety of chronic diseases and health complications, including obesity, diabetes and cancer. In addition to improving a patient’s overall health, increasing physical activity has proven effective in the treatment and prevention of chronic diseases. Even with all the benefits of physical activity…levels of inactivity are alarming. We are facing what is now referred to as an 'inactivity epidemic,' with tremendous costs" (Exercise is Medicine®, American College of Sports Medicine, 2015).

      This module provides you with an understanding of the positive effects of physical activity, both on health and with respect to the development of non-communicable diseases worldwide. In addition, you will learn about fundamental concepts in sports medicine and become familiar with general recommendations for physical activity, including the essential components of an exercise prescription.

      It is important to correctly perform a physical activity health screening.  This module gives you the chance to practice this screening with your patient and, by the end of this module, you will confidently evaluate and write an exercise prescription for your patient. Furthermore, you will be able to motivate your patients to exercise.

      Furthermore, through self-examination of your own personal exercise, you will be better equipped to motivate your patients to exercise. As the above-referenced fact sheet (ACSM, 2015) notes, “40% of U.S. primary care doctors and 36% of U.S. medical students do not meet 2008 federal physical activity guidelines. Physically inactive doctors are less likely to provide exercise counseling to patients and provide less credible role models for the adoption of healthy behaviors.”

      Upon completion of this module, students should be able to perform the following:

      • Describe the relationship between physical activity and health
      • Describe the global physical activity guidelines recommended by the WHO
      • Describe the major evidence for the physical activity components (aerobic, strength, flexibility, and balance)
      • Develop an exercise prescription
      • Evaluate a patient prior to the initiation of physical activity
      • Motivate patients to increase their physical activity
  • Module 3 : Lesson 1: Introduction to Physical Activity

    Module 3 : Lesson 1: Introduction to Physical Activity

    Figure on an elliptical exercise machine
    Learning Objectives
    • Describe the relationship between physical activity and health
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    4 URLs, 1 Quiz
    Module 3 : Lesson 1: Introduction to Physical Activity
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe the relationship between physical activity and health

    • Global Recommendations on Physical Activity for Health URL

      Read section 2.1, "Public Health Significance of Physical Activity" (page 10).

    • Your Prescription for Health - Exercise Is Medicine - Fact Sheet URL

      Read the entire fact sheet.

    • Quiz: Module 3: Lesson 1

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy URL

      Read the Summary. 

    • 23 and 1/2 hours: What is the single best thing we can do for our health? URL

      Watch the entire video.

  • Module 3: Lesson 2: Recommendations on Physical Activity

    Module 3: Lesson 2: Recommendations on Physical Activity

    Paper with writing and check boxes.
    Learning Objectives
    • Describe the global physical activity guidelines recommended by the WH
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    2 URLs, 1 Quiz
    Module 3: Lesson 2: Recommendations on Physical Activity
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe the global physical activity guidelines recommended by the WHO

    • Global Recommendations on Physical Activity for Health URL

      Read the Executive Summary (pages 7-8).

    • Quiz: Module 3: Lesson 2

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • How fast does the Grim Reaper walk? Receiver operating characteristics curve analysis in healthy men aged 70 and over URL

      Read the Abstract.  For additional information, read the entire article (optional).  Note:  This article is based on scientific research.

  • Module 3 : Lesson 3: Components of Physical Activity

    Module 3 : Lesson 3: Components of Physical Activity

    Figure lifting weight
    Learning Objectives
    • Describe the major evidence for the physical activity components (aerobic, strength, flexibility, and balance)
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    2 URLs, 1 Quiz
    Module 3 : Lesson 3: Components of Physical Activity
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe the major evidence for the physical activity components (aerobic, strength, flexibility, and balance)

    • Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise URL

      Read the entire article.

    • Quiz: Module 3: Lesson 3

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Activity Bursts Everywhere for Fitness - Physical Activity Engineered to fit YOUR life! URL

      Choose one exercise video to perform either at home, in the office, or in the waiting area.  Enjoy.

  • Module 3 : Lesson 4: Patient Evaluation

    Module 3 : Lesson 4: Patient Evaluation

    Evaluation
    Learning Objectives
    • Evaluate a patient prior to the initiation of physical activity
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    3 URLs, 1 Quiz, 1 Assignment
    Module 3 : Lesson 4: Patient Evaluation
    • Required Learning Resources and Activities

    • Learning Objectives IconEvaluate a patient prior to the initiation of physical activity

    • Exercise Prescription Doctor's Handbook URL

      Scroll down and in Chapter 3 (Pre-participation Health Screening), read pages 16-21.

    • Updating ACSM’s Recommendations for Exercise Preparticipation Health Screening URL

      Study Figure 2 (essential).  Then, read from the section ʺThe New Exercise Preparticipation Health Screening Process Algorithm" to the end of the article (essential).  The text preceding this section is optional reading.

    • 2019 PAR-Q+ The Physical Activity Readiness Questionnaire for Everyone URL

      Scroll through the questionnaire.

    • Quiz: Module 3: Lesson 4

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Mentored Activity: Pre-participation Health Screening Assignment
  • Module 3 : Lesson 5: Exercise Prescription

    Module 3 : Lesson 5: Exercise Prescription

    Female figure running
    Learning Objectives
    • Develop an exercise prescription
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    6 URLs, 1 Quiz, 2 Assignments
    Module 3 : Lesson 5: Exercise Prescription
    • Required Learning Resources and Activities

    • Develop an exercise prescription

    • Physical Education/Health Education; Grade 11 Active Healthy Lifestyles: Manitoba Physical Education/Health Education Curriculum Framework of Outcomes and A Foundation for Implementation URL

      Read from the section "The FITT Principle" (page 168) to the end of page 172.

    • Your Prescription for Health - Exercise is Medicine URL

      Read the text.

    • Physical activity on asthmatic and diabetic patients URL

      Under the heading "Exercise Rx for Medical Conditions", click on the links "Asthma" and "Type 2 Diabetes" and read the content, along with any other topics in the Health Series.

    • Physical Activity in Children and Adolescents URL

      Read the text.

    • Committee Opinion: Physical Activity and Exercise During Pregnancy and the Postpartum Period URL

      Read the entire document.

    • Quiz: Module 3: Lesson 5

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Mentored Activity: Exercise Prescription Assignment
    • Additional Learning Options

    • Mentored Activity: Exercise Prescription Implementation (optional) Assignment
    • The Borg Rating of Perceived Exertion (RPE) scale URL

      Read the entire article.

  • Module 3 : Lesson 6: Improving Exercise Adoption and Maintenance

    Module 3 : Lesson 6: Improving Exercise Adoption and Maintenance

    Workout routine
    Learning Objectives
    • Motivate patients to increase their physical activity
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    3 URLs, 1 Quiz, 2 Assignments
    Module 3 : Lesson 6: Improving Exercise Adoption and Maintenance
    • Required Learning Resources and Activities

    • Learning Objectives IconMotivate patients to increase their physical activity

    • Exercise Prescription Doctor's Handbook URL

      Scroll down to Chapter 4 (General Principles of Exercise Prescription), then read the section "Improving Exercise Adoption and Maintenance" (pages 33-37).

    • Healthcare Providers' Action Guide URL

      Read pages 2-3, 8-11, and 17-19.

    • Quiz: Module 3: Lesson 6

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Exercise Prescription Doctor's Handbook URL

      Scroll through the resource and read chapters and sections of interest to you.  Note: Some parts of this resource should already have been read.

    • Enrichment Activity (optional): Physical Activity and Local Guidelines Assignment
    • Peer Project Part II(optional): Personal Exercise Habits Assignment
  • Module 4: Nutrition

    Module 4: Nutrition

    Let food be thy medicine and medicine be thy food. — Hippocrates

    Competencies covered in this module
    1. Nutrition science, assessment, and prescription 

    Click here for the brief module introduction

    Module 4: Nutrition
    • Effective dietary counseling is difficult within the constraints of a primary healthcare clinic—and yet, poor nutrition and obesity play significant roles in every day health issues.

      This module provides you with the basic concepts of nutrition, the connection between nutrition and illness, and an understanding of the risk factors of obesity, along with its complications and treatment principles. You will learn about popular diets and their evidenced-based health benefits and risks, as well as how to shop for and cook healthy food.  Moreover, you will gain the expertise to write a nutrition prescription and assist your patients in adopting healthy eating behaviors.

      Upon completion of this module, students should be able to perform the following:

      • Describe the basics of nutrition, as well as the metabolic effects of different foods
      • Summarize the major nutrition studies and evidence base for nutrition prescriptions
      • Describe different types of diets and their effects on health
      • Understand the role of nutrition in preventing and treating chronic diseases such as cardiovascular disease
      • Describe the role of nutrition in preventing, treating, and reversing diabetes
      • Summarize nutrition prescriptions for the most common chronic diseases including hyperlipidemia, diabetes, hypertension, and cancer
      • Know how to prescribe nutrition for basic disease processes including inflammation: food patterns / macronutrients, food types / micronutrients, food preparation / oxidation
      • Demonstrate the ability to perform a basic nutrition assessment and to apply practical strategies to assist patients in achieving dietary changes
      • Describe the basic principles of healthy cooking
      • Properly interpret nutrition labels
      • Define obesity and understand its epidemiology, as well as assist patients in the prevention and treatment of obesity
  • Module 4 : Lesson 1: Introduction to Nutrition

    Module 4 : Lesson 1: Introduction to Nutrition

    Learning Objectives
    • Describe the basics of nutrition, as well as the metabolic effects of different foods
    • Summarize the major nutrition studies and evidence base for nutrition prescriptions
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    7 URLs, 1 Quiz
    Module 4 : Lesson 1: Introduction to Nutrition
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe the basics of nutrition, as well as the metabolic effects of different foods

    • Overview of Nutrition URL

      Read down to the section "Micronutrients".

    • EFSA sets European dietary reference values for nutrient intakes URL

      Read the web page.

    • Energy intake and expenditure URL

      Read slides 1-6.

    • Micronutrients for Health URL

      Read the document.

    • Vitamin Supplements: Hype or Help for Healthy Eating URL

      Read the web page.

    • Learning Objectives IconSummarize the major nutrition studies and evidence base for nutrition prescriptions

    • Disease Control Priorities in Developing Countries, 2nd edition URL

      Scroll down and click on "Chapter 44. Prevention of Chronic Disease by Means of Diet and Lifestyle Changes".  Then, under the heading "Chronic Disease Prevention", read the subsection "Eat a Healthy Diet" and the section "Potential of Dietary and Lifestyle Factors to Prevent Chronic Diseases".

    • Quiz: Module 4: Lesson 1

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Vitamins and Minerals URL

      Scroll through the site.

  • Module 4 : Lesson 2: The Role of Nutrition in Preventing and Treating Chronic Diseases

    Module 4 : Lesson 2: The Role of Nutrition in Preventing and Treating Chronic Diseases

    Vegetables
    Learning Objectives
    • Describe different types of diets and their effects on health
    • Understand the role of nutrition in preventing and treating chronic diseases, such as cardiovascular disease
    • Describe the role of nutrition in preventing, treating, and reversing diabetes
    • Summarize nutrition prescriptions for the most common chronic diseases including hyperlipidemia, diabetes, hypertension, and cancer
    • Know how to prescribe nutrition for basic disease processes including inflammation: food patterns / macronutrients, food types / micronutrients, food preparation / oxidation
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    18 URLs, 1 Quiz
    Module 4 : Lesson 2: The Role of Nutrition in Preventing and Treating Chronic Diseases
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe different types of diets and their effects on health

    • Healthy diet  URL

      Read the fact sheet.

    • Learning Objectives IconUnderstand the role of nutrition in preventing and treating chronic diseases, such as cardiovascular disease

    • Nutritional Recommendations for Cardiovascular Disease Prevention URL

      Read the entire article.

    • Diets for Cardiovascular Disease Prevention: What Is the Evidence? URL

      Read the entire article.

    • Learning Objectives IconDescribe the role of nutrition in preventing, treating, and reversing diabetes

    • The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern URL

      Read the entire article.

    • Can diet alone reverse Type 2 diabetes? URL

      Read the web page.

    • Learning Objectives IconSummarize nutrition prescriptions for the most common chronic diseases including hyperlipidemia, diabetes, hypertension, and cancer

    • Effects of Different Dietary Interventions on Blood Pressure URL

      Read the entire article.

    • Joslin Diabetes Center and Joslin Clinic - Clinical Nutrition Guideline for Overweight and Obese Adults With Type 2 Diabetes, Prediabetes or Those at High Risk for Developing Type 2 Diabetes URL

      Read the guideline.

    • 11 foods that lower cholesterol URL

      Read the entire web page.

    • Heal Well: A Cancer Nutrition Guide URL

      Read chapters 1 and 2 (pages 3-14) as well as chapters 5 and 6 (pages 21-24).

    • Learning Objectives IconKnow how to prescribe nutrition for basic disease processes including inflammation: food patterns / macronutrients, food types / micronutrients, food preparation / oxidation

    • Overview of Inflammation URL

      Read the entire article.

    • Foods that fight inflammation URL

      Read the web page.

    • Quiz: Module 4: Lesson 2

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • The Mediterranean Diet URL

      Watch the entire video.

    • Nutrition Pilot Curriculum (Archived) URL

      Watch the entire video.

    • Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health URL

      Read the entire article.

    • Mediterranean Diet and Diabetes: Prevention and Treatment URL

      Read the entire article.

    • Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review URL

      Read the entire article.

    • Macronutrient intake induces oxidative and inflammatory stress: potential relevance to atherosclerosis and insulin resistance URL

      Read the entire article.

    • Diet and Inflammation URL

      Read the section titled "Abstract".

  • Module 4 : Lesson 3: Dietary Guidelines and Nutrition Prescriptions

    Module 4 : Lesson 3: Dietary Guidelines and Nutrition Prescriptions

    Dietary Guidelines
    Learning Objectives
    • Demonstrate ability to perform a basic nutrition assessment and to apply practical strategies to assist patients in achieving dietary changes
    • Describe the basic principles of healthy cooking
    • Summarize the major nutrition studies and evidence base for nutrition prescriptions
    • Properly interpret nutrition labels
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    9 URLs, 1 Quiz, 1 Assignment
    Module 4 : Lesson 3: Dietary Guidelines and Nutrition Prescriptions
    • Required Learning Resources and Activities

    • Learning Objectives IconDemonstrate ability to perform a basic nutrition assessment and to apply practical strategies to assist patients in achieving dietary changes

    • Dietary Guidelines for Americans 2015-2020 (Eighth Edition) - For Professionals:  Recommendations At-A-Glance URL

      Read the entire guideline.

    • Learning Objectives IconDescribe the basic principles of healthy cooking

    • Choose MyPlate URL

      Scroll through the site.

    • Dietary Guidelines for Americans 2015-2020 (Eighth Edition) - For Professionals:  Talk to Your Patients & Clients About Healthy Eating Patterns URL

      Read the entire guideline.

    • Healthy cooking tips URL

      Read the entire web page.

    • Learning Objectives IconSummarize the major nutrition studies and evidence base for nutrition prescriptions

    • Nutrition prescriptions URL

      Read the entire web page.

    • Learning Objectives IconProperly interpret nutrition labels

    • What's On The Nutrition Facts Label URL

      Read the entire Fact Sheet.

    • Quiz: Module 4: Lesson 3:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Culinary Medicine – Resources for Patients and Clinicians URL

      Watch two recipes videos as well as the "Cooking at Home Instructional Videos" found at the bottom of the web page.

    • Dietary Guidelines for Americans 2015-2020 (Eighth Edition) - An In-Depth Look at the 2015-2020 Dietary Guidelines URL

      Read through the slide presentation.

    • Stanford Introduction to Food and Health URL

      Go to "Enroll Now", register, and do the course.

    • Enrichment Activity (optional): Nutrition Facts Label Assignment
  • Module 4 : Lesson 4: Obesity

    Module 4 : Lesson 4: Obesity

    Obese figure in front of mirror
    Learning Objectives
    • Define obesity and understand its epidemiology as well as assist patients in the prevention and treatment of obesity
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    13 URLs, 1 Quiz
    Module 4 : Lesson 4: Obesity
    • Required Learning Resources and Activities

    • Learning Objectives IconDefine obesity and understand its epidemiology as well as assist patients in the prevention and treatment of obesity

    • About Obesity URL

      Read the entire web page. Then, download the "Obesity is a disease statement" and read the statement.

    • Obesity and overweight URL

      Read the Fact Sheet.

    • Adult Obesity Causes & Consequences URL

      Read the web page and then click on the link titled "Obesity and Genomics".  Then, read the content of the web page titled "Behavior, environment, and genetic factors all have a role in causing people to be overweight and obese".

    • Measuring Obesity URL

      Read down to the beginning of the section titled "Bioelectric Impedance (BIA)".

    • U.S. Preventive Services Task Force - Screening for and Management of Obesity in Adults: Recommendation Statement URL

      Read down to the section titled ʺClinical Considerationsʺ.  Be sure to read Table 1.

    • Treatment for Overweight & Obesity URL

      Read the entire web page. Then, under the heading "Healthy eating plan and regular physical activity", click on the link titled "healthy eating plan" and read the web page titled "Eating & Physical Activity to Lose or Maintain Weight".

    • Quiz: Module 4: Lesson 4:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation URL

      Read the entire article.

    • Obesity prevalence worldwide - Adults URL

      Explore the interactive map and read the country statistics listed below the map.

    • Overweight & Obesity URL

      Scroll through the site.

    • Treatment of Adult Obesity with Bariatric Surgery URL

      Read the entire article.

    • What's the Best Diet? Healthy Eating 101 URL

      Watch the entire video.

    • Healthy Weight Checklist URL

      Read the entire web page.

    • Office-Based Strategies for the Management of Obesity URL

      Read the entire article.

  • Module 5: Sleep Health

    Module 5: Sleep Health

    Competencies covered in this module
    1. Sleep health science and interventions

    Click here for the brief module introduction

    Module 5: Sleep Health
    • Insufficient sleep has been linked to the development of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression.

      In this module, you will be provided with information about the basic structural organization of sleep as well as the types of sleep disturbances and how to manage common sleep disorders. By the end of this module, you will be able to evaluate patients who cannot sleep and suggest lifestyle-based changes as well as coping behaviors that can improve their sleep.

      Upon completion of this module, students should be able to:

      • Understand sleep’s role in health and chronic disease
      • Understand the basic physiology and the structural organization of sleep
      • Know the common types of sleep disorders and the tools to evaluate and manage sleep
      • Identify lifestyle-based activity, dietary, environmental and coping behaviors that can improve sleep health
      • Identify at least two lifestyle adjustments related to light exposure and meal composition and timing that support improved sleep
  • Module 5: Lesson 1: The Role of Sleep in Health

    Module 5: Lesson 1: The Role of Sleep in Health

    Learning Objectives
    • Understand sleep’s role in health and chronic disease
    • Understand the basic physiology and the structural organization of sleep

    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    8 URLs, 1 Quiz
    Module 5: Lesson 1: The Role of Sleep in Health
    • Required Learning Resources and Activities

    • Learning Objectives IconUnderstand sleep’s role in health and chronic disease

    • Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem URL

      Read from the beginning of chapter 2 titled "Sleep Physiology" down to the section titled "Sleep-Wake Regulation" (essential).  The rest of the chapter is optional reading.

    • Sleep and Chronic Disease URL

      Read the entire web page.

    • Learning Objectives IconUnderstand the basic physiology and the structural organization of sleep

    • Sleep and Disease Risk URL

      Read the information on the web page.

    • Recommended Amount of Sleep for a Healthy Adult:  A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society URL

      Read the entire article.

    • Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine URL

      Read the entire article.

    • Quiz: Module 5: Lesson 1:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Session 4: Understanding Sleep's Role in Health Promotion & Chronic Disease  (Archived Webinar) URL

      Watch and listen to the webinar.

    • Association of Sleep Duration with Chronic Diseases in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study URL

      Read the entire article.

    • Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem URL

      Read whichever section(s) that is of interest to you (for those interested in depth).

  • Module 5 : Lesson 2: Sleep Disorder Evaluation and Management

    Module 5 : Lesson 2: Sleep Disorder Evaluation and Management


    Figure sleeping at desk
    Learning Objectives
    • Know the common types of sleep disorders and the tools to evaluate and manage sleep
    • Identify lifestyle-based activity, dietary, environmental, and coping behaviors that can improve sleep health
    • Identify at least two lifestyle adjustments related to light exposure and meal composition and timing that support improved sleep

    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    11 URLs, 1 Quiz
    Module 5 : Lesson 2: Sleep Disorder Evaluation and Management
    • Required Learning Resources and Activities

    • Learning Objectives IconKnow the common types of sleep disorders and the tools to evaluate and manage sleep

    • Management of Common Sleep Disorders URL

      Read the entire article.

    • Learning Objectives IconIdentify lifestyle-based activity, dietary, environmental, and coping behaviors that can improve sleep health

    • STOP Questionnaire:  A Tool to Screen Patients for Obstructive Sleep Apnea URL

      Read down to the section titled "Materials and Methods".  Then, scroll down and read "Appendix 1:  STOP Questionnaire".

    • NIH MedlinePlus - the magazine (Summer 2012) URL

      Scroll down and read pages 19, 20 (Tips for Getting A Good Night’s Sleep), and 21 (Sample Sleep Diary).

    • Sleep Deprivation and Deficiency URL

      Scroll down and read the section titled "Strategies for Getting Enough Sleep".

    • Twelve Simple Tips to Improve Your Sleep URL

      Read the web page.

    • Sleep problems - Insomnia Management Kit URL

      Explore the site and read in detail the content of the link titled "Sleep: Facts and Hygiene".

    • Learning Objectives IconIdentify at least two lifestyle adjustments related to light exposure and meal composition and timing that support improved sleep

    • Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep URL

      Read the abstract, discussion, and conclusions.

    • Blue light has a dark side URL

      Read the entire health letter.

    • Relationship between Food Intake and Sleep Pattern in Healthy Individuals URL

      Read the entire article.

    • Quiz: Module 5: Lesson 2:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Your Guide to Healthy Sleep URL

      Look through the booklet.

    • Impact of lifestyle and technology developments on sleep URL

      Read the entire article.

  • Module 6: Tobacco Use

    Module 6: Tobacco Use

    Tobacco kills up to half of its users. - World Health Organization (2016)

    Competencies covered in this module :
    1. Fundamentals of Tobacco Cessation

    Click here for the brief module introduction

    Module 6: Tobacco Use
    • Stimulation of nicotinic cholinergic receptors releases a variety of neurotransmitters in the brain. One of them, dopamine, signals a pleasurable experience. Cigarette addiction involves physiological, psychological, and behavioral factors. As a physician, you generally have only five to ten minutes in your office to spend with a patient to help him/her stop smoking. Before you continue with this module, we recommend you watch this video titled "30 Seconds to save a life".

      In this module you will learn about the epidemiology of smoking-related diseases and their prevention. By the end of this module, you will know how to interview and counsel patients who smoke, as well as how to offer appropriate treatment in the setting of a primary healthcare clinic or practice.

      Upon completion of this module, students should be able to:

      • Understand the role of tobacco cessation in preventing and treating chronic disease
      • Summarize the evidence-based literature on tobacco cessation interventions
      • Be able to state the aspects of tobacco addiction (physiological, psychological, and behavioral)
      • Demonstrate the ability to assist patients to develop and implement plans for smoking cessation
      • Be familiar with the medications and treatments commonly used for tobacco cessation
      • Develop a written action plan based on the treatment prescription, adjusted for the appropriate stage of change
  • Module 6 : Lesson 1: Epidemiology of Tobacco-Related Diseases

    Module 6 : Lesson 1: Epidemiology of Tobacco-Related Diseases

    Learning Objectives
    • Understand the role of tobacco cessation in preventing and treating chronic disease
    • Summarize the evidence-based literature on tobacco cessation interventions
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    5 URLs, 1 Quiz
    Module 6 : Lesson 1: Epidemiology of Tobacco-Related Diseases
    • Required Learning Resources and Activities

    • Learning Objectives IconUnderstand the role of tobacco cessation in preventing and treating chronic disease

    • The Health Consequences of Smoking—50 Years of Progress:  A Report of the Surgeon General - Executive Summary URL

      Read the section titled "Overview" including Figures 1A and 1B (pages 1-3).  Then, read "Section 2:  The Health Consequences of Active and Passive Smoking:  The Evidence in 2014" (page 5) down to the section titled "Chapter 5: Nicotine" (page 7).

    • 21st-Century Hazards of Smoking and Benefits of Cessation in the United States URL

      Read the section titled "Abstract".

    • Learning Objectives IconSummarize the evidence-based literature on tobacco cessation interventions

    • Final Recommendation Statement: Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions URL

      Read the recommendation statement.

    • Final Recommendation Statement: Tobacco Use in Children and Adolescents: Primary Care Interventions URL

      Read the recommendation statement.

    • Quiz: Module 6: Lesson 1:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Additional Learning Options

    • Smoking Cessation Interventions for Youth: A Review of the Literature URL

      Read the report.

  • Module 6 : Lesson 2: The Physiological, Psychological, and Behavioral Components of Tobacco Use

    Module 6 : Lesson 2: The Physiological, Psychological, and Behavioral Components of Tobacco Use

    Learning Objective
    • Be able to state the aspects of tobacco addiction (physiological, psychological, behavioral)
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Cigar

    Click here to start this lesson

    3 URLs, 1 Quiz
    Module 6 : Lesson 2: The Physiological, Psychological, and Behavioral Components of Tobacco Use
    • Required Learning Resources and Activities

    • Learning Objectives IconBe able to state the aspects of tobacco addiction (physiological, psychological, behavioral)

    • Nicotine Addiction URL

      Read down to the section titled "Vulnerability to Addiction".

    • Pharmacology of Nicotine: Addiction, Smoking-Induced Disease, and Therapeutics URL

      Read the section titled "Mechanisms of Action". 

    • The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. URL

      Scroll down and in chapter 5, read the section titled ʺPathophysiology of Nicotine Addictionʺ.

    • Quiz: Module 6: Lesson 2:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

  • Module 6 : Lesson 3: Treatment of Tobacco Use

    Module 6 : Lesson 3: Treatment of Tobacco Use

    PrescriptionLearning Objectives

    • Demonstrate ability to assist patients to develop and implement plans for smoking cessation
    • Be familiar with the medications and treatments commonly used for tobacco cessation
    • Develop a written action plan based on the treatment prescription, adjusted for the appropriate stage of change
    • Prescription
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this module

    10 URLs, 1 Quiz, 2 Assignments
    Module 6 : Lesson 3: Treatment of Tobacco Use
    • Required Learning Resources and Activities

    • Learning Objectives IconDemonstrate ability to assist patients to develop and implement plans for smoking cessation

    • Physician advice for smoking cessation URL

      Read the section titled "Abstract".

    • Learning Objectives IconBe familiar with the medications and treatments commonly used for tobacco cessation

    • Toolkit for delivering the 5A’s and 5R’s brief tobacco interventions in primary care URL

      Read the section titled "II. The unique role of the healthcare provider in tobacco control" (page 6). Then, read from the sub-section titled "iii. Three Challenges of Quitting" (page 10) down to the end of the section titled "V. The 5R's model to increase motivation to quit" (page 13 -14).

    • Instrument:  Fagerstrom Test For Nicotine Dependence (FTND) URL

      Read the web page.  Then, open the attachment titled "Fagerstrom Test_2014March24.pdf" and read the questionnaire.

    • The Brief Tobacco Intervention URL

      Read the section titled "The 2As & R" (page 1).

    • Promoting Smoking Cessation URL

      Read the entire article.

    • Learning Objectives IconDevelop a written action plan based on the treatment prescription, adjusted for the appropriate stage of change

    • Stages of Change URL

      Read the entire web page.

    • Quiz: Module 6: Lesson 3:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Mentored Activity: Smoking Cessation Action Plan Assignment
    • Additional Learning Options

    • Quitting is a Journey URL

      Scroll through the site.

    • Very Brief Advice on Smoking - 30 Seconds to save a life URL

      Watch the video titled "30 Seconds to save a life".

    • For Smokers Who Want to Quit - One Step at a Time URL

      Read the entire booklet.

    • treatobacco.net: Resource library URL

      Scroll through the site.

    • Enrichment Activity (optional): Local Sources for Smoking Cessation Assignment
  • Module 7: Alcohol Use

    Module 7: Alcohol Use

    "What are you doing here?" he asked the drunkard... "Drinking," replied the drunkard, with a gloomy expression. "Why are you drinking?" the little prince asked. "To forget," replied the drunkard. "To forget what?" inquired the little prince, who was already feeling sorry for him. "To forget that I'm ashamed," confessed the drunkard, hanging his head. "What are you ashamed of?" inquired the little prince, who wanted to help. "Of drinking!" concluded the drunkard... - Antoine de Saint-Exupéry, "The Little Prince"

    Competencies covered in this module :
    1. Fundamentals of managing risky alcohol use

    Click here for the brief module introduction

    Module 7: Alcohol Use
    • According to the WHO , “the harmful use of alcohol ranks among the top five risk factors for disease, disability and death throughout the world”. Alcoholism often goes undiagnosed; the rate of screening for alcohol consumption in healthcare settings remains low. Some patients also may withhold information because of shame or fear of stigmatization.

      In this module, you will learn about the epidemiology and the harm of alcohol use, useful screening tools, and the implementation of treatment plans to reduce alcohol-related health risks. Your ability to implement an intervention is of great importance; its effectiveness requires a close relationship with your patients.

      Upon completion of this module, students should be able to:

      • Understand the role of moderating alcohol use in preventing and treating chronic diseases
      • Describe screening processes for harmful alcohol use
      • Demonstrate the ability to assist patients to develop and implement plans for avoiding risky alcohol use
      • Know the components of relapse prevention planning
      • Develop a written action plan based on the treatment prescription, adjusted for the appropriate stage of change

  • Module 7 : Lesson 1: Epidemiology of Alcohol-Related Diseases

    Module 7 : Lesson 1: Epidemiology of Alcohol-Related Diseases

    Learning Objective
    • Understand the role of moderating alcohol use in preventing and treating chronic diseases
    Drinking Alcohol

    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this lesson

    1 Quiz, 2 URLs
    Module 7 : Lesson 1: Epidemiology of Alcohol-Related Diseases
    • Required Learning Resources and Activities

    • Learning Objectives IconUnderstand the role of moderating alcohol use in preventing and treating chronic diseases

    • Quiz: Module 7: Lesson 1:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Global status report on alcohol and health 2014 URL

      Read the section titled "Executive summary" (pages xiii-xiv).  Then, read from the section titled "1.6.1 Health Consequences for Drinkers" (pages 11-13).  Ensure you examine boxes 3 and 4.

    • Additional Learning Options

    • Problem Drinking and Alcoholism: Diagnosis and Treatment URL

      Read the entire article.

  • Module 7 : Lesson 2: Screening for Harmful Alcohol Use

    Module 7 : Lesson 2: Screening for Harmful Alcohol Use

    Learning Objective
    • Describe screening processes for harmful alcohol use
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour
    Figure drinking from a bottle

    Click here to start this lesson

    2 URLs, 1 Quiz
    Module 7 : Lesson 2: Screening for Harmful Alcohol Use
    • Required Learning Resources and Activities

    • Learning Objectives IconDescribe screening processes for harmful alcohol use

    • Alcohol Screening and Counseling URL

      Read the web page (essential).  If you require additional information, click on the link titled "Vital Signs – Alcohol Screening and Counseling? [PODCAST – 1:15 minutes]" and listen to the PODCAST (optional).

    • STABLE Resource Toolkit URL

      Read pages 23 to 27 in the STABLE Resource Toolkit.

    • Quiz: Module 7: Lesson 2:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

  • Module 7 : Lesson 3: Intervention and Prevention

    Module 7 : Lesson 3: Intervention and Prevention

    Prescription

    Learning Objectives

    • Demonstrate the ability to assist patients to develop and implement plans for avoiding risky alcohol use
    • Know the components of relapse prevention planning
    • Develop a written action plan based on the treatment prescription, adjusted for the appropriate stage of change
    • Intervention
    Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

    Click here to start this module

    3 URLs, 1 Quiz, 1 Assignment
    Module 7 : Lesson 3: Intervention and Prevention
    • Required Learning Resources and Activities

    • Learning Objectives IconDemonstrate the ability to assist patients to develop and implement plans for avoiding risky alcohol use

    • Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use URL

      Read the section titled "II. Adapting Alcohol SBI to Your Practice" (pages 11-17).  The rest of the guide is optional reading.

    • Learning Objectives IconKnow the components of relapse prevention planning

    • Relapse Prevention Video: Early Warning Signs and Important Coping Skills URL

      Watch the video and read the text found below it.

    • Learning Objectives IconDevelop a written action plan based on the treatment prescription, adjusted for the appropriate stage of change

    • Enhancing Motivation for Change in Substance Abuse Treatment: Treatment Improvement Protocol (TIP) Series, No. 35 URL

      Read the section titled "Motivational Intervention And the Stages of Change" (pages 29-30) and examine Figure 2.2 (pages 31-32). Read chapters 4-7 to learn more about modifying treatments in relation to the patient's stage of change (optional reading).

    • Quiz: Module 7: Lesson 3:

      To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

    • Mentored Activity: Risky alcohol use intervention Assignment
  • Module 8: Emotional and Mental Well-being

    Module 8: Emotional and Mental Well-being

    "God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference." - Reinhold Niebuhr, The Serenity Prayer

    Competencies covered in this module:
    1. Emotional and Mental Well-being Assessment and Interventions

    People accept stress as an inevitable part of their lives, but exposure to chronic high levels leads to various forms of significant stress-induced morbidity.  

    In this module, you will learn how to identify a stressed patient and how to help him/her manage emotional and mental well-being.

    Upon completion of this module, students should be able to:

    • Understand the basic elements of stress response and the relationship between emotional distress and poor health
    • Describe the components of emotional wellness self-management
    • Use screening tools for stress, depression, and anxiety
    • Understand how skills of mindfulness-based stress reduction (MBSR) and other approaches can help patients intervene in stress reactions and better care for themselves
    • Demonstrate the ability to manage depression and anxiety in patients with comorbidities
    • Be familiar with the unique stressors associated with being a physician, along with the possible ways of coping with stress, and describe the role of the provider in facilitating the emotional well-being of patients
    Module 8: Emotional and Mental Well-being
    • Module 8 : Lesson 1: Relationship Between Stress and Health

      Module 8 : Lesson 1: Relationship Between Stress and Health

      Anxiety, stress facial expression
      Learning Objectives
      • Understand the basic elements of stress response and the relationship between emotional distress and poor health
      • Describe the components of emotional wellness self-management

      Click here to start this lesson

      4 URLs, 1 Quiz, 1 Assignment
      Module 8 : Lesson 1: Relationship Between Stress and Health
      • Required Learning Resources and Activities

      • Learning Objectives IconUnderstand the basic elements of stress response and the relationship between emotional distress and poor health

      • The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication URL

        Read down to the sub-section titled "Effects of chronic stress on hematopoietic stem cells in cardiovascular diseases".

      • Learning Objectives IconDescribe the components of emotional wellness self-management

      • 6 ways to improve your emotional wellness URL

        Read the entire web page.

      • Quiz: Module 8: Lesson 1:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • The Nature of Stress URL

        Read the entire article.

      • Positive Emotions and Your Health: Developing a Brighter Outlook URL

        Read the entire article.

      • Enrichment Activity (optional): Guided Meditation Assignment
    • Module 8 : Lesson 2: Screening and Screening Tools

      Module 8 : Lesson 2: Screening and Screening Tools

      Evaluation form, two people conversing between form
      Learning Objectives
      • Use screening tools for stress, depression, and anxiety

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      2 URLs, 1 Quiz, 1 Assignment
      Module 8 : Lesson 2: Screening and Screening Tools
      • Required Learning Resources and Activities

      • Learning Objectives IconUse screening tools for stress, depression, and anxiety

      • Depression Anxiety Stress Scales (DASS) URL

        Click on the link titled "Overview of DASS" and read the content.  Then, return to the home page and click on the link titled "Download DASS".  Download the response forms as well as the scoring template and read the content of those documents.

      • Official Standards of the American College of Lifestyle Medicine URL

        Scroll down and click on the link titled "Standards document".  Then, in the document titled "Lifestyle Medicine Standards" read from the section titled "Stress Management/Guidelines" (page 9) down to the section titled "Tobacco Use Cessation Guidelines" (page 10).

      • Quiz: Module 8: Lesson 2:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Mentored Activity: Patients’ Emotional Wellness Assignment
    • Module 8 : Lesson 3: Lifestyle-related Intervention Strategies

      Module 8 : Lesson 3: Lifestyle-related Intervention Strategies

      Integrated health
      Learning Objectives
      • Understand how skills of mindfulness-based stress reduction (MBSR) and other approaches can help patients intervene in stress reactions and better care for themselves

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      9 URLs, 1 Quiz
      Module 8 : Lesson 3: Lifestyle-related Intervention Strategies
      • Required Learning Resources and Activities

      • Learning Objectives IconUnderstand how skills of mindfulness-based stress reduction (MBSR) and other approaches can help patients intervene in stress reactions and better care for themselves

      • Learn to manage stress URL

        Read the entire web page.

      • Exercise, Yoga, and Meditation for Depressive and Anxiety Disorders URL

        Read the entire article.

      • Relaxation techniques for stress URL

        Read the entire web page.

      • Mindfulness-Based Stress Reduction URL

        Read the web page.

      • Your mindfulness practice can be formal or informal URL

        Read the article.

      • Quiz: Module 8: Lesson 3:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • 3 Tips to Manage Stress URL

        Read the web page.

      • Mindfulness-Based Stress Reduction Program URL

        Read the handbook for more information about Mindfulness-Based Stress Reduction (MBSR).

      • Body scan meditation session URL

        Listen to the audio titled "15-minute meditation: Body scan".

      • Guided Meditations URL

        Listen to the guided meditation audios in the language of your choice.  Download the transcripts if needed.

    • Module 8 : Lesson 4: Depression and Anxiety in Patients with Comorbidities

      Module 8 : Lesson 4: Depression and Anxiety in Patients with Comorbidities

      Seated figure with head in hands
      Learning Objectives
      • Demonstrate the ability to manage depression and anxiety in patients with comorbidities

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      1 URL, 1 Quiz, 1 Assignment
      Module 8 : Lesson 4: Depression and Anxiety in Patients with Comorbidities
      • Required Learning Resources and Activities

      • Learning Objectives IconDemonstrate the ability to manage depression and anxiety in patients with comorbidities

      • Addressing comorbidity between mental disorders and major noncommunicable diseases URL

        Read abstract, executive summary, and from introduction to.the beginning of the section titled ʺ1.2 Political commitment to addressing the burden of mental disorders and major noncommunicable diseasesʺ.  Then, read the sections titled ʺKey factsʺ (bullet points) and ʺConclusionsʺ for each noncommunicable disease found in sections 2.1 to 2.4.  Then, read the chapter titled ʺ4. Conclusionsʺ (page 25-26).

      • Quiz: Module 8: Lesson 4:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Mentored Activity: Management of Depression and Anxiety in Patients with Comorbidities Assignment
    • Module 8 : Lesson 5: Stress and Burnout Among Physicians

      Module 8 : Lesson 5: Stress and Burnout Among Physicians

      Figure with hands held to head indicating stress
      Learning Objectives
      • Be familiar with the unique stressors associated with being a physician, along with the possible ways of coping with stress, and describe the role of the provider in facilitating the emotional well-being of patients

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      2 URLs, 1 Quiz, 1 Assignment
      Module 8 : Lesson 5: Stress and Burnout Among Physicians
      • Required Learning Resources and Activities

      • Learning Objectives IconBe familiar with the unique stressors associated with being a physician, along with the possible ways of coping with stress, and describe the role of the provider in facilitating the emotional well-being of patients

      • The BASICS - Strategies for coping with stress and building personal resilience for physicians URL

        Read the chapter titled "B is for Body" (pages 4-11).

      • Burnout among physicians URL

        Read the entire article.

      • Quiz: Module 8: Lesson 5:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • Peer Project Part III (optional) : The BASICS Assignment
    • Module 9: Sexuality and Health

      Module 9: Sexuality and Health

      Sexual health working definition: “... a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”  The World Health Organization (2006)

      Click here for the brief module introduction

      Module 9: Sexuality and Health
        • Sexuality and health

        Patients may have difficulty talking to their physician about sexuality and sexual health for many reasons. Sexual problems can greatly impact a person’s life, influencing both physical and psychological well-being. The causes for sexual dysfunction are numerous; they include various medical conditions and treatments, and can happen at any stage of life. Your responsibility as a physician is to create a trustworthy and secure environment where delicate subjects can be discussed during the medical visit.

        In this module, you will learn about sexuality-related health issues and how to talk to your patients about these issues.

        Upon completion of this module, students should be able to:

        • Understand what is meant by the term ‘healthy sexuality’, and the relationship between sexuality and health
        • Understand the role and the limitations of the physician in counseling and treating in the field of sexuality
    • Module 9 : Lesson 1: Relationship Between Sexuality and Health

      Module 9 : Lesson 1: Relationship Between Sexuality and Health

      Conflict
      Learning Objectives
      • Understand what is meant by the term ‘healthy sexuality’, and the relationship between sexuality and health

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      5 URLs, 1 Quiz
      Module 9 : Lesson 1: Relationship Between Sexuality and Health
      • Required Learning Resources and Activities

      • Learning Objectives IconUnderstand what is meant by the term ‘healthy sexuality’, and the relationship between sexuality and health

      • Defining sexual health URL

        Read the web page.

      • How Chronic Illness Can Affect Sexual Function URL

        Read the entire web page.

      • Drug-induced sexual dysfunction in men and women URL

        Read the entire web page.

      • Quiz: Module 9: Lesson 1:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • Sexuality in Later Life URL

        Read the web page.

      • Lesbian, Gay, Bisexual, and Transgender Health URL

        Explore the web site.

    • Module 9: Lesson 2: Counseling Patients with Sexuality Issues

      Module 9: Lesson 2: Counseling Patients with Sexuality Issues

      Counseling
      Learning Objectives
      • Understand the role and the limitations of the physician in counseling and treating in the field of sexuality
      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      2 URLs, 1 Quiz, 1 Assignment
      Module 9: Lesson 2: Counseling Patients with Sexuality Issues
      • Required Learning Resources and Activities

      • Learning Objectives IconUnderstand the role and the limitations of the physician in counseling and treating in the field of sexuality

      • Talking With Patients About Sexuality and Sexual Health URL

        Read the fact sheet.

      • Sex Therapy for Non-Sex Therapists URL

        Read down to the begining of the section titled "Sex Therapy Interventions".

      • Quiz: Module 9: Lesson 2:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Option

      • Mentored Activity (optional) : How to Consult About Sexuality Assignment
    • Module 10: Implementing Lifestyle Medicine

      Module 10: Implementing Lifestyle Medicine

      “People are generally better persuaded by the reasons which they have themselves discovered than by those which have come into the minds of others.” - Blaise Pascal

      Competencies covered in this module:
      1. Tools to promote health change
      2. Key clinical processes in lifestyle medicine

      Click here for the brief module introduction

      Module 10: Implementing Lifestyle Medicine
      • You have reached the final module in this training. Now is the time to summarize and integrate the course components into a comprehensive practical plan that will serve both you and your patients. As was mentioned throughout this course, change is a gradual process that requires patience; new skills are incorporated incrementally into your life through small, manageable steps.

        In this module you will be provided with the tools necessary to implement health promotion into your practice.

        Upon completion of this module, students should be able to:

        1. Describe strategies for incorporating wellness into clinic, medical office, or other healthcare settings (wellness programs for health providers)
        2. Describe the key strategies for leveraging the interdisciplinary team to enhance health behavior change interventions
        3. Describe how planned and group visits can optimize office visits to support lifestyle modification
        4. Describe screening and diagnostic tests relevant to lifestyle-related diseases
        5. List components of the patient history and physical, with emphasis on lifestyle risk factors
        6. Describe how to interpret the tests using evidence-based national guidelines
        7. Demonstrate how to screen, diagnose, and monitor a lifestyle-related condition (case examples)
        8. Describe appropriate situations for referring and collaborating with other health professionals, such as dieticians, health educators, fitness trainers, and psychologists
        9. Cite strategies for effective office systems and office tools for tracking screening frequency and test results, and proactively prompting follow-up
        10. Develop an action plan for implementing lifestyle medicine in clinical and personal settings by using tools and strategies for effective office systems
        11. Describe strategies for a clinical practice to obtain information about local community resources
    • Module 10 : Lesson 1: Health Promotion in Clinics and Practices

      Module 10 : Lesson 1: Health Promotion in Clinics and Practices

      Promotion
      Learning Objectives
      • Describe strategies for incorporating wellness into clinic, medical office, or other healthcare settings (wellness programs for health providers)
      • Describe the key strategies for leveraging the interdisciplinary team to enhance health behavior change interventions
      • Describe how planned and group visits can optimize office visits to support lifestyle modification
      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      10 URLs, 1 Quiz
      Module 10 : Lesson 1: Health Promotion in Clinics and Practices
      • Required Learning Resources and Activities

      • Learning Objectives IconDescribe strategies for incorporating wellness into clinic, medical office, or other healthcare settings (wellness programs for health providers)

      • 4 Strategies for Promoting Healthy Lifestyles in Your Practice URL

        Read the entire document.

      • Physician Wellness: Preventing Resident and Fellow Burnout URL

        Read the entire module.

      • Learning Objectives IconDescribe the key strategies for leveraging the interdisciplinary team to enhance health behavior change interventions

      • Ten principles of good interdisciplinary team work URL

        Read the entire article.

      • Learning Objectives IconDescribe how planned and group visits can optimize office visits to support lifestyle modification

      • Leveraging Time With Lifestyle-Based Group Visits URL

        Read the entire abstract.

      • Quiz: Module 10: Lesson 1:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • Employer Resources for Success URL

        Browse the web page and click on any links of interest to you.

      • Healthy Team Healthy U: A Prospective Validation of an Evidence-Based Worksite Health Promotion and Wellness Platform URL

        Read the entire article.

      • Ten Lessons in Collaboration URL

        Read the entire article.

      • Effects of a Multi-Disciplinary Lifestyle Intervention on Cardiometabolic Risk Factors in Young Women with Abdominal Obesity: A Randomised Controlled Trial URL

        Read the entire article.

      • Patient Experiences of a Theory-Based Lifestyle-Focused Group Treatment in the Prevention of Cardiovascular Diseases and Type 2 Diabetes URL

        Read the entire article.

      • Obesity: Are shared medical appointments part of the answer? URL

        Read the entire article.

    • Module 10 : Lesson 2: Key Clinical Processes in Lifestyle Medicine

      Module 10 : Lesson 2: Key Clinical Processes in Lifestyle Medicine

      Figure searching garbage dumpster for food
      Learning Objectives
      • Describe screening and diagnostic tests relevant to lifestyle-related diseases
      • List components of the patient history and physical, with emphasis on lifestyle risk factors
      • Describe how to interpret the tests using evidence-based national guidelines
      • Demonstrate how to screen, diagnose, and monitor a lifestyle-related condition (case example)
      • Describe appropriate situations for referring and collaborating with other health professionals, such as dieticians, health educators, fitness trainers, and psychologists

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      12 URLs, 1 Quiz
      Module 10 : Lesson 2: Key Clinical Processes in Lifestyle Medicine
      • Required Learning Resources and Activities

      • Learning Objectives IconDescribe screening and diagnostic tests relevant to lifestyle-related diseases

      • The role of primary health care in preventing the onset of chronic disease, with a particular focus on the lifestyle risk factors for obesity, tobacco and alcohol URL

        Read pages 4 to 7 up to "6. Interventions for modification of lifestyle risks in primary health care "

      • Screening for High Blood Pressure in Adults: Recommendation Statement URL

        Read the entire article.

      • Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Recommendation Statement URL

        Read the entire article.

      • Learning Objectives IconList components of the patient history and physical, with emphasis on lifestyle risk factors

      • Comprehensive Adult New Patient Health History Questionnaire URL

        Examine the questionnaire.

      • Learning Objectives IconDescribe how to interpret the tests using evidence-based national guidelines

      • 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC8) URL

        Download the pdf version of the article by clicking on the link found at the top left side of the web page.  Then, read all 9 recommendations listed in the box found on page 511 and examine the algorithm to manage hypertension outlined in Figure 1 (page 516).  The rest of the guideline is optional reading.

      • Screening for and Diagnosing Diabetes URL

        Read the web page and explore the interactive screening tool. For more information, click on the link titled “Full Guidelines” found under the heading titled ʺGuidelinesʺ located on the top left side of the web page. Then, click on the link to chapter 3 titled ʺDefinition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndromeʺ found under the heading titled ʺ2018 Guidelinesʺ, and read the text (optional reading).

      • Learning Objectives IconDemonstrate how to screen, diagnose, and monitor a lifestyle-related condition (case example)

      • Diabetes Mellitus Type 2 URL

        Read the content of all links found under the heading titled "Table of Contents".

      • Lifestyle Management of Adult Obesity URL

        Read the content of all links found under the heading titled "Table of Contents".

      • Learning Objectives IconDescribe appropriate situations for referring and collaborating with other health professionals, such as dieticians, health educators, fitness trainers, and psychologists

      • 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children URL

        Scroll down and read the chapter titled "9. Role of the health care team in the evaluation and management of obesity" (pages 51-54 in the Adobe toolbar).

      • Adding Health Education Specialists to Your Practice URL

        Read the entire article.

      • Quiz: Module 10: Lesson 2:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • Lifestyle Issues in Cardiac Health URL

        Read the introduction to the case study.  Then, click on the links titled ʺPatient Presentsʺ, ʺPatient Historyʺ, and ʺPhysical Examʺ found on the left side of the web page.  Read the content of each link.  The rest of the case study deals with the diagnosis and management of the condition.

      • Nutrition Guideline Referral to Registered Dietitian URL

        Read the entire guideline.

    • Module 10 : Lesson 3: Strategies for Effective Office Systems to Plan Screenings, Follow Up on Test Results and Clinical Follow-Ups

      Module 10 : Lesson 3: Strategies for Effective Office Systems to Plan Screenings, Follow Up on Test Results and Clinical Follow-Ups

      Systems
      Learning Objectives
      • Cite strategies for effective office systems and office tools for tracking screening frequency and test results, and proactively prompting follow-up
      • Develop an action plan for implementing lifestyle medicine in clinical and personal settings by using tools and strategies for effective office systems

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      3 URLs, 2 Assignments, 1 Quiz, 1 Workshop, 1 Forum
      Module 10 : Lesson 3: Strategies for Effective Office Systems to Plan Screenings, Follow Up on Test Results and Clinical Follow-Ups
      • Required Learning Resources and Activities

      • Learning Objectives IconCite strategies for effective office systems and office tools for tracking screening frequency and test results, and proactively prompting follow-up

      • Committee Opinion: Tracking and Reminder Systems URL

        Read the entire article.

      • Automated Clinician Prompts and Referrals Facilitate Access to Counseling Services, Leading to Positive Behavior Changes Among Patients URL

        Read the entire article.

      • Learning Objectives IconDevelop an action plan for implementing lifestyle medicine in clinical and personal settings by using tools and strategies for effective office systems

      • Comparative Effectiveness of Mailed Reminder Letters on Mammography Screening Compliance URL

        Read the entire article.

      • Mentored Activity: Action Plan for Implementing LM in Your Clinic Assignment
      • Quiz: Module 10: Lesson 3:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • Enrichment Activity (optional): Commitment to Lifestyle Medicine Assignment
      • MCQ-writing activity (Optional) Workshop
      • Summary of the Course Peer Project (Optional) Forum

        We hope that by the end of this course, you feel healthier and happier thanks to the personal health behavior change project! 

        In this forum, you can share your reflections on your peer project experience. To do it, Summarize your project in writing according to the following guidelines:

        1. Your summary should be around 500 words.
        2. Describe the chosen area of change and goals of your peer
        3. Describe the intervention and behavioral tools you used
        4. Report the results, successes, and challenges
        5. Describe how the project affected your health
        6. Describe how the project affected your attitude towards the attempts of patients to change their behavior
        7. In a few sentences, state the most important lessons you learned in the project

    • Module 10: Lesson 4: Strategies to Obtain Information about Local Community Resources

      Module 10: Lesson 4: Strategies to Obtain Information about Local Community Resources

      Learning Objective
      • Describe strategies for a clinical practice to obtain information about local community resources
      Community

      Approximate time required for the readings for this lesson (at 144 words/minute): 1 hour

      Click here to start this lesson

      3 URLs, 1 Quiz
      Module 10: Lesson 4: Strategies to Obtain Information about Local Community Resources
      • Required Learning Resources and Activities

      • Learning Objectives IconDescribe strategies for a clinical practice to obtain information about local community resources

      • Section 8. Identifying Community Assets and Resources URL

        Read the entire web page.

      • Quiz: Module 10: Lesson 4:

        To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

      • Additional Learning Options

      • Primary Health Care Resource Centre URL

        Explore the web page.

      • Health together: how community resources can enhance clinical practice URL

        Read the entire article.

      • We hope that you have enhanced your personal health with the personal health behavior change project and that you will continue to become healthier and happier in the future!

        Final thoughts

        You are invited to read the story titled The 100th Monkey, a story about social change (found within the learning activity labelled "Enrichment Activity (optional):  Commitment to Lifestyle Medicine", Module 10, Lesson 3). Try to reflect on its deeper meaning for a few moments and imagine how you can contribute to the good health of our planet - and why not start doing so right away?

        Thank you for taking this course. We wish you good luck on your final exam and all the best for a good, happy, and healthy life!

    • Final Exam

      Final Exam

      Click here to start Final Examination

      Final Exam
      • Final Exam Quiz
        Restricted Not available unless any of:
        • All of:
          • The activity Mentored Activity: Apply Techniques for Health Behavior Change is marked complete
          • The activity Mentored Activity: Pre-participation Health Screening is marked complete
          • The activity Mentored Activity: Exercise Prescription is marked complete
          • The activity Mentored Activity: Smoking Cessation Action Plan is marked complete
          • The activity Mentored Activity: Risky alcohol use intervention is marked complete
          • The activity Mentored Activity: Patients’ Emotional Wellness is marked complete
          • The activity Mentored Activity: Management of Depression and Anxiety in Patients with Comorbidities is marked complete
          • The activity Mentored Activity: Action Plan for Implementing LM in Your Clinic is marked complete
          • The activity Peer Activity 1: Tools for Behavior Change is marked complete
        • You belong to a group in Kirksville College of Osteopathic Medicine

        To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 51 questions, and you will have 51 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.

        You will need to complete all the required activities before you can attempt the final exam. Once all required activities are completed, email info@nextgenu.org and request the password for the final exam. Be sure to include your full name and the name of the course. 

        To access the exam, click on the name of the exam provided above. On the following screen, click the attempt quiz button to respond to the questions.



    • Course and Self Evaluation & Certificate

      Course and Self Evaluation & Certificate

      In this section, you can provide feedback about this course to help us make NextGenU.org better. Once evaluations are completed, you will be able to download your certificate of completion.
      Click here give your feedback
      1 Questionnaire
      Course and Self Evaluation & Certificate
      • Course Evaluations Questionnaire
        Restricted Not available unless: The activity Final Exam is marked complete
      • Self Evaluation Questionnaire
        Restricted Not available unless: The activity Final Exam is marked complete
      • Health Behaviors Survey Questionnaire
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    Lifestyle
    Lifestyle Medicine Home Page
    Module 1: Introduction to Lifestyle Medicine
    Module 1 : Lesson 1: Definition, Role, and Evidence Base for Lifestyle Medicine
    Module 1 : Lesson 2: The Importance of Lifestyle Medicine in Treating the World's Lifestyle Disease Burden
    Module 1 : Lesson 3: The Role of Physician Health and Physician Advocacy
    Module 1 : Lesson 4: Environmental Lifestyle Factors and Their Impact on Non-communicable Diseases
    Module 2: Fundamentals of Health Behavior Change
    Module 2 : Lesson 1: Introduction to Behavior Change
    Module 2 : Lesson 2: Tools for Health Behavior Change
    Module 2 : Lesson 3: Techniques for Health Behavior Change
    Module 2 : Lesson 4: Building Effective Relationships with Patients
    Module 2 : Lesson 5: Maintain Healthy Behaviors
    Module 3: Physical Activity
    Module 3 : Lesson 1: Introduction to Physical Activity
    Module 3: Lesson 2: Recommendations on Physical Activity
    Module 3 : Lesson 3: Components of Physical Activity
    Module 3 : Lesson 4: Patient Evaluation
    Module 3 : Lesson 5: Exercise Prescription
    Module 3 : Lesson 6: Improving Exercise Adoption and Maintenance
    Module 4: Nutrition
    Module 4 : Lesson 1: Introduction to Nutrition
    Module 4 : Lesson 2: The Role of Nutrition in Preventing and Treating Chronic Diseases
    Module 4 : Lesson 3: Dietary Guidelines and Nutrition Prescriptions
    Module 4 : Lesson 4: Obesity
    Module 5: Sleep Health
    Module 5: Lesson 1: The Role of Sleep in Health
    Module 5 : Lesson 2: Sleep Disorder Evaluation and Management
    Module 6: Tobacco Use
    Module 6 : Lesson 1: Epidemiology of Tobacco-Related Diseases
    Module 6 : Lesson 2: The Physiological, Psychological, and Behavioral Components of Tobacco Use
    Module 6 : Lesson 3: Treatment of Tobacco Use
    Module 7: Alcohol Use
    Module 7 : Lesson 1: Epidemiology of Alcohol-Related Diseases
    Module 7 : Lesson 2: Screening for Harmful Alcohol Use
    Module 7 : Lesson 3: Intervention and Prevention
    Module 8: Emotional and Mental Well-being
    Module 8 : Lesson 1: Relationship Between Stress and Health
    Module 8 : Lesson 2: Screening and Screening Tools
    Module 8 : Lesson 3: Lifestyle-related Intervention Strategies
    Module 8 : Lesson 4: Depression and Anxiety in Patients with Comorbidities
    Module 8 : Lesson 5: Stress and Burnout Among Physicians
    Module 9: Sexuality and Health
    Module 9 : Lesson 1: Relationship Between Sexuality and Health
    Module 9: Lesson 2: Counseling Patients with Sexuality Issues
    Module 10: Implementing Lifestyle Medicine
    Module 10 : Lesson 1: Health Promotion in Clinics and Practices
    Module 10 : Lesson 2: Key Clinical Processes in Lifestyle Medicine
    Module 10 : Lesson 3: Strategies for Effective Office Systems to Plan Screenings, Follow Up on Test Results and Clinical Follow-Ups
    Module 10: Lesson 4: Strategies to Obtain Information about Local Community Resources
    Final Exam
    Course and Self Evaluation & Certificate
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