Thursday, January 31, 2019

January Leadership and Workplace Mondays roundup

keywords:  leadership, workplace, workplace culture, being an employee, mentorship and mentor relationships, mindfulness and leadership

Inspiration for Employees and their Leaders 

Review of the "Leadership and Workplace Mondays" theme from the public HHP Facebook Page, January 2019

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Related blogposts on Leadership

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CMS public comment call out for coverage of acupuncture for low back pain

Medicare, Medicaid, insurance coverage, major hospital insurance entities, federal health care coverage policy, health care policy

CMS and acupuncture coverage for LBP
The U.S. Center for Medicare and Medicaid Services (CMS), whose coverage policies are intertwined in hospital and medical center systems, has announced a call for public comment on the topic:  “acupuncture coverage for low back pain”.

To my knowledge, this is the first time in history the CMS has ever announced a public comment call for anything related to coverage of acupuncture services.  Tell your hospital sponsors and advocates.  If CMS reimbursed for acupuncture and other integrative health therapies, that would be a major milestone.

CMS is under the U.S. Department of Health and Human Services (HHS).  HHS is an enormous department that also contains the National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ)

In the announcement, they state, 
“In response to the U.S. opioid crisis, HHS is focused on preventing opioid use disorder and providing more evidence-based non-pharmacologic treatment options for chronic pain. The [AHRQ, CMS, and NIH] are collaborating in this effort.”  In June 2018, AHRQ “published a systematic review of noninvasive, nonpharmacological treatment for chronic pain.”  “This review included assessment of several nonpharmacological interventions, including exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation for [chronic low back pain] CLBP. “

Then, the CMS announcement says:
“The NIH recently issued a Funding Opportunity Announcement for interested parties to apply to conduct an efficient, large-scale pragmatic trial to evaluate the impact of, and strategies to best implement, acupuncture treatment of older adults (65 years and older) with chronic low back pain.”

“CMS is opening this national coverage analysis (NCA) to complete a thorough review of the evidence to determine if acupuncture for CLBP is reasonable and necessary under the Medicare program.  CMS is soliciting public comment on this topic.  We are particularly interested in comments that include scientific evidence and discuss appropriate clinicians and training requirements to provide acupuncture that improves health outcomes.  In addition, for commenters recommending Coverage with Evidence Development, we are interested in comments related to appropriate outcomes and study designs.  While CMS has conducted previous national coverage analyses on acupuncture, the scope of this current review is limited to acupuncture for chronic low back pain.”

Public comment period ends 2.14.2019

Wednesday, January 30, 2019

January 2019 Research Thursdays Summary

key words:  research literacy, funding and grants, sharing related research in the field, research in integrative health

The January Research Roundup

(and funding announcements!)

Review of the "Research and Metrics Thursdays" theme from the public Facebook Page and newsletter

NCCIH and NIH Research Funding Opportunity--the HEAL Initiative 
Patient-Centered Outcomes Research Institute (PCORI) Funding Announcement

National Academy of Medicine (NAM) 2018 “Non-Pharm Pain” Conference.  
  • December 2018 recording.  recommended lunchtime listen
  • The recordings from this conference are now available to view.  I added the NAM playlist for this conference to the HH Project channel’s library.  Thank you to ACIH for announcing this information.  
  • The NAM conference was 2 days, so the recordings playlist is long.  So far, I recommend the first video with Dr. Cherkin. 
  • Here is the link to the playlist.
  • Here is the link to this NAM conference agenda, to help you choose recordings most interesting to you.
Upcoming NCCIH Conference:  Workshop on Acupuncture Research
  • Translating Fundamental Science of Acupuncture into Clinical Practice:  For Cancer Symptom Management, Pain, & Substance Abuse

Massage Therapy
  • Massage Therapy Foundation Poster Abstract Submission deadline 1.31.2019
    • For those of you working with or leading massage therapists and collecting metrics, the 2019 call for poster abstracts for the International Massage Therapy Research Conference (IMTRC) is out:
    • Call for Posters for IMTRC 2019 ends 1.31.2019
    • Go here for the poster application
    • The IMTRC is held once every 3 years.  It is “an opportunity to learn the latest research, connect with colleagues, and gain insight into best practices in massage therapy.” And it “brings together thought leaders in the profession and educators to discuss massage therapy innovations”
    • The next IMTRC conference is May 9-10, 2019 in Alexandria, Virginia.
  • Massage Therapy Foundation Research Grants for 2019—applications are now open. Submission deadline is March 1st, 2019.
    • “Massage Therapy Foundation Research Grants are awarded to those conducting studies that seek to advance our understanding of specific therapeutic applications of massage, public perceptions of and attitudes toward massage therapy, and the role of massage therapy in health care delivery.”
    • Read more and apply at:
  • Massage Therapy Foundation Community Service Grants for 2019—applications are now open. 
    • Submission deadline is April 1st, 2019
    • If you work with a 501c3 organization providing massage, you may qualify.  They say they take applications from the U.S., internationally, and have a specific grant opportunity for those providing massage therapy in northern Illinois.  Learn more about this community service grant here:
  • Massage therapy case report submissions

FDA Roadmap Series with the National Health Council
  • The January 17th, 2019, webinar was on "Untangling the Terms: Endpoints, Items, Outcomes, PROs, PROMS, PRO-PMs" with Ashley Slagle, MS, PhD.  For more about this series and to watch the latest webinar, go to the FDA Roadmap Lunchtime Listen recommendation post.

Breathwork, a foundation in Traditional Chinese Medicine practice, and a research article
  • Research Thursday...Breathwork
  • As an east Asian medicine practitioner (acupuncturist) I have been teaching my patients diaphragmatic breathing on day one and reinforced practice throughout treatment course with related self-care homework. This breathing practice often also called "belly breathing" has been known for a long time to help us consciously switch our breathing state into the parasympathetic state (rest and digest). Because, in our modern world, most people go about their day in sympathetic state of breathing (fight or flight). Breathwork, the conscious control of your breath, is the foundation of qi gong and mindfulness practices.
  • More recently, research has been conducted to test these age-old practices, such as this article available on PubMed.  --Megan

Recommended Studies to Read in Older Newsletters

For more on the topic of research
  • follow the tag/label in this blog for "research literacy"

More Research Thursdays Summary posts
December 2018

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Tuesday, January 29, 2019

Resource: The Teaching Kitchen Collaborative (TKC) and Healthy Kitchens, Healthy Lives

key concepts:  improving public health through whole systems nutrition, patient-centered care, Traditional East Asian Medicine paradigm of wellness, incorporating integrative health paradigms into modern health care system practices, teaching cooking skills to improve health, teaching patients self-care, modifying determinants of health through changing individual behavior around eating & cooking..nutrition

keywords: mind-body medicine, integrative health, community health and wellness,  learning nutrition for health, Teaching Kitchen Collaborative (TKC), Healthy Kitchens Healthy Lives® conference
TCM = Traditional Chinese Medicine
NCCAOM® = National Certification Commission on Acupuncture and Oriental Medicine
HKHL = Healthy Kitchens, Healthy Lives®

“If a patient has a chronic condition, first modify diet and lifestyle, then add medicine”.  –paraphrase, inspired by Sun Si Miao

In East Asian Medicine, we know that, for best long-term self-care and health maintenance, we prescribe patients foods to incorporate in their diet.  Why? To manage their conditions and support their constitution.  For example, individualized TCM nutrition consults were a self-care session I would do with my chronic pain patients when they were interested in learning more about food as a basic support system for health.  As a board-certified TCM herbalist (NCCAOM®-board certification), it took me time to research and put their personalized plan together.  And, for a patient, modifying diet takes courage and commitment and follow up.

There is a new resource for helping patients learn and practice cooking healthy meals coming to a neighborhood medical facility or academic center near you, the "Teaching Kitchens".  Well, maybe not so new.  Several of these teaching kitchens have been around for a decade, but the hope is, that with the collaborative now helping stand-alone centers connect to more resources, that the movement will grow and expand.

What is this new resource for providers and patients?
The Teaching Kitchen Collaborative

Twenty years ago, Dr. David Eisenberg noticed that few health professionals understood the science of nutrition and most of them knew even less on how to cook healthy meals for themselves, let alone teach such skills to their patients.  So, he worked with a team (Harvard School of Public Health and the Culinary Institute of America) to create an annual conference for health care professionals to bring together physicians, dietitians, nurses, allied health professionals, hospital administrators, and culinary specialists together, the Healthy Kitchens, Healthy Lives® conference, the first of which was in 2006 [Eisenburg, JACM, July 2018],

Dr. Eisenberg was an early advocate of the integrative health paradigm and, from the enthusiasm and success of the Healthy Kitchens Healthy Lives® conference, launched The Teaching Kitchen Collaborative (TKC). 
The resource-sharing collective that the TKC can be, has the potential to encourage academic health institutions to recognize that nutrition and lifestyle change is a viable part of the treatment plan.
TKC is a "data-driven, taste-driven, whole system, experiential ... transformation campaign to put food, nutrition, and lifestyle front and center, in transitioning our medical industry toward ... a health care system."  [Eisenburg, JACM, July 2018]
TKC launched in 2016 by the Harvard T.H. Chan School of Public Health-Department of Nutrition and The Culinary Institute of America (CIA).  The TKC "is an invitational network of over 30 organizations using teaching kitchen facilities as catalysts of enhanced personal and public health.  The TKC's mission is to enable early adopters to learn about one another's facilities and educational programs, to develop best practices for reproducing and scaling emerging models, and to document the clinical, behavioral, and financial impact of teaching kitchens for a broad range of populations."

Individual Teaching Kitchens include:
  • The Cleveland Clinic Center for Lifestyle Medicine
  • Maine General Health
  • Kaiser Permanente San Francisco Medical Center 
  • Turner Farm with University of Cincinnati Center for Integrative Health and Wellness
  • University of Michigan's MHealthy 
  • University of Minnesota's Center for Spirituality and Healing 
  • Vanderbilt University Medical Center's Osher Center for Integrative Medicine and Center for Biomedical Ethics 
  • The Sampson Family Branch of YMCA Greater Pittsburgh
  • Google
  • member list landing page

The Teaching Kitchen Collaborative is a movement to connect teaching kitchens to each other.  Because a Teaching Kitchen can, potentially, be a "catalyst of enhanced personal and public health across medical, corporate, school, and community settings.”

The TKC regularly hosts research days or other opportunities to share your program’s story, progress, and research.  If you are already doing this work, the TKC seems like a great way to share what you are doing and be connected to others doing similar work.  It seems like it would be a good place to support each other while changing the U.S. culture of health, wellness, and “food as grounding for health”.

Why join the TKC?
For all the reasons, watch the video below.  Here are some useful quotes from the video:
from long-term research studies:
“We've learned that healthy dietary choices have a huge impact on the number of years that we live and how we feel during those years that we're alive and the teaching kitchen collaborative is a way to translate what we've learned into the… meals that people can have available and enjoy.” minute 0:11 Walter C. Willett, MD, DrPH
On benefits of being a member: 
"tap into the expertise of all the other members on things like outcomes based research” minute 3:27   
“It's just been fabulous hearing from all the other members, the discussions, the collaborations, and opportunities that we have going forward to work as teams and across institutions all over the country” minute 03:32
“The benefit from being part of the collaborative is [it] helps… resource good information.  So, I see it as it’s not just a network of people collaborating together,  but… it will … be a rich database…to access…the research...  It is a network, too, so the ability to develop relationships with people around the country--for that matter around the world--is an opportunity that I think we couldn’t have gotten anywhere else.” Lori Knutson, RN minute 4.56

TKC kitchens are places/groups 
“who are using kitchens as catalysts of personal and societal health enhancement.  [Teaching kitchens are] the vehicle to teach people about food, nutrition, and new habits.” minute 00:31 
A teaching kitchen is “a platform to really acknowledge the crucial role of nutrition and dietary information in the entire whole look at a person's lifestyle choices and wellness” minute 01:40
“[Teaching] kitchens, when used appropriately for different populations in different settings, will change behaviors for the better…will change health outcomes for the better…will be sustained changes."  
"And ultimately we hope to prove that they will change [lower overall population healthcare] costs either by preventing chronic disease [or by] bringing people with chronic disease portfolios back to a healthier state.” David Eisenberg, MD  minute 4.19
“So I think the capacity for multi-site research trials around food and mindful living and exercise and movement is enormous to be able to scale up as opposed to a one kitchen .”  [TKC has] “the capacity to reach so many more kids and families.  The capacity to prevent cardiovascular disease…prevent diabetes and hypertension…prevent the major chronic conditions that we know are very heavily influenced by lifestyle… the capacity as a collective group is enormous.” Sian Cotton, PhD minute 5.16
“But the goal is to show that we can build reproducible teaching kitchens that will change our society for the better on the individual basis and across populations.  And that we will also save money while doing that.” David Eisenberg, MD minute 5.48

The conference for the TKC, the Healthy Kitchens, Healthy Lives conference, is next week, February 6-8th, 2019

Is your program or hospital system connected to this resource? 

  • the opening presentation for the research day and abstracts:
  • The Teaching Kitchen Collaborate
  • The Healthy Kitchens, Healthy Lives conference, annual 
  • PBS NewsHour 8 minute video 
  • The 2018 TKC Research Day Abstracts
    • The Journal of Alternative and Complementary Medicine.  Volume 24, no. 7. Teaching Kitchen Collaborative Research Day Abstracts.  The Estate Yountville, Napa Valley, CA, USA. February 7th, 2018
    • “A day of original research and innovative strategies involving teaching kitchens and their potential to positively impact behaviors, improve health outcomes, and reduce costs.”
    • Published online 1 Jul 2018
    • Citation:  The Journal of Alternative and Complementary Medicine.  Jul 2018. Ahead of print. Published in volume: 24 issue 7:  July 1, 2018.

Related blogposts  

More on Teaching Kitchens (added October 2019)

  • 🥕🥗

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