{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:49:12Z","timestamp":1782121752938,"version":"3.54.5"},"reference-count":47,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100009410","name":"Southern California Clinical and Translational Science Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009410","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Center for Advancing Translational Sciences at the National Institutes of Health","award":["UL1TR001855"],"award-info":[{"award-number":["UL1TR001855"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Occup Ther"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    In primary care (PC) clinical, healthcare utilization, and financial outcomes associated with Lifestyle Redesign\n                    <jats:sup>\u00ae<\/jats:sup>\n                    Occupational Therapy (LR-OT), a framework that incorporates healthy habits into daily routines, are not well documented in the United States.\n                    <jats:bold>Purpose:<\/jats:bold>\n                    (a) Compare clinical outcomes, healthcare utilization, and associated cost differences between patients who received LR-OT and a control group. (b) Assess the investment required integrate LR-OT into PC.\n                    <jats:bold>Method:<\/jats:bold>\n                    LR-OT was integrated into a safety-net PC clinic. In a hybrid effectiveness-implementation clinical trial (#NCT03293914), clinical (glycated hemoglobin A1c [HbA1c], blood pressure, cholesterol, and body mass index) and utilization (outpatient, emergency department [ED], hospital visits) data were extracted from medical records of provider-referred adults with diabetes (HbA1c \u2265 9.0%) who were willing to make lifestyle changes.\n                    <jats:bold>Results:<\/jats:bold>\n                    Of 155 referred patients, 142 were randomized to LR-OT (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200973) or a control group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200969), and 42 completed eight LR-OT sessions within 6 months. Underpowered clinical outcomes indicated no significant change, with aggregated trends suggesting LR-OT supports sustained cardiometabolic improvement. Savings of $250,518.96 is attributed to LR-OT, driven by significant decreases in ED visits (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.03) and hospital days (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.03), despite nonsignificant increases in outpatient utilization. The projected cost-benefit of integrating a full-time LR-OT in PC is $352,326.72 with a 236% return on investment.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Clinical trends and significant reductions in acute care services drove healthcare-wide cost savings, demonstrating clinical and financial value of integrating LR-OT into PC.\n                  <\/jats:p>","DOI":"10.1177\/00084174261421403","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T16:38:32Z","timestamp":1772037512000},"page":"204-216","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Primary Care Lifestyle Redesign\n                    <sup>\u00ae<\/sup>\n                    Clinical Trial: Diabetes Outcomes, Healthcare Utilization, and Costs"],"prefix":"10.1177","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8751-2583","authenticated-orcid":false,"given":"Valerie","family":"A. 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