Every week a group of people gather at the Alameda Health System (AHS)-Hayward Wellness Center for happy hour to dance, laugh, eat and connect. The only thing missing is the cocktails.

“One of AHS’s PRIME projects focuses on depression – screening, treating, and monitoring. In addition to conventional medications and counseling services, we wanted to develop a deeper behavioral support group to help our depressed patients and integrate it with our ‘Food is Medicine’ program,” said Steven Chen, M.D., medical director for the Hayward Wellness Center. PRIME or Public Hospital Redesign and Incentives in Medi-Cal is one of Medi-Cal 2020’s programs.

Depression is a common coexisting condition of many chronic illnesses like heart disease, diabetes and obesity. Medication can be prescribed to treat these ailments but it is usually coupled with a recommendation from a health care provider to increase physical activity and eat a well-balanced diet. Unfortunately, there is no pill to replace exercise or an elixir that can pour out a healthy meal.

Staff at the Hayward Wellness Center recognized the barriers patients face when trying to make behavioral changes like not having funds for a gym membership or not having access to a healthy grocery store. They decided to take matters into their own hands and create a behavioral pharmacy to meet these needs and Open Source Wellness (OSW) provided the perfect formula.

“To help us meet this PRIME metric on depression, we’ve partnered with organizations like OSW and Dig Deep Farms to provide an on-site delivery system for a ‘Behavioral Pharmacy’ and a ‘Food Farmacy,’” said Chen.

OSW “behavioral pharmacy” was founded by two psychologists, Elizabeth Markle, PhD and Ben Emmert-Aronson, PhD, who left clinical practice in order to address the gap they experienced between offering patients “behavioral prescriptions,” such as “exercise more,” knowing that all patients do not have access to resources to create healthy behavior change.

“One of the best things about our program is it brings people together who would probably never interact with each other and its trans-diagnostic,” said Emmert-Aronson. “Whether patients are struggling with obesity, diabetes, heart disease, or depression, our four basic pillars of Move, Nourish, Connect and Be, provide the building blocks for sustained wellbeing.”

On Thursday’s OSW and Hayward Wellness Center staff participate in these group medical visits with 12-15 patients. The visit opens with patients taking their vital signs and then moving to physical activity (Move) led by OSW to high-energy music. Next is meditation (Be), which serves as a cool-down period and a time for patients to focus on mindfulness.


There is also a nutrition (Nourish) component led by AHS nutritionist and certified diabetes educator, Zalak Trivedi. Patients receive a healthy snack, a recipe and have conversations on alternate ways the snack can be prepared. “I enjoy having the extra time to connect with my patients. These group medical visits give me a chance to really get to know them and help them make healthy lifestyle changes at their own pace,” said Trivedi.

The class closes with patients going into mini groups (Connect) to discuss their personal health goals. When the group medical visit is over, patients are given produce prescription vouchers for fresh vegetables from the “Food Farmacy” in the lobby hosted by Dig Deep Farms. Produce prescription vouchers are funded through a grant secured by the AHS Foundation.

“We want our patients to know we have a delivery system that is convenient and part of their medical home,” said Chen. “These group medical visits allow providers to spend more time with patients to help address other issues that we wouldn’t be able to discuss in a 15-20 minute visit. This behavioral pharmacy leads to greater relationship building, management of multiple diagnoses, improved treatment and care and has the potential to transform how we care for patients system wide.”

When patients were asked about the best part of the class they said it was the camaraderie which isn’t surprising. Data shows that in just 4-6 weeks, patients report having a better reduction in depression from participating in OSW group visits than taking antidepressant meds. Additionally, they also have, lower weight and lower blood pressure.  Please see patient testimonials below.

I needed this because I’m a caregiver so this gives me time to take care of myself, you learn a lot of good information, nutrition and get good socialization. I’m able to set small goals for myself and they help me with health issues. I haven’t missed a group visit since I started.

The socialization and learning from each other is very enlightening. I duplicate the healthy recipes we learn in group visits at home. My main problem was I couldn’t exercise but this program forces me and I like it, it has helped a lot.

I am here for my wife, she needs to get out and get exercise, she also needs her blood pressure checked regularly. She needs the support, we need the support. We have fun and it’s nice to have a break from my busy schedule.