For Clinicians - internal resources | UCSF Integrative Hepatology

The BRIDGE program for collaborators

Behavioral Resources and Intervention through Digital Group Intervention (BRIDGE) is a group telehealth program designed to complement clinical care and promote self-management for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This group-based intervention offers accessible, longitudinal psychoeducational support to individuals across the MASLD spectrum, including sessions directed toward liver transplant recipients and individuals with cirrhosis. The BRIDGE program is integrated into clinical care through 90-minute group medical visits (shared medical appointments) held every two weeks over a 12-week period, independently led by an advanced practice provider.

The program aims to empower patients with knowledge while encouraging active participation in their care through peer-based learning and support. Drawing on Social Cognitive Theory and the Transtheoretical Model, BRIDGE fosters shared learning about the connections between health behaviors and liver health, builds community through peer interaction, and offers personalized support for developing self-management skills.

Each session follows a structured format: a 10-minute check-in, a 20-minute live PowerPoint presentation by the group leader, a 30-minute facilitated group discussion with Q&A to promote self-awareness and motivation for change, and a one-on-one consultation with the clinician to help patients set personalized health goals.

Clinicians interested in becoming BRIDGE group leaders will play a vital role in delivering education, guiding discussions, and providing personalized support to help patients improve their liver health and overall wellness. For more information about the BRIDGE program, please refer to the pilot study: Dalal, N & Catalli L et al. “Behavioral Resources and Intervention through Digital Group Education (BRIDGE): implementation of a group telehealth psychoeducational program through shared medical appointments for MASLD management” BMC Public health 2024 Jun 7; 24(1):1546. https://pubmed.ncbi.nlm.nih.gov/38849779/

BRIDGE program for MASLD patients - power point slides for providers

To open/download the presentations just double click on the image

BRIDGE Session 1: Introduction to Metabolic dysfunction-associated steatotic liver disease (MASLD)

This session provides an introduction to MASLD, covering key topics such as the dynamic nature of fatty liver disease, the role of metabolic dysfunction, its prevalence, and potential health impacts. Participants will gain an understanding of how MASLD is diagnosed and monitored over time. The group activity focuses on introducing cognitive behavioral strategies to help participants explore the connections between their environment, thoughts, emotions, physical symptoms, and health-related behaviors.

BRIDGE Session 2: Improving outcomes in MASLD

This session focuses on strategies to improve outcomes for MASLD and metabolic dysfunction through sustainable health-related behaviors, lasting weight loss, and the use of medications. Emphasis is placed on participants becoming active participants in self-care. The group activity helps participants identify their core values that inspire positive health behaviors and introduces the BRIDGE goal tracker as a tool to prioritize specific areas of health to focus on.

BRIDGE Session 3: Motivation and Making Change

This session explores the factors that drive behavioral change, including an overview of the Transtheoretical Model, which outlines the stages of change and strategies for addressing relapse of unwanted behaviors. Participants learn about feedback loops that support ongoing adjustments in behavior and are introduced to SMART goals, which they can apply using the BRIDGE goal tracker. During the discussion, participants assess their position in the cycle of change, identify what motivates progress, and recognize barriers that hold them back.

BRIDGE Session 4: Eating Habits for a Healthy Liver

This session provides evidence-based recommendations on dietary practices that support liver health, covering key components of healthy eating, factors influencing food choices, and mindful eating techniques. Handouts are provided on the Mediterranean eating pattern, reading nutrition labels, and tracking carbohydrate intake. During the discussion, participants share their dietary goals and reflect on situations that lead to either desired or undesired eating habits.

BRIDGE Session 5: Physical activity for a Healthy Liver

This session highlights the benefits of various types of exercise, including cardiovascular activities and strength training, to improve MASLD, metabolic health, and overall well-being. Practical strategies to increase physical activity are discussed, with demonstrations and resources provided. During the discussion, participants share insights into what motivates them to engage in physical activity based on the session content.