How to Actually Succeed at Behavior Change

Here’s a harsh bit of reality for you: there is no magical method to making healthy lifestyle changes. Fad diets and exercise crazes might make it seem like there is, but they’re wrong. Sad news for the members of your community who want to change thier behavior.

The truth is that the secret to meeting overall health recommendations, from quitting smoking to getting more exercise, is to put one foot in front of the other–and keep doing it. Changing the way you live is simply hard. It just is.

However, there is one technique that actually can make that tough transition easier: setting SMART goals.

SMART Goals

SMART goals break down any task that seems too big to meet by breaking it down into what’s Specific (S) about the goal, how you can Measure (M) it, making it Achievable (A), and also Realistic (R) or Relevant, and setting up a Timeline (T) to complete it.

We talk about SMART goals all the time in our health education materials because they are so effective.  They make big lifestyle changes more manageable.

For example, think about someone who feels overwhelmed by a new diagnosis of hypertension. Their doctor tells them they need to exercise more and lose weight. They might start thinking “I have to run a marathon!” even though they’ve never walked further than the mailbox, or “I need to lose 20 pounds this month!” without considering what needs to change in their diet. Those goals are discouraging and impossible to achieve–a real setback for successful self-management.

Now, when you put a goal like “exercise more” into a SMART format, it changes from “run a marathon” to “walk around the block twice this week.” The difference is huge and makes behavior change something that most people can actually do.

SMART Goals and Behavior Change

Here are some examples of how SMART goals work with different health motivations. To take a SMART approach, they answer these questions (copy them down so you can use them with yourself or a client today):

  • What is Specific about the goal?
  • How will you Measure the goal to know it’s been achieved?
  • Is it Achievable?
  • Is the goal Realistic?
  • Is the goal on a Timeline?

Hypertension

Unspecific goal: “Follow the DASH diet.” The DASH (Dietary Approaches to Stop Hypertension) is a diet that many health providers recommend to patients.

SMART approach: “This week I will eat two cups of fruits and vegetables with dinner and lunch.”

Exercise

Unspecific goal: “Get healthy.” This very fuzzy goal is all too common among people who are trying to build more physical activity into their lives.

SMART approach: “I will meet with a mall walking group on Saturday morning.”

Dieting

Unspecific goal: “Lose 40 pounds.” Many people know they need to lose weight, and even how much, but that’s difficult without a path.

SMART approach: “This month I will lose 5 percent of my current weight. This will allow me to meet my goal by the end of the year.”

Smoking

Unspecific goal: “Stop smoking.” This is a common and clear directive. People need to stop but don’t know how.

SMART approach: “Tomorrow I will replace all the ashtrays in the house with a pack of Nicorette gum.”

Drinking Alcohol

Unspecific goal: “I shouldn’t drink so much.” Breaking through the habit of drinking is hard without a plan.

SMART approach: “I will pick two days this week when I won’t drink.”

Do you see how these short goals seem like something you can do? Meeting one goal makes it easier to move on to a new one. And that is the secret to better health: one step at a time.

Free Ebook: America’s Walking Renaissance

Everybody knows they need to exercise more and eat less. They probably even know that getting some physical activity—even walking for 20 minutescan reduce the chance of getting diseases like heart disease and hypertension, controlling stress and keeping the brain engaged. Plus, studies show that people who spend more time each day sitting (watching TV, driving around or sitting at a desk) are more likely to die early than those who don’t.

That’s all real. We know it, and that’s why we promote health in the communities where we live and work. But then the unrealisitc excuses kick in. That you have to run a marathon to be in shape. That you have to exercise by yourself. That you’ll never be able to fit in another thing with work, school, family…whatever's taking up time.

We need to correct that and show people that you can see real health gains by taking a short walk, and that getting any exercise is better than none.

America’s Walking Renaissance

You don’t have to take my word for it. Listen to Heidi Simon and her colleagues at America Walks and the Every Body Walk! Collaborative, who just released a new (free!) book: America’s Walking Renaissance.

America's Walking Renaissance

America’s Walking Renaissance is a journey across the US, taking a look at walkable cities of all shapes and sizes and providing resources and information on the growing walking movement,” Simon said in an email interview. “From Phoenix to Birmingham to Northeast Iowa, we look at how the US is taking steps towards walkability and look at lessons [from] other communities.”

She, along with Jay Walljasper and Kate Kraft, spent more than a year interviewing, researching and visiting locations all around the States to document successful walking programs. The aim in this project is to share information along with actionable tips, so more organizations and health educators can spark walking programs where they are.

Successful Walking Programs to Copy

A few examples from the free ebook:

Vision Zero, active in more than a dozen cities to reduce the number of walkers who are killed when crossing the street. Vision Zero pushes campaigns through local law enforcement and public education.

Better Bridges Bash, in St. Paul, MN, which puts on street parties in urban environments that are bisected by freeway bridges and overpasses.

Arlington, VA, a success story among suburban cities. Arlington has been named the most walkable suburb in the country. The city transformed itself over years, revamping everything from sidewalk space to accessibility of stores.

“It is our hope that this book will serve as an inspiration for communities looking to embrace walking and motivation for those already on the walking path,” says Simon.

Download the Free Ebook

Download America’s Walking Renaissance for free.

Popular Healthy Community Courses Now Available in Spanish

Release Date: Aug. 1, 2016

Learners can learn about diabetes, health literacy and health insurance in Spanish or English

WOBURN—Talance, Inc., today expanded the reach of its popular courses in health education and promotion. Now, three of the most popular courses are available in Spanish as well as English: Health Literacy: A Start, Navigating Health Insurance and Diabetes and Prediabetes.

The Spanish version of the online courses feature the same interactive curriculua as their English counterparts, and are accessible from nearly any screen from talance.com. They also allow learners to ask questions and have discussions in Spanish. The courses also contain new and updated on-the-job resources available for Spanish speakers.

“Having these courses available in Spanish is a powerful tool for spreading information about these vital health topics,” says Monique Cuvelier, president and co-founder of Talance, which provides training to groups, teams and organizations across the US. Past projects from Talance include courses in Hebrew, French and English as a second language.

“Spanish is the biggest non-English language spoken in this country, and having courses available to this huge swath of the population is important.”

Health Literacy: A Start (Entendiendo la Información Sobre Salud: Primeros Pasos) offers an introduction to health literacy and why it matters, including assessment and communication skills for addressing literacy gaps.

Navigating Health Insurance (Entendiendo los Seguros Médicos) introduces the terms and concepts related to health insurance so participants can help clients get insured.

Diabetes and Prediabetes (Diabetes y Prediabetes) introduces non-clinical community and health workers to diabetes and prediabetes so they can support their clients’ management of the disease.

Talance’s ready-to-go courses take place over one week and feature expert facilitation by fluent Spanish speaking instructors. They’re designed to build healthy communities in schools, worksites, health care and community-based settings. Talance also creates custom curricula for clients who want to build their own healthy communities.

For more information on these courses and other educational materials from Talance, please visit talance.com or contact Monique Cuvelier at (888) 810-9109.

Exercise for Disease Management Is a Bitter Pill To Swallow

Many find the advice of exercise for disease management a bitter pill to swallow, even when faced with a scary diagnosis like diabetes or hypertension. Thinking of exercise as doctor-ordered medicine makes it seem too tedious and boring. Simply “exercising for 30 minutes a day” can feel like too much of a time commitment. Sitting still is easier. This is why sedentary lifestyles lead to as many as 1 in 10 premature deaths around the world.

But what if exercise could be fun rather than a chore?

I saw this in action the other day at the gym. Looking out the window, trying to forget I was on the elliptical machine, I saw swarms of kids running, spinning around and racing each other everywhere. It’s the kind of behavior I hadn’t seen since I was about 12.

I wondered what on earth could push kids of all shapes and sizes to voluntary physical fitness. After all, these are the same children who statistically spend more than seven and a half hours a day in front of a screen.

They were playing Pokémon GO.

Making Physical Fitness a Game

Pokémon GO, for the uninitiated, is a wildly popular game for mobile devices that sends players on real-world scavenger hunts for online characters. Players see their real environment through their phones but with an image of a Pokémon character.

The unintended benefit of this game is that the kids in my neighborhood are becoming more physically active. Why? Because it’s fun.

This is the message we push in our work with schools, companies and communities. Make regular exercise fun, and people will keep doing it. Getting in 30 minutes per day does not have to be drudgery—honestly!

Ideas for Promoting Healthy Living

Pokémon GO is one suggestion for making healthy kids. Here are some other ideas from some of the people who participated in our Promoting Healthy Lifestyles course:

For two clients who are in wheelchairs but need physical activity:

“I recommend hand bikes, stretchy bands, leg lifts (if they are not paralyzed), and/or pool exercises.”

For a 16-year-old girl unhappy with her weight who loves animals:

Volunteering at an animal shelter to walk the dogs/socialize with the animals is a low-cost way to get some exercise without ‘overtly’ exercising.”

For someone with arthritis pain to work healthy habits into his life:

“Since one of his barriers is pain in his joints, I advised him to start small by parking his car farther away from the entrance when he went shopping.”.

For motivating a family member to exercise regularly:

“My daughter was overweight and a loner. We started to go to Zumba classes together. She enjoys it and she has lost weight. She has maintained her weight and she changed her diet on her own.”

Share these ideas with someone who could use a little motivation for active living today.

4 Summer Reading Picks That Are Good for You

If you like your summer reading to reaffirm the work you do building healthy communities, we’re here to help. Here’s your professional development reading assignment that’s actually fun. Some are learner favorites from our courses and others just deserve attention. Read on for picks for the summer reading season, which we hope will inspire you to keep learning even when you’re on the beach.

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

by Anne Fadiman, Paperback, 368 pages

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

The Spirit Catches You and You Fall Down could be a textbook case study for culturally competent care—it’s certainly a rich example and one we use in our health literacy course—but it’s also the compelling tale of what happens when well-intentioned health care workers fail at cross-cultural communication. Author Anne Fadiman tells with masterful literary journalism the story of Lia Lee, a Hmong child from a refugee family from Laos living in California. Lee, diagnosed with severe epilepsy, suffers while her loving parents and providers miscommunicate while she goes from emergency room visits to intensive care unit (ICU) admissions to legal courts and finally to irreversible neurologic damage.

Read an Excerpt

The Spirit Catches You and You Fall Down (Chapter 1) Birth

If Lia Lee had been born in the highlands of northwest Laos, where her parents and twelve of her brothers and sisters were born, her mother would have squatted on the floor of the house… READ THE FULL EXCERPT

The Arrival

by Shaun Tan, Hardcover, 128 pages

The Arrival

The Arrival is a stunning, compelling piece of art with a powerful story about what it’s like to leave your home for a new country. Shaun Tan’s graphic novel–which doesn’t use a single word (aside from the title)–is a lesson in empathy and communication. The migrant story trails a man who leaves his wife and child in a faraway city to find opportunity elsewhere. Everything is fantastical and foreign: strange animals, unintelligible languages, and incomprehensible customs. Along the way, he’s helped by strangers, who each have their own complex histories. Its gorgeous pages let you experience what it’s like to be helpless in a strange place, and also provide a valuable example of how you can communicate when words fail.

One Step Behind

by Henning Mankell, Paperback, 440 pages

One Step Behind is truly beach reading material, but it shows that illness can befall anyone, even Inspector Kurt Wallander. Henning Mankell’s popular Swedish crime series is just as gruesome and horrific as his other novels (spoiler alert!), but this time Wallander is solving crimes while dealing with a new diagnosis of type 2 diabetes. He shows that diabetes self-care is extremely challenging when you have a busy day job. This book didn’t make the cut of our Diabetes and Prediabetes course, but it still provides an interesting perspective on juggling health care needs with work.

Tip for TV-watchers: this book was also made into an hour-long series starring Kenneth Branagh.

Watch a Clip

Instant Influence: How to Get Anyone to Do Anything—Fast

by Michael Pantalon, Hardcover, 256 pages

Instant Influence

Students of Motivational Interviewing know that this communication framework is invaluable for inspiring people to stop smoking, eat less salt, exercise more, and generally make positive behavior changes. Instant Influence: How to Get Anyone to Do Anything—Fast by Dr. Michael Pantalon is an excellent introduction to how motivational interviewing can have a positive effect on just about anyone, including your patients, clients and community members. The author draws on his 20-year career in addiction research and clinical practice to realize that:

  1. Motivating someone to enter treatment can be done with effective strategies. (Interventions rarely work)
  2. We have treatments that work, but we’re not using them. (Most rehabs don’t use scientifically supported treatments)
  3. You need help to get good help. (AA is not treatment, a recovery coach will help you get treatment)

Watch a Clip

Sneak Peek at Our Course Diabetes and Prediabetes

Diabetes affects more people today than ever before. In the US, 29.1 million people have diabetes, and that number is on the rise — up four million from 2010. Alarmingly, more than 8 million of those people are untreated. They may not even know they have the disease.

Community members might generally know they need help controlling their disease, but they lack the knowledge and motivation to make it happen.

We want to make that easier and more accessible with our course Diabetes and Prediabetes, recently revamped. This online course is a way to empower people to make it easier to change behaviors among those with, or at risk of developing, diabetes. It’s being used by schools, neighborhoods, and workplaces.

Check out the Diabetes and Prediabetes course overview to see more about the topics covered, and look at the sneak peek below.

Diabetes from Talance on Vimeo.

If you’d like to know more or are interested in a deeper look, please let us know! Contact me to set something up. Happy viewing!

You Spoke, We Listened: What You Want To Learn

Whether it’s hearing about outstanding programs that build healthy communities or free toolkits and downloads, it’s clear you have an appetite for improvement.

Thanks to all of you who participated in our survey, telling us what kinds of information you’d like to learn in the coming weeks, months and years. We’re thrilled with the feedback and suggestions that help identify the most pressing challenges you face, so we can create resources to help you learn and improve.

A big takeaway from the experience is that you all want more inspiration and resources that will help you build healthy communities—whether it’s for a team of community health workers going door to door or pushing for policy change in neighborhoods or encouraging healthy living in workplaces.

We’ll be responding to your suggestions in future articles (remember, suggestions are always welcome!) but in the meantime, we found a few all-star articles that correspond to your top responses in the poll. Read on to find out what these are and pick up tips you might have missed in the past.

Important Notice!

Part of addressing your needs is expanding both what we write about and what we do. So the next blog article you read from us will be at our parent site, Talance, Inc. We’ll be opening our focus to include tips for building healthy communities everywhere: neighborhoods, health centers, schools, workplaces. You can look forward to more tips, resources and downloads, and also events and educational opportunities.

We hope you’re as excited as we are.

Top 4 Suggestions from the Poll

1. You want more free resources.

Resource For Navigating One Of The Most Overlooked Kinds Of Insurance

Tobacco Cessation Barriers Flashcards

10 Free Apps For Tobacco Cessation

Family Health History Initiative Starter Kit

2. You like to read about successful programs that use CHWs and the work individuals do.

Make The Case For CHWs: 7 Return On Investment Studies

Report On Washington State’s Popular CHW Training Program

Excellent Video That Explains Patient Navigators

Washington Helps Hundreds Of Community Health Workers Begin New Careers

How Susan G. Komen Is Speeding Up Breast Cancer Diagnosis and Treatment with Patient Navigtors

How One CHW Feeds Her Love Of Health Education

3. You need information on setting up and sustaining training programs.

E-learning Strategy in 6 Steps (this also falls under the “free stuff” category)

Why Should You Choose E-Learning For CHWs?

Hiring Skilled Facilitators Vs. Training Existing Staff

6 Ways To Market E-Learning

7 Supereffective Ways To Respond To Every Healthcare Learner

4. You like general topics about building healthy communities.

More Soldiers In The Battle Against Tobacco

We Can Leave Tobacco Behind

Food For Thought

Resource for Navigating One of the Most Overlooked Kinds of Insurance

Travel Medical Insurance Worksheet for CHWsOne in eight travelers will be impacted by an unforeseen problem: medical treatment or evacuation, natural disasters, or other issues, but only 29% have travel insurance.

Even though community health workers are dedicated to helping patients choose the right health insurance, they often overlook travel insurance.This is important because most traditional health insurance doesn't cover emergencies when traveling.

Get a free copy of this special worksheet for community health workers, promotoras, peer leaders, patient navigators, health advocates, and nyone who wants to help patients choose the best travel insurance. It includes:

  • What is typically covered by health insurance policies, including Medicaid and Medicare, and what isn’t
  • A step-by-step worksheet that provides the most important questions to ask about coverage
  • Resources for buying travel medical insurance
  • Checklists for preparing for travel and in case of emergency

Request Your Free Toolkit

    What Would You Like To Read on the CHWTraining Blog?

    We are so excited that our blog viewership has grown so much! We want to keep up the trend by making sure that we’re creating content that you’ll find exciting, engaging, and most importantly, useful.

    We’d love to get your feedback on the topics that you care about and want to see more of on the CHWTraining blog. Please take a moment to respond to our short poll to tell us more about your priorities and focus points. Use the survey below (click the Done button when you’re finished), or use this link to take the survey.

    Gratefully,

    The CHWTraining editors

    How To Make Training Investments Really Pay Off

    We recently conducted a report of our course HIV/AIDS: Supporting Community Members. The results had us giving each other high fives around the office: 70% said the course gave them the tools they directly needed for work, 90% said they had significantly increased competence in the topic, and one person said they used the course to kick-start a syringe exchange program in their community. Exactly the kinds of results we love to see.

    But when we asked how much importance learners’ managers placed on the skills and concepts they picked up, we were less than enthused. More than a third said their managers did little to let them use their new skills.

    Uh oh.

    Investing in health worker training is a smart move. It sets employers to have loyal, motivated workers who can do more on the job. Companies that invest $1500 or more for training, per employee per year, average 24 percent higher profits than companies with lower yearly training investments, according to HR Magazine. These figures are proof that training serves the organization well and increases the health of the community.

    While many employers recognize the value of investing in training, too many neglect this second step. They have to let people use what they’ve learned. Health worker training is of little use when that education ends with the last day of class.

    Here’s the secret to making sure investments in training pay off: make it easy for employees to learn, make it easy for them to share that knowledge, and set you and your staff up for success.

    1. Review your organizational goals before you register anyone in training. Your staff may love a course on creating walkable neighborhoods, but it doesn’t matter if your program’s focus is on oral health. (Read 11 Things To Know About Setting Training Program Goals.)
    2. When employees are done with a new training program, ask them to suggest new programs or improvements for existing ones based on their experience. Refer to earlier example of the syringe exchange program, which originated in a course forum discussion between two people at opposite sides of the country.
    3. Ask participants to share the knowledge they just learned. Ask them to prepare a presentation to give to the rest of the care team, or have them summarize some of the most salient resources in an email to your whole organization.

    Repeat with every person at every educational opportunity.