1
The Health Benefits of Success Experiences
David S. Sobel, MD, MPH Director of Patient Education and Health Promotion
Regional Health Education
The Permanente Medical Group, Inc.
Kaiser Permanente Northern California 510-987-3579
Mobile Health 2012 May 17, 2012
The Future of “Baby Steps”
2
Language Matters
a) “Mother May I” Game? b) Bill Murray? c) BJ Fogg?
What is the origin of “Baby Steps?”
3
Is the “baby” in Baby Steps…
A empowering? inspiring? engaging?
B patronizing? condescending? insulting?
4
Do you prefer?
A Baby Steps?
B Simple Steps? Small Steps? Tiny Steps?
5
The Holy Grail of “Baby Steps”
What if “baby steps” do not lead to sustained behavior change and
ongoing health habits?
6
A Tale of Donkeys
http://www.ishkbooks.com/mulla_nasrudin.html
7
8
How does behavior effect health?
DIRECT EFFECTS of behavior change on health
Exercise, diet, smoking, alcohol/drugs, sleep, preventive care, medication adherence, etc.
INDIRECT EFFECTS of successful change
Enhanced mood and confidence
9
The Mystery Begins…
“We were able to
demonstrate only weak
associations between
changes in behavior and
changes in health status.”
10
Chronic Disease Self-Management: Healthier Living- Managing Ongoing Health Conditions Workshop
Small groups of people with different diseases
2 ½ hours a week for 6 weeks
Peer-led workshop
Content: skills for symptom management, exercise, nutrition, problem-solving, communication, advanced directive
Process: Self-efficacy, action planning, sharing
Lorig K, Holman H, Sobel D, Laurent D,
Gonzalez V, Minor M: Living a Healthy Life with
Chronic Conditions, Palo Alto, CA: Bull, 2006
*Chronic Conditions Self-Management Program
http://patienteducation.stanford.edu/
11
Outcomes
Improves health behaviors, self-efficacy and health status
Cost effective
Outcomes are long-lasting and robust
Replicable
Lorig K et al Medical Care 1999;37:5-14
Lorig K, Sobel DS, Effective Clin Practice 2001;4:256-262
Lorig K, et al Medical Care 2001;39:1217-1223
Chronic Disease Self-Management: What we learned about OUTCOMES
12
Helping others helps
People benefit themselves from helping other people
Social comparison: “Things could be worse…”
Peer support and commitment
Confidence counts
Changes in health behaviors were not predictive of improvements in health outcomes
Self-efficacy or confidence was associated with health outcomes
Change the trajectory
Chronic Disease Self-Management: What we learned about PROCESS
Lorig, Health Ed Quarterly 1992;
Lorig K, Arthritis and Rheumatism. 1989;
Ornstein R, Sobel D: Healthy Pleasures. 1989
13
Simple Steps to Health
Simple Steps
Sustained Health Habit
Improved Health
Simple Steps
Success Experience
Improved Health
Confidence Optimism Self-Efficacy Mood etc.
Exercise Healthy Eating Smoking Preventive Care etc.
14
So… HOW can we create success?
3 Brief Tales of
Trout, Tide, and Tires
15
Find their Passion
What do you REALLY ENJOY?
16
Discover their Solutions
Laundry Detergent
Take your meds!
17
Celebrate their Success
18
Engaging People in Successful Change
1. Find their Passion
2. Discover their Solutions
3. Celebrate their Success
19
The Benefits of Failure??
• “Baby Steps” approach is designed for success
• When might failure increase motivation, skill, and chances of future success?
• When might failure increase appreciation and celebration of future success?
20
Thank you…
21
Resources for Change
22
Making Change Easier
23
Change and Willpower
24
Resources for Emotional Health and Wellness
25
Resources for Happiness and Wellness
26
Resources for Happiness and Wellness
27
Healthy Pleasures: 5 Part Online Video Program
YouTube “Healthy
Pleasures”