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Page 1: Mobile health 2012   david sobel

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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

[email protected]

Mobile Health 2012 May 17, 2012

The Future of “Baby Steps”

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Language Matters

a) “Mother May I” Game? b) Bill Murray? c) BJ Fogg?

What is the origin of “Baby Steps?”

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Is the “baby” in Baby Steps…

A empowering? inspiring? engaging?

B patronizing? condescending? insulting?

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Do you prefer?

A Baby Steps?

B Simple Steps? Small Steps? Tiny Steps?

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The Holy Grail of “Baby Steps”

What if “baby steps” do not lead to sustained behavior change and

ongoing health habits?

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A Tale of Donkeys

http://www.ishkbooks.com/mulla_nasrudin.html

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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

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The Mystery Begins…

“We were able to

demonstrate only weak

associations between

changes in behavior and

changes in health status.”

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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/

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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

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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

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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.

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So… HOW can we create success?

3 Brief Tales of

Trout, Tide, and Tires

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Find their Passion

What do you REALLY ENJOY?

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Discover their Solutions

Laundry Detergent

Take your meds!

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Celebrate their Success

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Engaging People in Successful Change

1. Find their Passion

2. Discover their Solutions

3. Celebrate their Success

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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?

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Thank you…

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Resources for Change

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Making Change Easier

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Change and Willpower

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Resources for Emotional Health and Wellness

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Resources for Happiness and Wellness

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Resources for Happiness and Wellness

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Healthy Pleasures: 5 Part Online Video Program

YouTube “Healthy

Pleasures”


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