Lifestyle Lifestyle Coaching Coaching

Lessons from the Diabetes Prevention ProgramLessons from the Diabetes Prevention Program

Shandiin Begay, MPH & Julie Nelson, RDShandiin Begay, MPH & Julie Nelson, RDDP Grant TrainingDP Grant Training

Denver, CODenver, COJuly 20, 2005July 20, 2005

Today’s AgendaToday’s Agenda

Coaching ModelCoaching Model Keys to SuccessKeys to Success Examples from CurriculumExamples from Curriculum

Coaching ModelCoaching Model

Health Coaching ModelHealth Coaching Model The health coaching model uses a team The health coaching model uses a team

of health professionals to assist patients of health professionals to assist patients in making behavior changes to improve in making behavior changes to improve their health.their health.

An assigned health coach works with the An assigned health coach works with the patient and multi-disciplinary team to patient and multi-disciplinary team to work collaboratively with the patient to work collaboratively with the patient to create a health plan by helping them to create a health plan by helping them to identify barriers and establish goals to identify barriers and establish goals to change health related behaviors. change health related behaviors.

Characteristics of a Health Characteristics of a Health Coach and Participant Coach and Participant

RelationshipRelationship Building TrustBuilding Trust Facilitating ChangeFacilitating Change Valuing DiversityValuing Diversity CommunicationCommunication Gaining CommitmentGaining Commitment Problem SolvingProblem Solving Revisiting and AdjustingRevisiting and Adjusting Building on SuccessBuilding on Success

Who’s on your Team?Who’s on your Team?

Who did DPP use as a Who did DPP use as a coach?coach?

Professionals were used in the DPPProfessionals were used in the DPP Paraprofessional helped supportParaprofessional helped support The coach needs to be supported by The coach needs to be supported by

a teama team

What are the What are the perceptions of weight perceptions of weight

loss in your community?loss in your community?

What are the What are the perceptions of physical perceptions of physical

activity in your activity in your community?community?

What to look for in a CoachWhat to look for in a Coachprofessional or paraprofessionalprofessional or paraprofessional

Be friendly and acceptingBe friendly and accepting Be optimisticBe optimistic Model healthy behaviorsModel healthy behaviors Follow through with what you say you’ll doFollow through with what you say you’ll do Hold accountable in a non-threatening wayHold accountable in a non-threatening way Be able to work with a teamBe able to work with a team Be willing to persevere and endureBe willing to persevere and endure Believe people can lose weightBelieve people can lose weight Believe that those you work with can Believe that those you work with can

changechange

How much work is it?How much work is it?

One-on-One contact with coachOne-on-One contact with coach DPP Research generally a 1:20 ratioDPP Research generally a 1:20 ratio Groups: estimate 8-10 hours per Groups: estimate 8-10 hours per

classclass Travel time not includedTravel time not included

How did coaching How did coaching influence influence

successful weight successful weight loss in the DPP?loss in the DPP?

KeysKeys Relationships- staff and familyRelationships- staff and family Clearly defined and achievable Clearly defined and achievable

goals and expectationsgoals and expectations Frequent contactFrequent contact IndividualizationIndividualization Local AdaptationLocal Adaptation Provide tools to achieve goalsProvide tools to achieve goals

RelationshipsRelationships

Consistency Consistency SupportiveSupportive HonestyHonesty Believe in youBelieve in you FamilyFamily

Defined and Achievable Goals Defined and Achievable Goals and Expectationsand Expectations

Individual weight loss goal (7%)Individual weight loss goal (7%) Physical Activity goal of 150 min per Physical Activity goal of 150 min per

wkwk Individualized fat and calorie goals for Individualized fat and calorie goals for

weight lossweight loss Time frame to meet stated goalsTime frame to meet stated goals Team contractsTeam contracts

Getting StartedGetting Started

MaterialsMaterials ContractContract Participant PurposeParticipant Purpose GoalsGoals Be a good group memberBe a good group member

Frequent ContactFrequent Contact

WeeklyWeekly MonthlyMonthly Most chose to come in more oftenMost chose to come in more often Campaigns/MaintenanceCampaigns/Maintenance Re-startsRe-starts

IndividualizationIndividualization

Fat gram, calorie, weight goals Fat gram, calorie, weight goals individualized to starting weight and individualized to starting weight and what helps them successfully lose what helps them successfully lose weightweight

Recipes and menusRecipes and menus Interpersonal and individual needs: jobs Interpersonal and individual needs: jobs

family responsibilities and languagefamily responsibilities and language Physical Activity Physical Activity

Local AdaptationLocal Adaptation

Use local examples to reinforce Use local examples to reinforce pointspoints 3 ways to eat less fat3 ways to eat less fat

Recipes and FoodsRecipes and Foods Designed for use in many different Designed for use in many different

ethnic groupsethnic groups Localizing recommendations for Localizing recommendations for

Physical Activity Physical Activity

Provide Tools to Achieve Provide Tools to Achieve GoalsGoals

Home weight scales, measuring cups and Home weight scales, measuring cups and spoons and food scalesspoons and food scales

Visual weight loss and exercise graphsVisual weight loss and exercise graphs Monthly exercise calendarsMonthly exercise calendars Weekly Menu plannersWeekly Menu planners PedometersPedometers Keeping Track books and fat counter Keeping Track books and fat counter

books and nutrition in the Fast Lanebooks and nutrition in the Fast Lane Provide sample foods, demos and recipesProvide sample foods, demos and recipes

Lifestyle Core Session #7:Lifestyle Core Session #7:Tip the Calorie BalanceTip the Calorie Balance

Eating and being active are Eating and being active are related in terms of calorie balancerelated in terms of calorie balance

Calorie balance relates to weight Calorie balance relates to weight lossloss

Review progress and changes Review progress and changes mademade

Develop a plan Develop a plan

Review Lesson #7Review Lesson #7

Take Home PointsTake Home Points Change is participant driven & participant is the Change is participant driven & participant is the

expertexpert Establish that the participant is an integral part of Establish that the participant is an integral part of

the teamthe team Short term goals long term goalsShort term goals long term goals Game plan can change, but the ultimate goal does Game plan can change, but the ultimate goal does

notnot What you do at the start is exciting build on thisWhat you do at the start is exciting build on this Use tools to establish relationshipUse tools to establish relationship Follow through builds expectations and relationshipFollow through builds expectations and relationship Resist giving too much infoResist giving too much info Coach and facilitator not the expert and teacherCoach and facilitator not the expert and teacher

www.bsc.gwu.edu/www.bsc.gwu.edu/dppdpp

Website for DPP Website for DPP

Lifestyle Manuals Lifestyle Manuals

and Other and Other InformationInformation

Other ResourcesOther Resources

NDEP- National Diabetes Education NDEP- National Diabetes Education Program website. Order free starter Program website. Order free starter packets with keeping track and fat packets with keeping track and fat counter book. counter book. www.ndep.nih.govwww.ndep.nih.gov

Small Steps Campaign at Small Steps Campaign at www.smallstep.govwww.smallstep.gov links to the new links to the new ad council clips and other helpful ad council clips and other helpful articles and resources.articles and resources.

SMALL STEPSSMALL STEPSBIG REWARDSBIG REWARDS

The risk is The risk is great.great.

The goals are The goals are important.important.

The changes are The changes are modest.modest.

The action steps The action steps are clear.are clear.

That doesn’t That doesn’t make it easy for make it easy for you, but the DPP you, but the DPP

demonstrated demonstrated that it can be that it can be

done.done.NIH Pub. No. 03-5335 Feb NIH Pub. No. 03-5335 Feb

20032003

Ongoing thanks to Ongoing thanks to the DPP participants the DPP participants and tribal community and tribal community partners for their partners for their commitment and commitment and dedication to the dedication to the goal of diabetes goal of diabetes prevention.prevention.