1. Lifestyle Coaching Lessons from the Diabetes Prevention Program Shandiin Begay, MPH & Julie Nelson, RD DP Grant Training Denver, CO July 20, 2005

2. Today’s Agenda  Coaching Model  Keys to Success  Examples from Curriculum

3. Coaching Model

4. Health Coaching Model  The health coaching model uses a team of health professionals to assist patients in making behavior changes to improve their health.  An assigned health coach works with the patient and multi-disciplinary team to work collaboratively with the patient to create a health plan by helping them to identify barriers and establish goals to change health related behaviors.

5. Characteristics of a Health Coach and Participant Relationship  Building Trust  Facilitating Change  Valuing Diversity  Communication  Gaining Commitment  Problem Solving  Revisiting and Adjusting  Building on Success

6. Who’s on your Team?

7. Who did DPP use as a coach?  Professionals were used in the DPP  Paraprofessional helped support  The coach needs to be supported by a team

8. What are the perceptions of weight loss in your community?

9. What are the perceptions of physical activity in your community?

10. What to look for in a Coach professional or paraprofessional  Be friendly and accepting  Be optimistic  Model healthy behaviors  Follow through with what you say you’ll do  Hold accountable in a non-threatening way  Be able to work with a team  Be willing to persevere and endure  Believe people can lose weight  Believe that those you work with can change

11. How much work is it?  One-on-One contact with coach  DPP Research generally a 1:20 ratio  Groups: estimate 8-10 hours per class  Travel time not included

12. How did coaching influence successful weight loss in the DPP?

13. Keys  Relationships- staff and family  Clearly defined and achievable goals and expectations  Frequent contact  Individualization  Local Adaptation  Provide tools to achieve goals

14. Relationships  Consistency  Supportive  Honesty  Believe in you  Family

15. Defined and Achievable Goals and Expectations  Individual weight loss goal (7%)  Physical Activity goal of 150 min per wk  Individualized fat and calorie goals for weight loss  Time frame to meet stated goals  Team contracts

16. Getting Started Materials Materials Contract Contract Participant Purpose Participant Purpose Goals Goals Be a good group member Be a good group member

17. Frequent Contact  Weekly  Monthly  Most chose to come in more often  Campaigns/Maintenance  Re-starts

18. Individualization  Fat gram, calorie, weight goals individualized to starting weight and what helps them successfully lose weight  Recipes and menus  Interpersonal and individual needs: jobs family responsibilities and language  Physical Activity

19. Local Adaptation  Use local examples to reinforce points  3 ways to eat less fat  Recipes and Foods  Designed for use in many different ethnic groups  Localizing recommendations for Physical Activity

20. Provide Tools to Achieve Goals  Home weight scales, measuring cups and spoons and food scales  Visual weight loss and exercise graphs  Monthly exercise calendars  Weekly Menu planners  Pedometers  Keeping Track books and fat counter books and nutrition in the Fast Lane  Provide sample foods, demos and recipes

21. Lifestyle Core Session #7: Tip the Calorie Balance Eating and being active are related in terms of calorie balance Eating and being active are related in terms of calorie balance Calorie balance relates to weight loss Calorie balance relates to weight loss Review progress and changes made Review progress and changes made Develop a plan Develop a plan

22. Review Lesson #7

23. Take Home Points Change is participant driven & participant is the expert Change is participant driven & participant is the expert Establish that the participant is an integral part of the team Establish that the participant is an integral part of the team Short term goals long term goals Short term goals long term goals Game plan can change, but the ultimate goal does not Game plan can change, but the ultimate goal does not What you do at the start is exciting build on this What you do at the start is exciting build on this Use tools to establish relationship Use tools to establish relationship Follow through builds expectations and relationship Follow through builds expectations and relationship Resist giving too much info Resist giving too much info Coach and facilitator not the expert and teacher Coach and facilitator not the expert and teacher

24. www.bsc.gwu.edu/dpp Website for DPP Lifestyle Manuals and Other Information

25. Other Resources NDEP- National Diabetes Education Program website. Order free starter packets with keeping track and fat counter book. www.ndep.nih.gov NDEP- National Diabetes Education Program website. Order free starter packets with keeping track and fat counter book. www.ndep.nih.govwww.ndep.nih.gov Small Steps Campaign at www.smallstep.gov links to the new ad council clips and other helpful articles and resources. Small Steps Campaign at www.smallstep.gov links to the new ad council clips and other helpful articles and resources. www.smallstep.gov

26. SMALL STEPS BIG REWARDS

27. The risk is great.

28. The goals are important.

29. The changes are modest.

30. The action steps are clear.

31. That doesn’t make it easy for you, but the DPP demonstrated that it can be done. NIH Pub. No. 03-5335 Feb 2003

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