the PILI Lifestyle Program.

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1 Last updated April 16, 2007 Page 1 f 16 PILI Lifestyle Prgram Facilitatr s Guide Sessin 7: Preventin is Key Welcme Alha and welcme back t lessn seven f the PILI Lifestyle Prgram. Let us begin with a review frm last sessin. Ask participants if they wuld like t pule (pray) befre starting. What did we talk abut last time? We talked abut dealing with scial situatins by: Staying away frm r changing the situatin, if yu can. Just saying N nicely. Planning ahead fr things yu knw will cme up. Knwing what triggers yur unhealthy behavirs and replacing them with healthy behavirs. Asking thers fr help. Let us review the actin plan yu made last time. [Review participants actin plans, their prgress, and address any cncerns they may have] Review the gals and main ideas frm the last sessin. Ensure the participants are clear n the gals and these main ideas. Ask participants t pull ut tracking infrmatin/act in plan t review. Ask participants if they have questins r cncerns abut what was cvered. Take n mre than 5 minutes t discuss hw everyne thught they

2 Last updated April 16, 2007 Page 2 f 16 did. What will we talk abut tday? We will talk abut ways t prevent prblems frm getting in the way f reaching yur healthy lifestyle gals. This lessn s theme is Preventin is key! We will talk abut hw t 1) Prblem-Slve t prevent difficult situatins frm getting in the way f maintaining yur healthy lifestyle gals. 2) Partnering with yur dctr t get the mst ut f yur healthcare t prevent health prblems. Answer participants questins abut this lessn s gals. Write these gals dwn n the flipchart/bard. Why is prblemslving imprtant? Many things can get in the way f being mre active and eating healthy. But prblems can be slved! Prblem-slving ahead f time is a great way t vercme barriers that may cme up - instead f aviding them r giving up. 5 Easy Steps t prblemslving: Step 1 The First Step is t describe the prblem in detail and be specific. Lk at what led up t the prblem. Find the chain f events (actin chain) that lead t the prblem. Try t lk fr the links in the actin chain. Things t lk fr include: Cues that make yu want t eat

3 Last updated April 16, 2007 Page 3 f 16 unhealthy r be inactive. Peple wh dn't supprt yu. Thughts r feelings that get in yur way. Here is an example f Kim s actin chain that led him t making unhealthy eating chices: Bss was critical f Kim Kim felt stressed and anxius S he didn't eat lunch He came hme tired, upset, and hungry He went right t the kitchen He saw ckies n cunter He ate ckies. Des Kim s actin chain sund familiar?

4 Last updated April 16, 2007 Page 4 f 16 Step 2 The secnd step is t think abut yur ptins. Here is an example f Kim s ptins fr each link in his actin chain: Links Bss was critical. Sme f Kim's Optins Talk with his bss abut slving the prblems at wrk. Felt stressed and anxius. Didn't eat lunch. Take a break. Get supprt frm a c-wrker. Quit his jb. (Just kidding) Pack a quick bag lunch. Came hme tired, upset, and hungry Went right t the kitchen G fr a walk after wrk t unwind. Enter huse thrugh different dr. Plan smething t d the minute he gets hme (like getting ut in the yard, straightening a clset r rm in the huse). Saw ckies n cunter. Dn't have ckies in the huse. Keep ckies ut f sight. Keep fruit in sight instead. As

5 Last updated April 16, 2007 Page 5 f 16 we went thrugh Kim s ptins yu might have nticed that at every link in his actin chain there was a way t deal with it t avid the next link frm happening. Fr example, if Kim was able t talk t a c-wrker when he began feeling stressed and anxius, it might have made him feel better abut taking a lunch break and eating lunch. And, if he had eaten lunch, he prbably wuld nt have been s tempted by the ckies n the cunter. D yu have any questins s far abut prblem-slving steps 1 and 2?

6 Last updated April 16, 2007 Page 6 f 16 Step 3 The third step is t chse an ptin that wrks best fr yu. Weigh the prs and cns. Chse ne that is very likely t wrk and that yu can d. Try t break as many links as yu can, as early as yu can. Ging back t Kim s example, if he feels uncmfrtable talking t his bss r ther c-wrkers, he culd take time ut t relax and calm dwn. He culd als keep ckies and ther candies and snacks ut f the kitchen and nly have fresh fruits as snacks available. Kim has many ptins because he was able t identify his actin chain and ptins. Step 4 The furth step is t make an actin plan. By nw yu are an expert at making actin plans. Here is an example f Kim s actin plan: I will: deal with any wrk stress by having lunch with a c-wrker t talk it ver. When: anytime my bss gets n my case.

7 Last updated April 16, 2007 Page 7 f 16 Radblcks that might cme up: I might be t upset t remember r n c-wrker may be available t have lunch. S, I ll try t bring hme lunch as ften as pssible. I will d this t make my success mre likely: I will have fruits and vegetables available as snacks in the huse. Step 5 The final step is t practice, practice, and practice. Prblem slving is a prcess s dn't give up! If it didn t wrk fr yu the first time, prblem-slve again. Maybe the ptins yu picked were nt the best fr yu. Let s practice ur prblem-slving skills by pulling ut the Lifestyle Balancer Prblem Slver handut and the What t d When Yu Run int Radblcks handut in the back f yur binder. [Briefly g ver handuts. Ask them t cmplete at hme and bring t next sessin fr discussin] Partnering with yur dctr Nw that yu have had practice prblem slving, a cmmn prblem that many peple have is that they are nt always cmfrtable ging t and talking with their dctr. Since ur dctr is ften an imprtant persn when it cmes t managing ur health and preventing prblems, let us talk ab0ut hw t partner with ur dctr.

8 Last updated April 16, 2007 Page 8 f 16 The next tpic we will talk abut is partnering with ur dctr in meeting ur healthy lifestyle gals. We will discuss hw t 1) Make the mst ut f yur dctr visit Hw is partnering with my dctr helpful? 2) Wrk with yur dctr as a team member t make decisins abut yur health By taking part in this prgram yu have already started a preventin prgram. By living a healthy lifestyle yu can help t prevent chrnic illnesses such as Diabetes Heart Disease Hypertensin r Strke But yu can als help prevent these health prblems and thers by talking with yur dctr n a regular basis. Hw can I PARTNER with my dctr? Wrking clsely with yur dctr can be ne f the best ways t prevent lng term health prblems. When yu partner with yur dctr, yu will need t TALK with him r her s that he r she can better understand what is happening with YOU! Just like when yu take yur car int the

9 Last updated April 16, 2007 Page 9 f 16 shp, yu need t talk with the mechanic s he r she can d a better jb f knwing exactly where the prblems are... What abut asking questins t understand any prblems? This will help yur dctr just like yur mechanic t knw where t fcus his/her attentin first and if any prblems are fund, t prescribe the best treatment fr YOU. If yur dctr finds a prblem, be sure t ask yur dctr what these prblems mean. If yu are nt satisfied with his explanatin, let yur dctr knw that yu still dn t understand the prblem. What if I m nt cmfrtable talking with my dctr? Ask him r her where yu can find additinal infrmatin. Yu may als want t ask fr written infrmatin abut the prblem if available. In sme cases, yur dctr may need t send yu t a specialist fr additinal treatment. Make sure yu understand the prblem, s yu can wrk with the specialist t deal with it. Many patients d nt feel cmfrtable talking with their dctr. Yet...talking with yur dctr is ne f the best ways t stay healthy and t prevent lng term health prblems. Here are sme cmmn reasns why peple say they dn t like talking with their D the Flip chart Pst-itnte Activity: Have pts. write dwn 3 reasns why they dn t like talking with

10 Last updated April 16, 2007 Page 10 f 16 dctr... their dctr. Then pass I m afraid the dctr will think my questin is dumb. I dn t want the dctr t get mad and scld me. If I tell the dctr what I m really them t the frnt Grup the reasns that are similar ding... I ll get a lecture. tgether. Read ut the Can yu think f sme ther nes? cmmn themes expressed by the grup. 3 EASY STEPS t Talking with Yur Dctr! Partnering with yur dctr t get the best health care might be easier than yu think... Yu Get the Mst ut f yur visit with the Dctr by fllwing 3 Easy Steps... 1: PREPARE Prepare means taking a few minutes befre yur dctr s visit t think abut what YOU want t talk t yur dctr abut. It desn t have t be cmplicated... just 1 r 2 things that yu wuld like yur dctr t fcus n fr that visit. Write it dwn and bring it with yu int the dctr s ffice. Prepare als means bringing: Recrds that yu have kept since yur last visit. List f medicines yu are taking (r the bttles) By bringing this infrmatin, the dctr can better help yu and it will help pen Ask fr a shw f hands f peple wh have dne this r thught f ding this. Have participants practice writing ut 1-2 things t ask their dctr at their next visit.

11 Last updated April 16, 2007 Page 11 f 16 things up fr yu t ask questins. 2: TALK IT OUT! When yu SEE yur dctr be sure t let him r her knw what yu want t talk abut during yur visit. Use the list yu prepared t remind yu...and dn t frget t shw him/her yur recrds and list f medicine These days, dctrs dn t seem t have enugh time t TALK THINGS OVER with their patients. But if yu cme PREPARED and let him r her knw what wrries yu the mst, yu will get mre ut f yur dctr s visit even if the dctr is busy! Can yu think back t the last time yu saw yur dctr? Was there smething that yu wanted t talk t yur dctr abut but frgt t? Let s talk abut them nw... [D the activity t the right] Activity: Pstit-nte - Flip chart entitled: Things I Wished I had Asked the Dctr But Didn t Ask the pts t write dwn questins n a pst-itnte (1 per nte) Paste the pst-it ntes n the flip chart, gruping similar nes tgether n the bard. Tally hw many f the items are repeated by participants (i.e. cmmn themes).

12 Last updated April 16, 2007 Page 12 f 16 3: MAKE IT HAPPEN! Dctrs ften dn t understand what patients have t g thrugh t make healthy changes in their lives. It s nt really anyne s fault... but it is imprtant t let yur dctr knw abut things yu might be cncerned abut...and t ask hw yu culd wrk with the dctr t help YOU take care f yur health. If yu are taking any medicatins, be sure t tell yur dctr if yu are having any side effects r prblems. It might mean that they will need t find nes that will wrk better fr yu. BE AN ACTIVE PARTNER! What this means is that yu will need t make a simple PLAN that yu and yur dctr can AGREE n t... Lse weight, Eat healthy, and Prevent lng-term health prblems. Activity: At the Dctrs -Rle Playing activity - Pt-MD case scenaris: Break ut int grups f 2-3. Each grup is t pick ut frm a hat 1 case study. Each case will describe a brief scenari abut a pt and a MD. Assign ne persn t play the dctr and the ther t play the pt. Gal is t figure ut hw each grup/pair will be able t find the cmmn grund fr helping each ther ut t imprve the pt s diabetes care. Encurage the pts t use

13 Last updated April 16, 2007 Page 13 f 16 Will it wrk r will I be bthering my dctr? Yu are the main persn when it cmes t managing yur health! Yur dctr r health care prvider shuld be encuraging yu t be mre invlved in being healthy and preventing lng term prblems. S there is n need t feel embarrassed r afraid that yur dctr will nt be supprtive. If yu still feel uncmfrtable with yur dctr s respnse, perhaps yu shuld think abut finding a dctr yu feel mre cmfrtable with and can talk with mre easily. the 3 steps they just learned. Ask each grup t share hw they wrked ut the case. What did the pt/family persn d and what did the dctr d t slve the prblem? Let s make an actin plan! After all... yu re the main persn when it cmes t living a healthy lifestyle. 1) What is the ne prblem r barrier that ften gets in the way f yu meeting yur healthy lifestyle gals?

14 Last updated April 16, 2007 Page 14 f 16 2) What are sme f yur ptins r ways f dealing with yur prblem r barrier? Optin 1: Optin 2: Optin 3: 3) Which ptin is mst likely t wrk best fr yu? 4) Hw will I practice using this ptin I chse t deal better with my prblem r barrier? What have we talked abut tday? PREVENTION is KEY! We said... Preventin is Key when it cmes t lng term health prblems like Diabetes Heart Disease Hypertensin r Strke

15 Last updated April 16, 2007 Page 15 f 16 Prblem Slips and barriers t yu living healthy can Slve be PREVENTED by prblem-slving ahead f time. Yu can being prblem-slving by: 1) Describing the prblem in detail and being specific. 2) Think abut yur ptins. 3) Chse an ptin that wrks best fr yu. 4) Make an actin plan. 5) Practice, practice, practice PARTNER with Yur Dctr! Serius health prblems are PREVENTABLE with regular check ups and healthy lifestyle behavirs (such as eating healthy and being active!) This means wrking with yur dctr and ther health care prviders t stay healthy and prevent lng term health prblems. Yu can d it... even if yur dctr is busy by fllwing thse 3 easy steps! 1: PREPARE 2: TALK IT OUT 3: MAKE IT HAPPEN!

16 Last updated April 16, 2007 Page 16 f 16 Make a PLAN that YOU can LIVE WITH! Yur dctr r health care prvider is ready t help yu manage yur health! S make a PLAN that yu think yu can live with t stay healthy. Be sure yu tell yur dctr what yur PLAN is... Be direct and simple Let yur dctr r health care team knw what they can d t help yu. Be mre invlved with yur wn health care. Remember yu are the main persn when it cmes t making healthy lifestyle changes. What will we cver in the next sessin! Yu wn t want t miss the next sessin... IT S THE LAST ONE... and it will deal with Managing negative thughts and emtins! Dn t frget t bring yur ntebks and thank yu fr cming t the sessin tday!