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Mobile health 2012 david sobel
1. Mobile Health 2012
May 17, 2012
The Future of âBaby Stepsâ
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
david.sobel@kp.org
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2. Language Matters
What is the origin of âBaby Steps?â
a) âMother May Iâ Game?
b) Bill Murray?
c) BJ Fogg?
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3. Is the âbabyâ in Baby StepsâŚ
A B
ďź empowering? ďź patronizing?
ďź inspiring? ďź condescending?
ďź engaging? ďź insulting?
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4. Do you prefer?
A B
ďź Baby Steps? ďź Simple Steps?
ďź Small Steps?
ďź Tiny Steps?
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5. The Holy Grail of âBaby Stepsâ
What if âbaby stepsâ do not lead to
sustained behavior change and
ongoing health habits?
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6. A Tale of Donkeys
http://www.ishkbooks.com/mulla_nasrudin.html
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8. How does behavior effect health?
DIRECT EFFECTS of behavior change on health
ď§ Exercise, diet, smoking, alcohol/drugs,
sleep, preventive care, medication
adherence, etc.
INDIRECT EFFECTS of successful change
ď§ Enhanced mood and confidence
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9. The Mystery BeginsâŚ
âWe were able to
demonstrate only weak
associations between
changes in behavior and
changes in health status.â
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10. Chronic Disease Self-Management:
Healthier Living- Managing Ongoing Health Conditions Workshop
ďźSmall groups of people with
different diseases
ďź2 ½ hours a week for 6 weeks
ďźPeer-led workshop
ďźContent: skills for symptom
management, exercise,
nutrition, problem-solving,
communication, advanced
directive
ďźProcess: Self-efficacy, action
planning, sharing
*Chronic Conditions Self-Management Program Lorig K, Holman H, Sobel D, Laurent D,
Gonzalez V, Minor M: Living a Healthy Life with
http://patienteducation.stanford.edu/
Chronic Conditions, Palo Alto, CA: Bull, 2006
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11. Chronic Disease Self-Management:
What we learned about OUTCOMES
Outcomes
ď§ Improves health behaviors, self-efficacy and
health status
ď§ Cost effective
ď§ Outcomes are long-lasting and robust
ď§ 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
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12. Chronic Disease Self-Management:
What we learned about PROCESS
Helping others helps
ď§ People benefit themselves from
helping other people
ď§ Social comparison: âThings could
be worseâŚâ
ď§ Peer support and commitment
Confidence counts
ď§ Changes in health behaviors were
not predictive of improvements in
health outcomes
ď§ Self-efficacy or confidence was
associated with health outcomes
ď§ Change the trajectory
Lorig, Health Ed Quarterly 1992;
Lorig K, Arthritis and Rheumatism. 1989;
Ornstein R, Sobel D: Healthy Pleasures. 1989
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13. Simple Steps to Health
Simple Simple
Steps Steps
ďźExercise ďźConfidence
ďźHealthy Eating Sustained Success ďźOptimism
ďźSmoking Health Habit Experience ďźSelf-Efficacy
ďźPreventive Care ďźMood
ďźetc. ďźetc.
Improved Improved
Health Health
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14. So⌠HOW can we create success?
3 Brief Tales of
Trout, Tide, and Tires
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18. Engaging People in Successful Change
1. Find their Passion
2. Discover their Solutions
3. Celebrate their Success
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19. The Benefits of Failure??
⢠âBaby Stepsâ 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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