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Melon Health Blog

The First Step To Self-Management: Activation

Posted by Siobhan Bulfin on Jul 31, 2019 4:05:45 PM

Almost half of the U.S. population has at least one chronic illness. It’s possible to limit the progression or reverse non-complex conditions with self-management. But there are often overwhelming barriers that prevent patients from self-managing their condition.

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Many patients with ongoing illnesses want to be more involved in managing their condition but lack the confidence to do so. For instance, 6 out of 10 people living with chronic illness are aware they could be doing more to limit their symptoms. Often, simple things like better education and more support would move the needle to help them take charge of their own health.

What would it take to move patients from awareness to activation? 

Helping patients identify their “why”

Each person with chronic conditions has different barriers that hinder self-management. Yet each one has something in common with the other—their choices are strongly tied to internal motivation. That’s why they need help identifying their “why” when it comes to behavior change.

Some patients are ready to change simply as a result of teachable moments—such as being diagnosed with chronic illnesses or developing new symptoms. Others are in a position where self-activation is more manageable—their schedule allows for it or life circumstances make healthy choices more achievable.

On the other hand, some patients are overwhelmed at the thought of making lifestyle adjustments. Take mothers, for instance. Their natural instinct is to respond to their family’s needs before taking care of their own health. They may work long hours to ensure their children’s needs are provided for and there’s food on the table and have little time left over exercise.

Many patients struggle with competing priorities when it comes to behavior change. They may want to reverse their symptoms, but they also have other responsibilities and pressures to manage at the same time.

With so many different motivational factors in play, activating patients in self-management may seem impossible. The good news is that there are ways to help patients overcome internal and external barriers to lifestyle change.

Exploring patient motivation

A key component to activation is motivational interviewing. With this counseling approach, patients can discover what keeps them from self-managing their health conditions. As they remove these barriers, they’re liberated to create practical and measurable goals.

Values-based motivation

Why do people want to control their conditions? The simple answer is that they don’t want to face worsening symptoms. However, for most people, the desire goes much deeper than that. Motivational interviewing seeks to help patients discover their driving motivation behind behavior change and helps patients leverage those desires to fuel self-management.

Sometimes there’s a disconnect between clinical goals and a patient’s goals. Patients may not be motivated by the same factors their clinicians are. That’s not to say health care should eliminate clinical goals; it simply means those factors don’t always motivate patients to change. 

For patients to take the first step toward activation, they need to verbalize and define the factors that motivate them to change.

  • What’s important to them?
  • What makes it hard to alter their lifestyle?
  • What makes them want to improve their condition?

Sustaining activation through difficult times

By jumpstarting patient activation with motivational interviewing, clinicians can also help patients sustain their motivation during difficult times

Consider a patient at risk of developing heart disease who needs to lose weight. Initially, they may see significant progress only to hit a plateau later on. What will keep them going? 

If motivational interviewing has been part of their self-management journey, their coach will know how to encourage them. Say, for example, the person used to be involved in high school sports, and they long to have the energy they used to have. Health coaches can remind them of this memory-driven goal to help fuel their resolve.

Outlining the first step

While some patients may respond well to all the action steps required to counteract or manage their condition, others may be overwhelmed. To activate patients without overwhelming them, health coaches can help them set an initial, values-based goal during their motivational interview. 

For a patient with diabetes, the first step may be setting a simple goal to walk three times a week for 20 minutes. If they can achieve this first goal, their confidence may begin to skyrocket. This confidence can result in greater motivation as they begin to believe they can self-manage their condition. 

Lower the cost of chronic conditions for your organization with supported self-management. Download our “Checklist for Self-Supported Management” to discover how. 

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Topics: patient engagement, patient community, behavior change

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