Managing diabetes requires careful attention to modification of lifestyle. This can include improving diet, exercising regularly, quitting smoking, and reducing or quitting alcohol use.
In order to achieve success, it is usually helpful to encourage the client to set specific goals with a time frame for achieving them. For example, a client’s goal may be to “walk 10 minutes to the band office and back, three times a week. In two weeks, I will have accomplished this goal.” This is specific because the time or distance is described as well as the frequency. It also includes a deadline by which the client will accomplish the goal.
These goals should represent small steps towards change, and the client should feel comfortable and confident that he/she can attain them. When a client is able to complete several small goals in a row, then he/she starts to feel more confident about making bigger changes. It is also helpful to assist the client in designing a method for tracking whether or not he/she is meeting a goal. This could involve writing down progress on a log sheet.
The client will receive information from many people on how to make lifestyle changes and set goals: the nurse, the doctor or the diabetes educator. At this stage of the development of the CHW program, we recommend that CHWs play a role in monitoring whether or not clients are following any self-management goals they may have set for themselves, with the support of doctors or health educators. (At a future date, we hope to provide training to CHWs to coach clients to set these goals – this is a skill which requires more advanced training.)
CHWs should be meeting monthly with the care team (doctors, nurses) and discussing what self-management goals have been set by clients. CHWs should make note of these goals and reinforce them at their next visit with the client.
1. Inform the client that you will be speaking with them about their lifestyle.
2. Ask the client what part of their lifestyle they are working on now – diet, exercise, smoking, alcohol or other.
“Improving lifestyle is an important part of managing diabetes. Is there any area that you’re trying to focus on these days? Diet? Exercise? Smoking? Alcohol?”
3. If you know the client has previously set a specific goal, ask if he/she kept track of progress and succeeded.
“I understand that at your last visit with ______, you set a goal to __________________. How is that going? Were you able to achieve your goal? Were you able to track progress? Did you keep a log?
4. If last goal was achieved, encourage a follow-up goal. If unsuccessful, ask about barriers, and discuss modifications to the goal to try next.
If the last goal was unsuccessful: "What kind of difficulties were you having with your goal? Is there anything you’d like to do differently? Would you like to try to modify your goal?"
If the last goal was successful: "That’s great news, congratulations! Is there a new goal that you’d like to try?"
5. Record goals on CHW visit log.
Download or use this online CHW sample form to practice the contents of this module.
Please note that these training modules are to be used for the purposes of CHW training in diabetes management. CHWConnect does not provide medical advice or specific diagnostic or treatment information.