Heart disease takes the lives of about 665,000 Americans each year.[1] According to the Centers for Disease Control and Prevention (CDC), the following healthy behaviors can help lower the risk of heart disease:[2]
- Eating healthy
- Exercising
- Not smoking
- Maintaining a healthy weight
- Taking medicines as directed—particularly those that treat high cholesterol, high blood pressure and diabetes
As a population health management company, Health Dialog has spent decades coaching and engaging individual members from all walks of life to better manage their heart health. Health coaches can play a pivotal role in helping people create and stick to action plans that address all five of these behaviors. Our Health Coaches shared their perspective on which member engagement strategies can best help people stick to these key healthy habits.
1. Engaging Members to Improve Their Diet and Increase Their Exercise
A diet rich in fruits, vegetables, whole grains, lean meats, low-fat dairy products and sugar-free beverages can help prevent heart disease. In addition to a healthy diet, regular physical activity helps to maintain a healthy weight and lower blood pressure, cholesterol and blood sugar levels.
“When it comes to engaging a member with issues related to diet and exercise, we’ve found that it’s important to set expectations from the start,” a Health Dialog registered dietitian explained. “It all comes down to building trust and meeting the member where they are. For example, some people may need to learn basic nutrition information from scratch, while others may have a high level of knowledge.”
Health Coaches then engage members to help them examine their motivations and barriers to change, so they can work together to come up with specific, concrete goals. For example, rather than setting a goal to “lose weight,” the goal might be to “workout for 10 minutes a day, three days a week, and to eat out only two times a week.” Through our interactions with millions of members over the years, we’ve learned that it’s important for the plans to be individualized. “We’ve got to understand what will work in their day-to-day lives,” the dietitian said. “If someone has no time for exercise, we’ll focus on diet.”
Along the way, members can feel discouraged. “We remind them of all the positive changes they have already made and that change doesn’t happen overnight,” said the dietitian. Additionally, having someone to be “accountable to” can make all the difference in maintaining motivation. A health coach who shows empathy and patience can be that cheerleader, supporter and friend.
2. Motivating and Engaging Members to Quit Smoking
Smoking cigarettes significantly increases the risk of heart disease, but it’s never too late to stop. Within just one year of quitting, the risk for heart disease can be cut in half. However, quitting smoking, which for some members may be a lifelong habit, can be challenging. Working with a health coach in a smoking cessation program can be tremendously beneficial in helping members kick the habit.
Over the years, we’ve learned that the key to success in getting members to quit, and quit for good, is to help them understand the true impact of their tobacco use, identify triggers, such as stress or anxiety, and develop a customized and realistic cessation plan that fits their lifestyle.
“We’ve found that it’s important to personalize the program to each individual based on why they want to quit,” says Steve Dowell, a registered respiratory therapist who supervises smoking cessation Health Coaches. “We look at barriers with our members and talk about how their lives will be better. For example, we had a member who wanted to babysit her grandchild, which motivated her to quit. One strategy we used was to have her place wallet-sized photos of her grandchild on her packs of cigarettes as a constant reminder.”
At the end of the day, the timelines and approaches are different for everyone. “While some studies show that the use of nicotine replacement therapy and counseling has a greater success rate, we see some people who are able to go cold turkey,” says Dowell. “Sometimes a plan fails and you try something else. It’s important to learn from any failures and build on what works for the individual.”
3. Improving Members’ Medication Adherence to Cholesterol, High Blood Pressure and Diabetes Medications
If someone takes medicine to treat high cholesterol, high blood pressure or diabetes—three conditions that put people at a high risk for heart disease—it is critical that they continue taking those medications exactly as their doctor instructed. However, some people may not take their medications, or may not take them as instructed, for a number of reasons, such as forgetting to pick up or take their prescription, not knowing why the medication is important or how to take it, fear of side effects, or affordability issues.
A health coach can engage a member to get to the root of why they may not be taking their medication and help them overcome their personal barriers to adherence. “We know that a one-size-fits-all solution won’t work,” says Jenny Glennon, PharmD, MPH, the director of pharmacy services at Health Dialog. For example, if the problem is forgetfulness, a health coach can help a member set up alarms and use a pillbox to remind them to take their medication. “At Health Dialog, we have found that truly personalized coaching can have a significant impact on behaviors, and ultimately, medication adherence,” says Glennon.
These learned behavior changes that improve medication adherence apply to any medication, including those that treat high cholesterol, high blood pressure or diabetes.
Supporting a Healthy Heart
Maintaining a heart-healthy lifestyle is a day-to-day commitment, and it isn’t always easy. With the support of a health coach, members can learn to develop plans to stay on track and make lifelong behavior changes. Engaging members to stick to a healthy diet and exercise plan, a smoke-free lifestyle, and a consistent medication regimen (if needed), can help them prevent heart disease and lead longer, healthier lives.
[1] Centers for Disease Control and Prevention (CDC). Heart Disease Facts. https://www.cdc.gov/heartdisease/facts.htm.
[2] CDC. Prevent Heart Disease. https://www.cdc.gov/heartdisease/prevention.htm.
