• Fresh Views

    Diabetes Technology and Solution-Focused Practice: Words are Powerful

    Word cloud from participants with diabetes in some of our research

    “Words are, of course, the most powerful drug used by mankind.” – Rudyard Kipling

    Words are powerful! Consider these famous brands whose whole identity is defined by a few  words. 

    • Bounty: The Quicker Picker Upper. 
    • American Express: Don’t leave home without it. 
    • United Airlines: Fly the friendly skies. 
    • Disney: The happiest place on earth. 

    We remember these words. These words have power. These words have certainly left an imprint!

    In our series on diabetes and technology, today we’re revisiting a previous post about the power of language. When using technology tools, especially for virtual visits, the words we choose are just as important, if not more so than with in-person conversation. It’s hard (or even impossible) to read body language, voice tone and inflection, etc. So choosing person-centered, strength-based language during technology discussions is critical. 

    If you’ve followed our blog over the last 3 years, you’ve seen that we’ve focused a lot on the power of words. Words can define how people view themselves and their situations. Words can empower. Or words can stigmatize and judge. Our belief and practice @AFreshPOVforYou centers around using words that focus on strengths and create solutions, instead of words that dwell on the past and on problems. 

    Changing the conversation

    You may know that we partnered to help create the Telly Award winning video, Changing the Conversation (you can find it here), that focuses on the impact words have when living with a chronic medical condition. The video begins with Words are powerful!  We’ve watched this video hundreds of times and yet, it still brings a tear to our eyes. Why? Because the words resonate with our emotions and what we believe to be true, but most importantly, the words came directly out of the mouths of individuals who live with diabetes – Every. Single. Day. They shared their thoughts, feelings and emotions with us to create the inspiring words incorporated in the video.

    Now what if the same thing happened with healthcare communication? If careful thought was given to words used in conversation with clients; choosing words that resonated with people living with diabetes. Words that mattered. We can change the way they feel. Words that empowered them. Words that could transform them for the better. 

    Over the course of writing our blog, engaging in research, and connecting with the diabetes community we have been compiling words that align with the tenets of a solution-focused approach to care and education. You see some of those in the word cloud above. Words spoken by people with diabetes in surveys, research and focus groups. Words expressed during Twitter chats. You can read a few of our blogs about strengths, exceptions and possibilities here.

    How are your words impacting others today? 

    Together, we can slowly evolve our vocabulary and ultimately change our messages. Together we can embrace possibilities, opportunities and create a fresh vision for the future.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a healthcare professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Smart Insulin Pens

    Sunrise dawning over the hills of Central Kentucky

    Let’s go invent tomorrow instead of worrying about what happened yesterday. – Steve Jobs

    When we discuss technology and the opportunity for technology to support person-centered, strength-based discussions, we always return to the impact of person (patient) generated health data (PGHD). As technology evolves, more PGHD are appearing and creating new opportunities to identify things that are working well and identify successes to build upon. With older technology, when individuals were using traditional insulin pens and syringes, we were unable to rely on PGHD to help people in their diabetes management.

    So, as part of our series on diabetes technology and solution-focused practice, this week we’re focusing on one of the newer technologies, Smart Insulin Pens.

    We reached out to our friend and colleague Janice MacLeod, MA, RD, CDCES, FADCES, Director of Clinical Advocacy at Medtronic Diabetes, to share her experience and knowledge about how the diabetes care and education specialist (DCES) can incorporate solution-focused techniques into their practice when using Smart Insulin Pens and discussing PGHD.

    Here is what Janice shared with us….

    Smart insulin pens (SIPs) are bringing the millions of people who rely on insulin therapy into the digital age making possible a connected diabetes care ecosystem for people with diabetes and their providers. The first FDA-cleared commercially available SIP in the United States, InPen™ is designed to automatically record doses, track active insulin, send missed dose alerts and provide meal and correction dose recommendations. The user is also able to share integrated data reports with their care team allowing users and their care team to coll

    aborate in real-time or asynchronously to make data-informed adjustments in the care plan as needed. Data visibility leads to more collaborative conversations.

    The DCES can lead the team in helping people who rely on insulin to IDENTIFY the best method of insulin delivery for them. If the individual prefers injection therapy but would like the smart dosing support previously only available through pumps, a SIP is a great option. Next, it is important to get the patient off to a strong start by helping them CONFIGURE the SIP for their specific needs. This includes providing individualized insulin therapy settings. Finally, the DCES can lead the care team to COLLABORATE with the user by providing a plan for sharing and reviewing the data together on an ongoing basis. (You can read about the ICC framework in our blog here.) Partner with the individual to uncover and resolve barriers to taking insulin.  Next, optimize the long-acting insulin dose before fine-tuning meal and correction dosing factors. 

    DATAA Counseling Strategy

    The DATAA counseling strategy was introduced by Isaacs et al (Isaacs D, et al. Technology Integration.  TDE, 2020;46(4):323-333). Here is an example of using this approach with integrated glucose, insulin dose and meal data available for the first time through SIPs:

    D – DATA: Thank the individual for sharing their data report and acknowledge their diabetes care efforts

    A – ASSESS SAFETY: Review the glucose stats and graph assessing and resolving any issues with hypoglycemia as a priority 

    T – TIME IN RANGE:  Note times of day or days of the week where the care plan seems to be working well. Discuss ways to replicate this success at other times of day or days of the week. 

    A – AREAS TO IMPROVE:  Note if there are missed doses, a need to check glucose prior to dosing or to use the dose calculator recommendations or to set reminders to check if a correction dose is needed. Maybe it is a dose timing issue. Having a conversation about the data leads to problem solving!

    A – ACTION PLAN:  Together with the patient determine the next steps to take, for example: 

    • Set dose reminder in app for lunch dose
    • Take my dinner time dose 15 minutes prior to eating
    •  Send report prior to my next scheduled visit

    Learn more about building a data-driven practice model for MDI therapy including a case study using the DATAA approach with a patient using SIP in the The Reference Guide To Integrate Smart Insulin Pens Into Data-Driven Diabetes Care and Education.

    We thank Janice for the information she shared with us and our readers in this week’s blog.

    Stop back by in 2 weeks to see what we write about as we continue to share about a variety of other technologies that impact and influence diabetes care and education!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Meditation and Mindfulness Apps

    Mindfulness is a way of befriending ourselves and our experience.- Jon Kabat-Zinn

    Lake Como in Italy. This view from our travels there a few years back we always find calm, peaceful, and a reminder to live in the moment and be mindful.

    This week in our Diabetes Technology and Solution-Focused Practice series we’re discussing the value of meditation and mindfulness apps in solution-focused practice. You may have seen the results of a meta-analysis recently published in Diabetic Medicine which showed that mindfulness and acceptance-based approaches to diabetes education may more effectively reduce A1C levels, anxiety, depression, and diabetes distress than education as usual. This impact was noted both immediately and up to 1-month post intervention. In helping your clients find what works for them, and build on that, meditation and mindfulness apps can be another tool in your solution-focused “tool box”. 

    Do you encourage your clients with diabetes to use meditation and mindfulness apps? There’s certainly no shortage of options these days! Over the last few years, more than 2000 new meditation apps have rolled out, with even more new options as a result of increased demand during the pandemic. And who doesn’t welcome those that are free! 

    5 FABULOUS FREE MEDITATION AND MINDFULNESS APPS

    These 5 apps are free, with several of them also having premium paid versions with extra content and capability. We find that the free versions are helpful to be able to get a taste of the app and it’s approach, with the option to move on to the premium version with expanded content options, if desired.

    Smiling mind. (Available for iOS) This app not only provides opportunity to take a break from life stresses through meditation, it guides in incorporating mindfulness practice throughout the day through “activities” like journaling or audio prompts bringing attention to your senses by counting things that can be seen, felt, heard, smelled and tasted. Pretty cool! There are a number of “programs” related to stress management and sleep.

    UCLA Mindful. (Available for iOS and Android). The name says it all. Heavily grounded in the science of mindfulness, this app developed by the Mindful Awareness Research Center at the University of California, Los Angeles (UCLA), features a variety of meditations in English and Spanish. There are sessions as short as 3 minutes long and some up to a half hour long that they refer to as “podcasts”. This app can help one practice self-kindness, work through challenging emotions, as well as focus on other areas.

    MyLife Meditation. (Available for iOS and Android). You may have been familiar with this award-winning app as Stop, Think, & Breathe, which it was formerly named. There is a section focused on what mindfulness is and why it’s beneficial. We’re fans of the fact that each day when you open the app, you’re asked to “take a breath” and check in with yourself, then rate how your mind and body are on a scale of “rough” to “great”. Based on emotions you’re feeling that you select from lists of words, the app then recommends guided sessions according to those feelings. (Premium paid version also available).

    Insight Timer. (Available for iOS, Android, and web) Tami uses this on her phone. This app offers over 90,000 free guided meditations. Topics covered include anxiety, stress, sleep, mindfulness, relationships, insightful talks, and much, much more. Sometimes for quieter mindfulness and focus, she’ll use the feature where you can simply set a timer and focus or meditate to  calming ambient noise or calming music. (Premium paid version also available)

    Calm. (Available for iOS, Android, and web) Tami downloaded this free during an offer early into the pandemic. There currently is a free trial with a premium paid version.  Calm includes meditation and sleep stories focused on improving sleep quality, reducing stress and anxiety, improving focus, and overall self-improvement. Deb uses the Premium version specifically for the nightly sleep stories. She really enjoys the simple yet calming stories to help her fall asleep. Yes, they are not stories that are engaging and exciting, but that’s the plan. The goal is to not have your brain try to engage, but to relax and prepare to sleep.  

    During this crazy and chaotic year, creating opportunities to calm your mind and create opportunities to support a peaceful bedtime or a stress-free break in the middle of the work  day is very important.  

    How can you support your clients to develop positive mindfulness habits?

    We suggest striving for open and frank discussions with clients when meeting with them. Ask about their mental and emotional health to identify if a mindfulness app might help them.

    1. An easy way to move towards this conversation is to ask about their sleep patterns and quality? If they are having trouble sleeping you might ask them if an app might be an option they would consider.
    2. Ask about their anxiety level. Is Anxiety impacting their ability to make healthy behavior changes? If the answer is yes, continue to ask probing questions to identify what they are willing to do to make health behavior changes.  Remember, one small change in the direction of their goals will lead to more changes in the future.

    It may be beneficial to revisit this past year, explore how they’ve grown and changed, and consider what’s next and how to move forward. Mindfulness and meditation apps can be helpful in managing stress, diabetes distress, anxiety, and depression to ultimately help impact blood glucose and improve happiness and quality of life. 

    May is Mental Health Awareness month so a great opportunity to think about ways to encourage healthy habits.

    We plan to continue to write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Applied to Activity Tracker Conversations

    Tami walked the length of the Sahara Desert!

    Just keep taking the next step and keep having excellence in the ordinary. – Dave Ramsey

    In this week’s Diabetes Technology and Solution-Focused Practice post we’re discussing taking a solution-focused approach to activity tracker and physical activity conversations. We are both huge advocates of activity trackers, and have used several different versions ourselves over the years. Currently, Deb relies on her Apple Watch, while Tami likes her Fitbit (although it’s on it’s last leg…so something new will be coming soon!)  Recent estimates are that about 1 in 5 Americans use a smartwatch or fitness tracker. Whether a smart watch, wrist band, clip on pedometer, smartphone app, or other variety, activity trackers can give extra incentive to get active. They also provide a wealth of statistics on workouts and general health to have the data needed to achieve fitness goals. Many track not only steps and movement, but distance, activity intensity, calories burned, mindfulness, sleep, heart rate, and more. There are even fitness trackers for children with a variety of fun functions beyond tracking activity.

    A Facebook memory popped up the day we were posting the blog – Tami and Deb walking 10,000 steps along the Chicago lakefront with their husbands!

    Focus on “exceptions”, rather than gaps

    When reviewing physical activity frequency, duration, step counts etc with clients, there is  opportunity to implement a solution-focused approach (rather than focusing on “gaps” in activity). For example, when reviewing fitness tracker logs such as the one below, where this individual’s goal was to get 10,000 steps each day – rather than focusing on 3/10, 3/11, and 3/12 where step counts were far below their goal, turn instead to focus on 3/7 where they achieved 7016 steps, and 3/13 where they got 8681 steps. If we focus on the days where activity was low, we miss out on identifying successes

    4 questions we could ask when acknowledging those “successful” days are:

    1. How did you work that many steps into your day? 
    2. What were you doing differently than on 3/10-3/12, for instance?
    3. How can you do that more often? 
    4. What are some other ways you can be more active?   

    A case example from Tami…

    Years back, I worked with a client that was a dentist, and as such was fairly sedentary most of the day. When I began seeing her, she had recently learned that she had type 2 diabetes and was trying to increase her activity, in addition to managing her weight and blood glucose. Over the course of several visits we talked about the huge benefits of physical activity and the value of activity trackers in raising awareness around physical activity. While initially resistant to “exercising”, she eventually agreed to purchase a wrist band activity tracker with an initial goal of wearing it for 2 weeks to learn what her average movement and step count was during the day. She learned that she averaged 1200-1500 steps/day. She found that information enlightening, and immediately started considering how she could be more intentional to increase her movement. When she returned a month later for her follow-up visit with me, she had already increased her average step count to 5000-6000 steps each day. Wow! 

    I acknowledged her mindfulness, intentionality, time, and hard work. In applying the 4 questions above with her, I learned that to increase her activity, she was getting up between appointments and walking around the office. Then, she decided that at home in the evenings while watching TV and knitting, she would get up and walk around the house during commercials. From there, she went on to take-up swimming laps, then added doing a circuit work out at a local gym. She built upon her successes and leveraged those. 

    She was one of those special people you never forget. She had a fantastic sense of humor! She  enjoyed traveling and I frequently would have photos show up in my email of her swimming in a pool on a cruise, swimming in the lake at her lake house, or getting a “hydro massage” after working out at her local gym.  Applying a solution-focused approach to activity and activity tracker conversations assisted her in self-discovery and leveraging her successes in moving more for even greater successes.

    While activity tracking apps can help motivate individuals to make health behavior changes, just like anything else, if we focus on the negatives, success will be more difficult to achieve. When working with clients, help them set realistic goals to achieve to set them up for success, then build upon their achievements in a slow and steady process.

    We plan to continue to write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Applied to Mobile Apps

    “You`re only as weak as you let yourself become, and you`re only as strong as you allow yourself to be.”

    Daniel Hansen

    Beautiful bougainvillea, Palm Desert, CA

    In this week’s installment of Diabetes Technology and Solution-Focused Practice we’re discussing mobile apps. In our last blog we focused on using a solution-focused approach to interpreting and discussing continuous glucose monitor (CGM) data. This week’s blog we’ll focus on a new discovery for us – the WW mobile app. We will share insights on other apps in future blogs. We believe that using solution-focused language within mobile applications can improve user engagement with the app, as well as encourage individuals to make progress towards their health behavior goals.

    WW App: Deb’s experience…

    As you may know, Weight Watchers is now known as WW. I have been using their app, the WW app, to help  stay on track during the COVID-19 lockdown. You can learn about the different WW programs and pricing here. There are several options to choose from, I only use the app for logging and motivation.  I was encouraged to continue using the app because of the nature of the messaging. Then I began to wonder if they were incorporating a solution-focused approach? 

    From a weekly in-App push a few weeks ago, the headline was “Why you should do what works: You might already have more tools in your toolbox than you think.” If that doesn’t sound like solution-focused messaging, I’m not sure what does! The post reminds us that people typically focus on what isn’t working well and how to deal with challenges. Of course, that is not motivating, and not helpful when trying to make hard health behavior changes.

    But, what if you “Flip the switch” so to speak? (See our many blog posts from 2019 about “Flipping the paradigm” –  here’s one on healthy eating, and here’s one on healthy coping). The WW message goes on to encourage focusing on the things that come naturally and leverage strengths or what’s worked in the past! Wow! We’ve written about strengths in this blog multiple times (you can read about strengths here), and so believe in focusing on what one does well,  building confidence, and increasing happiness by doing so. 

    Make Strengths your Secret Weapon. According to WW, leveraging your strengths will help you be successful. They suggest asking 3 questions to uncover strengths:

    1. When do I feel like my best self?
    2. What makes me unique?
    3. What comes most naturally to me?

    Those are questions that diabetes care and education specialists (DCES) can easily incorporate into diabetes-related conversations with clients as well. Once those questions are answered, WW suggests creating an “affirmation” to help remember to focus on personal strengths. You can read their post here. One exercise that helps people think through writing their own affirmation includes showing a word cloud to help direct thinking about potential ideas of strengths (including humor, cleverness, bravery, creative etc.). What a powerful visual tool, that would be so easy to employ in any diabetes care and education program! Finally they suggest saying the affirmation out loud every morning or posting on your computer so it will be visible every day. For instance, “I am strong.” “I am resilient.” You get the idea

    I loved this way of thinking about making healthy choices, and reading and engaging with the content. I created my own affirmation and have it posted on my computer with a sticky note so I  glance at it multiple times during the day! Tami has affirmations on her desk and in the kitchen that she sees when making coffee in the morning to start the day off.

    Helping clients create their own affirmation using solution-focused principles is a great opportunity to highlight what is working well already and focusing on their strengths, as well as supporting the development of resilience. 

    Do you recommend mobile apps to your clients? 

    If you have a client interested in weight loss or adopting healthy eating habits, the WW mobile app might be a good option. (We are not endorsed by WW and do not receive any compensation from WW). Knowing the positive strength-based language that is being used is so encouraging. Also of note, WW recently hired Adam Kauffman, formerly of Canary Health,  to head their diabetes program (read the press release here) so we’re excited to see what’s to come in the future.

    We plan to continue to write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom but her words and opinions in this blog are her own. Tami is employed by the University of Kentucky Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Applied to CGM

     “The future depends on what we do in the present.” – Mahatma Gandhi

    Views of the Sierra Nevada Mountains from Folsom Lake, Granite Bay, CA

    In this week’s installment of Diabetes Technology and Solution-Focused Practice we’re discussing continuous glucose monitoring or CGM. If you’ve been reading our blog, you know we’ve written about CGM before in our posts about Exceptions and Possibilities and also in our series on “Flipping the Paradigm” when applying a solution focused approach to Monitoring

    Focus on “exceptions” rather than “problems”

    When we think about applying a solution-focused approach to CGM, Bright Spots and Landmines by Adam Brown comes to mind. It’s a framework for evaluating diabetes habits and decisions. (You can read our 2019 interview with him here.) As we were identifying our technology themed blog posts, Deb happened to watch a North Carolina JDRF Chapter presentation by Adam (see slides here) that really highlighted the approach we encourage  diabetes care and education specialists (DCES) to take when discussing CGM data. 

    When evaluating CGM data similar to that below, the typical first response may be to focus on the glucose spike and try to identify what went wrong.

    However, when taking a solution-focused approach, we want to turn focus to all of the things that are working well (rather than what went “wrong”). Similar to Adam’s “Bright Spots”, we call them “Exceptions” or times when the problem did NOT occur and when things were going well. Below you can see where Adam focuses on his Exceptions, instead of his “landmines” and identifies all of his successes during the day. If we only focus on times that are not working well, we miss identifying successes.

    CGM creates a great opportunity for discovery learning!

     When CGM was first incorporated as a management tool, the focus was typically on hypoglycemia, and preventing serious events from happening. As CGM has evolved and more individuals with type 2 diabetes are incorporating it into their diabetes care, the focus has broadened and now includes focus on making healthy behavior changes. CGM creates a great opportunity for discovery learning, where people can try different foods or activities and personally experiment to learn what works well for them. While Adam identifies 42 factors that can impact blood glucose, he stated that there are more likely more than 60-100 factors if you include mental health and other daily issues. There’s so much to learn!

    As DCES use CGM in practice with clients with type 2 diabetes, applying a solution-focused approach to CGM data can be motivating and help reinforce habits and choices that result in increased time in range (TIR) and overall quality of life. (The recommended goal for TIR is > 70% of glucose values between 70 and 180 mg/dL) Focusing on their “best day” pattern (the day with the greatest TIR) and working towards increasing TIR is a positive goal to strive for because they can “do more of what’s working” instead of giving up or stopping something they enjoy. Our “fresh view” photo today was taken by Deb on an easy hike near her home. Physical activity is one of many factors that can help one see more TIR. Applying a solution-focused mindset with CGM can help your clients want to learn to use their own data to learn about their diabetes and create a plan that works for them, where they can be successful.

    Do you use CGM in your practice and with your clients? If you do, try focusing on times when they are in their goal range and inquire about their actions and activities during that time. Help them identify what’s working well and what choices will move them towards more TIR. 

    • One mnemonic to facilitate conversation is MGLR, which stands for “more green, less red” when looking at the TIR bar. The goal is to see more green (time between 70-180 mg/dL) and less red (< 70 mg/dL). Talking about TIR can be a great way to have a solution-focused discussion and to help clients identify opportunities to succeed instead of focusing on past failures. 
    • A second mnemonic is FNIR, or “flat, narrow and in-range”, which is a goal for the trend graph. When viewing the trend graph the goal is to have the majority of the data fall within the target range, again typically 70-180 mg/dL without extreme variability swinging from below range to above range. CGM creates an opportunity to move towards a clients goals while providing constant, non-judgemental feedback on their progress.

    We plan to continue to write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: A Telehealth Experience

     It’s not what you look at that matters; it’s what you see. – Henry David Thoreau

    Joshua Tree National Park, California

    Back in January we shared the top 10 things that 2020 taught us (you can read it here) and #5 was to Keep a mindset focused on finding solutions, rather than focusing on problems. Little did we know that we would be applying that lesson to many aspects of our lives throughout the year. In some ways it’s difficult to believe that an entire year has passed since the world first shut down and the new concept of “social distancing” became the norm. And with that the need to quickly find a solution to no longer being able to meet with clients in person. Tami works with a dually accredited Diabetes Self-Management Education and Support program (DSMES) in public health which quickly became part of a statewide pilot to pivot to online virtual delivery. Rather than fixating on the “problem” at hand (no longer being able to meet in person), she and the team focused on creating solutions, leveraging the ideas, input, skills and expertise of the team she works with. To echo the Thoreau quote above, it’s all about what you envision and see in looking to the future.

    Here’s Tami’s telehealth experience…

    I will never forget hearing people say, “What’s so hard about switching to facilitating online. You just open up your computer and talk!” But it quickly became evident that virtual delivery is SO much more than that…my home office rapidly transformed into a small studio complete with green screen for virtual background (to hide the chaos of working from home), a webcam (for clear image and sound), a ring light (for proper lighting), a second device to log-in (to see what the participants are seeing), elevating my laptop (so it was the right height), rigging up my desk so all props were within reach, placing my notes where I could see them and still look in the camera, plus learning how to use Zoom and Docusign!  And not to mention adapting the entire curriculum and mode of delivery to be interactive and engaging. Many times I told my husband I not only had to be a content expert, but also be engaging, be entertaining, and be my own IT. It seemed that each day new considerations and challenges popped up (after all, I didn’t know what I didn’t know), but we kept a mindset focused on building solutions. And thank goodness for technology in these days of “social distancing”! The photo above from Joshua Tree is reflective of the many pieces and aspects that together built a successful telehealth program and required us to rely on a strong network of people, technology and new ideas to be resilient. (If you’ve followed our blog, you know we enjoy sharing a fresh view through an inspiring photo with each post!)

    Tami’s office set-up for virtual delivery

    Engaging differently through virtual visits

    One quick learning with the transition to virtual DSMES delivery was that engagement is significantly different through virtual visits. Engaging virtually can bring an added level of stress…How do I connect to Zoom? My internet is unstable. How do I mute myself? Can you hear me? How do I turn off my camera? Can you see me? How do I position my laptop because I don’t like what’s in my background or how I look?…I bet you can relate to some of these! In an effort to reduce stress, and start each encounter on a positive note, I started each session in a solution-focused manner with the questions: What’s 1 thing that went well this past week (no matter how big or small)? What’s 1 change you were able to make? How were you able to do that?  Whether unmuting and sharing, or replying in the chat, this helped acknowledge each individual’s hard work and guide the discussion toward finding solutions. At the conclusion of each DSMES series when setting post-program goals, again we turned focus to areas each individual was already achieving some success and how they could leverage that for future benefit.

    Telehealth virtual delivery was a success!

    I’m happy to share that after facilitating multiple cohorts our program has had a 100% completion rate for most of the cohorts! Much higher engagement and completion than in-person delivery. That’s a huge win!

    How has technology changed your practice or your thinking? We’d love to hear from you!

     Over the next few posts we’ll write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!


    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients.

    Deb is employed by Dexcom but her words and opinions in this blog are her own.

  • Fresh Views

    Bring A Fresh Perspective to Diabetes Technology Through Solution-Focused Conversations & Principles

    Perspective is everything when you are experiencing the challenges of life. – Joni Earackson Tada

    Arch Rock, Joshua Tree National Park, California

    In this new year, are you looking to add a fresh perspective to your diabetes care and education conversations?

    Over the past two years, through this blog and our research publications and presentation we’ve been sharing tips and guidance to help diabetes care and education specialists incorporate principles of solution-focused practice into their conversions with clients. At its core, solution-focused practice is based on relationship building between the client and the clinician who acts as a “think partner.” The overarching themes of most of our blogs help the diabetes care and education specialist to view their interactions with a new perspective and challenge them to think differently. (With the mention of “overarching” we thought the photo above as fitting for our “fresh view” for this post.)

    With the rapid evolution of technology-enabled care during the COVID-19 pandemic, we’ve been discussing the need to focus some of our learnings to support the use of solution-focused principles when incorporating technology into care and education. So, we’ve decided to launch a series of blog posts focused on different aspects of technology-enabled diabetes care and education and incorporating solution-focused principles. Over the next few posts we’ll write  about various technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching.

    In the meantime, there are two papers focused on incorporating technology into practice that we encourage you to check out. They were published by colleagues (including Deb) in August 2020 in The Diabetes Educator journal (now The Science of Diabetes Self-Management and Care):

    • The second paper used continuous glucose monitoring (CGM) as an exemplar for integrating technology into practice. In this paper a simplified process for evaluating CGM data was presented. This DATAA model (an acronym for download data, assess for safety, time in range, areas to improve and action plan) not only simplifies data interpretation, but also includes solution-focused principles along with strength-based language practices to empower people to use their data for learning and behavior change.

    Stop back by in two weeks to see which technology to impact and influence diabetes care and education that we focus on first!  

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom but her words and opinions in this blog are her own.

  • Fresh Views

    7 Key Accomplishments in 2020 and What’s Next for 2021

    1.Dream it. 2.Envision it. 3.Think it. 4.Grow it. 5.Become it. 6.Live it. 7.OWN it.― Germany Kent, The 7 Steps to Transformation

    Joshua Tree National Park, California

    The photo above depicts 2020 in our minds! We felt like we were walking through prickly desolate days at times, yet we kept our eyes on the horizon, the peaks ahead, and kept moving forward despite the pandemic and changes in our world. With 2021 in full swing, we continue to envision new possibilities, opportunities, and fresh views on solution-focused practice, and we hope to encounter beautiful vistas and images to imprint in our minds along the way.

    We love the above quote by Germany Kent. We find that at the core it aligns with our accomplishments in 2020 here at A Fresh POV For You, and helps describe what we envision in 2021.

    Dream it. We dreamed that we would continue this blog to share solution-focused practice techniques with our colleagues and get more of our research published. We did it! This blog recently passed it’s second anniversary. And in March we published our second paper about incorporating solution-focused practice in AADE in Practice (now ADCES in Practice): A Paradigm Shift: Taking a Solution-Focused Approach to Practice 

    Envision it. We envisioned sharing the impact of solution-focused techniques and building the evidence to support incorporation of solution-focused principles into diabetes care and education by publishing more of our research. In October 2020 that happened! Applying a Solution-Focused Approach to Life With Diabetes: Insights Gleaned via Twitter was published in The Diabetes Educator journal (now The Science of Diabetes Self-Management and Care journal)

    Think it. We continuously think about and consider the power of words we choose to use in  client interactions every day. So throughout 2020 we wrote a series of “word of the week” blogs. In each post we shared a word related to solution-focused practice along with practical tips and guidelines to inspire solution-focused thinking and practice among diabetes care and education specialist, and to slowly instill confidence in solution-focused principles. We embrace those words in practice and hope that you’ve found them impactful in your conversations too.

    Grow it. We wanted to grow our reach. Over 2020 we’ve added many subscribers to this blog and have shared it on multiple social media channels. In 2021 we’re thinking of expanding to podcasts and other methods too. Stay tuned!

    Become it. We were so excited to have a podium presentation accepted at ADCES 2020 annual meeting. Unfortunately due to the pandemic and transition to a virtual meeting, we did not present, but are hopeful to be able to share our presentation this year. We’re also considering offering ongoing webinars due to great interest from our readers. What do you think about that?

    Live it. We practice what we preach. We organize our life with solution-focused thoughts. We wake up and think about what has worked well for us and how we can “do more of that.” One thing we tried hard to do in 2020 was stay connected. You can read more about Support here and how we stayed connected with friends, family and colleagues. 

    Own it. We “own it” when it comes to our belief in the transforming power of solution-focused practice. The power of identifying what has worked and leveraging that for future successes. In 2021 our goal is to build upon this. Do more research. Write more to spread the word of solution-focused practice. And continue to educate ourselves and our colleagues .We’d love to hear from you, and learn about what you are interested in learning regarding incorporating a solution-focused approach in  your practice!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

  • Fresh Views

    Top 10 Things 2020 Taught Us

    We were happy to see the sun set on 2020! 

    Life is not about how fast you run or how high you climb, but how well you bounce. – Vivian Komori

    It’s been said that “Life is not about how fast you run or how high you climb, but how well you bounce.” That pretty much sums up 2020! We’ve all learned to “bounce” through the multitude of challenges before us this past year. Yet, through it all there were many positives that we @AFreshPOVforYou personally realized during those unprecedented days. And one of those positives was celebrating the second birthday of this blog!

    WHO ARE WE? 

    If you are new to our blog, we are solution-focused diabetes care and education specialists. We are passionate about doing diabetes care and education differently. Too much of life is spent focusing on problems. Instead, we believe in turning attention to possibilities, opportunities, and a fresh vision for the future. We see the benefit in stepping alongside our clients as “think partners” to focus on what’s important to them, what’s already going well, and build upon that to reach their goals so that they may live life to the fullest. We invite you to join us in doing the same if this is a new paradigm for you. We are advocates for person-centered, strengths-based language, and believe that self-compassion is essential when living with a chronic condition. 

    OUR MISSION

    As we welcome the new year, our Mission continues to be that We guide healthcare professionals in taking a solution-focused approach to practice to enable clients with diabetes to embrace possibilities, opportunities, and a fresh vision for the future.

    Our interest and passion around taking a solution-focused approach to practice (and life), means acknowledging what has gone well, acknowledging how that success was achieved, then identifying how to do more of that and build upon that moving forward.

    TOP 10 THINGS THAT 2020 TAUGHT US (in no particular order)

    1. Importance of connection with others and having support. We don’t take the human touch for granted after living through 2020. We learned that connection and support comes in many different forms. We found creative easy ways to Keep Friends Close, as well as family, through Zoom virtual happy hours, virtual graduations, virtual birthday celebrations; hugs through windows; and drive by celebrations. Find 5 ways to guide your clients to engage in ongoing diabetes support here.
    1. Do hard things early in the day to feel accomplished. We both work the best in the morning. While we’ve known this, it was never quite so clear as it was in 2020. We did the “hard” work early in the day when our minds were freshest, so that we felt accomplished. The stressful days left us tired and spent by days end, and after dinner to help us relax and “escape” we could often be found indulging in Netflix, Prime, and others (who knew you needed so many streaming channels?). We identified a time when things were working well (in the morning) and tried to do more of it. When working with clients, try to identify when they think the clearest and encourage them to focus on their diabetes at that time. Help them identify their “Exceptions”, those times when things are going well. If your client wears a CGM, help them identify a quiet time to retrospectively review their CGM reports to identify patterns and trends and develop 1-2 small behavior changes to move then towards their goals by “doing more of what is working well.”
    1. We CAN be healthy. While many have gained the “COVID 19 pounds”, and may have been over indulging during the past several months, we learned that we could continue to adopt healthy habits, even during a stay at home order. Deb likes and has been focusing on the Mediterranean eating plan that includes lots of healthy fruits and vegetables with less red meat. She also decided to go back to using her WW (formerly Weight Watchers) app to help her track her food, activity and sleep. Tami purchased an under desk elliptical machine to help keep her active during the week, and spent time enjoying great outdoor walking trails on the weekends while social distancing. While in ways it has been challenging being home so much, we learned that it can also be healthy. When eating at home there’s more control over the ingredients added to recipes. There also may be a little more time to prepare meals, or do “meal prep” for the week. Read more tips here.
    1. There are many possibilities, we just have to identify them. With restaurants closed and outside entertainment challenging, we quickly began to think of out of the box possibilities. Deb and her husband decided to have a “car picnic” after they picked up wine at a local winery. From the front seat of their car they could see the peaks of the Sierra Nevada Mountains while enjoying a picnic lunch and a cool glass of Rose. On the work front, taking a solution-focused approach to diabetes care and education can be a fresh new start and bring possibilities to light. Gather some tips from our blog here.
    1. Keep a mindset focused on finding solutions (rather than focusing on problems). We learned that in matters big and small, diabetes-related or not, by embracing a mindset that focuses on solutions, and channeling energy into leveraging strengths and possibilities, we can cultivate a solution-focused mindset. One that envisions success. One which helps manage stress. In our blog you’ll find 7 strategies you can use to step alongside your clients and support them in embracing a solution-focused mindset and managing stress.
    1. Acceptance and gratitude. While social distancing and stay at home orders in 2020 kept us from living out our plans for the year, we eventually came to accept that, and focus on what we could do and find gratitude and happiness in that. Read our tips on developing acceptance as a personal strength and helping cultivate it in others in our blog here, and tips to get started with daily gratitude practice here.
    1. The joy in giving. With life moving at a little slower pace, Tami found joy in giving to others. Small surprise “porch drops” on family and friends’ porches to brighten their day. Dropping by bags of food to be distributed to those in need in the community. She even took up baking bread as surprise drop-offs to those who would enjoy it. With the news coverage of families without food, Deb’s family and her workplace donated to www.feedingamerica.org on multiple occasions to support those in need. Sparking Joy in life and in diabetes education is an important element of our mission.
    1. Active listening is critical. With our daily Zoom meetings and family gatherings we learned that listening is crucial. It can be challenging to not “talk over” people when the virtual conversation includes many individuals. We couldn’t have “side bar” conversations unless they were by text or personal chat. We couldn’t read body language easily. Read more about how listening in a solution-focused practice can support the process of becoming a “think partner” with your clients.
    1. Resilience can be developed. How many virtual conferences or meetings have you attended in 2020? We attended more than we can count, and who knew just how successful they could be! While we missed the ability to be face-to-face with our friends and colleagues, we appreciated the opportunity to continue to learn and conduct business. We just kept going! That is what resilience is all about! Learn how you can build resilience in our blog here.
    1. Power of humor. How could we have survived the past year without humor! Laughing with friends online, reading silly memes on social media, and trying not to take ourselves too seriously. One of our dear colleagues and friends always provides us with comical relief and was no exception in 2020. You can sample our thoughts on humor in our blog here.
    Virtual happy hour laughs!

    2020 was a good teacher! Let’s embrace 2021 with New Year’s “solutions”, rather than “resolutions”

    Our challenge to you as we embark on this new year still facing struggles and uncertainty, is what if, instead of making New Year’s Resolutions this year (which require change and “fixing problems”), you instead guide your clients (and yourself) in making New Year’s Solutions? Who doesn’t like a solution after all? One way to identify solutions is to focus on things that have gone well in the past, and pinpoint how you can do more of that (rather than trying to change). One of the benefits of focusing on what went well, is that you can do it every day. Instead of dwelling on what you didn’t accomplish today, identify what was successful and try to do that “one thing” again tomorrow.

    WHAT’S TO COME? 

    Throughout 2020 we launched a series of posts, each revolving around a “word of the week” to inspire solution-focused thinking and practice. We embrace those words in practice and hope that you’ve found them impactful in your conversations too. What will we write about in 2021? Here are some of our ideas that we may write more about in the months to come: practical coaching tips; building your solution-focused question library; solution-focused behavior change; and incorporating solution-focused principles in a technology-enabled world. We’d love to hear from you, and learn about what you are interested in learning regarding incorporating a solution-focused approach in  your practice!

    We hope that  2021 will be kind to all of us and that together we can learn how to help people with diabetes live their best life!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

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