• Fresh Views

    Diabetes Technology and Solution-Focused Practice: Noom App

    Noom messaging to support healthy thinking!

    We at A Fresh POV for You hope you enjoyed summer and are now heading into fall with excitement and initiative!  As we continue our series on diabetes technology, today we’re sharing Deb’s experience with the Noom app. Both of us have used many different apps for healthy living, some of which we’ve written about in past blog posts. 

    Deb started using Noom recently because of all of the great things she was reading and hearing about the psychology behind behavior change.  While our goal as diabetes care and education specialists is to incorporate behavioral techniques into practice, including solution-focused practice, it’s often challenging to have enough time to teach the skills needed to embrace the behavior change. That’s where Noom comes in. 

    What’s interesting about Noom is that you answer many survey questions including history, habits and desires, then Noom crafts an ideal plan for weight loss or making healthy choices before you have to decide to commit to the cost. Noom incorporates several behavior techniques including Cognitive Behavioral Therapy. The overarching premise of Noom is to help people set small, achievable goals, so that as those are reached one will stay motivated, thus building  self-efficacy, which helps boost motivation.

    Noom has several statistics they share regarding their success rate. We only have the reports and can’t share personal experience as we are new to this app and technique. Some insurance plans will cover the Noom program and Noom will facilitate the process.

    What’s different about the Noom app is the psychology lessons each day – you choose how many minutes you want to engage, Deb’s been doing 10 minutes a day. The app encourages taking notes, writing down calls to action, setting goals and documenting them. Overall the theme of Noom is “I believe I can change my behavior”.  And it’s encouraged that the user reminds himself as time goes on.

    Noom also creates a social connection. There are Noom community groups as well as a Noom coach if one chooses to engage. The language used in the app is very encouraging, person first, and a questioning approach is used.

    So what does this have to do with a solution-focused approach? The psychology behind Noom assumes that the user has the power they need, but they need support and coaching to help develop positive thinking. That is a key component of a solution-focused approach – to start with the strengths of the individual and then build upon them. And as stated, they use a questioning approach, encouraging the individual to think about what might work for them as opposed to setting a strict plan.

    If you’ve been reading our blog you know we’ve written about the WW app (the old Weight Watchers) and some of the positive messaging we’ve seen from that app. We would say that Noom goes one step farther in teaching the mini-lessons focused on psychology.

    As with any healthy living app, the best app is often the one that resonates with you or your clients. If your clients are looking for something new, this might be an option, depending on costs.

     Please note that this blog is our personal experience and we receive no financial incentives from Noom.

    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

    Association of Diabetes Care and Education Specialists 2021 Virtual Annual Meeting Preview

    We hope your summer has been going well! We’ve been busy with work and spending time with family.  Here @AFreshPOVforYo we are getting excited for the upcoming ADCES21 Virtual conference. For those of you that are attending, we have highlighted 13 presentations that are interesting to us and align with our thinking around behavior change, person-centered care, use of language, and of course use of technology.  While there are many, many more sessions we plan to join, we are showcasing just a few!

    We hope you’ll attend our session on Saturday 8/14/21 at 3:15 pm CT, S30 – Adopt A Fresh Point of View: A Solution-Focused Approach to the ADCES7 Self-Care Behaviors™.  We presented two years ago at #AADE19 and shared an overview of what a solution-focused approach is all about. This year we’ll go a little farther and address the ADCES7 self-care behaviors. We’ll be sharing more info about our program in two weeks, so stay tuned for that!

    While we wish we were connecting with our colleagues in person this August, we appreciate the great program put together virtually. We’re crossing our fingers that we’ll be grabbing a coffee or a glass of wine at ADCES22 in Baltimore next year!

    Enjoy the meeting if you’re attending! We’ll share some of our thoughts about the meeting in a future post. We’ll also be Tweeting during the conference to share some pertinent information!

    T02 – Help People With Diabetes Shift Their Mindset and Change Their Approach to Self-Care Behaviors

    Mark Heyman, PhD, CDCES

    Thursday 8/12/21 10:35-11:05 am 

    In this session, presenters will show a framework for how diabetes care and education specialists can empower people with diabetes to take a new relationship approach to change their entire emotional experience with diabetes to improve self-care behaviors.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Describe a framework for empowering people with diabetes to change their emotional experience with diabetes
    • Describe how different types of relationships with diabetes impacts psychosocial and emotional functioning
    • Utilize practical tools to help people change their relationship with diabetes

    T10 – Achieve Better Outcomes by Using Individually Customized Messages

    Marlisa Brown, MS, RDN, CDCES, CDN

    Thursday, August 12, 2021

     12:45 PM – 1:15 PM

    This session will discuss how to achieve better results by combining smart goals, virtual programs, motivational interviewing, coaching, stages of change and behavioral strategies with customized messages designed individually to improve outcomes.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Combine behavior change techniques with customized messaging designed to improve individual outcomes
    • Embrace fears and help an individual to overcome barriers
    • Identify a starting point and build an action plan

    T17 – Collaborative Psychosocial Care for Youth With Diabetes

    Korey Hood, PhD

     Thursday, August 12, 2021

    1:20 PM – 1:50 PM

    Psychosocial care for youth with diabetes presents challenges for the care team. This presentation will cover engagement and treatment strategies that optimize diabetes care in youth and collaborative care provided by diabetes care and education specialists and mental health professionals.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Identify psychosocial care opportunities in youth with diabetes
    • Select validated surveys and screening formats for identifying psychosocial issues in youth with diabetes
    • Adopt concrete strategies to help youth with diabetes

    T18 – Language in Diabetes Care From a Personal and Professional Perspective

    Lauren Plunkett, RDN, LD, CDCES

     Thursday, August 12, 2021

    1:20 PM – 1:50 PM

     Living with a disease that focuses on numerical values and patterns can be physically and mentally exhausting. Presenters will examine statements that trigger sensitive emotions and how to replace them with optimistic, inspirational coaching.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Collaborate with individuals to understand how they approach management of their diabetes
    • Articulate optimistic coaching methods to encourage individuals to live in partnership with diabetes
    • Reframe the standard clinical approach to a perspective that focuses on the individual experience

    T27 – Diabetes Stigma: Causes and Consequences for the Concerned Clinician

    Lauren B. Beach, JD, PhD

     Thursday, August 12, 2021

    3:25 PM – 3:55 PM

     In this session, participants will learn how diabetes stigma at individual, interpersonal and structural levels intersect and can compound other forms of social marginalization, contributing to health disparities and poorer outcomes.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Define diabetes stigma and name at least four dimensions of stigma
    • Name pathways by which diabetes stigma is associated with medication taking among people with diabetes
    • Promote diabetes pride in your practice and across the interdisciplinary diabetes care team

    F04 – Too Good? The Potential Dangers of Perfectionism in Diabetes

    Kersti Spjut, PhD

    Alexis Skelley, LISW-CP, LCSW, CDCES

     Friday August 13, 2021

    10:05 AM – 10:35 AM

     This session will provide ways to recognize signs of unhealthy perfectionism in diabetes management, its medical and emotional risks, and tangible steps for helping individuals become more flexible, mindful and compassionate approach.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Explain how perfectionism exhibits in diabetes management
    • List possible consequences of perfectionism in people with diabetes
    • Utilize strategies for preventing perfectionism pitfalls among people with diabetes

    F17 – Practical Approaches for Addressing Behavioral Health Needs

    Nicole Bereolos, PhD, MPH, MSCP, CDCES, FADCES

    Friday, August 13, 2021

    12:40 PM – 1:10 PM

    Performing an assessment of behavioral health needs in individuals with diabetes can be limited by lack of training, resources and time. This session will provide practical tools, resources and real-world examples to augment learning in this area for diabetes care and education specialists.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Identify the importance of addressing the behavioral health needs of PWD
    • Demonstrate real-world applications of addressing behavioral health needs
    • Utilize tools and resources appropriately to help address behavioral health needs in practice

     

    D07 – Diabetes Care and Education Specialists and Behavioral Coaching For Mental Health: Creating Successful Partnerships

    Korey Hood, PhD,

    Brooke Benton, CDCES, MS, RD, LDN

    Sunday, August 15, 2021

     10:05 AM – 10:35 AM

    Mental health issues can prove challenging to address for diabetes care and education specialists. This session will discuss how a behavioral coach can work alongside them to screen for mental health issues, recognize when individuals are struggling and connect them to available support resources.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Highlight models that promote partnership between the diabetes care and education specialist and the mental health specialist
    • Discuss the relationship between diabetes and mental health
    • Incorporate screening tools and identify referring sources to collaborate with for providing mental health care

    D19 – Diabetes Distress: An Overview of Prevalence, Assessment and Treatment

    Lawrence Fisher, PhD, ABPP

    Sunday, August 15, 2021

     11:15 AM – 11:45 AM

    This presentation will review the definition, clinical presentation, prevalence, assessment and treatment of diabetes distress due to its high prevalence and consistent links with self-management, making it an important target of clinical care.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Perform a clinical assessment for diabetes distress
    • Utilize recommended tools for clinical assessment of diabetes distress
    • Discuss the treatment of diabetes distress

     D25 – Optimize Support During Crises With Supplemental Peer Support

    Anna Norton, MS

    Sunday, August 15, 2021

     11:50 AM – 12:20 PM

    During the COVID-19 pandemic, peer support communities can serve as a supplemental resource for people with diabetes to maintain their mental health well-being. This session will provide strategies for diabetes care and education specialists to connect people with diabetes to these communities.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Recognize the need for psychosocial support for people with diabetes during a crisis
    • Provide suggestions and strategies for connecting people in their practice to peer support communities
    • Identify reputable resources for diabetes management outside of the healthcare environment

    Here are a few technology sessions you may be interested in as well.  

    T24 – Facebook Collaborative To Improve Diabetes Management

    Lorena Drago, MS, RDN, CDN, CDCES

    Miguel Johns, BS

    Thursday, August 12, 2021

     2:50 PM – 3:20 PM

    Sharing diabetes challenges and engaging with peers through Facebook groups helps people with diabetes make connections and learn/reinforce actionable self-care behaviors. This session will discuss how to use social media to teach, reinforce and support people with diabetes.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Discuss how sharing diabetes challenges fosters connections and improves self-care habits
    • Increase diabetes education support outside of the provider’s office using social media marketing strategies
    • Create engaging social media content to obtain measurable results

    ET07 – Powered by Dexcom: Continuous Glucose Monitoring Empowers Self-Management and Expands the Horizons for Connected Care

    Moderator: Deborah Greenwood, PhD, RN, BC-ADM, CDCES, FADCES
    Clinical Education, Dexcom

    Panelists:
    Malinda Peeples, RN, MS, CDCES, WellDoc

    Denise MacKenzie, RPh, PharmD, CDCES, OnDuo

    Aimée José, RN, CDCES, Steady Health

    LaurieAnn Scher, MS, RD, CDCES, Fitscript

    Lindsay Vettleson, RDN, CDCES, ACE-CPT, ACE-CHC, One Drop

    Friday, August 13, 2021

     10:45 AM – 11:30 AM
    Join the discussion with DCES digital health experts that are leading the development and implementation of digital platforms to support people with type 2 diabetes to engage in personalized, data-driven, self-management and support coaches and HCPs to inform therapeutic decisions.

    S04 – Technology Interventions in High-Risk Populations: The Identify, Configure, and Collaborate (ICC) Framework in Action!

    Donna M. Rice, MBA, BSN, RN, CDCES, FADCES

    Deborah A. Greenwood, PhD, RN, BC-ADM, CDCES, FADCES

    Saturday, August 14, 2021

     10:05 AM – 10:35 AM

     This presentation will describe the ADCES technology framework Identify, Configure and Collaborate (ICC) using a program that delivers care with technology-enabled devices in high-risk communities.

    Learning Objectives:

    At the completion of this activity, participants should be able to:

    • Describe the Identify, Configure, and Collaborate (ICC) framework and its application to high risk populations
    • Discuss the role of the diabetes care and education specialist in evaluating technology interventions within their practice
    • Discuss a technology assessment tool that can be utilized to assess specific technology needs

    We’ll see you in two weeks with a more detailed description of our Saturday educational session!

    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

    KEEP FRIENDS CLOSE: Today’s words to jump-start solution-focused practice

    “Friendship is born at that moment when one person says to another, ‘What! You too? I thought I was the only one.” – C.S. Lewis

    With friends in the Mediterranean this time last year (before the days of social distancing)

    As our world begins reopening from the pandemic, we are longing for the day when we can be in close proximity to friends and family again! Some of the most treasured moments for us personally are sharing life adventures, laughter, and good food and drink with friends (can you see that in our smiles in the picture above from our Mediterranean escape a year ago??) Yet in these days of physical distancing, we are reminded how critical it is to keep friends close, and stay connected while being physically away.   

    Today’s words are: KEEP FRIENDS CLOSE

    So with that, today in our series on words to jump-start a solution-focused approach when managing diabetes, we’re again using a few words (rather than just one) to generate thinking about how to focus on being healthy, living healthy, and making healthy choices, as a follow-on to our last blog “YOU CAN BE HEALTHY”.

    We chose today’s words – Keep Friends Close – because they were used frequently during Diabetes Social Media Advocacy (#DSMA) Twitter chats we hosted in 2018, and seem appropriate in these days of physical distancing. It became crystal clear during those Twitter chats that among people with diabetes, friendships are incredibly impactful and important – especially friendships with peers who also live with diabetes.

    Beyond the concept of friendship alone, we want to stress 3 things (maybe it’s 4 things):

    • Truly valuing friendship
    • Understanding how friendships can support one in living their best life
    • How even in crazy times like we are now living, it is possible to maintain friendships, and might we even suggest, strengthen them

    Video chats, calls, and linking up through social media can provide breaks from upsetting news coverage and help reduce feelings of isolation, loneliness, fear, disappointment (missed graduations, delayed weddings, and the list goes on), help cope with stress, and manage diabetes distress. Those who regularly engage in social media and online discussions, like the previously mentioned Twitter chats have some advantage during these pandemic days because they’ve already experienced the benefits of online friendship and support. 

    Deb’s friends and family participating in a Zoom graduation party.

    What does this mean for diabetes care and education specialists (DCES)?

    Here are 6 solution-focused questions you can use in your conversations to focus on VIPs (friends) and identify opportunities to receive support and strength:

    1. Who do you most enjoy spending your time with?
    2. What traits would your VIP say you have that will help you reach your goals?
    3. What do important people in your life consider to be your best qualities?
    4. How can you use those qualities now?
    5. Suppose your friend with diabetes had the same issue you are facing, what solution would he/she find?
    6. What would the important people in your life say that is different about you when you achieve your goal?

    In these days, here are 5 ways you can encourage your clients to Keep Friends (VIPs) Close virtually: 

    1. Talk about concerns, how they’re feeling, and share emotional support.
    2. Swap strategies for coping with changes in sleep or eating patterns.
    3. Do virtual stretching, workouts, or meditations to help care for you mind, body and spirit.
    4. Share ideas on how they’re eating healthy. Since May is National Mediterranean Diet Month, maybe find a Mediterranean-style recipe they and a friend can cook together virtually via Zoom. Or try this favorite of ours from a previous blog here.
    5. Provide an outlet to unwind and laugh.

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we’re including a solution-focused challenge that can help evolve care and education in a solution-focused manner. Here’s this week’s challenge: When working with clients these next few weeks, try asking at least 3 questions to understand their VIPs and how they are working to Keep Friends Close during this pandemic. Here are some examples:

    1. Who are the most important people in your life?
    2. How have they been helpful for you?
    3. How are you focusing on staying connected with them while we have been staying at home?
    Friends and colleagues from around the world with a connection to diabetes (looking forward to the days we can huddle in for a picture like this again!).

    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. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    STRENGTHS: Today’s word to jump-start solution-focused practice

    The strength in the Dolomite Mountains towering over a lovely placid lake in Northern Italy from Deb’s travels in 2018.

    We find ourselves in the middle of National Words Matter week. Did you know there was such a week? Words are the basis for communication, no matter what language is spoken. Because words matter, we’ve written about the #LangaugeMatters movement many times, you can read more here and here. Here at AFreshPOVforYou, we embrace the importance, power, and impact of words, not just this week, but all year long!

    Our series focusing on words to inspire solution-focused thinking and practice continues this week. You can read more about our take on the power of word selection here. Last week’s word was “Acceptance” – check out our perspective here.

    Today’s word is “Strengths”

    According to the Miriam Webster Dictionary, “strength” is: the quality or state of being strong : capacity for exertion or endurance: a strong attribute or inherent asset. In solution-focused talk, “strengths” are tasks or actions an individual can do well. For instance, seeking support. In a 2018 #DSMA Twitter Chat we asked participants about their strengths. One individual with diabetes replied:

    “I am strong when it comes to seeking support. When I am down, I am self-aware enough to address my hardship. I’m not afraid to be vulnerable.”

    Another replied:

    “My strength is that I refuse to give up. I am tenacious and do not take no for an answer.”

    An individual typically can recognize and clearly identify things they are able to do or achieve and feel happy. We can then encourage focus on those strengths, doing more of what is working, and leveraging those strengths, skills and qualities to create new opportunities. In the same Twitter Chat mentioned above, another participant shared:

    “I concentrate on the lifestyle. The day to day life of a person with diabetes. I work for overall health through exercise, and diet for BGL [blood glucose] results. The support I receive takes care of the rest. So, cure or not, let’s make it as good as we can and support the other.”

    We’ve learned that sometimes self-identified strengths are not areas we might immediately think of in the healthcare world, as evidenced by this individual’s reply:

    “My strengths are passion, humor, and striving to connect with the human being that is each of us. And reminding myself I’m a work in progress.”

    Diabetes care and education specialists can learn a lot from simply asking people what strengths they have to help them live well with diabetes. Those words speak volumes, as evidenced in this individual’s reply:

    “I have the strength to keep on going even [when] I have a few bad readings here and there.  I keep living and doing what I do.”

    The Association for Diabetes Care and Education Specialists (ADCES, formerly AADE) embraces using strengths-based language in diabetes care and education, and has a page of resources here that you may find helpful. 

    A solution-focused challenge

    So our challenge to you this week is to focus on using strengths-based language in your communications to help uncover strengths your clients have. And encourage them to build upon those strengths to do more of what is working for them.

    Here are 5 solution-focused questions you can incorporate to focus on strengths:

    1. What strengths do you have and use to help you manage your diabetes every day? 
    2. What other strengths can you identify? (Note: whenever possible we ask “what else” to expand the thought process)
    3. What would success look like for you (e.g. in life, in living with diabetes etc.)?
    4. How can you use your strengths to create opportunities for success?
    5. What else would you like to share with me today?

    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. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    ACCEPTANCE: Today’s word to jump-start solution-focused practice

    Half Dome, Yosemite National Park, California

    “Acceptance means to be in the embrace of what is without resistance. True acceptance is one of the most powerful and life-changing practices you can choose for your life journey.” ~Kirra Sherman 

    In our last blog we asked… 

    How can we draw attention to words that are powerful, impactful and transformative. More importantly, how can we build a new vocabulary in healthcare so these words easily flow into conversations between diabetes care and education specialists and their clients?

    Join us today as we launch into a series of posts that will focus on words to inspire solution-focused thinking and practice…words which we embrace in practice and believe you will find them impactful in your conversations too. Each post will introduce a new word to weave into your conversations when talking about diabetes or life in general. (Think of this as similar to Merriam-Webster’s Dictionary “Word of the Day”.)

    Today’s word is Acceptance

    We’re referring here to self-acceptance, as well as acceptance by the healthcare team in recognizing that people respond to change differently. We chose this as the first word because we believe it is foundational to solution-focused thinking. It underlies everything else. 

    Accepting oneself can be hard! 

    Being realistic about personal strengths and challenges is often easier said than done. For instance, we both love the outdoors and hiking, especially to take in a beautiful fresh view. However, with the ticking by of the years and impact of a couple injuries, we find we can’t quite embrace all of the things we used to do……like hiking up to mountain tops! Yes, that’s a bit of a bummer. We will never climb Half Dome in Yosemite National Park, pictured above! Yet, we’ve come to eventually accept that, and focus now on what we can do and find joy and happiness in that. So, we take flat hikes instead of climbing, we take a cable car ride to the top of the mountain, and we simply enjoy the beauty of it. 

    Here we are enjoying a beautiful view at Urquhart Castle, Inverness, Scotland.

    Striving to be honest with ourselves and accept who we are, our abilities, and acknowledge when we’ve reached our limits is the goal. Without acceptance it’s impossible to move forward.

    Acceptance is critical when living with a chronic condition like diabetes. 

    People need to feel safe when engaging with their care team to acknowledge what they can do, along with what is challenging for them. Diabetes care and education specialists on the other hand, need to support those that live with diabetes as they learn to accept changes and new challenges in dealing with diabetes.And, practice acceptance understanding that people react to challenges differently. It’s critical to accept the person in front of you as they are, without judgement.

    A solution-focused challenge

    So our first challenge to you is to build your capacity for acceptance. Bring this word front and center in each encounter. Develop acceptance as a personal strength and help cultivate it in others. 

    Here are 5 solution-focused questions you can incorporate to focus on building acceptance:

    1. Could  you tell me about your strengths and qualities you are happy about?
    2. What is one thing you have come to accept in your life that took some time to process?
    3. How did you feel when you were finally able to accept that challenging situation?
    4. How could you use those experiences and feelings to move you forward to accept a new challenge now?
    5. How can I help you come to realize acceptance in your life?

    We hope you will enjoy this new series. Please share with colleagues and students and encourage others in keeping acceptance top of mind in interactions. 

    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. 

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    Make New Year’s Solutions (Instead of Resolutions) for 2020!

    With the start of the new year, many find themselves reflecting on the past year, re-evaluating life, and pondering what “resolutions” they will set for the new year.  New year’s resolutions often focus on “stopping” doing certain things and starting to make changes. Many resolutions revolve around trying to be healthier in some way.  Yet evidence shows that about 80% of people fail to stick to their New Year’s resolutions longer than six weeks.  That means by the time that Valentine’s Day rolls around, many have abandoned their desire to change. Often resolutions are attempts to find ways to solve problems.

    What if, instead of making New Year’s Resolutions which require change and “fixing”  problems (and change is hard!) – you focus instead on 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).

    As you reflect on the past year, here are 5 questions to ask yourself and guide your thinking as you identify solutions:

    1. What went well for you in 2019?
    2. What did you feel happy about?
    3. What behaviors helped you feel successful and were doable?
    4. How can you do more that?
    5. Instead of thinking about “problems”, how can you reframe your thinking into positive “opportunities” and solutions? (Reframing a situation, idea, or belief can bring a fresh perspective. You can read more about this in our January 2, 2019 post.)

    We’d love to hear what your’re thinking about for your New Year’s Solutions. Connect with us on Twitter or Instagram @AFreshPOVforYou!

    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

    A recap of solution-focused sessions from IDF Congress 2019

    Busan Gamcheon Culture Village (부산 감천문화마을)

    “A mind that is stretched by a new experience can never go back to its old dimensions.” – Oliver Wendell Holmes

    Hi, this is Deb writing today. I just recently returned from the International Diabetes Federation Congress, in Busan, Korea. A few of our readers made it to this conference, along with many more friends from the diabetes community who presented interesting sessions that we @AFreshPOVforYou thought you might appreciate.

    Living with Diabetes Stream

    My main reason for attending was to present on a panel discussing #LanguageMatters as part of the Living with Diabetes Stream, a series of sessions that focus on life with diabetes where many people living with diabetes discuss their strengths and challenges and share real world experiences. It was a great opportunity to share lessons learned over the past several years about how empowering, person-first, strengths-based language can not only improve healthcare communication, but also health outcomes. I co-chaired the panel with Renza Scibilia, from Australia, one of the early adopters the #LanguageMatters movement. There were three speakers, each with a slightly different focus. 

    First, Shinomi Takahashi,  a nurse and PhD candidate from Japan, presented on the meaning of the word “diabetes” in different languages. It was fascinating to learn that in Japanese, diabetes, tou-nyou-byou (糖尿病) means “sugar-urine disease”, and many people feel this adds to the stigma of living with diabetes. There was a movement in Japan to change the names of type 1 and type 2 diabetes to describe the physiological differences of the conditions, similar to U.S. discussions. However, as several mentioned in the session – the differentiation between types actually leads to more stigma associated with type 2 diabetes.

    Next, I spoke on the Value of Language Guidelines. The key takeaway was that the use of guidelines helps to change the practice of healthcare. When educating healthcare professionals (HCPs) about the impact of language on engagement in care AND health outcomes, HCPs start to listen. If only all medical, nursing, dietetics and other health profession education programs began each year with a review of the use of strengths-based, person-first language, we’d all be in a better place. The more I learn, write, and speak about incorporating a solution-focused approach into diabetes care and education, the more I realize that this approach makes the use of strengths-based language so easy and natural. So, if we can help HCPs incorporate this approach into practice, we can help change the language at the same time! As always, I ended my presentation with the film co-designed by people living with diabetes and HCPs,  “Changing the Conversation”, that continues to resonate with audiences who engage with people with diabetes. (I think it was shown at least three times during the conference!)

    Deb presenting at the Diabetes Spotlight stage

    The final speaker, Elizabeth Snouffer, Editor for DiabetesVoice.org, presented information around the messaging and advertising that has wrongly portrayed diabetes in the eyes of the public. She shared how creating a culture of fear, victim blaming, and stereotyping does nothing but fuel the myths and misconceptions. What was really fascinating was the focus on how advocacy organizations and other consumer focused groups actually contribute to the stigmatizing language. Some of the images she shared were unbelievable (You can see some of those here on Twitter). She concluded with examples of successful campaigns that have made a difference in changing the conversation around diabetes. 

    Digital Health

    I also sat on a digital health panel, Technology; The future is now, with a line-up of amazing individuals representing the spectrum of the digital health:

    • Kyle J. Rose (Healthcare Enthusiast and Innovator), a newly elected Vice President for IDF Global, and previously with mySugr, chaired the panel 
    • I represented the perspective of the HCP, diabetes care and education specialist, and the realm of digital coaching 
    • Renza Scibilia (Type 1 Diabetes and Consumer Voice at Diabetes Australia), as she proclaimed, was the “most important person on the panel, the person living with diabetes” (and of course we all agreed) 
    • Manny Hernandez (Head of Community, Livongo) represented the health technology industry
    • David Staehler (VP, Eli Lilly, Global Brand Development), represented the pharmaceutical industry
    • Dr. Mahmood Kazemi (VP Global Medical and Scientific Affairs, Abbott Diabetes), represented the medical device industry, and 
    • Dr. Jane Speight (Foundation Director, The Australian Centre for Behavioural Research in Diabetes), represented the psychological side of living with diabetes and technology 

    Some of the key takeaways from the session were: 

    • Technology is not one-size-fits-all; tools need to be individualized.
    • Both population level data analysis and individual data interpretation are needed to change health outcomes.
    • There is a burden associated with technology and data for both the person living with diabetes and the HCP.
    • And from my perspective: There is often too much focus on data that is “out of range” taking a problem-focused approach, and not enough implementation of a solution-focused approach. 
    Deb, Manny Hernandez, Jane Speight and Renza Scibilia getting ready for the panel

    Diabetes Distress

    I also chaired a session on Diabetes Distress. Dr. Jane Speight, from Australia, gave a brilliant talk about the benefits of peer support for diabetes distress. Although not much research has focused on this issue, she shared a few research studies that showed significant and meaningful improvement in diabetes distress, especially in a group setting. Attending in-person group meetings can be challenging for people, but there is promise that online peer support groups can have the same impact as in person. She suggests that while more research is needed, peer support is beneficial.

    Living with Diabetes Award Lecture

    Manny Hernandez showing his now famous blue circle slide representing the time a person actually spends self-managing diabetes

    One of the highlights for me was the Living with Diabetes award lecture by Manny Hernandez.  Manny shared his journey with diabetes beginning with initially being misdiagnosed with type 2 diabetes. Fortunately, Manny had a primary care doctor who knew when he “was out of options” and referred Manny to an endocrinologist, who finally diagnosed him with LADA. For years, Manny was not connected with other people living with diabetes. Then one day he attended a group with other people with diabetes, and learned more in that one hour than he had in the previous four years. This experience led him to develop the tudiabetes.org online peer support community (and EsTuDiabetes.org in Spanish), and eventually The Diabetes Hands Foundation (DHF). The peer support experienced from these communities has impacted so many lives, so people no longer feel alone. I was on the Board of DHF when it closed with Manny’s transition  to work in industry (Manny was caring for his mother living with Alzheimers, so he needed to leave the nonprofit world and now works for Livongo). Yet, Manny had the foresight to ask Beyond Type One to take over the DHF communities and they continue to thrive. (Excitingly, I’m now working on a research study and engaged again with the EsTuDiabetes.org community….more to come on that next year!). The love for Manny in the diabetes community is strong and was evident during his presentation. I felt privileged to be there in person when he received this well-deserved honor.

    Manny’s diabetes “Tribe” after his award lecture (Photo courtesy of Boudewijn Bertsch)

    There were many other sessions I wanted to listen to, but they conflicted with my sessions. They included Riva Greenberg’s presentation on the Flourishing Approach (we wrote about it here), and a presentation on #TalkaboutComplications with Renza Scibilia and The Grumpy Pumper, which addressed language used when talking about diabetes complications, and the stigma and bias those discussions often lead to.

    The more we support using strengths-based language, the more we realize how closely connected language is to a solution-focused approach. Focusing on strengths and what’s working well generates solution-talk and a uniquely different experience between clients and HCPs. 

    Exciting advantages of speaking at conferences are the opportunities to learn something new,  meet new people, see new sights, and of course see fresh views. I’ve broadened my diabetes colleague network and made new friends on this trip, while reconnecting with old friends. I  saw many interesting sites in Busan and ended my conference by spending a few sightseeing days in Seoul before heading home. I even got to connect with my daughter’s freshman year college roommate who lives outside of Seoul. Hopefully I’ll make it to IDF 2021 in Bangkok, Thailand!

    Sunset over Busan

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    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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  • Fresh Views

    In All Things We Give Thanks

    Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow – Melody Beattie

    We are always grateful for the sunshine and beautiful outdoors

    On this Thanksgiving eve, we are reminded of ALL that we are grateful for…including YOU, our readers and followers!

    Gratitude is good for health

    According to the American Heart Association several clinical trials show that engaging in a practice of gratitude can lower blood pressure and help the immune system. “Grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol, and have higher rates of medication (taking)”. Several studies suggest that gratitude can decrease stress and anxiety by activating the areas in the brain that the release feel-good hormones serotonin and dopamine. 

    Research discussed in the Jan/Feb, 2019 issue of Diabetes Self-Management also shows that positive psychological states such as gratitude are associated with improved physical health in people with diabetes, improved sleep, and increased self esteem. While the relationship is not fully understood, positive emotions such as expressing gratitude, are linked to healthier lifestyle choices. And healthy lifestyle choices including healthy eating and being active are in turn linked to overall health.

    How to get started with gratitude in this season of Thanksgiving? 

    Here are 5 strategies to help develop daily gratitude habits: 

    1. Have gratitude reminders. These are simple cues to remind you to focus on gratitude daily. Maybe it’s an alarm on your phone, a bracelet or wristband, a photo, a magnet, or a post it note. And with that reminder, pause, take a breath and focus on being grateful in that moment.
    2. Keep a gratitude journal. We both have found this to be a good personal practice to express gratitude more readily and maintain focus on finding things to be grateful for. Some log entries in their journal weekly, and others daily. Our personal goal is to identify at least 3 things daily for which we’re grateful.While the goal is to write in the journal daily, sometimes life happens and weeks may go by without an entry, but we pick right back up with our entries. 
    3. Start a gratitude box. Keeping a box (jar, album, folder, or whatever works for you) filled with notes, pictures, and moments you are grateful for can bring a boost when needed. 
    4. Voice or write down one (two, or three) good things that happened in your day. On the homefront, this is a gratitude practice Tami has used with her son over the years. In the days when she would take and pick him up from school, she found that the drive time was a good time to learn about his day. That conversation always began with these words, “Tell me something good that happened today.” He knew he needed to answer that, acknowledging something good, before talking about the challenges of the day. 
    5. Use gratitude apps. There are a number of apps with a range of capabilities including sending reminders, sharing uplifting thoughts, and organizing memories for which you are grateful. 

    You can glean other insight in this post we wrote on Gratitude here.  

    Happy Thanksgiving!

    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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  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Reducing Risk

    You are braver than you believe, and stronger than you seem, and smarter than you think. – Christopher Robin

    National Diabetes Month is almost over, what informative and interesting activities were you engaged with this year?  

    Taking a solution-focused approach to diabetes self care

    As we near the end of the month, we are also finishing our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Problem Solving. And the prior weeks we focused on Taking Medications here, Monitoring blood glucose here, Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Reducing Risks 

    When looking at this picture above of the friendly neighborhood kitty balancing precariously across the covered porch rails, it reminds us of life with diabetes… trying to stay in balance never knowing when the bottom may fall out.  

    AADE7 Self-Care Behavior #7: Reducing Risks

    Taking care diabetes today can help people feel good today AND in the future. When blood glucose is in range, one is more likely to:

    • have more energy, both physical and emotional
    • be less tired and thirsty
    • pass urine less often
    • heal better and
    • have fewer skin or bladder infections

    Many say they are their “best self” when their blood glucose is in range. And managing diabetes TODAY means there will also be less chance of having health issues caused by diabetes over time. The important words there are “over time.” Taking care of diabetes now will help reduce the risk of heart attacks, stroke, damage to kidneys and nerves, and loss of vision. But It’s not just about the diabetes, it’s about supporting those with diabetes in living their best life! 

    A journey of a thousand miles begins with a single step. (Chinese Proverb)  Just one step.

    We want to support and guide our clients toward actionable steps they can take now to live well with diabetes and help reduce the risk or delay issues down the road. Then, the key is replicating that small step over and over again to build momentum and actually feel progress. Small steps add up. You may be surprised by the great impact these small, yet simple things can have! 

    The language we use when talking about diabetes complications is important to think about. When we use words like “prevent” as opposed to “reducing risk or delay progression” we imply that ALL complications CAN be prevented. Science tells us that this isn’t always true. Some people have genetic predispositions to either be “protected” from complications or to be at a higher risk. Healthcare providers can add to the stigma, shame and blame associated with diabetes when they don’t acknowledge the fact that some people will end up with complications……just because. We don’t want people to shy away from discussing health concerns, so let’s use our #LanguageMatters voice when we #TalkaboutComplications. That’s what The Grumpy Pumper (AKA Chris Aldred) has been doing this past year. Traveling around the globe, including a stop at #AADE19,  speaking openly and frankly about living with a complication from diabetes. You can read his blog here.  As Grumpy says, “Even with the best of care, people can get complications.” (from Diabetes Connections Podcast) So let’s use a solution-focused approach when talking with people with diabetes complications instead of rehashing any problems.

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this:  By no means is smoking a simple habit to change. What can you do more of that may help you smoke less? Or what needs to happen to help you make changes?

    Instead of this: You need to stop smoking. Smoking is bad news with diabetes.

    Try this: How can you fit in an extra visit to see your eye doctor during national diabetes month?

    Instead of this: You are behind on getting your eye and dental exams.

    Try this: On a scale of 0 to 10, with 0 being never and 10 being always, how often are you able to get an annual flu shot to help prevent illnesses?

    Instead of this:  You haven’t gotten your flu shot.

    Three follow-on questions to help you not only feel  better today, but to help prevent problems down the road:

    • What is one action you can take to reduce your risk? Work closely with your healthcare team to identify the best strategies for you to help manage them and prevent progression to live your best life.
    • What can you do NOW, right this second…to make life better now, as well as down the road.
    • What single change can you make over the next week?

    And consider how people in your life can help. Loved ones, family, and friends can be close allies in your diabetes management. (last week we discussed VIPs, you can read it here)

    We can encourage clients to keep taking those small steps each day. Consistency and routine build on each other. Small steps add up. If people do the best that they can do…then they can say at the end of the day, I did the best I could, and that’s a good feeling.

    We hope you’ve enjoyed our series and that we’ve made you think before engaging with clients. And if you’re a person living with diabetes, we hope our choices resonate with you. Each week we’ve challenged you to try some flips into your conversations. Let us know what impact they have had. Please reach out to us to share feedback.  Let’s continue to join together  to raise awareness of all issues that can improve living with diabetes.

    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. 

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Problem Solving

    I will breathe. I will think of solutions. I will not let my worry control me. I will not let my stress level break me. I will simply breathe. And it will be okay. Because I don’t quit. – Shayne McClendon

    Tomorrow, November 14 is #WorldDiabetesDay! Deb and Tami have had some impactful moments in recent years during diabetes month and on #WDD. Deb has been involved in hosting events at the California state Capitol with speakers, music and lighting of the Capitol in blue. Deb’s also spend #WDD 2017 at the headquarters of  Novo Nordisk in Denmark. Tami has done TV spots, radio shows, Facebook Live and videos, provided community programs, participated in screening events and published articles – all to raise awareness and encourage people to know their risk for type 2 diabetes. 

    The theme of #WorldDiabetesDay this year is the impact that diabetes has on the family. One of the goals is to promote the role of the family in the prevention, management, care and education of diabetes. In a solution-focused approach, the family is important, and we call them VIPs – .and this definition is broad – it includes any one who is a “very important person” in your life. Someone who can provide support when needed, who will notice changes being made, and  who can respect personal decisions and choices. What’s really important is that these VIPs are not the “diabetes police”, or people who make managing diabetes harder. As you think about problem-solving, think about including VIPs in both the discussion and the plan to help foster success and respect.

    Taking a solution-focused approach to diabetes self care

    This is week 6 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Taking Medications here.  And the weeks prior we focused on Monitoring blood glucose here,  Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Problem Solving.

    AADE7 Self-Care Behavior #6: Problem Solving

    With diabetes, “problem” solving is part of the daily routine…figuring out when, what, and how to eat for meals and snacks. What kind, how much, and when to fit in physical activity. When to check blood glucose, how to time any medications, and the list goes on.

    And then life throws curve balls, and no matter how well you plan, unexpected things happen that can send blood glucose out of range. And that’s when more problem-solving skills are called into action to determine how to handle the scenario and what to do to prevent it from happening again. 

    Also, diabetes needs may change over time, requiring adjustments because previous solutions no longer work.

    In taking a solution-focused approach, we typically don’t focus on solving problems….as you know. We focus on solutions…looking for what is already working and trying to do more of that.  So this self-care behavior is not as intuitive to translate. Here are 4 strategies to help diabetes care and education specialists and people with diabetes flip the problem-solving paradigm.

    1. Practice self-compassion. Diabetes is different every day, even when people make similar choices. We learned from our Twitter research that people living with diabetes would like to practice more self-compassion. They want to be kinder and not blame themselves. 
    2. What has gone well today? When you are faced with challenges, think about what DID work for you during this challenging time. Instead of doing a deep dive into all of the issues that might have impacted you, spend some time focusing on your successes. Then tomorrow, try to do more of what worked.  
    3. Keep a journal of solutions. When things are going well, keep track of these small wins so the next time you are faced with a challenge, you have some “go to” solutions ready to try.
    4. Share with your VIPs. Ask your VIPs about their ideas.  Do they have some ideas about what works well for you and the times they see your successes.

    When working with clients, instead of traditional problem-solving exercise, try to focus on existing solutions to create change.  Begin by exploring these 3 questions to flip the conversation.

    1. Tell me about a time when you felt the happiest about your diabetes management?
    2. What was it about that day or time that made it better?
    3. Can you think of times when the challenge you are facing now was not present in your life? What were you doing then?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week for our final installment as we discuss a solution focused-approach to the self-care behavior around reducing risks.

    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. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

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