Unit 3 Flashcards
1
Q
planning
A
the process of achieving a goal
2
Q
where should you start planning a hpp
A
getting support from the top dogs, dms
3
Q
why should u be careful with top dog support
A
they might have needs that the PP doesnt want, the pp is still ur #1 priority so be careful
4
Q
resource
A
usually money
5
Q
support
A
non money resource
6
Q
what happens if the idea comes from the top
A
better for you because then you dont have to gain their support, you already have it
7
Q
how do u gain support before you start
A
find out what dms want, make a rationale based off of that
8
Q
what do most organizations value
A
human resources
9
Q
human resources protection
A
many organizations have their values and goals based around this, protecting the lives of employees and organization members
10
Q
prevention programs
A
unlikely to see a change in health status immediately, will take time
in terms of money this sucks but in terms of humans this has large value because of health. money shouldnt be the deciding factor in human resources
11
Q
three things that have different goals that the organization values
A
employee, employer, community
12
Q
leading by example
A
measures the organization’s commitment to employee and organizational health status and support measures
13
Q
what 4 things does leading by example measure
A
leadership support
worksite support
economic awareness
business alignment with health
14
Q
4 main steps to creating a rationale
A
gather evidence
title it
write the actual content
reference list/credibility part
15
Q
what research should you include in your rationale
A
epidemilogical data (evidence based stats)
global scale relevance
whats happening in other places, be careful - might not generalize to your pp
goals, objectives, plans
budget/economic plans (CBA - ROI)
needs assessment (unlikely that it’ll be done at this point)
how it can benefit the organization
why it would benefit and make sense for the organization to invest in this program
16
Q
content of rationale
A
economic factors epi data needs assessment global scale - get research on most macro scale whats happening elsewhere solution proposal why successful implementation plan eval design proposals
17
Q
conclusion of rationale should include
A
references - show where and how credible your research is
conclusion - state how this is beneficial
18
Q
evidence
A
data that is used to make decisions
19
Q
evidence based
A
decisions that are made based on evidence, if something is evidence based it has more credibility if there was no evidence
20
Q
social math
A
an interesting way of presenting statistics, do this so your dm’s arent bored while reading your rationale
21
Q
cost benefit analysis
A
shows you profit in relation to expenses using a ROI - return on investment
22
Q
return on investment
A
how much profit youre making
23
Q
roi = 0
A
break even
24
Q
roi > 0
A
profit
25
rot < 0
losing money
26
planning committee, when can you make one
once you have some support from key decision makers cna start a planning committee
27
planning committee
a collection of people that have complimentary skills that will actually plan the program that is to be implemented
28
what are planning committees also known as
planning team, steering committee, advisory board
29
what does the size of the planning committee depend on
the program and pp itself
| should be small enough to reach consensus but large enough to do work
30
what/who should the planning commitee include (6)
- pp
- those with health risk
- variety of personalities (doers, thinkers, planners, motivators, influencers)
-key stakeholders not rep. in pp
- org/sponsor
- leader
= SUCCESSFUL PLANNING COMMITTEE
31
what should you be aware of in a planning committee with people/leader
should be operating of the best interest of the PROGRAM not the PERSON
- be aware of politics and political personal agendas that may see people trying to act in their best interest - WRONG
32
what should a leader be
organized, planning, strong in achieving a goal, motivating, creative and effective
33
what should you do with a planning committee
- should evaluate it regularly
- add new people
- establish term limits (permanent, temporary, ad hoc?)
34
what is ad hoc?
| ad hoc committtee?
temporary
35
what should you answer early in planning?
what is the dm support
are the looking to embed or institutionalize the program
is the planning committee temp, ad hoc or permanent
what resources available
how much money
what is the dms commitment
what autonomy or control does the PC have
36
parameters of planning
should be established early on, what parameters the program will work within
estbalish early to avoid problems and reduce risk of wasting resources
37
effective committee has 3 things
has an agenda
have communication between dm, planning committee and key stakeholders (PP)
organized
38
need
difference between now and desired level/state
39
true actual need
what you actually need and is required
40
perceived, desired need
what you want
41
what needs should you cater to
all of them - doesnt matter if its perceived or true
42
needs assessment
collecting data and analyzing it to see what needs and problems arise, determines the degree to which they're being met, prioritize them baed on greatest risk factor and need in the community,, pp and what interventions and programs can be implmented to solve
43
what does a needs assessment identify
```
need
how its being taken care of right now
priority
implememntation intervention to take
resources/assets in community
```
44
2 goals of NA
assess needs, degree to which they're being met (priority)
45
2 types of needs
service needs
| service demands/desires
46
service need
professional approach
what the pros think the pp needs
be careful - may not be accurate
47
service desire/demand
what the pp thinks they need
| - accurate
48
which is more important need or demand/desire?
both equal - have to balance and make sure both are satisifed, but again the PP is your main concern
49
when is not performing a NA okay?
- categorical funding
when one was just completed
no resources/money - stupid!!!!
50
what do you expect from an NA
```
needs
degree theyre being met
priority list
assets and resources available
suggested methods of intervention
```
51
what will an NA answer
```
what is going on in the community
what are the risks and issues and needs
what degree are they being met
what interventions are promising
what is being used in the commnunity right now to address them
where are subgroups
what are their needs
where are they located geographically
what can be done
what is most pressing
```
52
community building
using the assets of the community to mobilize
| strength based - what the community already has and can be used
53
how do you get NA data
primary sources
| secondary sources
54
primary sources
actually conducted info from the PP themselves
55
pros of primary sources
- tailored to pp - fits well
- relevant
- will address needs accurately
PARTICIPATORY DEMOCRACY AND JUSTICE = FACILITATES BUY IN from the PP
56
what will a good planner do??? in light of what???
use 2ndary data in light of its limitations
57
cons of primary data
costly
time
hard to get sometimes
resource intensive
58
secondary sources
data already collected, not from PP
59
pros of secondary data
easy to locate, free, fast access
60
cons of secondary data
may not fit pp
may not be relevant is it accurate?
barriers to obtaining re: confidentiality issues
61
types of primary data sources
- single step surveys/cross sectional surveys/point in time surveys
- multistep surveys [delphi technique]
- meetings
- town hall meetings/community forum
- focus groups
- nominal groups
- observations
- self assessments
62
different types of single step surveys
```
written
electronic
face to face
telephone
group interviews
```
- proxy measure
- signficant others
- key informatants
- opinion leaders
63
what are the 4 types of observations
- direct (intrusive, unintrusive)
- indirect (proxy measure)
- walkthrough/windshield
- photovoice/videovoice
64
2 types of self assessments
HRAs - health risk assessments
| HSAs - health status assessments
65
2ndary data sources (4)
govt
non govt agencies
data already collected from existing records
databases/internet (literature)
66
Mapping
putting needs on a map - mapping them geographically
67
what tool is used to map NA data
GIS - geographical information system
68
self report
the pp tells you about themselves, need to be careful for bias and info that may not be true, mostly has pretty good validity though
69
proxy measure
way of seeing if the behaviour actually occurred if the PP doesnt want to give you info self-disclosure
70
significant others
the pp doesnt have to tell you about their needs themselves, people very close to them can do that for them - aka - significant others, lovers, friends, family - can accurately report on what people need
71
key informatants
people in the community that have been strategically placed to report on needs - may be biases
72
opinion leaders
well respected individuals in the community that report on needs and can tell planning committes what they need or want in the community, are pretty represenative and people will take what they say with merit
- usually early adopters/influencers
73
written surveys
```
most often used
can reach easily
can reach many
quick to administer
time effective
not that expensive unless targeting many
```
cons: low response, can facilitate response increase by making it pretty, puttin ID number and folowing up, incentives, no clarification if needed
74
face to face
```
better because can have clarification
can probe
more time costly - travel time
can have visual cues
can produce bias/influence answers
participatory for the PP - good
training required for consistency of question asking and taking responses
```
75
probing
a technique used by interviewers to get more indepth answer
76
telephone surveys
more wireless only households random digit dialing - doesnt work, random selection (cell phones, answering machines, may not have same area code) - no visual cues, quick, need trianing, can have bias, probing, can clarify, time effective
77
group interviewers
good - can get many info form many people at once
bias is possible
can probe - have same adv. as face to face interviewers, short time
78
electronic interviews
can hire companies to do part of the work for you - eg coming up with questionnaires - payment depends on service and length of time the service was used
- easy
- people familiar with technique
- technology - not eveyone comofrbale
- privacy
- canr each many people
- good control
- no clarification
- can design it as you wish
- more increasing use of technology in life
79
multistep surveys
delphi technique, gather info on more than occasion
- send out questionnaire, broad questions get answer, conduct another survey based on those answers - can go for 5 or fewer rounds
80
community forum/town hall meeting
led by a skilled moderator, people fromt he pp come together to discuss issues that they may have - has to be controlled by a moderator and follow a agenda - be careful of silent minority of vocal minority
81
meetings
meetings of a couple of people from the pp
- if small group may not be entirely representative of the PP - have to take in the whole PP into account and how they may have different needs and desires than the small group interviewed and meeting discussed
82
focus groups
came out of group therapy
a group of 8-12 people come together that dont know each other and were chosen based on a characteristic to discuss a certain topic
- need moderator as well - as topics get more controversial, need better worded questions and more skilled
- need to discuss, record and evaluate for later purposes - may be videotaped
83
nominal groups
groups of 5-7 people that come together, put down responses and THEN discuss the issues to ensure that there is no bias and that responses were already recorded prior to hearing what everyone else thinks - your true feelings and needs are put forward
- once discussed, focus is on prioritizing and ranking issues by IMPORTANCE
84
direct observations
can be intrusive - people know that youre observing them and their behaviour,this may lead to social desirability bias, hawthorne effect
can be unintrusive - people don't know that youre observing them - is this ethical?
85
indirect observations
proxy measure - measure if the behaviour actually occurred
86
windshield/walkthrough
actually walk through the neighborhood, see what changes need to be done, what community health needs
87
photovoice
document needs via a photo, catalogue them and inform policy makers of what needs to be done and change
88
self assessments
the pp can self-assess themselves for health risks but the reliability and validity of these are variable, a bit more realiable when computed but can self-calculate risk as well
89
health risk assessment
how likely you are to die from it, the risk youre at
90
health status assessment
your overall health status at the present moment
91
what makes primary data so useful?
facilitates participatory democracy and justice, faciliating buy in and program ownership for PP stakeholders
92
stakeholder
anyone that has an interest in the program or battling the issue at stake
93
what are the steps in conducting an NA?
```
Id purpose of the NA
gather data
analyze data
assess the community risk factors
- prioirtize/set goals/set program focus
review
```
94
STEP 1 - ID PROGRAM FOCUS
```
what youre going to analzye
what needs
what implementation
what is the purpose of this ...
participatory democacy
determine how many problems you want to focus on (depends on resource and financial status of your initiative)
```
95
gather data
```
primary or secondary data
same level as program
use both qualitative and quantitative data
evidence based
use models and grassroots participation
```
96
analyze data
make sure you take in cultural differences - cultural competence
- may be the hardest step becuase you might not be able to see effects and trends clearly
- prioritize based on BPR 2.0 MODEL
97
bpr 1.0
basic priority rating model
| - revised bc focused too clearly on communicable diseases - BPR 2.0
98
BPR 2.0
- size
- seriousness
- effectiveness of program
- PEARL
99
PEARL
```
propriety
economics
accessibility
resources
legality
```
0-1 = if 0 ~ falls to bottom of priority list
100
4) ID RISK FACTORS
- identify the risk factors that poses a risk and if changes can lessen the risk
101
5) DETERMINE THE PROGRAM FOCUS
reinforcing, enabling and predisposing factors that need to change - which to focus on
102
6) REVIEW
make sure that the need you identifyied is the actual need that has the most priority otherwse you just wasted a shit ton of resources and you are stupid and need to start over
103
Health impact Assessment
done on top of NA , decided by DMs if needed
| measures the potential impact of the intervention on the population/risk
104
steps of a HIA
```
screening
scoping
assess risks and benefits
make reccomendations
report
evaluate
```
105
what are the 4 values that a HIA is based on
```
equity
sustainability
democracy
ethics
SEED
```
106
Interventions
the actual services and strategies/activities implemented to the PP - what is between the pretreatment and post treatment
107
what are the two things that an intervention MUST be
efficient
| effective
108
what does the size of the intervention depend on
- resources
109
multiplicity
the amount of activies/strats *THE MORE THE BETTER*
110
dose
the number of units delivered in the intervention *THE MORE THE BETTER*
111
levels of influence
who does it affect (interpersonal, intrapersonal, community) **THE MORE THE BETTER*
112
intervention strategy
general action plan for the intervention to take place through, they are not mutually exclusive, can overlap and have elements of the others and work in conjunction - the more the better *multiplicity is key
* it is rarely sufficient to only use 1 or 1 type of strategy
113
what are strategies for interventions used for
communicating change, creating awareness, motivating, increasing demand, building social norms
114
health communication strategy
the use of communication channels to influence people and create awareness of a program
most often used
determined by what channel it can go through to the people
highest penetration rate
cost effective
less threatening (eg: rxns)
rarely sufficient alone
115
traditional communication model
reciever is passive, message is passed top down from sender
116
multidirectional communication model
can go many ways - can go bottom up, horizontal (consumer shared)
117
how do you ensure a communication health strategy is effective
if it is consumer based - you have to understand the PP wants and desires and motivations to be effective
118
communication channels (5)
```
intrapersonal
interpersonal
community groups
mass media
social media
```
119
intrapersonal communication channel
```
individual based strategy
most often used, time and costly
tailored to person > personalization > targeting (groups)
enhanced via technology
person specific
coaching is an example
```
120
interpersonal
same elements as intrapersonal but more people (small group)
121
community groups
can communciate via groups already established in the community
122
mass media
use media channels to communicate (eg: news, billboards)
123
direct mass media influence
target people to change directly
124
indirect mass media influence
make changes in the environment to influence and change behaviour
125
social media
channel that is gaining prominencie, can control easily upload, reach many people, good for promotion
126
what is at the heart of social media
networking and relationships
127
how do you evaluate social media
POST
PEOPLE
OBJECTIVES
STRATEGIES
TECHNOLOGY
128
Health LIteracy
being able to understand and read literature and items to inform and influence good decision making for attaining an optimal level of health and wellness
129
4 levels of health literacy
below basic
basic
intermediate
proficient
130
what level of reading is effective for writing
reading @ 6th grade level is good
131
Document Literacy
being able to fill out documents/applications
132
prose literacy
being able to read prose
133
quantitative literacy
using numbers and using that for literacy
134
health numeracy
reading and interpreting biostats, statistics, proabilities, numbers, etc for influencing and acting on it for good health
135
health education strategies
using education and learning to communicate a program or intervention - eg: health classes
not mutually exclusive - very close to health comm strats
planned learning experiences in an educational setting, providing knowledge to elicit for healthy behavioural change
136
what do you need to know in order for health edu strats to work
how the pp learns
137
curriculum
the knowledge thats being presented, leading to a level of proficiency in it
138
scope t
the breadth and depth of what youre learning
139
sequence
order in which u learn the units of study
140
lessons
what you learn in 1 sitting
141
lesson plan
written outline of 1 lesson - intro, body, conc
142
10 principles of learning
- motivation
- relevance
- unknown to know
- learner has to be engaged and active in learning
- attention
- dsitraction
- senses
0 application
- pace
143
5 principles of adult learning
- adult needs to know why learning
- build on previous knowledge
- active
- motivated
- culturally relevant
144
5 stages of learning
- attention
- present stimulus
- engage
- feedback
- retention and transference
145
health policy strategies
```
implement a law to change PP behaviours
a way of forcing change
good method as a last resort
may be controversial ~ taking away freedoms as decisions made my authority but counterargument is that it is for the better health of the overall community and greater good
based on incentives
can affect built environments
```
146
what do you need to ensure for a policy
its well written
followed by everyone
affects everyone, everyone has same commitment and desire to follow it
147
6 phases of policy implementation
```
agenda setting
formulate
approval
implement
assess
modify
```
148
environmental change strategies
evoke a change in environment to evoke changes in behaviours - eg: smoking bylaws
get people to change by removing barriers and making the healthy choice the easy choice (ottawa charter of health_
- can be closely realted with policy change strats
149
health related community service strats
- put things like flu clinics, free check ups in and around the community
- has merit because closely associated with health care professional
- services tests and health care in the community
reduce barriers to obtaining it
cons - ethical obligations
150
community movbilization strats
- community org/building
| - community advocacy
151
community advocacy
enabling pp to influence policies in their community to account for change for the collective good on behalf of a health goal
152
7 methods of community advocacy
1. electioneering
2. direct lobbying
3. turning grass roots to direct lobbying
4. internet
5. media advocacy - newspapers
6. media adovacy - resource person
7. influence voting
3 tiered method - good, better, best
good - do it yourself
better - do it yourself + influence others
best - all the above plus for a long period of time
153
behaviour modification activities
modifying behaviour
- pick something to monitor
- monitor it, analyze, pick a plan of action, change
154
health status evaluation
can help kick start beh modification
155
organizational culture activities
organizations can have their own culture - their personality, can have activities based on that
what is and what isnt important to the company/organization
156
cultural audit
evaluation of values and norms of a organization, see if they support the HPP
157
social activities
- buddy system
- contests
- contracts (with contingencies)
- social events (fill a void)
- social networking (relationships)
158
incentives and discentives
rewards or consequences for a behaviour
can work well and motivate
can be financial or nonfinancial
159
how do you figure out what incentives to use
ask in a na
| put many incentives in pp - mass appeal
160
what should incentives be/do
should be consistent with health
of value
big deal
linked to beahviour and overall outcome desired
161
how can you make an incentive effective
- figre out outcome
- link beh to outcome
- figure out incentive
- link outcome with incentive
- assess
162
planning approaches (2)
high risk micro
| popn based macro
163
there are instances where a major or mass amount of people with a low risk of a disease or health risk can lead to a greater incidence than a smaller population of people with high risk
there are different instances in life to use a popn based approach or micro based approach, one will never obliterate the other completely
164
High Risk Micro Approach
people with a high risk of disease are targeted to recieve the intervention
165
pros of micro high risk
- tailored to person with high risk
- individual based with high risk = good sense of resources
- affecting person you know needs it
- benefits > risk
- motivation for both client and practicioner are both high
motivates behaviour change
166
cons for micro high risk approach
medicalization for prevention - dont know youre at trisk till youre told
attaining ideals is hard if not impossible
hard to monitor risks unless you start early or have previous ailments
not behaviourally appropriate - goes against norms
- results are temporary - neeed to shift to other preventative measures too
167
when should you use a micro approach
when you need to decrease incidence in a small number of individuals with a HIGH risk
168
when is micro not effective
when you need to change the health status of many people with a low or moderate risk
169
macro population approac
when many people are at a low or moderate risk for the factor
170
pros of macro population approach
hits many people
attempts to change social norms - works with them to establish something that is culturally and socially acceptable, unlike micro approach
attempts to change behaviours of many
attempts to find root cause and eliminate it
benefits good for popn, low for indivudlas
changing exposure has good qual and quan effects on people and subsequent generations
171
cons of macro
lack of motivation
| risky - sometimes benefits not outweight the cost (eg: fake fat)
172
when should you use macro
when the only way is to get through the population
need to affect many people
need to affect many with the least possible adverse side effects (eg: smoking bylaws)
173
creating a HP intervention
there is no best model, every PP is different but multiplicity is good
174
6 criteria for a GOOD intervention
- addresses needs/risk factors
- solves needs/goals
- engages the community
- does good impact on community
- allows comm to get involved
-follows standards of practice
- easy to evaluate
uses resources
175
what should an intervention be
efficient and effective
176
efficient
uses resources well
177
effective
actually meets goal
178
settings approach
tailoring your intervention to your pp
179
best practice intervention
recommended, shows evidence of working where it was previously implemented
180
best experience
no critical peer review but evaluation shows promise
181
best process
shows that planning is good - may work
182
4 types of interventions
- evidence based
- effective
- promising
- emerging
183
tailoring
making the intervention cater specifically to your pp and their wants/desires, makes them want to pay attention to it more
184
cultural sensitivity
making sure that the intervention caters to the different cultural spectrum in the pp
185
mutliplicity
having multiple strategies in the inverntion
| - the more the better - more channels, more likely to influence the population, more response and exposure
186
adapting interventions
- can adapt evidence based interventions to your own pp - be careful though, doesnt always work, needs constant revisions
187
6 steps of adapting
```
assess
select
prepare
pilot test
implement
revise
```
188
3 intervention intentions
learning
behaviour
environmental
189
motivational interviewing and coaching
behaviour cahnge individual approaches
190
health promotion
the act of people enabling control over and increasing their health
191
there are many components to health
we each satisfy them in different and the same ways
192
individual approach to health
has large value because it can help those that are in high risk and need help and as well as those that are at a low risk but want to improve their overall level of vitality and health/living
beneficial to all on an individual sclae
193
when meeting with a health coach
advice and well meant advice may be taken the wrong way, met with blame, frustration and blank stares, unproductive persuasion
- how we speak to clients is just as important as what we say to them because the motivation is all in the qualitity of interaction and relationship
194
client relations is just as important as client impact
friendsly advice is not endorsed, may lead to frsutration and blame
you dont give input as a coach but you guide the client to finding the own answers that are within
195
coaching
client centeresd behavioural cognitive change approach that has theoritical underpinnings
196
3 theories of CALC
TRA TPB SCT
197
client resistance may be a product of
quality of interaction adnw what youre saying
198
motivational interviewing
- used in addiction counselling
miller and rollnick
individual, client centered behavioural change approach that focuses on a way of being with people
- if you focus too much on the tools, you lose sight of the central approach
- faciliate behavour cahnge by resolving ambivalence
199
ambivalence
conflict in not knowing which behaviour change route to take - biggest obstacle
200
7 key points of motivational interviewing
- the answers are within the client
- passive, quiet, directive approach
- clients role is to find the answers, practicioners just guides
- primary obstacle is ambivalence
- resistance is just feedback, overestimate of clients readiness to change
- persuasion is not effecitve
respect clients right to choose - relationship as equals
201
4 guiding pricinples of MI
R - resist righting reflex - NO ADVICE/PERSUASION/COERCION
U - understand client's internal motivations - listen with genuine curiositiy
L - listen! (1 mouth, 2 ears)
E - evoke transformation - michaelangelo approach - saw the marble, saw david
202
Coactive Life Coaching
many behaviour models, this is what irwin uses
- based on theories (SCT/TRA/TPB)
- main goal, help people help themselves
- intrapersonal channel
- uses underpinnings of MI
203
coactive
relationship between the coach and client is that of equals
204
4 cornerstones of CALC
- NCRW
- answers from within
- aim to motivate to change
- holistic approach
205
client assumptions
- clients have the answers
- nothing is wrong with the clients
- answers are there but there are barriers
206
coach's role
help the client find the answers not by giving advice but by using questions that are open ended and based on anything because holistic approach to life impacts helath
listen to inuition, resist righting reflex
DROP ASSUMPTIONS, REPLACE WITH CURIOSITY
207
3 types of coaching
fulfillment
balance
process
208
Fulfillment Coaching
help the client get fulfilment in life overall
| thoery - SCT
209
balance coaching
get many different perspectives
| theory - TRA/TPB
210
process coaching
help the cient open up to see where they are in life and how to gain control of their life and where they are in this moment
211
why is coaching/talking effective
humans value talking about our selves, releases stress and self-disclosure helps us really understand ourselves and connect
social connection motivates us
212
fulfillment coaching
expectations, expectancies, values, self efficacy, acknowledgements and reinforemcenet
- uncovering goals, championing - SCT, showing clients what they're capable of
213
process coaching
explains voluntary behaviour and intentions - look at all different perspectives of life just not social and subjective norms or lack of percieved behaviour control - if you see many perspectives then you can see different paths of actions TRA/TPB
214
process coachin
no theoretical base - just look at where the client is in their life and regain control of their life by exploring it
215
CALC AND OBESITY STUDY
study conducted at UWO that shows that CALC could be an effective behavioural change intervention that could help obese people lose weight - has much potential although more time should have been let for the study as well as more people so more evidence could be gathered to further see effects of CALC on obesity and weight loss
- changes in waist circumference, HRQOL, healthy eating, self esteem, confidence ability, DPA
- no change in BMI and self-efficacy (again research shows this could help - need longer study)
- participants had buy in $20 per 7 sessions
could talk about anything with coach on the phone
- this opened up their lives and have support which increased confidence and perspectives in clients leading to results that were mentioned above
216
CALC AND SMOKING CESSATION STUDY
study done at UWO showing that CALC has potential for helping smoking cessation
- clients barriers - control, identity
- triggers - stress, social situations
- through MI and coaching saw different perspectives relating to quitting and stopping cigarettes from controlling their lives
- yielded mixed results - coaching brings MI principles into action
- increased trends in self-efficacy, control over cigarettes, decrease in # of cigarettes, self esteem
- 1 mo follow up - increased awareness of dependency, control, barriers
3 mo follow up - empowerment, control, possibility for change
6 mo follow up - shift in overall perspectives
- coaching helped find a substitute for cigarettes and was fundamental in gaining insights
need more people trained and knowledgeable about coaching - more people - more time, more control - more effective results that are generalizable
