Facebook and Health

As a technologically conscious team, we have integrated several tech tools into our program to help our participants achieve their goals. More specifically, we have developed an app that allows users to track their exercise, step count, and healthy eating behaviours either directly in the app or with the help of our partner apps. Additionally, app users can set goals and measure their physiological fitness level using our proprietary STEPTM Test.

 

We also offer participants the opportunity to set up their own personal social network with the help of our partner, Tyze Social Networks. Tyze networks are purpose built for the health field and include cool features specific to this area.

 

Although a social networking partner is not available to everyone out there, there is evidence that other social media platforms (and social networking sites in general) are a useful tool for those trying to improve their health behaviours. If you are a health coach looking for a social media platform that might be useful for your clients, could facebook be a candidate?

 

A recent study by Sue Yeon Syn and Sung Un Kim out of the Catholic University of America explored the health information activities of college students on Facebook. Some of their findings are interesting and applicable to our program and the practices of other health coaches:

 

  • Those surveyed had higher intentions to read health-related posts from reliable sources including health professionals, as opposed to “non-expert” sources like broadcasting and media, friends, and family members.
  • Respondents indicated that for less sensitive health issues, such as healthy lifestyle changes, they were (approximately) equally willing to pose questions to “expert” health information sources and friends.
  • Respondents indicated that, in terms of low-sensitivity health-related information, they intended to answer the questions of family members more than other categories, including friends.

 

This provides evidence that health professionals, like many health coaches, can engage with an audience on this platform. Users may very well engage in two-way communication with professionals, by both reading posts and posing questions to such sources. Additionally, this platform can also facilitate communication between a user and their network of friends and family, which is an important source of social support, a critical determinant of successful behaviour change and maintenance.

 

The potential for facebook to be an effective platform for fostering information gathering/social support is huge, given they have 1.65 billion monthly users. Several intervention-focused studies have attempted to leverage the site to either be the main setting for a health intervention, or a supplemental platform. Several of these studies have shown improvements in perceived social support, as well as behavioural changes like increased physical activity and improved eating behaviours.

However, like any strategy, the way in which it is actually implemented is much more important than the medium itself. If you are a coach looking to leverage facebook for your clients/participants, consider the following tips:

 

  • If you decide to build a presence on facebook to share tips and thoughts about your area of health coaching, makes sure to keep active and share with some level of regularity. Irregular posting can be hard to follow, and as a health coach you can understand the importance of building habits.
  • Encourage your participant/client to ask questions/share successes on with their friends on facebook *IF THEY ARE COMFORTABLE DOING SO*.
  • If a participant is not comfortable sharing with their larger group of friends, they can easily create a private (invitation-only) group that can be populated only by the health coach, those who are in the participants close support circle, or those who are also attempting a health behaviour change. You could also consider setting up a facebook group and inviting all your clients to join!

 

Are there any other tips you can think of to optimize facebook to support a health behaviour change? Tweet to us @healthesteps!

Fostering Self-Confidence and Social Support from Friends

Making a positive behaviour change is hard. Trying to move more, sit less, or eat healthier can be a big change from one’s current lifestyle, so it’s important to find ways to maximize the chances you will be able to maintain the new behaviours.

Academic research can often help to illuminate some of the factors that are most important to focus on when trying to make a positive health behaviour change. For example, researchers from Australia, Germany, and Poland recently took a look at how two factors contributed to physical activity: Self-efficacy and friend support.

Self-efficacy is a little like self-confidence – the belief that one can succeed – but is limited to a very specific area. For example, an individual could have a strong belief (high self-efficacy) that they can eat healthier, but could have a lower self-efficacy for getting enough sleep. In this particular study, self-efficacy was determined by asking the respondents to indicate their level of agreement with the statement, “I am confident that I could do moderate-to-vigorous physical activity”.

Friend support is pretty much what is sounds like – in this study it included encouragement, praise, or participation by friends concerning physical activities.

The purpose of the study was straightforward: To see whether these two factors helped individuals to be more physical activity. It turned out that both of these factors were important predictors of people’s intentions to be more physically active, although self-efficacy was a stronger predictor than friend support.

Interestingly, in those who reported very high self-efficacy for being physically active, support from friends did not affect their physical activity levels at all. Even when an individual did not have any friends who supported them, a strong belief that they had the ability to be physically active was all that mattered. Conversely, in those who had a weaker belief in their ability to be physically active, support from friends was a way to make up for that weaker belief.

So what are the implications of this study if you are trying to become more physically active? Well, it appears as if your personal belief in your ability to be physically active is most important. If you have a high enough self-efficacy, the level of support around you matters much less. So how does one improve their self-efficacy?? We will be covering this in a future blog post!

Alternatively, if you are finding yourself not very confident in your ability to be consistently physically active, try to foster some support from your friends or family. This external support can help to compensate for lower self-support until you start to realize you can totally do this!

For more information, please see the original study:
Hamilton, K., Warner, L. M., & Schwarzer, R. (2016). The Role of Self-Efficacy and Friend Support on Adolescent Vigorous Physical Activity.Health Education & Behavior, 1090198116648266.

Exercise & Physical Activity: Is There Really A Difference?

It is clear the exercise plays a big role in the health of Canadians, and is also a behavior that can be voluntarily changed…that is why it is one of the central pillars of the HealtheSteps program. Over the years, we have seen many of our participants substantially increase their levels of exercise over their time in the program, the long-term benefits of which are clear. However, researchers are beginning to understand that exercise is only one piece of the puzzle. In fact, physical activity, which can be considered more broad than exercise, has also found to be an important behavior that can improve health.

Based on this new line of research, we actually define exercise and physical activity as different behaviors. This may seem strange, but it really helps our participants to better define areas that they can improve upon.

Firstly, we define exercise as structured activity in which the body movement itself is the purpose of the activity, and improving physical fitness is the end goal. Going for a run, a bike, or a swim, or going to the gym to lift weights all fall under the definition of exercise.

On the other hand, physical activity is much more broad and includes any type of body movement, whether the movement is the means to another end, or the goal is not to improve fitness. For example, walking around in the grocery store and then lifting the bags from your car into the kitchen could be considered physical activity. Neither of these activities are done for the purpose of becoming more fit, the activities are a means to an end – buying food.

These definitions are consistent with the scientific literature that has come to understand these two behaviors as somewhat unique. Although I’m sure everyone out there knows that exercise is good for one’s health, we are only starting to realize that ‘physical activity’ – or all the other activity besides structured exercise – has a unique effect on health.

 

Exercise

Exercise, whether that means going for a run, a bike ride, or lifting weights, is independently associated with a number of health benefits, including reducing the risk of heart disease, stroke, certain types of cancer, obesity, osteoporosis, chronic obstructive pulmonary disorder, depression, anxiety, cognitive decline, and in general a better quality of life. These conclusions have been spread across many research studies over the years and are well established. In fact, 7 of the top 10 causes of death in Canada have links to exercise, where increased levels are related to a reduced risk of onset.

However, exercise is only one piece of the puzzle. Many individuals think that if they get a workout in every day or couple of days, they have checked off that box and are OK to lounge around for the rest of the day.

 

Physical Activity

Scientists have recently turned to this question to determine whether it is not only important to get sufficient levels of exercise in but to also make sure one is not sitting around for the rest of the day. As it turns out, sedentary behavior, or a lack of physical activity, is also associated with a number of negative health outcomes similar to exercise. Interestingly however, risks of developing obesity and diabetes are associated with total sitting time independently of how much a person is exercising.

To build on these studies, interventions have actually tested the effects of programs that focus on only improving exercise, only reducing time spent sedentary, or both. Although this line of research is in its infancy, preliminary findings suggest that those who increase their exercise levels and increase their non-exercise physical activity have better health outcomes than those who only improve one behavior.

These results bolster our approach in actually separating these behaviors and focusing on them independently. We give participants an exercise prescription, which focuses on weekly exercise time performed at a heart rate personalized to the participant based on their performance on a sub-maximal VO2 Max test. We then work with the participant to come up with ways to integrate more exercise in their life. That includes questions related to activity preferences, their weekly schedule, and how to remind themselves to exercise. The Canadian Society for Exercise Physiology recommends that adults achieve 150 minutes of exercise per week, so this is the ultimate goal for all of our participants. However, we want to focus on setting achievable goals, so we work towards this goal over the course of the entire program.

After that process has been completed, we then set a separate physical activity prescription. Whereas exercise focused on actual exercise time, the physical activity prescription focuses only on daily step count. Steps could be counted during exercise, but also while walking the dog, taking a break at work, or even walking around the couch during a commercial break in the hockey game. The Canadian recommendation is 10,000 steps per day, so this is our ultimate goal, however we have a proprietary method for setting shorter-term goals that soon add up to big changes.

It is particularly important to cover these behaviors separately because the barriers and facilitators to engaging these behaviors can be so different. For exercise, an individual needs to block out an hour or so on most days of the week, and may need some equipment (e.g., bike, swimming gear, etc.) to get their exercise in. Conversely, physical activity is something that slowly accumulates over the course of a day, where little things like walking to the fountain to fill up a water bottle can add up to a big outcome.

The measurement of these behaviors is also different. Exercise is easily measured through self-report, as it is a simple task to think about how much purposeful, scheduled exercise an individual has engaged in over a week. On the other hand, it would be really hard to guess or report on how many steps you have taken in a day. For that reason, we rely on pedometers to track our participants behaviors. Hip pedometers can be found for cheap at many popular electronic stores, and fitness trackers like the FitBit have become very popular. Pedometers integrated into the smartphone, like the one included in the HealtheSteps app, can be found for free on the iTunes or Google Play Store.

 

Do you currently focus on both exercise and physical activity? If you are a HealtheSteps coach you do, but if not you’re not associated with the program you should certainly consider covering both exercise and physical activity with a client.

Have any other questions? Tweet to us @HealtheSteps!

Official Press Release: Launch of the HealtheSteps Program Training Platform

 

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In response to the ample evidence that exercise, physical activity, and healthy eating play an important role in preventing chronic disease, researchers at Western University in London, Ontario, Canada, led by Dr. Rob Petrella, developed the HealtheSteps Program, an evidence-based lifestyle prescription program

The program improves the health of Canadians and reduces their risk for chronic disease by tackling three major risk factors that are shared across a number of chronic diseases: physical inactivity, sedentary behaviour, and poor diet. Each HealtheSteps participant receives an individualized healthy living Rx for exercise, physical activity (step count) and healthy eating, supported by coaching and technology tools to help them move more, sit less, and eat healthier!

After conducting several research studies that have demonstrated the Healthesteps Program has a positive impact on the exercise, physical activity, and healthy eating behaviours of our participants, as well as other important health outcomes including reduced weight and blood pressure, we have decided to launch a brand new website and online coaching program to make Healthesteps accessible Canada wide. Individuals across the country can become a certified Healthesteps Coach and improve the health of those around them!

The HealtheSteps training program is available for purchase via our new website, at www.healthesteps.ca. We made the decision to charge a minimal fee for the training in order to support the research staff who will in turn support our new coaches, and to support the ongoing improvement of the program. All funds raised through this not-for-profit training program will support HealtheSteps to these ends.

 

Want to become trained in the Healthesteps Coaching Method?

The proprietary HealtheSteps coaching method is grounded in Motivational Interviewing, and provides an excellent framework for motivating your patients, clients, friends, or family to improve their lifestyles. In the past, HealtheSteps coaches have included physicians, dietitians, nurses, pharmacists, and office employees. Each HealtheSteps coach is certified after undergoing a comprehensive and rigorous training program that can be found on our brand new website. We have created a vibrant online community of practice that includes a biweekly blog, a weekly podcast, forums for coaches to interact in, and monthly webinars with the central research team.

To mark the beginning of this exciting journey, for the next 4 weeks we are offering our training course for just 50% off to any new coaches (using the coupon code NewCoach at checkout).

Launch of the HealtheSteps™ Program Supported by Exercise is Medicine® Canada

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Exercise is Medicine® Canada is a national leader in promoting healthy lifestyles among Canadians; its’ expert multidisciplinary clinical work is based on the ample evidence that exercise and physical activity play an important role in preventing and managing chronic disease.

Motivated by this same evidence, his personal experience with his patients, and evidence supporting healthy living interventions, Dr. Rob Petrella, a family physician and professor at Western University, developed the HealtheSteps™ Program, an evidence-based lifestyle prescription (Rx) program. The program improves the health of Canadians and reduces their risk for chronic disease by tackling three major risk factors that are shared across a number of chronic diseases: physical inactivity, sedentary behaviour, and poor diet. Each HealtheSteps™ participant receives an individualized healthy living Rx for exercise, physical activity (step count) and healthy eating, supported by coaching and technology tools to help them move more, sit less, and eat healthier!

With the strong support of several research studies demonstrating the HealthestepsTM Program has a positive impact on participant exercise, physical activity, and healthy eating behaviours, as well as other important health outcomes including reduced weight and blood pressure, we are making HealthestepsTM accessible Canada wide through launch of a brand new website, mobile phone app, and online coaching program. Individuals across the country can participate in the program, or can choose to become a certified HealthestepsTM Coach and improve the health of those around them!

 

Want to participate in the HealthestepsTM Program?

The FREE HealthestepsTM App for iOS and Android devices are now available. This innovative smartphone app allows anyone to benefit from the HealthestepsTM Program, regardless of where they live. Users can measure their fitness level and heart rate, set goals, track their exercise time and step count, and can also link the app to the eaTracker app developed by the Dietitians of Canada to track their eating behaviours. Users also choose one of six fun and personable virtual coaches to help them keep motivated!

 

Want to become trained in the HealthestepsTM Coaching Method?

The proprietary HealtheStepsTM coaching method is grounded in Motivational Interviewing, and provides an excellent framework for motivating your patients, clients, friends, or family to improve their lifestyles. In the past, HealtheStepsTM coaches have included physicians, dietitians, nurses, pharmacists, and office employees. Each HealtheStepsTM coach is certified after undergoing a comprehensive and rigorous training program that can be found on our brand new website. We have created a vibrant online community of practice that includes a biweekly blog, a weekly podcast, forums for coaches to interact in, and monthly webinars with the central research team.

Habit Pairing: One Way to Make a New Behaviour Habiutal

Behaviour change can be challenging, I think we can all empathize with that. What makes something like exercising more or eating healthier especially challenging to change is that it is not a rare or one-time thing (e.g., getting a flu shot), it is a behaviour that should be engaged in nearly every day. If an individual is trying to reduce their time spent sedentary, that is a new way of acting that they will have to consciously think about every day. Often times the cognitive effort required to stay on top of a new behaviour every day is an important barrier to long-term change.

This means that, in the long term, a behaviour change must become habitual if it is to be maintained. A habit can be defined as a behaviour that is frequently engaged in, to the point where if mostly occurs unconsciously or automatically. Can you think of any of your behaviours that have become habitual? If you’re lucky, maybe you get up and go to the gym a couple times a week without even thinking about it. Or, maybe you bite your nails or can’t operate without your morning coffee. Working on a new behaviour to the point that it becomes an automatic habit is quite the challenge, and what HealtheSteps™ coaches work with participants to achieve.

So, if you are coaching someone to be healthier or trying to improve your own health, are there any tricks to facilitate this process?

One great strategy is called ‘habit pairing’. Because habit behaviours are generally under automatic or unconscious control, they are initiated in response to a cue or trigger. For example, in the morning you might walk into your kitchen and put the kettle on without even thinking about it. The cue/trigger in this situation could be walking into the kitchen in the morning, and the automatic (habitual) response is putting on the kettle. Habit pairing leverages the trigger – response process by piggybacking on an established habit and using that as a trigger.

For example, let’s say you are trying to improve the number of fruits and veggies you are eating on a daily basis. If you were unaware of habit pairing, you might just plan to eat an extra apple whenever you had time during the day. This isn’t really the best way to maintain a behaviour change, because the consumption of the apple isn’t really tied to a clear trigger. You may be totally motivated to eating that extra apple for a week or two, but after the novelty of the change wears out you might find it difficult to remember to get that extra fruit in.

Now let’s try planning a change using habit pairing – you know that every morning you are totally on autopilot: You get up, shower, make some coffee, etc. A smart move in this situation may be to put out a bowl of apples and oranges right beside the coffee maker. That way, you can work on making one of your established habits (making coffee) the trigger for a new behaviour change! This is a more efficient way of attempting to habituate a behaviour, because with repetition the new behaviour (eating fruit in the morning) will become assimilated into your regular morning routine.

If you are trying to make your own behaviour change, think about ways you can pair it to one of your existing habits! The best habits to piggyback on are the ones that happen about the same frequency as the new behaviour you are trying to habituate. For example, the coffee habit works well with the fruit behaviour because they both happen every day. If you are planning on making a change that doesn’t happen every day, maybe going for a run 2-3 times a week, think about a habit that matches that frequency. In this example, maybe putting your running shoes beside the garbage bins and going for a jog every time you take out the garbage could be a good solution.

Can you think of any other good examples of habit pairing? Tweet to us @healthesteps!

5 Ways To Be More Physically Active At Work

The workplace is one of the most important settings in which to integrate healthy living behaviors. Although it is generally not feasible to get in any exercise while at work, it is certainly possible to accumulate steps during your time away from home. This is especially important if you work in an office, where you may be at risk of being sedentary for hours at a time. Here are five tips to increase your number of steps at work:

1. Drink more water!

Why are we talking about water? I thought this was about steps? In fact, drinking more water, in addition to being a healthy practice in and of itself, will lead to more steps in two ways. Firstly, it is a good excuse to get up and walk over to the kitchen area or water fountain to fill up your water bottle. Consider drinking some water while standing in the kitchen or by the fountain for a short while before returning to your desk. Secondly, drinking more water will inevitably lead to more bathroom breaks. Walking to and from the bathroom is another great way to rack up the steps throughout the day.

Pro Tip: If you work in a multi-story building, consider talking the stairs up to the washroom one floor above or below you. Over the day, this small difference will produce big increases in overall step count.

2. Take the stairs!

This is a pretty easy one. If you work in a multi-story building and your floor isn’t too high up, consider taking the stairs instead of the elevator. If your floor is a little too high, and it isn’t reasonable to climb the stairs all the way up there from the ground floor, consider getting off a couple floors below and taking the stairs the rest of the way. Remember, this tip doesn’t have to be isolated to your office. If you’re going to a meeting or to see a client in a different office, the same tips apply!

3. Park strategically!

Although walking to work is the ultimate step-producing machine, this isn’t a feasible practice for most folks out there. However, that doesn’t mean that you can’t rack up the steps outside of the office. If you drive to work, consider choosing a parking spot that has a reasonable distance from the front door. Walking from the car at the beginning of the day will give you an extra active start to the day.

4. Lunch on the go!

The time you have in the middle of the day for lunch is one of the best opportunities to get some extra steps in. Find a nice spot outside of the office to eat your lunch, and stroll around afterwards. This not only increases your daily step count, but the extra activity will allow you to return to your work more focused and attentive.

5. Make your meetings active!

Have a meeting with one or two other people? Consider taking the meeting on the go! A walking meeting is definitely feasible in small groups and allows you to stay active while also being productive. Many organizations have started implementing walking meetings, and report that the practice of walking around while thinking allows their teams to come up with more creative solutions to problems!

Twice-Baked Broccoli-and-Kale-Stuffed Potatoes

Twice-Baked Broccoli-and-Kale-Stuffed Potatoes

This is a super healthy, super easy recipe that can be enjoyed as a quick snack, lunch, or as a side to a healthy dinner. By reducing the amount of cheese and adding in some green veggies, this recipe is sure to contribute to your healthy living goals while still tasting great.

Active Time: 20 minutes

Total Time: 80-90 minutes

Serves: 2

Ingredients:

  • 2 russet potatoes
  • 1/2 cup milk
  • 2-3 tablespoons cheddar cheese, grated
  • 6 large tuscan kale leaves (bagged, prechopped kale is also fine)
  • 1 cup cooked broccoli
  • Salt and pepper, to taste

Instructions:

  1. Preheat oven to 425 degrees Farenheit (218 degrees Celsius).
  2. Scrub potatoes, then poke each deeply several times with a fork.
  3. Place the potatoes on a baking tray, and bake for 50-60 minutes, until tender, then remove from the oven.
  4. While the potatoes are cooking, wash and dry the kale leaves, remove and discard the thick inner stems, and roughly chop the leaves (if using bagged, pre chopped kale, just wash and dry).
  5. Cook in a pot of rapidly boiling water for 2 minutes, then drain and run under cold water. Set kale aside.
  6. Slice potatoes lengthwise, and scoop the insides out into a blender, leaving 1/4 inch of potato flesh still attached to the skins (if you don’t have a blender, a hand blender or mixing with a fork also works).
  7. Add the broccoli, kale, and milk to the blender and blend until smooth.
  8. Season to taste with salt and pepper.
  9. Scoop the mixture back into the potato skins, sprinkle with grated cheddar cheese, return to the baking sheet, and bake for another 10 minutes.
  10. Change the oven setting to broil, and continue cooking on high for 3 minutes until cheese is golden.
  11. Remove from the oven, cool for a couple minutes, and serve.

Recipe and image from: http://greatist.com/health/twice-baked-broccoli-and-kale-stuffed-potatoes

Speak to a Dietitian

Would you like the advice of a registered Canadian dietitian without having to leave your home? 

Well you are in luck. The Dietitians of Canada, a proud partner of the HealtheSteps Lifestyle Prescription Program, offer Canadians the opportunity to speak with a dietitian over the phone – toll free – throughout the work week. If you live in British Columbia, Alberta, Manitoba, or Ontario, call the numbers below:

  • In Ontario, call toll free 1-877-510-5102 Monday to Friday 9:00 a.m. to 5:00 p.m. Eastern Time (ET). Evening hours are Tuesday and Thursday to 9:00 p.m. ET.
  • In Alberta, call toll-free 1-866-408-LINK or 780-408-LINK in Edmonton and 403-943-LINK in Calgary.
  • In British Columbia, call toll free 8-1-1, Monday to Thursday 8:00 a.m. to 8:00 p.m and Friday 8:00a.m. to 5:00p.m. Pacific Time (PT).
  • In Manitoba, call toll free 1-877-830-2892 or 204-788-8248 in Winnipeg, Monday to Friday 8:00 a.m. to 6:00 p.m. Central Time (CT)

Plan Your Meals

Canadian Diabetes Association logo                 EatRight Ontario

Meal planning is one of the best ways to make sure you are eating healthy on a day to day basis. Not only does planning meals allow you to examine your food-group and nutrient intake, but it gives you a really good idea of the foods you will require over the next week – making the next grocery shop a breeze. Planning and preparing meals beforehand also helps you avoid the draw of a quick bite from your local fast food chain…it is much easier to make the healthy and cheap choice when you have a great lunch you have prepared yourself available. All thats left is to decide what to do with all that extra energy and money!

Our partners at the Canadian Diabetes Association and Eat Right Ontario (brought to you by the Dietitians of Canada) have really great resources that can help you get off on the right foot in terms of planning your meals. Please feel free to visit both links!

Diabetes Association of Canada: http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/basic-meal-planning

Eat Right Ontatio (brought to you by the Dietitians of Canada): https://www.eatrightontario.ca/en/menuplanner.aspx