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| Communication Basics - Behaviour Modification and Relationship building |
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| INTRODUCTION |
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Understanding behavior modification and relationship building is perhaps the most important of all sections in
the tutorial! New behaviours replace older habits, and this process of change is challenging as individuals progress through stages of change with regression and successes along the way, aiming always for long-term, sustainable change. Behavioral and lifestyle change processes transcend not only how our patient and clients move
toward adopting healthier choices but how we collaborate, interact and support them in this ever evolving relationship. This module will help you gain a basic understanding of those processes.
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| LEARNING OBJECTIVES |
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THE LEARNER WILL BE ABLE TO:
Behaviour modification
- Understand and explain successful health behavior change strategies related to cardiovascular rehabilitation
- Assess readiness, willingness, ability and challenges to change
- Tailor messages and coaching to patient’s stage of and/or readiness to change
- Understand process of motivational interviewing and lifestyle coaching and adopt the coaching role for the purpose of encouraging healthy and active lifestyle changes
- Identify common triggers for behavior patterns including lapses and relapses
Relationship building
- Develop and create trust with patient by creating a comfortable, safe and mutually environment
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Identify facilitators and barriers by engaging in problem-solving through process of questioning, and coaching patient through lifestyle behaviours,
activity preferences, activity levels, goals and aspirations, and by identifying barriers to successful
lifestyle behaviour change
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| CONTENT |
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Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention (3rd Ed., 2009)
- Chapter 6: Behavioral and Psychosocial Issues
- Chapter 9: Risk Factor Modification and Secondary Prevention
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ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription (6th Ed., 2009)
Section 1: Health Appraisal, Risk Assessment, and Safety of Exercise
- Chapter 15: Psychosocial Status and Chronic Disease
- Chapter 16: Assessment of Psychosocial Status
Supplemental Section: Programmatic and Professional Materials
- Chapter 43: Principles of Health Behavior Change
- Chapter 44: Health Behavior Counseling Skills
- Chapter 45: Channels for Delivering Behavioral Programs
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| LEARNING ACTIVITIES |
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Case study Questions: Review Leonard Patrick’s case, focusing on Patient information
part 2. From what you have learned about behavior change:
- How would you determine what stage of change Leonard is in with respect to his smoking behavior?
- What would be a first step in building a ‘coaching relationship’?
- With a colleague, roll play a motivational interviewing session using Leonard as a patient
Check Answer
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| REFERENCES |
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- ACSM’s Advanced Exercise Physiology, ACSM, 2005.
- Exercise Physiology: Energy, Nutrition and Human Performance, 6th ed; McArdle, Katch & Katch, 2006.
- ACSM’s Certification Review 2nd ed
- ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription, 5th Ed,
- ACSM Learning Portal
- Glanz K, Patterson RE, Kristal AR, DiClemente CC, Heimendinger J, Linnan L, et al. (1994) Stages of change in adopting healthy diets: fat, fiber, and correlates of nutrient intake. Health Education Quarterly. 21:499-519.
- Hellman EA. (1997) Use of the stages of change in exercise adherence model among older adults with a cardiac diagnosis. Journal of Cardiopulmonary Rehabilitation. 17:145-55.
- Kelly L, Brown JB. (2002) Listening to Native patients: Changes in physicians’ understanding and behavior. Canadian Family Physician. 48:1645-1652.
- Miller WR, Rollnick S. (2002) Motivational Interviewing: Preparing People for Change, 2nd Ed. Guilford Press: New York.
- Paul S, Sneed NV. (2004) Strategies for behavior change in patients with heart failure. American Journal of Critical Care. 13(4): 305-313.
- Prochaska, J. O., & Velicer, W.F. (1997). The Transtheoretical Model of health behaviour change. American Journal of Health Promotion. 12: 38-48
- Prochaska JO, DiClemente CC, Norcross JC. (1992) In search of how people change. American Psychology. 47:1102-4.
- Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, et al. (1994) Stages of change and decisional balance for 12 problem behaviours. Health Psychology. 13:39-46.
- Resnicow K, DiIorio C, Soet JE, Borelli B, Hecht J, Ernst D. (2002) Motivational interviewing in health promotion: It sounds like something is changing. Health Psychology. 21:444-51.
- Rollnick S., Miller WR, Butler CC. (2007) Motivational Interviewing in Health Care: Helping Patients Change Behaviour. Guilford Press: New York.
- Smylie J. (2000) A Guide for Health Professionals Working with Aboriginal Peoples: SOCG Policy Statement.
- Zimmerman GL, Olsen CG, Bosworth MF. (2000) A ‘Stages of Change’ Approach to Helping Patients Change Behaviour. American Family Physician. 61(5): 1409-1422.
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