Wednesday, August 28, 2013

Heart Healthy Tweets: Cues to Action for Fighting Diabetes

In health coaching, it's referred to as "the expert approach." That is, the approach where the hired professional tries to help the client only by sharing information and dictating what should be done. The client is given little, if any, autonomy. The underlying assumption is that the client simply doesn't know what should be done or can't get it done due to some flaw of will power. Essentially, the client is incomplete and the "expert" will make the client complete by sharing information. An example of this is a client stating a goal of weight loss, and the nutritionist or trainer saying to go on a low carb or low fat diet.

While this does work with some, the expert approach often fails. Knowledge is not always the missing key. There are usually other problems that need solving: lack of confidence in the recommendation working, lack of confidence in oneself to start or carry out the task, or maybe the recommendation just doesn't fit with the client for some reason. Diet studies are great illustrations of this point: adherence is generally poor even though the participants often receive educational materials and diet counseling.

This gap between science and application is why the field of health behavior exists. People often need other resources to help them start and carry out a desired action. With that in mind, I want to help those who are worried about developing or who have already developed type 2 diabetes. The Heart Healthy Lifestyle: The Prevention and Treatment of Type 2 Diabetes is a resource full of research-based ideas for fighting diabetes, success stories, and tasks to help build confidence in your ability to perform the recommended ideas. However, maybe you want more help, and that's why Heart Healthy Tweets (HHT) exist.

Heart Healthy Tweets

In many behavioral health studies, cues to action are used to serve as reminders, motivation, educational tools, and confidence builders. HHT are daily cues to action and serve those purposes. However, before discussing more about HHT, let's answer the critical question: do cues to action really work?

The Journal of Diabetes Science and Technology published an article that covered studies ranging from three to 12 months with short-message interventions for diabetics [1]. These were mostly text messages covering a variety of purposes including education, information on blood-glucose monitoring, motivation to exercise and eat well, foot-care information, and even medication reminders. Not only were the results overwhelmingly positive, but nine of 10 text message interventions led to improvements in blood sugar.

Here are some of the specific research results achieved, categorized by study length:
  1. Three Months: A hemoglobin A1c decrease of 2.15% in individuals that started at 7.0% or greater. Also, fasting and post-meal blood sugar average decreases of 28.6 mg/dl and 78.4 mg/dl. Participants receiving texts experienced fewer hypoglycemic episodes while exercising and practicing foot care more frequently.
  2. Four Months: Total sitting dropped by 5.9 and 5.2 hours during the weekdays and weekends.
  3. 12 Months: HbA1c decreased in the text-message group by a total of 1.32%. On the other hand, the control group— who received the standard care from medical professionals —increased 0.8%.

Having short-message reminders helped diabetics make huge strides in blood sugar, self-care, exercise frequency, and sedentary habits.

Instead of going the text message route, I took a more modern approach: Twitter. HHT provide reminders, motivational messages, and ideas for taking action based on the recommendations found in The Heart Healthy Lifestyle: The Prevention and Treatment of Type 2 Diabetes.

The tweets are published daily around 11:30 AM EST/8:30 PST. Subscribing to HHT is free. The Twitter accounts are:

@THHLbook (my account, featuring HHT as well as health articles and other thoughts)
@HeartHealthyTw (HHT only)

(For those who have not read The Heart Healthy Lifestyle, some of the Tweets may not have the same impact or make sense).

I highly recommend following HHT - it's an effective resource in the path to preventing or improving type 2 diabetes, and every resource helps.

Note: The Heart Healthy Lifestyle: The Prevention and Treatment of Type 2 Diabetes is currently only available in Kindle format on Amazon. For people who don't have a Kindle, iPad, or iPhone, download this free program to read Kindle books on your computer. The download is simple and takes less than a minute.

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