Building a Healthy Habits Challenge: What Works and What Doesn’t

The team at CHWTraining might know all about developing and keeping healthy habits, but that doesn’t mean we always do it. Even for people in the health education business like us have habits we’d like to change: stopping smoking, drinking less alcohol, drinking more water, eating less meat, eating fewer sugary foods.

This January, our parent company Talance wanted to encourage this kind of change internally instead of just for our clients and course participants. Here’s what happened.

First, we researched several workplace wellness challenges to find a format we liked. This article on Health.gov, 7 Simple, Fun Wellness Challenges to Start At Work, had some ideas we liked.

Importantly, we wanted people to control how they participated. We teach many people about behavior change with techniques like Motivational Interviewing, and we all know that no one will change anything unless they’re inwardly motivated to do so. We wanted to tap into intrinsic motivation as well as extrinsic motivation. NBC’s Better explains it well in this article 3 types of motivation that can inspire you to do anything.

Setting Healthy Habits Goals

Armed with some ideas, we decided to create a challenge that affirmed any positive change that anyone wanted to make. However, because cutting back on smoking is the single best thing anyone can do for their health, we wanted to especially encourage any smokers to cut back or stop. The 31-Days-Free Challenge was born.

The 31-Days-Free Challenge was open to anyone who wanted to participate in one of two ways:

Title: Challenge description - Description: No Smoking Challenge: Stop smoking or cut back.Put Something Else in Your Mouth Challenge: Don't smoke? Pick something you DO or DO NOT want to do that will improve your health (drink water, quit drinking, cut out sugar).

From the start, everyone was very interested in curious about the challenge. But as time went by, fewer people decided to participate. We would have loved everyone to join, but creating new habits is tough. It has to happen on an individual basis—not just because there’s a challenge there or because it’s January 1. So we hope to catch more next time.

We were left with a core of four who signed up and stuck with it for the whole month. Here’s what our challenges looked like:

Anastasia

Title: goal - Description: My challenge: Smoke not more than 5 cigarettes per day for 5 days/ week. Don't smoke at all for 2 days/week. 

Monique

Title: Goal - Description: “Reduce alcohol consumption in January from 5 units to 3 units by drinking only on weekends (Friday, Saturday, Sunday).”

Pamela

Title: Goal - Description: “I will reduce the sugar treats (cake, cookies, chocolate, ice cream, candies) + junk food (that's a long list including diet soda) from almost every day to *1 serving per week*.”

Peter

Title: goal - Description: “Eat vegetarian for 8 days in the month (about 2 days a week)”

We’re All Winners Here

There were no losers in this challenge–only winners. So we designed a system where every week participants would self-report how they did based on the achievement points (see the full list below), which were added to a scoreboard. During the week, we opened our internal chat channel (#31-days-free) to advice, reports, tips and encouragement.

This is what a typical week looked like on the scoreboard:

What Worked and What Didn’t

The result? It worked! Everyone who participated made improvement. Most people kept to their goals for the whole month, or at least got close. We all felt better physically and also had fun as a team in a different way that wasn’t related to a project.

As Anastasia said, “For me, it was important that we did it as a team, and that each week I had to say how I was [doing] and state specific achievement points.”

As planned, our chat channel was busy with reports, encouragement and recipes. It was empowering to see how everyone was working toward their goals and how they were navigating barriers. We were all in the spirit of helping each other succeed.

And as expected, there were some unforeseen holdups. For example, my challenge, which required me to cut out my dinnertime glass of wine most nights, didn’t take into account a mid-week birthday celebration that included champagne. So next time, I know to build in some flexibility.

This is a good lesson for anyone who doesn’t reach their goal, whether it’s someone with type 2 diabetes trying to cut down on sugary foods or someone who’s looking to control substance use. Failure can be valuable. It teaches you what your limits are and reveals obstacles that you can navigate next time.

Smokers know this too. Quitting is hard. Slip-ups are inevitable and can be discouraging. According to one study, “it may take 30 or more quit attempts before being successful.” But each slip-up is a learning experience. Note it, what caused it, and keep moving.

There were also some problems with the format. It felt too much like a competition to some. Anastasia said, “Competition didn’t work for me. I wanted to help and learn from the others so I couldn’t see it as a competition.”

There were also some logistical hiccoughs. About halfway through the month, we noticed that some people were making excellent progress but not earning any achievement points. We added a “fill-in-the-blank” point to use whenever you’re doing well but aren’t fitting the list of points.

Next time, we’ll probably forget any points and instead focus on supporting healthy habits only. Importantly, there will be a next time, and many of us are still sticking with our new healthy habits even past January. Hello, flexibility challenge!

Wellness Achievement Points

Here were the achievement points we awarded, which you can copy for motivating your group.

General Points

  1. Post your SMART goal to #31-days-free
  2. Put yourself on the scoreboard
  3. Help someone on  #31-days-free stay on goal
  4. Share a tip on #31-days-free for staying on challenge
  5. Stick to your challenge for 1 week for 1 bonus point
  6. Stick to your challenge for 2 weeks for 2 bonus points
  7. Stick to your challenge for 3 weeks for 3 bonus points
  8. Stick to your challenge for 4 weeks for  4 bonus points
  9. Recruit one person in your life to do your challenge with you
  10. Find a team partner
  11. Meet your challenge goal on both Saturday and Sunday
  12. Walk around the block instead of doing something you’re trying to stop
  13. Set your health goal for February
  14. Meditate
  15. Suggest an achievement point (if it gets enough thumbs-up, you
    get a point, and we’ll add it to the list)
  16. Distract yourself by doing a good deed for a few minutes

No-Smoking Points

  1. Go 1 day without smoking
  2. Try Nicotine Replacement Therapy (NRT), such as Nicorette gum, patch, lozenge
  3. Get a Chantix prescription
  4. Walk past the tobacconist
  5. Play with your phone rather than smoke
  6. Remove all ashtrays
  7. Look up number for local quitline
  8. Call quitline
  9. Set a quit day
  10. Download a quit app to your phone (QuitNow! for Android or QuitNow! for Apple)
  11. Read a quit smoking book
  12. Give money for a pack of cigarettes to a trusted friend or charity for safekeeping instead of buying one (count how much you have on Feb. 1)
  13. Attend a support group, such as https://stepbac.com/ or https://www.icoprevencio.cat/uct/en/quit-smoking/
  14. Try an alternative therapy, like acupuncture
  15. Take smoking cessation class
  16. Go to a smoke-free zone when you feel like smoking

Put-Something-Else-in-Your-Mouth Points

  1. Download a healthy eating app to your phone (food log, exercise log, no drinking log)
  2. Walk 1000 steps (or 1/4 mile or 1 km) instead of putting That Thing in your mouth
  3. Get a pedometer
  4. Cook a new healthy recipe (share it on #31-days-free)
  5. Skip meat at 1 meal
  6. Have a meatless Monday
  7. Eat 5 servings of produce in a day
  8. Drink a glass of water instead of a glass of wine
  9. Drink 8 glasses of water in a day
  10. Walk somewhere instead of driving/taking a taxi/metro
  11. Create a healthy grocery list
  12. Try one new healthy food you haven’t tried before
  13. Read a healthy eating/cooking book
  14. Take a cooking class that meets your challenge
  15. Plan a weekly menu (post it here!)
  16. Instead of putting That Thing in your mouth, chew a stick of gum

The 27 New Skills You Can Now Learn on CHWTraining

This year, more community‐based organizations, hospitals and health systems than ever hired new community health workers (CHWs). CHWs are undeniably a benefit to the health workforce, but many employers are struggling to adequate train their new CHWs, lay health worker, community health advocate, and promotores.

Enhancing this workforce’s core competencies is fast and accessible with the dozens of new online training modules from CHWTraining.

Each month we add to our growing course library dedicated to population health. This quarter we added 10 new or updated courses covering everything from basic core skills to health literacy to a host of self-guided titles in Spanish. Many more modules are headed for release in early 2019.

The new courses now available on CHWTraining are:

Core Skills

Advocacy Skills and Habilidades de abogacia (Advocacy Skills in Spanish)

The Advocacy Skills course, available in both English and Spanish, cover essentials of public advocacy, such as pushing for policy development and policy change. It also covers communication skills, which learners can use to speak up for individuals and communities, be a health advocate for their clients and encourage people to be their own advocate.

Communication Skills

Participants in this course learn how to use language confidently and in ways that motivate their clients and patients to change. With an emphasis on communicating following Plain Language guidelines, it shows learners basic skills such as using empathy, active listening, and creating clear health education materials so they can improve the community where they work.

Motivational Interviewing: Peer Support for Behavioral Change and Entrenamiento de la salud y la entrevistas motivacionales (Motivational Interviewing in Spanish)

The new Motivational Interviewing course (both in Spanish and English) provides a solid introduction to interviewing techniques for further exploration. This course offers plenty of practice and reflection on techniques such as OARS, as well as modeling through video, audio and case studies.

Chronic Illness

Asma: cuidados y autocontrol (Improving Asthma Outcomes in Spanish)

Our popular Improving Asthma Outcomes course has now been updated for Spanish-speaking audiences. It covers how asthma works and what to do in case of an asthma emergency. It focuses on conducting home visits and how to guide patients and their families through making easy changes that will help them manage asthma better.

Presión arterial alta (Hipertensión) [High Blood Pressure (Hypertension) in Spanish]

Heart disease and stroke are the most common causes of death in the US, and many of the fatalities are among Latinos. This course on hypertension has been linguistically and culturally translated for reaching all populations, with an emphasis on Latino health.

Healthy Living

Behavioral Healthcare

More people have behavioral health problems than are being treated for them. This course addresses how to support people with mental health and substance use issues. This course has been completely revamped to include the most common behavioral health issues.

Depression and Anxiety: Helping Others Cope

Most people can overcome problems caused by depression and anxiety with the proper support. This course introduces learners to fundamentals of what depression and anxiety are so they can help those who suffer cope.

Substance Use

The Substance Use module provides critical training to meet the nation’s need for substance misuse, including opioids, tobacco, alcohol and other substances. Learners discover strategies for helping clients avoid and deal with addiction.

Asistencia para dejar el tabaco (Supporting Tobacco Cessation in Spanish)

This course introduces your team-members to the basics of tobacco use as well as counseling techniques that front-line health workers can use to support individuals in different stages of cessation. Updated and translated into Spanish.

Want to see what else we offer? View all of CHWTraining’s courses today.

How One CHW Feeds Her Love of Health Education

Tasha Whitaker, CHW

Some people might picture community health workers as busy little worker bees buzzing around with surveys, checklists, and clipboards. There’s an element of truth to that image: They’re indeed active as they educate clients and patients about health care issues and connect them with appropriate services and resources.

But CHWs aren’t just names on some roster – they have individual, unique backgrounds and experience that qualify them to perform this increasingly important role in the nation’s health care system.

Let’s meet one of them. Tasha Whitaker has followed an unusual path, from reading Dr. Seuss books to pre-kindergartners to seeing that Medicare patients receive the right pre-diabetes screenings, among other tasks. Whitaker is a Community Health Worker II at Baylor Scott & White Health, in Dallas, Texas, and a strong proponent of health education.

Q. What exactly are your duties?

A. We work as a multidisciplinary team – a physician, medical assistant, CHW, pharmacist, and licensed clinical social worker. We are assigned a load of patients over 50. We assess their charts and provide health education and resources to the patient that are needed. These referrals come through the providers and other staff, and we follow up with the patient to make sure that their wellness visits, A1C test [for diabetes], medication list, depression screening and other metrics are all completed. If not, we make sure to get those patients in for an appointment.

Q. How did you arrive at your current position?

A. I went to school to become an RN. It wasn’t until I got to my health-ed classes that I figured that I loved the education part. So I graduated with degree in health education studies. The next best thing to me is teaching. A bunch of people in my family are in teaching. I went through certification programs, got an education, did some pre-K, then started in another job, working for a podiatrist. I got laid off and went back to substitute teaching. Then I got a job here. My journey wasn’t really “on purpose”; it just happened. My title when I was hired was community health educator. Once I started working, my employer gave me the opportunity to get certified as a community health worker. After working in one position for 4 ½ years, I was promoted and moved into a new role as a Community Health Worker II. Eventually, I want to go back and get my RN license and continue with health education and chronic-disease management.

Q. What makes you feel passionate about the work you do?

A. I love educating people about health and chronic diseases. I enjoy being able to break down complicated and complex information to people who may be struggling with turning their health around. It’s rewarding to see patients change their behavior and see many of them push through barriers to reach their goal.

Q. What’s unique about the needs of the people you serve?

A.  Because they are seniors, some have barriers involving sight, reading, and instruction comprehension.

Q. Describe a time when the work you did truly made a difference for someone.

A.  There was a patient I worked with in a pre-diabetes management class, and she was a bus driver. She was in the program to try and reduce her risk for getting diabetes. It was difficult because the goal was to lose 7 percent of her body weight through healthy eating and exercise. She came very close. She eventually lost weight and changed the snacks and drinks she would consume as she drove the bus. That, in turn, allowed others to see her progress and get them to be interested in the program. It was a really good feeling to know that our time in class was making a difference.

Diabetes and Prediabetes Learning Track

Train your staff to help patients and clients understand how to live with and manage diabetes and prediabetes. They’ll learn the most relevant methods for improving health outcomes, living healtier, and making meaningful changes.

Learn More

10 Free Apps for Tobacco Cessation

Some smokers will tell you cigarettes give them something to do with their hands. Here are 10 free smartphone apps that occupy the fingers of people who want to quit.

Smoking and smartphone

1. SmokefreeTXT

“SmokefreeTXT is a mobile text messaging program that provides 24/7 tips, advice, and encouragement to help you quit smoking.”

2. quitSTART

QuitSTART is a free app made for teens who want to quit smoking, but adults can use it too. This app takes the information about an individual’s smoking history and offers customized tips, inspiration, and challenges to help become smoke-free.

3. Smoke Free

An iPhone (and Android) app with over 20 different, evidence-based, techniques to become smoke-free. Includes details on money saved, counts the number of cigarettes not smoked, tracks time since last cigarette, and more.

4. 1-800-QUIT-NOW 

A phone-based service with educational materials, coaches, a quit plan, and referrals to local resources to help you quit tobacco use.

5. 1-855-DÉJELO-YA (1-855-335-3569) 

A phone-based service to help Spanish speakers quit tobacco use.

6. Kwit

Kwit is a game-based tobacco cessation tool that makes quitting fun. Score points for not smoking, receive rewards for achievements, and get support from friends.

7. LIVESTRONG MyQuit Coach

The LIVESTRONG MyQuit Coach application creates a personalized plan to help quit smoking. Evaluate current status, set goals and adjust preferences according to needs. Only for iPhone. LIVESTRONG also has an active and helpful community support site for stopping smoking.

8. QuitNow!

Another game-based approach to help stop smoking. It tracks achievements, money saved, health progress and has an online community.

9. My Last Cigarette – Stop Smoking Stay Quit

A smoker enters details of the smoking habit and personal details then watch as various indicators display expected increase in lifespan, yur circulatory and lung function improvements, savings, and more. The full app costs $0.99 but the lite version is free.

10. Quit Smoking: Cessation Nation

This free Android app tracks time lapsed since quitting, money saved, cigarettes not smoked, and health improvements in a fun game-based format. Connects to a Facebook community.

Support to Quit Tobacco

Let us help your organization increase and improve tobacco cessation programs in your community. FInd out how you can improve your team’s training so they can help their clients give up using cigarettes and other tobacco products.

Learn More

We Can Leave Tobacco Behind

It was the summer of 1957, and the way my parents met was like something out of an Elvis movie: a waterskiing blind date. My mother, Annette, a skinny 17-year-old, hit the water so hard at Denver’s Cherry Creek Reservoir that it pulled off her bikini top. Mortified, she hid behind her best friend Dee, who struggled to cover Mom while my 20-year-old eventual dad, Sherman, reclaimed her top.

Could you blame him for asking her out on a second date? And another after that?

To be that young in 1957 was to be hale, hearty, and invincible. They went to sock hops and double features. They went spelunking in the Rockies and took entry-level jobs with odd hours. Soon they eloped and started a family. My two sisters and brother came just a year and a half apart from one another. It was a typical home full of chaos and kids – and cigarettes.

Everybody smoked back then, and my parents were no different. It was cheap, cool, and everywhere. President Eisenhower lit up in the White House. Every good and bad guy smoked on screen. Cigarette vending machines were in all the restaurants. A few studies began to show a link between smoking and lung cancer by the 1950s, but such studies were still new and little-known.

Dad eventually gave up cigarettes, but still puffed a pipe and cigars, and he kept a can of chew in his pocket. Mom only gave it up when she reached her 60s. By the time she stopped, it was too late. She had emphysema and needed oxygen support. When she turned 71, she was diagnosed with small-cell lung cancer and was gone a year later.

Cigarette smoke was my constant companion growing up, but it was never my friend. I saw the failed attempts to quit, the premature aging, the coughing, the colds and flus, and the expense. I supported my mom as these smoking-related diseases claimed her body. I lived through her self-blame and depression. It wasn’t peaceful or easy.

Of course, 2016 isn’t 1957, and opinions about tobacco are different. It’s uplifting to know that tobacco use is generally down in this country, but that’s not good enough. It’s still the leading cause of preventable illness.

So when I have the chance to help other people stop using tobacco, I don’t just jump at it, I hurl myself at it. Our new course, Supporting Tobacco Cessation, is a source of passion because organizations like yours can use it as a tool to reduce tobacco use in families like mine.

My hope is that one day soon, tobacco will be among those relics of history that we’ve left behind along with lead makeup and bloodletting. Quitting tobacco is tough; my mother couldn’t do it for most of her life. But it is possible if we work together: program directors like you, educators like me, and determined individuals like my mom. I’m confident that we can and will.

Support to Quit Tobacco

Let us help your organization increase and improve tobacco cessation programs in your community. FInd out how you can improve your team’s training so they can help their clients give up using cigarettes and other tobacco products.

Learn More

Want to Make America the Healthiest Nation by 2030?

Logo for National Public Health WeekAmericans, you need to take better care of yourselves. Most of us who feel passionate about healthy lifestyles know this, which is why we fight so hard to schedule you for screenings, sign you up for health care, help you put down that cigarette, and encourage you to watch your diets.

Every April, people who feel passionate about public health come together as part of National Public Health Week in an effort to understand the issues and strengthen policies. The goal is to make America the healthiest nation in the world by 2030 – just one generation away. The effort, organized by the American Public Health Association, “develops a national campaign to educate the public, policymakers, and practitioners about issues related to each year’s theme.”

It’s pretty fun; there are classes, runs, health fairs, forums – a little something across the country for the people who really care. CHWTraining is a partner, so stay tuned for news about our participation.

View the initiative, post your public health events, check out the activities of others, and unite to build healthier communities across the United States:

National Public Health Week

Health Coaching and Motivational Interviewing

Introduce your team to motivational interviewing, so they can help patients and clients give up certain behaviors and develop lasting incentives to take charge of their health.

Learn More

Report on Washington State’s Popular CHW Training Program

Community health workers in Washington are getting better at their jobs.

Washington State’s Popular CHW Training Program Evaluation

That’s according to the results of a state-wide program survey published by the Washington State Department of Health’s Office of Healthy Communities. Since 2011, the program has trained over 1000 people in the role of community health worker (CHW) in everything from core competencies such as organizational skills to health-specific topics such as behavioral health care.

People working in a CHW role are frontline health workers who perform cultural mediation between communities and health and human services, provide counseling and health education, advocate for their clients and provide direct services. They also may be called advisors, advocates, promoters, patient navigators, and promontoras, among other titles.

The evaluation looked at how 375 participants and 80 employers have used the skills they learned in the program. The results are overwhelmingly positive. About 90 percent of respondents would recommend the program and the majority have applied information and skills from their training in the last year.

Talance, Inc., CWHTraining’s parent company, has been working with the Office of Healthy Communities since the training program’s inception. It has to worked with the Washington team to develop custom curricula in topics including oral health and tobacco cessation. Washington also licenses some of what were identified some the most popular modules in the survey, including health literacy and health insurance.

A few highlights from the report:

  • A majority of participants who worked as a CHW in the past year reported applying information and skills learned from the each of the Core Competencies. Participants most frequently cited applying information about communication (85%), cultural competency (79%), and CHW roles and boundaries (79%).
  • Participants most frequently applied information and skills from the Prediabetes and Diabetes optional module in their work as CHWs (48%), followed by Health Literacy (42%), Behavioral Health (39%), and Navigating Health Insurance (38%).
  • Employers considered most of the optional Health Specific Continuing Education Lessons important in the work their staff does as CHWs, especially health disparities and social determinants, behavioral health (mental health and substance abuse/addiction), health literacy, and nutrition/active living.
  • The top 5 health issues participants worked on as CHWs included accessing health services, women’s health, nutrition, diabetes prevention and management, and physical activity.

How often use information and skills from health specific modules

Participants listed some of the top benefits as a result of the program as connecting people to information and resources in their communities, as well as gaining knowledge, skills, tools and resources to be used on the job.

Employers also weighed in, citing reasons for enrolling their staff in the program, which is offered by the state for free, and the importance of learned skills.

Read the entire Training Program Evaluation Report (scroll to “Training Program Evaluation Report” under Important Links) and learn more about Washington’s program.

Read more:

  • Washington State Department of Health’s Community Health Worker Training Program – A free eight week combination of online and in-person training designed to strengthen the common skills, knowledge and abilities of the community health worker.
  • CHWTraining – CHWTraining provides online training programs to organizations that serve the community’s health care needs. We transform passionate community members into agents of change.
  • Talance, Inc. – Curriculum consulting, learning technology and program building for public good organizations.

How Health Insurance Works

Educate your team in the basics of health insurance and how to support their clients with Navigating Health Insurance.

Request Information now

Spend Down Your 2014 Budget and Build CHW Skills

October is almost over–time to use up your budget before the end of the year before you lose it. An easy way to enrich your training program and build skills among your staff is to offer new courses from CHWTraining.org.

Courses for non-clinical health workers include:

•    Health Literacy: A Start
•    Introduction to the Newest Vital Sign
•    Navigating Health Insurance
•    Behavioral Healthcare
•    Diabetes and Pre-Diabetes
•    Facilitating Online Professional Development

View the full list of courses here: http://chwtraining.org/course

Register for a cohort of 10 by November 15 and receive 20% off.

CHWs are, as One Million Community Health Workers says, "uniquely positioned to improve access to care, health-seeking behavior, and healthy behavior." CHWs can play a critical role in educating communities in Ebola Virus Disease (EVD) awareness and protection and also contact tracing and surveillance.

If you haven't yet begun training your CHWs in what to do with Ebola in your community, start now. Here are a few dependable resources you can begin with by circulating to your team:

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Ebola Educational Materials for CHWs

If there’s one enormous lesson US-based health organizations can take from the Ebola crisis, it’s to be prepared. Yet in my experience working with health departments across the United States, this preparedness rarely trickles down to community health workers.

CHWs are, as One Million Community Health Workers says, “uniquely positioned to improve access to care, health-seeking behavior, and healthy behavior.” CHWs can play a critical role in educating communities in Ebola Virus Disease (EVD) awareness and protection and also contact tracing and surveillance.

If you haven’t yet begun training your CHWs in what to do with Ebola in your community, start now. Here are a few dependable resources you can begin with by circulating to your team:

Ebola: What Business Travellers Need To Know

Ebola: What Business Travellers Need To Know

Excellent introductory video from International SOS on risks and statistics about EVD. Aimed at business travelers, but helpful information for anyone wondering more about the disease.

Watch the video >>

What Is Contact Tracing?

What Is Contact Tracing?

Helpful infographic from the CDC on what contact tracing is and how the process works. Especially useful for understanding how CHWs fit into the process.

Download the PDF >>

Standard Operating Procedures for Contact Tracing and Follow up during Ebola Virus Disease Outbreak

Standard Operating Procedures for Contact Tracing and Follow up during Ebola Virus Disease Outbreak

A succinct 11-page document that outlines the procedures for contact tracing and gives worksheets for keeping notes.

Download the PDF >>

Ebola Guides and Factsheets from CDC

Ebola Guides and Factsheets from CDC

A comprehensive website that contains constantly updated information on new guidelines and instructions on dealing with EVD, from signs and symptoms to treatment.

View the website >>