Living well with chronic disease

Evidence-based program helps people gain confidence to make changes to better manage their health conditions.
April 9th, 2019
Hispanic women standing at gym
Rosa Gutierrez battled high blood pressure for eight years. But now she’s learned how to achieve small goals resulting in bigger successes. Photo by Kati Blocker, UCHealth.

Six months ago, Rosa Gutierrez set three daily goals: eat more fruits and vegetables, exercise and work on her English for one hour.

“Now, when I don’t do them, I feel like I’m missing something,” Rosa explained.

That wasn’t always the case. Rosa never exercised and the family meals she’d prepare for her husband and three kids rarely included fruits or vegetables. She had also been battling high blood pressure for more than eight years.

Then a coworker told her about Tomando Control de su Salud, one of UCHealth’s five Living Well programs.

“I thought I’d see what was there and what it was like, because I care about my family,” Rosa said.

Living Well is an evidence-based program to help people gain confidence to make the changes to better manage their health conditions, explained UCHealth Community Health Educator Ellen Pihlstrom, who coordinates the programs. Along with Tomando Control, the Spanish-speaking version of the chronic disease program, other Living Well programs address pain, cancer and diabetes.

“The Living Well programs are about incorporating a behavior change in someone,” Pihlstrom said. “It’s about action-planning, brainstorming and decision-making. It’s not for everyone, but great for those open minded to changing their lifestyle to be their healthiest self.”

Rosa was enthusiastic.

She committed to a free six-week program. For two and a half hours each week, she met with a group of peers who helped her set and be accountable for small goals, and provided support and guidance.

Hispanic women walking on indoor track
Rosa Gatierrez walks the track at the Fort Collins’ Northside Aztlan Community Center. Photo by Kati Blocker, UCHealth.

Each week, participants learn new tools they can use for the rest of their lives. Learning and incorporating the seven steps to problem-solving is one example, Pihlstrom said.

“Lots of times when we are not feeling well, we think, ‘This is a problem,” and we jump right to step seven: I can’t do anything about it,” she explained. “But we must remind the brain to go through the steps. What is the problem? Make a list of how to solve the problem and try something on the list. If it doesn’t work, they have something else on the list to try. They are not giving up automatically and are able to get through their daily issues.”

After learning a tool, participants create an action plan.

“Action plans break down those big projects into something that’s doable so you can be successful,” Pihlstrom said.

By establishing the what, how much, when and how often, participants are more likely to be more confident in their action plan. This results in higher success in achieving that plan, thus leading to subsequent successes.

With the complexity surrounding disease management, this is extremely helpful, she added. Take diabetes, for example.

“When people find out they have diabetes, they are instructed to change almost every aspect of their life and it is often overwhelming and scary,” Pilhstrom said. “They often head home, back to the comfort of their not-so-healthy routine or make drastic changes that cannot be sustained. We support them to understand that they can change, not overnight, but little changes in little increments.”

outline of the action planning process
Creating action plans to tackle little challenges is how big changes are maintained.

Rosa began adding fruits and vegetables to her shopping list, which she was surprised to find out, were easier on her pocketbook than meat. She used the internet to find good recipes and then added more vegetables than required in the recipe. And she found fun ways to incorporate fruit, such as a fruit cocktail.

Her husband was still a bit reluctant, she admitted. So, she found ways to “camouflage” the vegetables, like in chili. She limited meat to only a few times per week.

Her husband would often ask where the meat was. With a grin, Rosa confessed, “I’d just tell him, ‘Maybe tomorrow.’”

Each week, participants report back to the class, which fosters accountability. There is a lot of sharing and brainstorming among the group, Pihlstrom explained. And that leads to support, as Rosa found out.

“One lady in class called and asked me, ‘Did you exercise?’ I told her, ‘No,’ and she told me that we should do it together,” Rosa said. “Even though I didn’t want to do it at that moment, I did. It helps a lot.”

Rosa has applied similar tools to her sleep habits and is now on a more consistent schedule and getting better sleep.

And that high blood pressure? It’s under control now, too.

“It is behavior changes — helping them realize there are resources and where to look for them,” Pihlstrom said. “When they leave their class, they know how to do these things on their own. We are not here to say, ‘you need to ….’ We are really here just for guidance, and it’s what they do that makes them successful.”