4/27/2016

The Sweet Taste of Success: Guiding People to Successful Experiences Through Tailored Interventions

Catherine Serio, PhD

Editor’s Note: Behavior change promises to be one of the most revolutionary movements in health care in the 21st century. In three posts, Catherine Serio, Senior Director of Behavior Change Strategy, explores a three-step process for developing a behavior change program that engages people, supports your quality metrics, and helps you achieve the Triple Aim. In this last post, we’ll look at how behavior change science has tailored interventions for every level of patient readiness and how, by becoming a behavior change facilitator, you can guide your members to success experiences.


My husband and I met on a backpacking trip in the Blue Ridge Mountains of Virginia. We share a love of playing outside—hiking, biking, and even canoeing. One afternoon, we were canoeing down the James River, watching eagles and Great Blue Herons overhead, when we caught a glimpse of a different river creature: a kayak.

Being the outdoor enthusiasts we are, we signed up for an upcoming kayaking class. Our young, eager instructors met us on the river bank. After a brief, onshore lesson, they jumped into their kayaks to show us how to “roll” and flip the kayak 360 degrees in the water and to do “wet exits” (when you can’t get your kayak upright and have to exit the boat while you’re underwater).

We pulled on our wetsuits, shimmied into our kayaks, and paddled into the river. Thirty seconds in, my boat flipped. I was underwater holding my breath, the current resisting my efforts to roll the kayak upright. My natural response was to kick my legs—to swim. But my legs couldn’t move inside the kayak shell. I banged my hand on the upper shell to signal an instructor for help. I was drowning. Thankfully, I managed to pull my entire body out of the cockpit underwater and, gasping, break the water’s surface.

Once onshore, I pulled off my wetsuit, left class, and gave up on kayaking. Today, my husband and I live in Idaho—home to world-class whitewater kayaking. But I don’t kayak. I hike the Sawtooth Mountains and occasionally paddle a canoe on Payette Lake. Because 25 years ago, in less than one hour’s time, I decided I would never kayak again.

My story is about giving the wrong intervention to the right person. I love playing outside and trying new things. Motivation is not a barrier to taking action. This is true for many people who are motivated to live healthier lives, manage an illness, or improve their relationship with their doctor. Their barriers are lack of understanding, lack of experience, or lack of confidence.

Half of Americans want to lose weight. They are actively motivated. But too often they lack understanding and confidence. They don’t know how to build a success experience. People read about the latest fad diet or supplement and try those. A few weeks later, they find themselves at the same weight and a little bit poorer. Others decide to “get fit in a day” and take a spin class, followed by kickboxing, then an evening jog. Their reward: a pulled Achilles tendon. And then there are people who want to be engaged in their health, but the only option they hear is “change now.” You know the story: “Do you want to quit smoking?” “Not right now.” “OK. Come back to me when you’re ready.”

Behavior change science has tailored interventions for every level of readiness:

  • Not ready to commit to quitting smoking today, but you are interested in learning about medicines to curb withdrawal. How about information on nicotine replacement therapies?
  • Motivated to take action, but haven’t gotten off the couch in 6 months. How about a daily walk to the mailbox for starters?
  • Your doctor said you have prediabetes and you said, “Let’s deal with it when I have an actual condition.” How about learning about the pros and cons of making changes before you actually get diabetes?
  • Want to learn to kayak, but have no prior experience? Meet us at the YMCA for beginner’s training in the pool.

The experiences we guide people to set their course. In my case, I was guided to a terrifying experience that turned me away from kayaking for life. We can be better guides in health care. We can listen to what someone cares about, determine where they are in their journey—from newbie to experienced—and serve them options for success. Because when we guide people toward success experiences, confidence levels rise and people come back wanting more.

You can be powerful behavior change facilitators. Keep your members afloat by listening, focusing, and guiding them toward success experiences. Thank you for the work you do. Because change is good for everyone’s health.