Dr Ronaldo M Toledo, Md

Ronaldo M. Toledo, M.D. Diabetes Conversation Map: A New Diabetes Educational Tool Outline 1. Diabetes Conversations Program a. Organizations b. Philosophy/Principles 2. Components of the Diabetes Conversations Experience 3. How you can be a part of the program?

Diabetes Conversations

Three Organizations

A program which aims to seek out and deliver innovative diabetes education resources • It features the use of a highly visual and interactive diabetes educational resource- The Conversation Map Tools • It was developed by Healthy Interactions Inc. in collaboration with the International Diabetes Federation and supported by Eli Lilly •

Healthy Interactions Inc. Vision “To enable 100 million meaningful conversations that lead to better health care decisions and outcomes.”

Healthy Interactions Inc. Approach “ Based on a fundamental belief that sustainable personal change requires a meaningful, factfocused discussion of issues and a verbal commitment to change”

Ronaldo M. Toledo, M.D. Diabetes Conversation Map: A New Diabetes Educational Tool International Diabetes Federation(IDF) Mission “ To promote diabetes care, prevention and cure worldwide.”

Eli Lilly and Company “ At Lilly, our goal is nothing short of arresting the progression and impact of diabetes for patients and across society. We recognized that therapy is an important component of effective diabetes management, but we also believe that we must go beyond therapy to ultimately achieve success. By providing a unique, interactive way to increase a patient’s knowledge of diabetes, we believe that we can provide patients with tools they need to successfully mange their diabetes for life.” Dr Robert J. Heine, PhD, FRCP, Executive Medical Director for Diabetes and Endocrine Joachim Becker, Director International Marketing, Diabetes

Philosophy and Guiding Principles

3 Basic Principles 1. People want simple solutions to complex problems. 2. People will “tolerate” what health care professionals have to say, but they ultimately will act on their own conclusions 3. There is a tremendous power in speaking with someone in the same situation as you.

Conversations Are Critical

Conversation Map Philosophy

70%

Visual Passive

Group

50%

Engagement

ActiveEngagement

RetentionRates

Conversation Map Tools

Socratic

30% 20%

“We believe in facilitated small-group, discovery learning, combined with visual learning principles. We believe these principles, integrated with a stimulating Socratic approach (questions that illicit dialogue and conclusions) are a dramatically more effective technique to creating personal health engagement than traditional didactic learning.” - Healthy Interactions

11

10% Read

Hear

See (Graphically)

See & Hear

Discuss With Others

Knowles MS. The Adult Learner: A Neglected Species. Houston: Gulf Publishing Company; 1990.

12

Ronaldo M. Toledo, M.D. Diabetes Conversation Map: A New Diabetes Educational Tool Healthcare Outcomes Continuum

Patient-Centred Model Conversation Map™ tools are aligned with the patient-centred model Medical-centred model

Patient-centred model

Compliance

Autonomy

Adherence

Patient participation

Planning for patients

Planning with patients

Behaviour change

Empowerment

Passive patient

Active patient

Dependence

Independence

Professional determines needs

Patient defines needs

Immediate Learning*

Knowledge Skills

Skelton A. Evolution not revolution? The struggle for the recognition and development of patient education in the UK. Patient Educ Couns. 2001; 44:23-27.

13

Behaviour Change* Exercise Diet Taking medication Monitoring Problem-solving Reducing risk Healthy coping

Post-Intermediate Clinical Improvement Clinical Indicators • HbA1c • BP • Lipids Process Measures • Eye exam • Foot exam Other Measures • Smoking cessation • Aspirin use • Pre-pregnancy counselling

Long Term Improved Health Status Overall Health Status Quality of Life Days Lost From Work or School Diabetes Complications Healthcare Costs

Adopted from:Peeples M, Mulcahy K, Tomky D, Weav er T. The conceptua l framework of the Na tiona l Diabetes Education Outcomes System (NDEOS). Diabetes Educator. 2001;27:547-562.

14

Six (6) Components of the Diabetes Conversation Map Experience 1. 2. 3. 4. 5. 6.

Intermediate

Conversation Map Visuals Conversation Questions Conversation Fact/Information Cards Group Participants and Interactions The Facilitator Action Plan (Goal Setting)

1. Conversation Map Visuals • The map is a 1.0 m x 1.5 m or about 3 ft. x 5ft. colorful picture • A “common mental model” • Depicts several issues and the relationships between these issues • Shows day to day life among people with diabetes according to culture • Images are metaphorical

Conversation Questions

Examples of Conversation Questions

• Serve as focus for discussion by the group • Prompt the participants to discuss a variety of topics at various points throughout the session • Determine the pace and direction of the group’s discussion • Allow for situational problem solving

1. How would you define diabetes? 2. What did you feel when you were diagnosed to have diabetes? 3. Do you know about the specific benefits of healthy eating when it comes to managing your diabetes? 4. Does anyone know what are some of the complications of diabetes?

Ronaldo M. Toledo, M.D. Diabetes Conversation Map: A New Diabetes Educational Tool 3.Conversation Fact/Information Cards • Used to focus the group’s discussion on the realities of the issues being explored • Spark conversation among the members of the group • Bring additional information and engagement to the sessions • Have game-like feel and help engage participants in the learning process

5. The Facilitator • Role is not like the typical lecturer or teacher • He uses the materials (conversation questions) to guide the group conversation • Engages the participants in the process of exploration and learning • He must create a non-threatening environment • He must make the session full of fun, interactive, engaging, and full of learning

4. Group Participants and Interactions • The diabetes conversation map tool is designed to be used in groups of 3-10 people • An open and trusting environment for dialogue is present during the session • Thru the process of discussing facts with peers ( co-equal), people are able to change what they believe to be true.

6. Action Plan/Goal Setting • This provides the participants with a process by which they can plan changes in their decision-making and behaviors. • Output of the participant • Verbal commitment of the participant to change

Ronaldo M. Toledo, M.D. Diabetes Conversation Map: A New Diabetes Educational Tool BE A PART OF THIS PROGRAM! Join the Facilitators Training • 6 Hours Training • Basic Requirements 1. Health Care Professional 2. Knowledgeable about Diabetes 3. Direct Contact with people with diabetes 4. Can start implementing the program within a month after training

This Diabetes Conversation Map is an add-on to your existing programs or a new stand-alone curriculum to educate people with diabetes!

Join us! Let us UTILIZE, ADVOCATE AND ADVANCE the Diabetes Conversations Map Program!