A personal health coach for those living with chronic diseases Priscilla Pemu

When I first became a doctor

in Benin City, Nigeria,

some 30-odd years ago,

I was drawn to help
people live full lives.

But often, I found myself
feeling impotent.

Here I was, a brand-new doctor
with all these skills,

but I couldn’t cure my patients
who had chronic diseases –

illnesses like heart disease,
asthma, diabetes –

and needed more than just
handing them a prescription

or providing grief counseling
in the office to get the job done.

Fast-forward 15 years later:

I’m in Atlanta, Georgia;

it’s a different world,

but it was déjà vu all over again.

As doctors, we see our patients
who have chronic illnesses

in an episodic way.

In between,

the patients have to learn how to make
a lot of decisions for themselves.

I’ll give you examples.

If you have medications
you’re supposed to take every day,

what do you do when you’re sick?

Are you still supposed to take it?

How do you recognize
a complication when it happens?

How do you recognize
a side effect when it happens?

What do you do with it?

In addition to all of this,

they’re dealing with the inevitable
loneliness, isolation and anxiety

that people who have
chronic illnesses deal with.

In the US alone, six in 10 adults
have a chronic illness.

That’s 125 million people.

A recent report from
the Robert Wood Johnson Foundation

showed that health habits
account for 50 percent

of the health outcomes
that people experience,

while medical care
only accounts for 20 percent.

In fact, the Centers for Disease Control

says that if we could eliminate smoking,

physical inactivity and poor nutrition,

that we can prevent
80 percent of heart disease,

80 percent of type 2 diabetes

and 40 percent of cancer.

But we also know

that changing health behaviors
is very difficult.

So we asked the question:

What if we could create a resource

that could motivate people
to change health behavior?

The truth is, there are a lot
of these resources out there

that help people acquire
these so-called self-management skills.

But many a time, they’re not
easily accessible or relatable,

particularly to individuals within
minority and underserved communities,

who face bias in addition to barriers
like language and culture

and inadequate health insurance coverage.

And so in the last 12 years,

my colleagues and I
at Morehouse School of Medicine

have created a
technology-based application

to assist with chronic illness care.

It’s freely available on the web

and as an app.

And what we do is get people
to track variables –

blood pressure, blood sugar –

and then report it back to them
in a color-coded format.

So green would indicate a healthy range,

and red would indicate a problem
that needs something done about it.

We link these stats to a curriculum.

The curriculum helps the individual
learn about their health condition,

whatever the chronic illness is.

They also work with a health coach

to learn self-management skills,

skills that’ll help them prevent
complications of their illness.

In order for the coach to be successful,

they have to be able to gain the trust

of the individual
that they’re working with.

We tested this application

in clinics, where the health coaches
were medical assistants,

and in a large urban church,

where the health coaches were volunteers
from the health ministry.

A year later, a third of the participants

were able to acquire
three new self-management skills

and maintain them to the extent
that it was able to improve

their blood pressures, their blood sugar

and their exercise.

Now, what was simple yet fascinating to us

was that the group from the church
did just as well or even better

than the group that were
under purely medical care.

And we wanted to learn why that was.

So we looked a little further
into the research –

400 hours of recorded conversation –

and what we learned was that
the coaches from the church

did have more time to spend
with the patients,

they had access to the patients' families,

and so they could figure out
what people needed

and provide those resources for them.

My team and I call this
“culturally congruent coaching.”

To illustrate this concept
of culturally congruent coaching,

I want to tell you about
one of our patients.

I’ll call her Ms. Bertha.

So Ms. Bertha is an 83-year-old lady
with diabetes and hypertension.

She was assigned to Anne,
her health coach in the church.

Anne also happened to be a family friend
to Ms. Bertha for many years,

and they were fellow congregants.

Anne observed after the first few visits

that even though Ms. Bertha
faithfully recorded her stats,

they were all showing up as red.

So she probed a little deeper

to try to understand
what was going on with Ms. Bertha,

and Ms. Bertha gave her the real-real.

(Laughter)

She told her that there were times

when her medications made her feel weird,

and she wouldn’t take them
the way they were prescribed,

because she thought
it was due to the medicines

but she didn’t tell her doctor that.

She also skipped out
on some doctor appointments

for a variety of reasons,

but one of them was
she wasn’t doing better

and she didn’t want
to make her doctor mad,

so she just didn’t go.

So Anne talked to Ms. Bertha

and asked her to bring her daughter
in for the next visit, which she did.

And at that visit,

Anne was able to print out
a log of all these stats

that Ms. Bertha had been collecting,

gave them to her and encouraged them
to go see the doctor together,

which they did.

With that information,

the doctor was able to make changes
to Ms. Bertha’s treatment.

Within three months, Ms. Bertha’s numbers
were all in the green.

No one was more excited
or surprised than Ms. Bertha herself.

Now, Anne was successful as a health coach

because she cared enough
to go below the surface

and probe Ms. Bertha’s deep culture

and was able to reach her at that level.

She knew how to listen,

and she knew how to ask
the right questions

to get to what was needed.

We all have deep unconscious rules

that drive the way we make
our health decisions.

That’s our culture.

The relationship and the conversation
between Anne and Ms. Bertha

illustrates what’s possible

when we have conversations
with our patients,

our friends and our neighbors

on a deep cultural level.

And personally, I’m beyond excited

to think that with this simple concept
of culturally congruent coaching,

we could change the lives
of 125 million Americans

and many others across the world

that are living with chronic diseases.

Thank you.

(Applause)

大约 30 多年前,当我第一次

在尼日利亚贝宁市当医生时

我被吸引来帮助
人们过上充实的生活。

但很多时候,我发现自己
感觉无能为力。

在这里,我是一位
拥有所有这些技能的全新医生,

但我无法治愈
患有慢性疾病的患者——

心脏病、
哮喘、糖尿病等疾病——

并且需要的不仅仅是
给他们开处方

或提供悲伤
在办公室进行咨询以完成工作。

快进 15 年后:

我在佐治亚州亚特兰大;

这是一个不同的世界,

但又是似曾相识的感觉。

作为医生,我们偶尔会看到
患有慢性

疾病的患者。

在此期间

,患者必须学习如何
为自己做出很多决定。

我给你举个例子。

如果你有
你应该每天服用的药物,

当你生病时你会怎么做?

你还应该接受吗?

当并发症发生时,您如何识别它?

当它发生时,你如何识别副作用?

你用它做什么?

除了所有这些,

他们还要应对慢性病患者不可避免的
孤独、孤立和焦虑

仅在美国,十分之六的成年人
患有慢性病。

那是1.25亿人。

罗伯特伍德约翰逊基金会最近的一份报告

显示,健康习惯
占人们经历

的健康结果
的 50%,

而医疗保健
仅占 20%。

事实上,疾病控制中心

表示,如果我们能够消除吸烟、

缺乏运动和营养不良

,我们就可以预防
80% 的心脏病、

80% 的 2 型糖尿病

和 40% 的癌症。

但我们也知道

,改变健康行为
非常困难。

所以我们问了一个问题:

如果我们可以创造一种资源

来激励
人们改变健康行为呢?

事实上,有
很多这样的资源

可以帮助人们获得
这些所谓的自我管理技能。

但很多时候,它们并不
容易接触或相关,

尤其是对于
少数族裔和服务不足社区的个人而言

,除了
语言和文化

等障碍以及医疗保险覆盖不足之外,他们还面临偏见。

所以在过去的 12 年里,

我和我
在莫尔豪斯医学院的同事

们创建了一个
基于技术的应用程序

来协助慢性病护理。

它在网络上

和作为应用程序免费提供。

我们所做的是让
人们跟踪变量——

血压、血糖——

然后
以颜色编码的格式报告给他们。

所以绿色表示健康范围

,红色
表示需要解决的问题。

我们将这些统计数据与课程联系起来。

该课程帮助个人
了解他们的健康状况,

无论慢性病是什么。

他们还与健康教练

一起学习自我管理技能,这些

技能将帮助他们预防
疾病的并发症。

为了让教练成功,

他们必须能够获得与

他们一起工作的个人的信任。

我们

在诊所(健康教练
是医疗助理)

和一个大型城市教堂

(健康教练是
卫生部的志愿者)测试了这个应用程序。

一年后,三分之一的

参与者能够获得
三项新的自我管理技能,

并将其保持到能够

改善血压、血糖

和锻炼的程度。

现在,让我们感到简单而有趣的

是,来自教会

的那群人的表现与纯粹接受医疗保健的那群人一样,甚至更好

我们想知道为什么会这样。

所以我们更
深入地研究了这项研究

——400 小时的录音对话

——我们了解到,
教会的教练

确实有更多的时间
与患者相处,

他们可以接触到患者的家人

,所以 他们可以
弄清楚人们需要什么,

并为他们提供这些资源。

我和我的团队称之为
“文化一致的教练”。

为了说明这种
文化一致性教练的概念,

我想告诉你我们的
一位患者。

我会称她为伯莎女士。

所以伯莎女士是一位
患有糖尿病和高血压的 83 岁女士。

她被分配给
她在教堂的健康教练安妮。

安妮也恰好是
伯莎女士多年的家庭朋友

,他们是同胞。

安妮在前几次访问后观察到

,尽管伯莎女士
忠实地记录了她的统计数据,

但它们都显示为红色。

因此,她进行了更深入的探索

,试图
了解伯莎女士的情况,

而伯莎女士给了她真实的真实。

(笑声)

她告诉她,

有时她的药物让她感到奇怪

,她不会按照
处方的方式服用,

因为她认为
这是药物的原因,

但她没有告诉她的医生。 由于各种原因,

她还跳过
了一些医生预约

但其中一个原因是
她没有做得更好,

而且她
不想让她的医生生气,

所以她没有去。

所以安妮与伯莎女士交谈,

并要求她带她的女儿
来进行下一次访问,她照做了。

在那次访问中,

安妮能够打印出伯莎女士收集
的所有这些统计数据的日志

将它们交给她并鼓励他们
一起去看医生

,他们照做了。

有了这些信息

,医生就能够
改变伯莎女士的治疗方法。

三个月之内,伯莎女士的数字
全部变好。

没有人
比伯莎女士本人更兴奋或更惊讶了。

现在,安妮作为一名健康教练取得了成功,

因为她足够关心

潜入地下并探究伯莎女士的深厚文化

,并能够在那个层面上接触到她。

她知道如何倾听

,她知道如何
提出正确的问题

来得到需要的东西。

我们都有深刻的潜意识规则

,这些规则驱动着我们做出
健康决定的方式。

这就是我们的文化。

Anne 和 Bertha 女士之间的关系和对话

说明了


我们与患者

、朋友和邻居

在深厚的文化层面上进行对话时可能发生的事情。

就个人而言,我非常兴奋

地想到,通过这种
文化一致的教练的简单概念,

我们可以改变
1.25 亿美国人

和世界上许多其他

患有慢性病的人的生活。

谢谢你。

(掌声)