Lose and Win Facilitator Skills Training Session

About Judgment

2

“Don't judge another person until you've walked a mile in his or her shoes.”

2

Training Overview

3

▶ Program background & overview

▶ Reported program results

▶ Facilitator responsibilities

▶ Facilitator skills

▶ Recruitment process

▶ Data collection process

▶ Implementation process

▶ Additional resources

▶ Facilitator guide content review

3

Lose and Win Program

4

Lose and Win was created to help employees learn how to achieve and maintain a healthy weight

• Worksite group support for weight loss

• Eight-week behavioral modification program

• Evidence-based and derived from latest research

• Incorporates key aspects of successful weight loss behaviors

• Focus is on nutritional modifications, consistent physical activity and cognitive restructuring

4

Lose and Win Program

5

Peer-Facilitated Group Support Program

Session 1: On your way to a healthy weight

Session 2: Move to lose

Session 3: Planning ahead for healthy eating

Session 4: Healthy habits

Session 5: Overcoming exercise barriers

Session 6: Healthy eating — in and out

Session 7: Managing stress

Session 8: Staying positive

▶ Eight-week behavior modification turnkey program

▶ Incorporates key aspects of successful weight loss

▶ Customizable pre- and post-program surveys

▶ Six additional modules

5

Lose and Win Program Overview

Session Objectives Topics covered

Kick-off ▶ Review attendance. ▶ Motivate and encourage healthy behaviors. ▶ Collect baseline data.

▶ Program components ▶ Expectations for success ▶ Food and activity journal

On your way to a healthy weight

▶ Discuss the importance of a healthy weight. ▶ Explain the key components of weight loss. ▶ Discuss everyday tips to eat fewer calories and move more. ▶ Provide resources that help participants determine a healthy weight and daily

calorie needs.

▶ Benefits of a healthy weight ▶ Body Mass Index and healthy weight ▶ Calorie balance for weight loss ▶ Portion sizes ▶ My Pyramid and daily calorie needs

Move to lose

▶ Discuss the benefits of exercise. ▶ Review the exercise recommendation for weight loss. ▶ Define moderate-intensity exercise. ▶ Encourage participants to develop and adhere to an exercise plan. ▶ Provide tips and resources to help participants move more every day.

▶ Benefits of physical activity ▶ Short bouts of activity to meet

recommendation ▶ Issues to consider when developing

exercise plan ▶ Everyday ways to move more

Planning ahead for healthy eating

▶ Promote healthy eating. ▶ Encourage participants to plan meals. ▶ Provide sample healthy meal plans. ▶ Demonstrate how to read the

nutrition labels.

▶ Meal planning steps ▶ Healthy, on-the-go snacks ▶ Grocery store shopping ▶ Reading nutrition labels ▶ Saving time by preparing ahead

6

Healthy habits ▶ Encourage participants to be mindful eaters. ▶ Help participants recognize cues and triggers that lead to

unhealthy behaviors. ▶ Discuss how to create healthy environments at home and work. ▶ Encourage participants to develop new healthy habits.

▶ Mindless eating ▶ Hunger scale ▶ Identifying triggers ▶ Setting up cues for healthy behaviors ▶ Planning ahead for challenging situations

Overcoming exercise barriers

▶ Identify participants’ barriers to exercise. ▶ Discuss the importance of prioritizing a healthy lifestyle. ▶ Encourage participants to find support systems. ▶ Provide examples of ways to be active when on the go.

▶ Common exercise barriers ▶ Making time to exercise ▶ Staying motivated ▶ Support systems ▶ On-the-go activities

Healthy eating — in and out

▶ Review key components of a healthy diet. ▶ Provide substitutions and healthy tips to help participants prepare better

meals at home. ▶ Discuss strategies to help participants make better choices when dining out.

▶ Healthy eating guidelines ▶ Whole-grain examples ▶ Ingredient substitution ▶ Eating out healthy tips ▶ Better choices for every cuisine

Managing stress ▶ Help participants identify sources of stress. ▶ Discuss the health consequences of stress. ▶ Provide strategies to reduce and manage stress. ▶ Demonstrate how problem solving can be used to reduce stress.

▶ Signs of stress ▶ Sources of stress ▶ Healthy ways to deal with stress ▶ Problem-solving steps ▶ Identifying possible solutions

Staying positive ▶ Encourage participants to use positive self-talk. ▶ Discuss best practices and help participants find ways to overcome ongoing

challenges. ▶ Review keys to success. ▶ Encourage participants to reassess progress and set new realistic goals. ▶ Collect post-intervention data.

▶ Positive self-talk ▶ Realistic expectations ▶ Argument against excuses ▶ Assessing progress

Lose and Win Program Overview (Continued)

7

Frequently Asked Questions

1. Is this program available for HealthSelect participants only? No, you do not have to be a HealthSelect participant to participate. All employees are welcome to attend the worksite sessions.

2. Can employees who are already at a healthy weight participate? Yes. Any employee looking to improve daily lifestyle choices can benefit from participating in the program.

3. Where do I get all the materials for the class? All Lose and Win materials can be found in the Benefits/Wellness Coordinator tab on www.healthselectoftexas.com.

4. How do I facilitate a program if I have multiple locations? Once you determine how many people want to participate in the program, you can then determine how many meeting times and locations you will need. We suggest that you train at least one facilitator for each location. You can offer the course via webinar, but our experience shows that results are better if offered in person.

5. Can this program be spread over several months? We suggest that you offer the program for eight continuous weeks to develop a supportive and trusting learning environment.

8

6. How long is each session? Each session was designed to be 60 minutes. However, the sessions can be modified to fit a 30-minute or 45-minute time frame by choosing shorter activities and discussions.

7. How can we motivate people to keep their food & activity journals? At the first session set the expectation that participants will make three commitments: attend each class complete a daily food and activity journal actively participate in each session You can offer small prizes each week or enter names into a drawing for one big prize at the end of the program for participants who completed this commitment.

8. Should I weigh all the participants each week? Weekly weigh-ins are not part of the Lose and Win program. If you do want to weigh participants, UnitedHealthcare recommends that you work directly with your legal department to ensure that anything you do is within HIPAA compliance.

9. What if someone asks a question in class and I don’t know the answer? Please feel comfortable taking the question back to your wellness expert.

10. Does HealthSelect offer a weight loss team challenge? Yes. All program materials can be found on www.healthselectoftexas.com.

Frequently Asked Questions (Continued)

9

Reported Results

• Lose and Win was successfully launched in January 2009.

• More than 1,000 companies have participated.

• Data from those that report have been positive:

• Over 90% of participants rated the program as good or excellent.

• Over 80% of participants lost weight.

• Average weight loss was 4–5 pounds per participant.

• 73% of participants reported making healthier food choices.

• 65% of participants reported eating smaller potion sizes.

• 75% of participants reported increasing physical activity.

10

Facilitator Responsibilities

• Become familiar with all the Lose and Win materials.

• Determine days, times and locations for onsite meetings and coordinate registration.

• Facilitate completion of the pre- and post-questionnaires.

• Facilitate onsite sessions.

• Plan and conduct fun activities for each session.

• Determine how you will promote attendance.

• Take attendance at each meeting.

• Act as a contact for questions from participants.

• Celebrate program completion.

11

Background for Facilitator Skills

• Facilitator skills are derived from Motivational Interviewing.*

• Motivational Interviewing is a way of bonding with a person and creating collaboration.

• The process evokes awareness and motivation from within.

• The facilitator helps the participant find his or her solutions to his or her challenges, increasing the individual’s confidence to change.

* Motivational Interviewing: Preparing People for Change by William R. Miller and Stephen Rollnick – 2nd edition.

12

Five Skills for Facilitation

1. Ask open-ended questions.

2. Practice reflective listening.

3. Give positive affirmations.

4. Summarize statements.

5. Elicit change talk.

13

#1: Ask Open-Ended Questions

Open-ended questions:

• Designed to elicit more information

• Cannot be answered with “yes” or “no”

• Usually begins with “what,” “how,” “why” or “tell me more about…”

• Prompts the participant to think more

Who can share an example of an open-ended question?

14

Examples

• Tell me more about your exercise routine.

• What type of exercises do you do and how often?

• What concerns you about your health?

• What time of day is most convenient for you to fit in physical activity?

• What might get in the way of sticking to the program we’ve just discussed?

15

#2: Reflective Listening

• Involves restating or reflecting what the person said

• Clarifies that you were listening AND that you understood what the other person told you

• Your role is to summarize concisely what the participant has shared with you

16

Example of Reflecting Listening

Participant: “You know, I’m just fed up! I watch what I eat and I exercise every day. I am always thinking about my weight and constantly trying to do all the right things. I keep working and working and just don’t see the results I’m after.”

Facilitator: “Despite your best efforts, you’re not seeing the progress you had hoped for. It feels like you’re banging your head against the wall and you’re wondering if it’s worth it.”

Putting it together: Follow up with an open-ended question (skill #1) to elicit change talk (skill #5): “Can you give me some examples of what types of food you are eating and at what frequency?”

17

#3: Positive Affirmations

• Focus on the positive

• Statements recognizing individual’s strengths

• Compliments: sincere statements of appreciation and understanding

• Encouraging words that add to the participant’s motivation to change

18

Examples

Positive Affirmations for the facilitator:

• I know this is hard, but you can do it.

• You’ve been able to increase your exercise minutes, now let’s work on your healthy eating goals.

• In spite of some challenges, you are still giving it your best efforts.

Positive Affirmations for the participant:

• I choose to make positive healthy choices.

• I will succeed.

• I care about my health and I can do this.

19

#4: Summary Statements

• Clearly define the issue.

• Acknowledge the positive.

• Prepare the participant to start talking about change.

Define the issue: “It sounds like you’re struggling with making healthy food choices at night.”

Acknowledge the positive: “However, you are mindful of your eating and making great choices during the day.”

Probe for change: “What could you do to help support making better choices late in the day? What are you willing to try?”

20

#5: Eliciting Change Talk

• Disadvantages of the same: What worries you about your current situation?

• Advantages of change: How would you feel if things were different?

• Belief about ability to change: How confident are you that you can make this change?

• Willingness to change: What do you think you would be willing to try?

If you think you can change, you are more likely to succeed.

If you are willing to change, you are more likely to make changes.

21

1. Ask open-ended questions.

2. Practice reflective listening.

3. Give positive affirmations.

4. Summarize statements.

5. Elicit change talk.

Summary of Facilitator Skills

Rule of thumb: the participant talks more than you

22

Recruitment Process

Determine dates to run program.

Determine meeting sites (day, time, room, location).

Find back-up instructor (suggested).

Promote program (posters, emails).

Register participants (sign-up sheet).

Plan introduction/kick-off event.

23

Data Collection Process

• Online survey process through Survey Monkey.

• Facilitators will complete survey request form with UnitedHealthcare wellness representative: • Ability to add customer wellness program logo

• Ability to add three customized questions

• Facilitators will receive a survey link via email from their UnitedHealthcare wellness representative.

• Facilitator will gather email addresses during introduction session and send the survey link to the participants.

• Facilitator will send reminder to participants to complete survey within one week.

24

Implementation Process (Continued)

Introduction: Plan an ice-breaker.

Take attendance.

Collect email addresses.

Give a brief overview of the program.

Review participant expectations.

Conduct an activity.

25

Implementation Process (Continued)

Sessions 1 through 8:

• Review content before each session.

• Plan any activities.

• Send reminders to participants.

• Take attendance.

• Lead group and review session content.

• Encourage group discussion.

• Use motivational skills to support participants.

26

Best Practices

• Weekly communication between facilitator and attendees (for example, email with tip sheet or recipe)

• Consistent meeting location and time each week

• Sessions should occur over nine consecutive weeks; consider school calendar and holidays

• Sign identifying meeting room

• Identify primary facilitator with secondary facilitator identified and involved

• Arrange seats in “U” shape or circular form

• Class size of 15 to 20 participants

• Plan post-program activity

27

Lose and Win on HealthSelect

Summary

• Create an environment that is fun, engaging and supportive.

• Facilitate the behavioral change process by allowing the participant to resolve his or her own obstacles to weight loss.

• Encourage other participants to offer suggestions.

• Ask engaging and interesting questions.

• Let participants do most of the talking.

• Present and discuss the content provided in the guides.

• Be willing to learn and have fun while supporting co-workers.

29

Additional Modules (9–14)

• These modules are not part of the data collection process, so please administer post-questionnaire after week eight.

• Facilitator guide, participation guide, session presentation and tip sheets are available for each module.

• Visit www.healthselectoftexas.com, Benefits/Wellness Coordinator Resources, Lose and Win, Sessions 9–14.

30

Additional Modules

• Session 9: Creating a Healthy Eating Plan — Understand the definition of a healthy diet; determine daily calorie needs; learn about major food groups, including proteins, carbohydrates and fats.

• Session 10: Staying Healthy While Traveling — Learn practical tips on how to achieve and maintain a healthy eating and exercise plan while traveling.

• Session 11: Boost Your Health with Super Foods — Learn about “super foods” that provide important health benefits and how to incorporate them into an everyday eating plan.

• Session 12: The Truth About Dietary Fats — Understand the four major types of dietary fat and their sources. Learn how much fat is needed for a healthy balanced diet and how to avoid unhealthy fats.

• Session 13: Adopt a Healthy Lifestyle and Prevent Type 2 Diabetes — Learn about characteristics of type 2 diabetes and assess your risk. Learn dietary and exercise improvements as well as tips to help you prevent type 2 diabetes.

• Session 14: Healthy Eating on a Budget — Learn tips on how to stretch a dollar, how to incorporate healthy, budget-friendly foods into your eating plan and how to incorporate low-cost ingredients into favorite recipes.

31

Weight Loss Team Challenge

▶ The Lose and Win Weight Loss Team Challenge is a turnkey program that includes an educational brochure, program rules, a sign-up sheet and a consent form.

▶ For program information, visit www.healthselectoftexas.com, select Benefits/Wellness Coordinator Resources, Lose and Win, Weight Loss Team Challenge.

32

Lose and Win Weight Loss Challenge

Team challenge participation rules 1. Employees form teams of no less than three and no more

than 10 co-workers. 2. Teams select a team captain and a team name. 3. Teams must submit a Lose and Win Entry Form. 4. Team members must consent to a pre- and post-body-

weight screening.

At the end of the program, pre- and post-team weights are tallied up to see which team had the highest percentage of weight loss. Participants are advised to work with their physician for weight loss advice and encouraged to follow safe guidelines for healthy weight loss, no more than 1–2 pounds per week.

Program Goals: ▶ Reduce health risks associated

with being overweight or obese ▶ Promote team spirit and foster a

workplace culture of wellness

33