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Transforming Health Care One Book Group at a Time

Our ultimate goal at Iora Health is to transform health care. As a Health Coach, I am lucky to work towards this aim daily by building relationships and partnering with patients to address acute concerns, to help manage their chronic conditions, and to support people in reaching their individual health goals.

This is incredibly important, powerful, and gratifying work. Transforming health care is quite a big task so our team needs to be creative every day, always on the lookout for ways to enable this change in – and out – of the exam room.

This creative approach to our work recently led us in a new direction at our primary care clinic in Hanover, NH. We decided to experiment and offer a weekly workshop entitled “Women’s Book Club: Finding Your Own Healthy Body Weight”.

As a company we frequently ask ourselves: How can we connect people who are ready to work on their health? How can we purposefully design interventions that result in creating a healthier overall community?

The formation of a book club seemed to be an innovative and engaging format to address both of these questions. Within several hours of announcing the group in our newsletter, twelve women signed up.

This 10-week session grew out of a weight loss group that had been working together for nearly three years. Recently, the women involved had participated in an online Coursera Nutrition course, had gone walking to increase activity, and even done some simple healthy cooking together. Now, as facilitators, we were looking for a next step, one that would serve to inspire, that was fun, and that would intrigue and engage more participants. Ideally we wanted one that was provocative and different enough to catch people’s attention.

Thus the idea of reading “Half-Assed A Weight Loss Memoir” by Jeanette Fulda was born. This book chronicles Fulda’s journey towards lifestyle change during which she sheds nearly 200 pounds and blogs about it. It is a funny and engaging story that has Jeanette hiding loaves of bread from herself in the trunk of her car, learning to cook, and discovering a love of physical activity she never knew she possessed.

Our intent with the group was to promote discussion and to incite personal action. But how can simply reading a book about lifestyle change actually inspire action in others? This is where Motivational Interviewing entered the picture. We intentionally designed the workshop to mirror a motivational interviewing session (a process that engages motivation within a client to change behavior) and focused on the Stages of Change with participants. During our weekly meetings, participants identified where they fell on the spectrum of change and considered ways to increase their motivation.

At the outset of the workshop, patients were invited to meet with their care team (doctor and Health Coach) to develop a lifestyle approach and food plan that aligned with their health goals. They checked in midway and at the end of the course with their Health Coach to discuss changes – both mental and physical. Book group members were asked to read two chapters each week as “homework” and to reflect on a series of guided questions.

We just completed week ten. Was everyone successful? I don’t know. You’d have to ask them as this depends on individual goals. We shared a lot of laughs, everyone finished the book, and the ladies wrote letters to themselves explaining how their lives would be improved if they made the changes they desired. The cards are in the mail so everyone should be receiving an inspirational note in their mailboxes soon with a reminder to stay motivated.

Did people make behavior changes? Yes! One participant lost 10 pounds. Another started working with her spouse on meals that include more greens and moderation. Some started planning and cooking on Sunday afternoons for the week ahead. The group gelled and formed a strong support network for each other. And they all want to continue.

Did we transform health care? If working with a patient one-on-one in a visit to affect health change is powerful form of intervention, then sitting down with 12 women for an hour every Monday at lunchtime is an extremely powerful way to create change on both an individual and cultural level. We truly can multiply our impact in these group visits. Our team realizes we will only be successful when we work together to affect the culture in which our patients live. Transforming health care is ultimately only possible when we build a community with shared goals and support.

It is energizing to work for a company that encourages creativity and new approaches to help people feel their best. Never doubt that small group of committed individuals can effect change in the world, one book group, one community, one Iora practice at a time. And you might even be surprised by how many people sign up.