This week I thought I’d write about the difference between a lifestyle prescription and an action plan. It’s probably most aimed at physicians trying to integrate more lifestyle medicine into their practice, but think it will also be useful for those trying to make lifestyle changes – framing their change in a way that is likely to help them.
Lifestyle Prescription = actions needed to treat or prevent a condition based on the scientific evidence and the patient’s medical condition.
For example, in line with the CMO physical activity guidelines, a prescription to perform strength building exercises at least 2 days a week.
Action plan = the lifestyle prescription adjusted for the patient’s ability, readiness and confidence.
For example, start with 5 body-weight squats and increase as tolerated up to recommended amount – that chosen activities use all major muscle groups in both the upper and lower body and be repeated to failure.
How do you know how ready the patient/client is to make the change?
It’s important not to dive in with an action plan if your patient isn’t ready – be guided by them and base your action plan on the stage of readiness to change they are at.
|Precontemplation||Not thinking about making a change at all – either now or within the next 6 months||Discuss health risks associated with specific behaviours in the patient/client’s life.|
|Contemplation||Thinking about making a change within the next 6 months.||Personalise their health risks and weigh up the risks and benefits of behaviours on their personal goals.|
|Preparation||Thinking about making a change in the next month and/or preparing to make a change now.||Assist them with commitment to the change, plan the specific change and discuss ways they can modify their environment to be supportive of this change.|
|Action||Started the new behaviour within the last 6 months, target goal not yet reached or has not been reached consistently for 6 months as yet.||Structure their plan and make regular contact with the patient/client. Identify social support and problem solve around obstacles, use CBT if trained to help reframe unhealthy thought patterns they have.|
|Maintenance||Successfully reached goal and been performing new behaviour for 6 months.||Continue positive reinforcement +/- CBT|
|Relapse||Change previously reached for more than 6 months but now not performing the behaviour.||Problem solve as previously to work around obstacles faced.|
Next week I will be discussing how to develop an action plan with a patient or client.