KP Wellness Resources. Strains on Wellness. Jack Der-Sarkissian, MD SCPMG Physician, Adult Weight Management Lead; Unmanaged Stress.

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1 KP Wellness Resources Jack Der-Sarkissian, MD SCPMG Physician, Adult Weight Management Lead; Strains on Wellness Smoking Unmanaged Stress Overeating Wellness Inadequate Sleep Lack of Exercise Alcohol Overuse Lifestyle Medicine: Managing Diseases of Lifestyle in the 21st Century. Garry Egger, Andrew Binns and Stephan Rossner. Publication Date: December 1,

2 Patients as Partners Changing the behavior of people isn't just the biggest challenge in health care; it's the most important challenge. Source: Change or Die by Allen Deutschmann, Fast Company, May Stages of Readiness Not Ready 0-3 Stage of Readiness - Not Ready 0-3 Key Questions Raise Awareness Elicit Change Talk Advise and Encourage What would it take for you to consider making a change? (stop smoking, lose weight) When you are ready, we can help! Motivating for Success Andy Golden,MD;Pam Honsberger,MD; Carol Bernstein,LCSW Kaiser Permanente

3 Stages of Readiness Ready 7-10 Stage of Readiness - Ready 7-10 Key Questions Strengthen Commitment Facilitate Action Planning Suggest Specific Resources Why is this important to you now? What are your ideas for making this work? What might get in the way? How might you work around those barriers? How might you reward yourself along the way? Motivating for Success Andy Golden,MD;Pam Honsberger,MD; Carol Bernstein,LCSW Kaiser Permanente 2013 Motivating for Success NEW Clinician Patient Communication Assessing Readiness Behavior Change Theory CareActors Move your Patient to Next Step Health Education can take it from there. 3

4 Do you know your BMI? Overweight (BMI ) Obesity (BMI ) Extreme Obesity (BMI over 40) Expectations You can expect improved health outcomes if you lose 5-10% of your current weight Source: US Preventive Services Task Force (USPSTF) 4

5 Our Resources PROGRAM DESCRIPTION AVERAGE WEIGHT LOSS Lifestyle and Weight Management Class Single Session Weight management strategies and gateway to other programs 12 week Slim Down Behavior change based 16 week Low Calorie Flexible Diet (LCD) OR- Flexible Meal-Replacement Program *20 week Very Low Calorie Diet (VLCD) OR- Medical Weight Loss Program Wellness Coaching by Phone Partial meal replacement Medically managed; Total meal replacement 1:1 coaching support to address ambivalence, barriers, and set personal goals COST No cost to members -12 pounds $180+$20 (members) $270+$20 (non-members) COST BREAKDOWN $15 per week (members) -19 pounds $1,350 $6 per meal replaced (two meals per day) -26 pounds $2,500 Less than $7 per meal replaced (all meals replaced for 17 weeks) pounds (self-reported) No cost to members *Some medical centers implement a 24 week program and OC implements a 16 week program. The standardized version is 20 weeks. West Los Angeles Pilot Study: Body weight changes Average Body Weight (lbs) VLCD LCD Options Surgery 6 mo Before 2 mo 6 mo 12 mo 18 mo 24 mo Months Relative to Class Start/Surgery Date Options (Surgery Preparation- Educational Program) = -12 lbs LCD (Partial Meal Replacements) = -19 lbs VLCD (Total Meal Replacement) = -26 lbs Surgery (RNYG and Sleeve) = -67 lbs 5

6 Program Outcomes: 3 year data observations from West LA VLCD LCD Total number of participants Percentage that start and finish 69% 75% Average weight loss lbs lbs. KP Resources for Your Members Lifestyle and Weight Management class Single session 2 ½ hours Weight management overview Overview of other programs and resources available at local KP facility Empowers patients to take the next step in their weight management journey 6

7 KP Resources for Your Members Stress: Reduction and Relief Single session 2 hours Stress Management overview with strategies Overview of Mind Body Health (series) Empowers patients to take the next step in their total health journey KP Resources for Your Members Living Well: Freedom From Tobacco Single session Orientation- 1 ½ hours Empowers patients to take the next step in their readiness to quit tobacco Freedom From Tobacco- (series) 7

8 Wellness Coaching by phone Evidenced based methodology Uses patient centered motivational interviewing Enhances confidence to change Increases patient adherence 88% of referrals are from physicians Health Education should not be just accessible, it should be unavoidable. Sidney Garfield, MD, Founding Director, Permanente Medical Group, Co-Founder, Kaiser Permanente 8