To help patients with chronic disease make needed behavior change, encourage them to set a self-management goal by asking “Is there anything you are ready to do this week to improve your health?”
Answers such as “I know I should exercise more” or “You said I should stop smoking” may yield vague and daunting goals. Encourage them to take a more incremental approach to change by setting a “SLAM” goal:
Specific: The more specific the plan is, the more likely the patient will follow it. If a patient’s goal is to “exercise more,” encourage the patient to specify the type of exercise, how often it will be done, and how long. For example, “I will walk three times a week for 20 minutes.”
Limited: The goal should be limited to no more than a few weeks. The thought of sustaining the change for a long period of time is often overwhelming for patients. You and the patient can revisit and modify goals at each visit or at check-ins between visits.
Achievable: A daily five-mile run is not reasonable for a sedentary patient, but walking around the block three times a week is achievable and can lead to greater confidence and motivation to tackle more ambitious goals down the road.
Measurable: Goals that measure behavior, not just results, tend to be more effective. For example, instead of setting a goal to “lose 10 pounds,” patients should set a goal that measures the action they are supposed to take, such as “walk for 20 minutes three times a week.”
Read the full FPM article: “Five Communication Strategies to Promote Self-Management of Chronic Illness."
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