By Rajani Larocca, MD
Charlestown HealthCare Center

with Chrisanne Sikora, Senior Project Specialist
Diabetes Self-Management Education Program

Lifestyle change is ultimately in the hands of the individual, and our job as medical  providers is to find a way to empower people to make those changes. It’s an old problem, but the question is: how do we get there? And can new technology help us solve the problem in new and innovative ways?

In spring 2013, I ran a series of six weekly group visits with a group of my patients at MGH Charlestown HealthCare Center. The group was originally intended for those with metabolic syndrome, but the majority of the patients already had Type 2 Diabetes.  The idea for this program came from an interest in applying a public health approach to medicine. All of the patients volunteered for the program on my recommendation. The focus of the visits was to educate the participants about healthy lifestyle change, to help motivate them to implement this change, and to provide a support system to help keep them motivated.

Each session focused on a different topic. In addition to the introduction in the first week and a summary group in the last week, we discussed nutrition, exercise, stress reduction, and social connection. A key part of the sessions included removing the all-or-nothing mentality that many people adopt when they are trying to be healthier, focusing instead on taking what steps you can and forgiving mistakes in the past.

During the meeting in which we discussed exercise, everyone who participated was given a FitBit activity tracker to wear. Once the trackers were on, the group went on a short walk through the neighborhood. Many were surprised to learn they didn’t have to walk far to reach 1,000 steps.

In subsequent sessions, reviewing the Fitbit data was part of what we did during our time together. Interestingly, everyone liked the Fitbits – even those who didn’t have ready internet access or who weren’t really internet-savvy. Because the trackers had a display which showed results in real time, everyone could tell whether they were reaching their goals on a daily basis. While there was some friendly competition among participants, most were only competing against themselves, trying to beat their totals from the previous week.

After the program ended, the participants were allowed to keep their FitBits, and some were still wearing them eight months later. Some of those who stopped wearing them said it was because they had incorporated their new habits into their routine and didn’t need the tracker anymore. When asked how he would keep up with his daily walks during the winter, one gentleman responded “I’ll wear a coat!”

Electronic trackers like the FitBit make developing healthy lifestyle habits more fun, but we can’t underestimate what the social connection of the group did to foster people’s success. The participants really enjoyed the group setting, especially the sense of community that developed and the confidence they gained from learning that others face many of the same challenges. Living with a chronic disease can be isolating, but in this group, people realized that they were not alone.