Ending Type 2 Diabetes One Exercise, Nutrition, and Gardening Class at a Time

Accountability – A Key to Changing Behavior

In Nutrition Class on June 10, 2010 at 9:54 PM

Elizabeth starts at the left end of the row, and asks the woman sitting attentively,” Did you bring your food diary?” The program participant opens a notebook, whose pages are clearly empty, and with a sheepish smile says yes. Without hesitation Elizabeth understands that something about the process got lost in translation. She moves swiftly from the front of the classroom and takes a seat casually next to the participant.

” Que comiste hoy? What did you eat today?”

” Nada.” The woman replies, simply.

” Nada?!”

” Only some snacks. And water.”

” Perfect! You write the specific snacks, quantity, and time eaten here, in this space. The drinks go over here.”

When Elizabeth is confident that the communication has been received, she takes her place at the blackboard again.

” Did you bring your food diary?” She asks the next woman in the row.

The woman replies affirmatively, and Elizabeth adds a check under the informal ‘food diary’ column she’s drawn on the elementary school music room’s blackboard. This is one of the providers’ ways of holding the program participants to account, as well as a way to track their progress. Elizabeth never fails to use it as a teaching moment either.

The next question is how many times they exercised that week. One woman has a question about whether the walking she did could be considered exercise. Instead of attempting to describe what distinguishes recreational from aerobic walking, Elizabeth demonstrates her answer. A fast walk around the classroom, arms moving deliberately back and forth with each stride, for up to 30 minutes consecutively, counts. A stroll from your bedroom to your car, however, does not.

The questions and answers continue, from pounds lost this week to overall weight loss goals. Elizabeth celebrates each reported minute exercising, and uses every instance when a participant failed to meet their goal as an opportunity to discuss common barriers and possible solutions. She thanks them for their participation and candor.


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