Health & Wellness Coaching Board Exam
Part 2 The coach then assists the client in _____and ______health and wellness resources, as well as accurately ______ and ______ multiple sources of health information.
Finding/utilizing, evaluating/integrating .
The DASH diet, recommended for hypertension, recommends choosing foods that are:
Low saturated and trans fats, low sodium Rich in potassium, calcium, magnesium, fiber, and protein and to limit sodium to 2,300 mg, or 1,500 mg
Kidding
Making light of things can be incredibly helpful at the right time. But laughing off something important or serious someone shared with you can make them feel disrespected and undervalued.
substance abuse contributes to the following problems
Teenage pregnancy, HIV, STDs Domestic violence, Child abuse Motor vehicle crashes, Physical fights Crime, Homicide, Suicide
Commanding
Telling people what they can, can't, or will do is likely not your place. No one wants to be told what to do.
HIPAA Privacy Rule vs Security Rule.
The Privacy Rule- the protection of certain health information. The Security Rule- set of security standards for protecting certain health information that is held or transferred in electronic form.
behavioral goal vs outcome goal
behavioral goals isolate your actions from outside influence and are solely focused on what you, and only you, are doing. Outcome goals focus only on the results, i.e. weight loss, etc and more subject to outside influence.
improving quality of life for patients with fibromyalgia:
be active for 150 min per week, physical activity programs, self management education class
Motivational interviewing is a technique in which you
become a helper in the change process and express acceptance of your client. Your role is directive, with a goal of eliciting self-motivational statements and behavioral change from the client in addition to creating client discrepancy to enhance motivation for positive change.
oral glucose tolerance test measures your blood sugar:
before and after you drink a glucose liquid after fasting overnight After ingesting the liquid, it's checked 1, 2, and 3 hours afterwards
With OA, the cartilage within a joint:
begins to break down, it gets worse over time, can cause pain, stiffness, and swelling. Reduced function, disability.
De-identified health info:
no restrictions on the use or disclosure of de-identified health information that neither identifies nor provides a reasonable basis to identify an individual.
Nonmaleficence means
non-harming or inflicting the least harm possible to reach a beneficial outcome.
Your risk for heart disease, diabetes, and stroke increases with the ________ of metabolic risk factors you have. The risk of having metabolic syndrome is closely_________ to overweight and obesity and a lack of physical activity.
number/linked
Disengagement can be signaled by
poor eye contact, distracted behaviors such as looking at a phone or texting, or not participating in the conversation.
The Positive Principle from AI
positive actions/outcomes STEM from: POSITIVE energy/emotion, level 5 of pyramid
The coach establishes a:
positive and safe environment where the client feels accepted and supported, which helps the client clarify values/access motivation.
The coach calls attention to
positive shifts in the client's energy or emotion that may support healthy behavior change.
For pregnant women, physical activity reduces the risk of
postpartum depression.
Type 2 diabetes and pre-diabetic risk factors
prediabetic, Are overweight, Are 45 years or older family history, physically active less than 3 times a week gestational diabetes, or given birth to a baby above 9 lbs. Are POC
Generally there are three treatment stages for stroke:
prevention, therapy immediately after the stroke, and post-stroke rehabilitation.
Risk factors for stroke
previous stroke or TIA, hypertension, hyperlipidemia, CAD, diabetes, sickle cell disease
sympathy mean's identifying with someone's experience
primarily on an emotional level, and can make us feel similarly, which distracts from listening. I feel your pain, I feel your joy.
Safe and successful weight-loss programs should include:
behavioral treatment (lifestyle counseling), info about sleep/stress, and pros/cons of weight loss meds, feedback & support healthy weight loss goals 1-2 lbs per week. a plan for keeping the weight off
Possible risk factors for fibromyalgia include:
being female (twice as likely) Stressful or traumatic events, such as car accidents, post-traumatic stress disorder (PTSD). Repetitive injuries, viral infections, family history, obesity.
risk factors for arthritis
being overweight/obese, infections, joint injuries active occupations w repetitive movement, smoking
Preaching:
better communication skills are less about your subjective opinion and more about allowing space to consider the experience of the other person.
The coaching process cultivates self-efficacy as the client:
better understands his/her needs, gains self-awareness & insight that supports behavior change, learns from setbacks, develops new resources, and finds new ways to navigate his/her environment.
A heart attack happens when the blood supply to your heart is:
blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
An ischemic stroke occurs when
blood clots or other particles block the blood vessels to the brain. Fatty deposits called plaque can also cause blockages by building up in the blood vessels. most common type of stroke
Some research suggests that practicing meditation may reduce
blood pressure, symptoms of irritable bowel syndrome, anxiety and depression, and insomnia.
Mind and body practices focus on the interactions among the
brain, mind, body, and behavior.
When looking at popular free apps related to physical activity, very few of them are _____ ______ and respect the __________ for aerobic activity, strength/resistance training, and flexibility, set forth by the _______
evidence based/guidelines/ACSM
People who have metabolic syndrome often have two other conditions:
excessive blood clotting and constant, low-grade inflammation throughout the body.
Those with sleep apnea may also experience ____ ____ ______ as their sleep is commonly interrupted and may not feel restorative.
excessive daytime sleepiness
For all groups, physical activity reduces the risk of
excessive weight gain and helps people maintain a healthy weight.
empathy is the respectful understanding of another's
experience, including feelings, needs, and desires. i.e. I respect your pain, I celebrate your joy
Goal Review
explore full experience, starting with positive use reflections, expands inquiry about best experience, respond to challenges with reflections/inquiries, affirms client strengths, inquire about percentage of success
coaching program close
explore reasons for stopping, get feedback via a survey, celebrate learning, explore what they'd like to do next, encourage progress and/or check ins, express gratitude
In addition to listening to verbal information shared by the client, the coach is attuned to nonverbal cues which are: The coach also notices:
expression, tone, emotions, and energy. relevant behaviors (or lack thereof).
Anxiety disorders differ from normal feelings of nervousness or anxiousness, and involve excessive
fear or anxiety and are the most common of mental disorders and affect nearly 30 percent of adults at some point in their lives.
Pity is grieving someone's experience and is not helpful because
feeling 'sorry' for someone undermines self esteem and disempowers them. I feel sorry for you
signs that more help might be needed:
feeling sad or depressed for more than two weeks • Not being able to take care of yourself or family • Not being able to do your job or go to school because of your stress • Alcohol or drug use • Thinking about suicide
sympathetic nervous system and stress
flight or fight response, wear and tear on the body if activated a lot
Emotions can generate:
insight and impact the brain's capacity for learning and change.
scope of practice: Coaches assist clients to use their:
insight, personal strengths and resources, goal setting, action steps and accountability toward healthy lifestyle change.
scope of practice. Coaches support clients in mobilizing
internal strengths and external resources, and in developing self-management strategies for making sustainable, healthy lifestyle, behavior changes.
shifting focus reflection vs agreeing with a twist reflection
provide understanding, diffuse discord preface a reframe by agreeing with client first
Progressive relaxation, also called Jacobson relaxation involves:
involves tightening and relaxing various muscle groups. and is often combined with guided imagery and breathing exercises.
low neuroticism and high extraversion are positively associated with: and conscientious individuals have more:
quantity and quality of social ties/stable relationships over time
Risk factors for tobacco use include
race/ethnicity, age, education, and socioeconomic status.
Elicit the client's perspectives including:
reasons for change, solutions, ideas, experiments, desires, reactions, desired outcomes, rewards/incentives
New evidence shows that physical activity has immediate health benefits. It can :
reduce anxiety and blood pressure and improve quality of sleep and insulin sensitivity.
The sponsor is
is the entity (including its representatives) paying for and/or arranging for coaching services to be provided.
If your BMI is less than 18.5, it
is within the underweight range.
A1c Test
measures average blood sugar level over the past 2- 3 months. normal: below 5.7% pre-diabetes: 5.7- 6.4% diabetes:6.5% or above
Systolic blood pressure (first #)
measures the pressure in your arteries when your heart beats.
The second number, called diastolic blood pressure,
measures the pressure in your arteries when your heart rests between beats.
RA can be effectively treated and managed with meds that slow disease and prevent joint deformity, called: along with:
meds: antirheumatic(DMARDs), biological response modifiers (biologicals) and self-management strategies,
Known risk factors for fibromyalgia include:
middle aged, and older having Lupus or Rheumatoid Arthritis.
The coach uses ____ ______ to notice with _____ and _______what is happening with the client and with themselves during coaching.
mindful awareness/curiosity and non-judgment
A central aspect of the Privacy Rule is the principle of "minimum necessary" use and disclosure. A covered entity must make reasonable efforts to use, disclose, and request only the
minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request, and they must implement policies and procedures to reasonably limit uses and disclosures to the minimum necessary.
Physical activity recommendations for adults
moderate intensity: at least 150 min- 300 min (2.5-5 hours) a week vigorous intensity: 75 min- 150 minutes (1.25-2.5 hours a or an equivalent spread throughout the week, along with muscle-strengthening activities of mod intensity and that involve all major muscle groups on 2 or more days a week.
antidepressants might be prescribed to help:
modify one's brain chemistry, and are not habit forming.
When grief and depression co-exist, the grief is
more severe and lasts longer than grief without depression.
Individually identifiable health information includes many common identifiers such as:
name, address, birth date, Social Security Number
Excessive daytime sleepiness (including episodes of irresistible sleepiness) combined with sudden muscle weakness are the hallmark signs of
narcolepsy
Type 1 diabetes symptoms
nausea, vomiting, or stomach pains. develop in just a few weeks or months/ severe usually a child, teen, or young adult but can happen at any age.
Whole grains contain the entire grain kernel which consists of: examples of whole grains include:
the bran, germ, and endosperm. whole-wheat flour, bulgur (cracked wheat), oatmeal, whole cornmeal, and brown rice.
a growth mindset is the belief that:
the client's abilities can be improved continuously through experimentation and persistent efforts.
The coach helps the client develop self-efficacy, which is:
the client's belief in his/her ability to initiate change and achieve goals.
The principal way in which Ai breaks away from traditional problem-solving methods lies in its capacity to shift the attention given to 1, 2 & 3, to developing a deeper and constructive understanding of a person's experience of being human.
under-performance, failure and lack of motivation
Anxiety disorders can cause people to try to avoid situations that
trigger or worsen their symptoms. Job performance, school work and personal relationships can be affected.
patterns related to client behaviors and decision tendencies:
triggers, thoughts, emotions, physical sensations, and environment
the most common psycho-social risk factors for chronic disease are:
unmanaged stress, depression, and social isolation.
When the minimum necessary standard applies to a use or disclosure, a covered entity may not
use, disclose, or request the entire medical record for a particular purpose, unless it can specifically justify the whole record as the amount reasonably needed for the purpose.
symptoms of gestational diabetes
usually shows up in the middle of the pregnancy and typically doesn't have any symptoms. should be tested between 24 and 28 weeks
Help client explore and articulate:
values, sense of meaning, and purpose
lipotoxicity
visceral fat cells release their free fatty acids directly into the portal circulation, which affects the liver and surrounding organs, leading to organ dysfunction
Benefits of physical activity
weight control, life expectancy, improved mood, bone health, lowers risk of falling and risk of major diseases
make requests, not demands (NVC model)
what would you be willing to do/ or would you be willing to...? Using requests respects autonomy.
Avoidance goals
when you seek to avoid a negative outcome, which can too easily set off a pattern of negative thinking. It can also mentally reinforce that which you want the least. Ex: Don't fail that test, Try not to get fired, Avoid junk food
Moralizing
when you start using communication to label things as good or bad, you're at high risk of conflict. Your opinions are valid but so are those of the other person. Make sure you're not simply trying to impart your beliefs onto others.
The basics of a healthy diet, include
whole foods, lean proteins, adequate fiber, healthy fats, and the recommended intake of fruits and vegetables, drinking water, low fat dairy
Approach goals
you seek to attain a desirable or positive outcome, and it lifts your mood. Better for motivation. Ex: Ace that test, Be the superstar at work, eat healthy food
Because your blood pressure tends to rise as you get older,
your risk for high blood pressure increases with age. About 9 out of 10 Americans will develop it sometime during their lifetime.
The risk of having a first stroke is nearly _______ as high for blacks as for whites. Blacks are also more likely to _____from stroke than whites are.
twice, die
There are three main types of diabetes:
type 1, type 2, and gestational diabetes
risk factors for high cholesterol
type 2 diabetes, obesity, familial hypercholesterolemia
Almost 95 percent of people with substance use problems are
unaware of their problem
Things that help reduce the symptoms of depression:
Regular exercise, quality sleep, eating a healthy diet, avoiding alcohol.
Interrogating
Responding to authentic expression with a barrage of questions is a surefire way to make someone feel unseen, unheard, and unwilling to speak up again. Honesty is meant for reflection and validation, not probing and questioning.
if a waist to hip ratio rises above: (men & women) the chance of suffering a heart attack or stroke increases.
man's ratio above 0.95; for women above 0.85.
Self-determination theory posits several universal needs for psychological health and well-being:
autonomy, competence, and connection (relatedness)
Discuss and honor client's preferences for:
self-monitoring, accountability, mode of connecting (email, text, phone call)
One-Upping
"If you think that's bad, wait until you hear what happened to me!" That's not a response anyone wants to hear when they're venting, expressing, or sharing concerns, feelings, and experiences.
LDL (low-density lipoprotein) cholesterol is considered to be:
"bad" cholesterol because it can cause plaque buildup in your arteries,
HDL (high-density lipoprotein) cholesterol is considered to be
"good" cholesterol because higher levels provide some protection against heart disease.
Righting reflex in motivational interviewing refers to wanting to:
"make things right" when we see a problem. MI does not try to make things right and does not persuade, cajole, inform, prod, or in anyway try to change the client's behavior.
Action (stages of change)
'I am taking action for less than 6 mos' focus on strengths & values, increase support , re-frame relapses, strategies to overcome obstacles
Contemplation (stages of change)
'I may change in the next 6 mos' research/thinking rather than action, connect to strengths, increase pros, minimize cons, resolve ambivalence
Maintenance (stages of change)
'I still am taking action for at least 6 months' habit maintain motivation and interest, revisit strengths, values, resources, motivators
Preparation (stages of change)
'I will take action in the next 30 days' help pt create plans, generate commitment, build self efficacy with small wins. co-create solutions & strategies
Pre-contemplation (stages of change)
'I won't or I can't change': not thinking about change in next 6 mos, task: increase awareness and confidence/self efficacy by using empathy & unconditional acceptance, reflections, respect autonomy
A covered entity is permitted, but not required, to use and disclose protected health information, without an individual's authorization, for the following purposes or situations: (6 total) and they may rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make.
(1) To the Individual (2) Treatment, Payment, and Health Care Ops (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure; (5) Public Interest and Benefit Activities; (6) Limited Data Set for the purposes of research, public health or health care operations.
Excess body fat is associated with high levels/low levels of: It also impairs the body's responsiveness to:
(high) LDL ("bad") cholesterol and triglycerides / (low) HDL ("good") cholesterol. insulin, raising blood sugar and insulin levels.
Ethics: Professional conduct at large (6 total)
1.) reporting ethics violations involving me or others, 2.) not discriminating 3.)speak truth about coaching 4.)give others credit for work, claim ownership when appropriate 5.)recognize my own issues that interfere with coaching 6.)conduct research w consent, use contact info of others appropriately (i.e. coaches)
Nonjudgmental reflections ________ the client and inspire___________.
Engage/ learning
Attend to the client's: Acknowledge client's: Ask client to describe: Show: Foster:
1.) state of being (mood/affect/presence) 2.) emotions 3.) emotions when appropriate 4.) empathy (resonance with) 5.) self-compassion
Depression affects an estimated ____ in any given year and ____ people will experience depression at some time in their life.
1 in 15 adults (6.7%) / 1 in 6 people (16.6%)
FINAL SESSION: Invite the client to reflect on Assist in developing a:
:progress made, challenges experienced, lessons learned, and growth attained :sustainable pathway forward and/or maintenance/relapse prevention plan including available support and resources
Dialing 2-1-1 connects people to resources such as: (6 total)
1. Basic Human Needs Resources 2. Physical and Mental Health Resources - Work Support - 3. Access to Services in Non-English Languages - 4. Support for Older Americans and Persons with Disabilities 5. Children, Youth and Family Support - 6. Suicide Prevention
symptoms of a heart attack(myocardial infarction)
1. Chest pain, 2. light headed/nausea, tired 3. Pain or discomfort in the jaw, neck or back 4. Pain or discomfort in the arms or shoulder 5. Shortness of breath
Reframe competencies: (3 total)
1.) Address self-defeating perceptions 2.) Explore patterns related to client behaviors and decision tendencies (e.g., triggers, thoughts, emotions, physical sensations, and environment) 3.) Awareness of self-talk and adjustment as appropriate
Early coaching session (1 or 2) competencies (5 total) Assess Identify Explore/Clarify Establish/Refine Support
1.) Assess current & optimal state of health & well being, 2.) Identify gaps between current & optimal states. 3.) Explore/Clarify priority areas of focus, and learning preferences and accountability 4.) Establish/refine client's specific short term and long-term goals 5.) Support the client in achieving goals, action steps, back up plans
These techniques help narrow the conversation toward decisions, goal-setting, and commitment- all which support action. (5 total)
1.) Closed-ended questions 2.) Interrupt and re-direct 3.) Bottom-lining 4.) Scaling questions (using a scale of 0-10) 5.) Ask the client to summarize the topic
Initial Intake coaching session Describe Review Determine Clarify Allow Confirm
1.) Describe coaching process, 2.) Review info & assessments provided, 3.) Determine if coaching is appropriate. 4.) Clarify roles & expectations; 5.) Allow client to self determine their vision, goals, and action steps; & actively engages in new behaviors. 6.) Confirm logistics and responsibilities in written agreement.
The clinician practices motivational interviewing with five general principles in mind:
1.) Express empathy through reflective listening. 2.) Develop discrepancy between clients' goals or values and their current behavior. 3.) Avoid argument and direct confrontation. 4.) Adjust to client resistance rather than opposing it directly. 5.) Support self-efficacy and optimism.
Expanding the conversation competencies (6 total)
1.) Open-ended & powerful questions 2.) Metaphors- based on client 3.) Brainstorming 4.) Connect the focus to multiple dimensions of client's life 5.)Explore broader perspectives & inspire interest in new possibilities, 6.) Incorporate coach's intuition
Ethics: Professional conduct with clients (8 total)
1.) Speak truth about value of coaching 2.)Clarify scope of practice & outcomes 3.) Ensure clients understand coaching, confidentiality, and other arrangements, $ 4.) Clear coaching agreement (with roles/responsibilities) 5.) clear and culturally sensitive boundaries that govern interactions, physical or otherwise. 6.)Avoid any sexual or romantic relationship including between support staff/clients. 7.) client's right to terminate the coaching relationship at any point during the process 8.)protect the health, safety, and welfare of the client, encouraging changes as necessary with coach/other professionals.
Active listening & Presence Be: Pace communication to: Listen for: Attend to and address: Use silence:
1.) attentive and mindful, open-minded, be curious 2.)fit client's needs, 3.)what is not being said, 4.) nonverbal communication, 5.) appropriately.
Ethics: Conflict of Interest (5 total)
1.) be conscious of any potential conflict, disclose it and remove myself 2.) Clarify roles, set boundaries and review conflicts of interest that may emerge between coaching and other role functions. 3.) Disclose to all clients the coach's role and limits within the org 4.) Disclose anticipated compensation from third parties that I receive for referrals of clients 5.) The quality of coaching services and the quantity of coaching sessions must not be dependent in any way upon the purchase of any additional products or services by the client.
Routine Ongoing Sessions- overview (5 total) Ask about the: Refer to shifts in the Support the client in: Reflect the client's: Closing:
1.) client's current state (e.g., energy, mood); 2.) client's state, facilitate review of previous action steps, 3.) defining new action steps, 4.) understanding, perspectives, and learning. 5.) Closing: the client articulates new personal discoveries.
Open ended questions (starting with what/how) encourage: The coach helps expand the client's:
1.) exploration and highlight strengths, values, and opportunities for learning. 2.) perspective and explores interconnections in the client's life.
Part 3 These health info sources may include: (5 total).
1.) health care provider input 2.) health & wellness assessments 3.) health risk assessments 4.) basic bio-metrics 5.) appropriate referrals.
Wellness, as a concept, includes all aspects of: and it involves:
1.) physical, psychological, spiritual and social well-being; it is multi-dimensional and holistic. 2.) a self-directed and evolving process to achieve full potential.
Ethics: Confidentiality/Privacy
1.)Maintain strictest levels of confidentiality unless release is required by law, 2.)Have clear agreement about how coaching information will be exchanged among parties. 3.)Have a clear agreement about the conditions under which confidentiality may not be maintained (e.g., illegal activity, pursuant to valid court order or subpoena; imminent or likely risk of danger to self or to others; etc.) and inform authorities if appropriate. 4.)Require all those who work with me to adhere to these codes of ethics.
In 2016, more than ____ million Americans reported misusing prescription opioids in the past year.
11.5
Stage 1 hypertension range is (prehypertension)
130-139/or 80-89
Pregnant/postpartum women should do at least
150 minutes (2.5 hours) of moderate-intensity aerobic activity a week and aerobic activity should be spread throughout the week.
Physical activity guidelines for Americans recommends adults do at least
150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity, or a combination of both, along with 2 days of strength training per week.
More than ___ million opioid prescriptions were dispensed to American patients in 2017—with wide variation across states. With ____being the highest state and _____being the lowest state.
191, Alabama, Hawaii
A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as
2 minutes of moderate-intensity activity.
Sleep-disordered breathing (SDB), which includes sleep apnea, is characterized by intermittent airway obstruction or pauses in breathing. People with untreated SDB have______times the risk of heart attack and stroke.
2 to 4 times
Although your brain makes up only____% of your body weight, it uses ______% of the oxygen you breathe.
2, 20
my plate vegetable recommendations
2-3 cups, less for older adults >51 years of age and women
A patient typically receives ECT _____times a week for a total of six to 12 treatments. ECT has been used since the _____, and many years of research have led to major improvements.
2-3, 1940s.
Estimates show smoking increases the risk: For coronary heart disease and stroke by: For people developing lung cancer:
2-4 times/ 25 times
SDB may affect ____-____ percent of older adults and, if left untreated, is associated with a ___-____ fold increased risk of stroke and mortality.
20-40 %, 2-3
Poor sleep health is a common problem with ___% of U.S. adults reporting insufficient sleep or rest at least __out of every __days.
25%, 15/30.
Recurrent stroke is frequent; about ____% of people who recover from their first stroke will have another stroke within _____ years.
25%/ 5
my plate dairy recommendations
3 cups for adults
Nearly ________of all strokes occur in people over the age of 65 and the risk of having a stroke more than _________ each decade after the age of 55.
3/4 , doubles
The risk of developing diabetes is ____ higher for active smokers than nonsmokers.1,2
30-40%
About ______of all Americans have at least ____of 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.1
47% , 1
Tobacco use is the largest preventable cause of death and disease in the United States. Each year, approximately ______Americans die from tobacco-related illnesses. Further, more than ______ Americans suffer from at least one disease caused by smoking.4
480K, 16 million
my plate recommendations for protein
5-6.5 oz, less for older adults and women
my plate oil recommendations
5-7 tsp, less for women and older adults
my plate grain recommendations
5-8 oz, less for older adults and women
Depression is among the most treatable of mental disorders. Between ____to____ % of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.
80 -90
More than ___% of adults and youth do not meet the guidelines for both aerobic and muscle-strengthening activities.
80%
Pre-diabetes
88 million adults—more than 1 in 3—have pre-diabetes. more than 84% of them don't know they have it. blood sugar levels are higher than normal and it raises your risk for type 2 diabetes, heart disease, and stroke.
Demonstrate: Convey: Follow Through on: Openly name and address:
:benevolence, honesty, sincerity, and authenticity :unconditional positive regard :commitments :discord/conflict as it occurs and resolve in a timely manner
Positive reframing is: Positive conversations are:
:looking at things in an alternative, more positive way—to shift perspectives :are more likely to inspire motivation and forward progress.
Client is the expert in: The coach provides:
:navigating his/her own life, based upon personal preferences and past experiences. :the structure of the session and serves as a facilitative partner.
Coronary artery calcium scan
A computed tomography (CT) scan that looks in the coronary arteries for calcium buildup and plaque.
Metabolic Risk Factors: you must have three of these five metabolic risk factors to be diagnosed with metabolic syndrome.
A large waistline. A high triglyceride level A low HDL cholesterol level High blood pressure High fasting blood sugar
Neighborhood and Built Environment key issues:
Access to healthy food, Crime and Violence Environmental Conditions, Quality of Housing
abstract vs concrete goals
Abstract goals aren't motivating and they don't provide much guidance when faced with daily decisions. Rather than using a vague phrase, get as specific as possible to create concrete goals.
Health and Health Care key issues:
Access to Health Care, primary care, Health Literacy
Factors negatively associated with adult physical activity include
Advancing age, Low income Lack of time, Low motivation Rural residency, Perception of great effort needed Overweight/obesity, Perception of poor health Being disabled
People who have obesity are at increased risk for many serious diseases and health conditions, including
All-causes of death, hypertension, dyslipidemia Type 2 diabetes, CAD Stroke, gallbladder disease OA, sleep apnea, breathing issues Many types of cancers , Low quality of life Mental illness, Body pain and difficulty with physical functioning
Motivational interviewing is a counseling style based on the following assumptions:
Ambivalence about change is normal, and can be resolved by working with the client's intrinsic motivations and values. Collaborative partnership. An empathic, supportive, yet directive, counseling style provides conditions under which change can occur.
A mentor is
An individual who conducts coaching skills performance audits and provides feedback to coaching students/coaches for the purpose of developing and enhancing health and wellness coaching skills.
Faculty is
An individual who provides primary instruction/training to students enrolled in an NBHWC-approved coach training program.
four types of client resistance:
Arguing, interrupting, denying, ignoring
NBHWC Pledge of Ethics:
As a Health and Wellness coach, I acknowledge and agree to honor my ethical and legal obligations to my coaching clients and sponsors, colleagues, and to the public at large. I pledge to comply with the NBHWC Code of Ethics and to practice these standards with those whom I coach, teach, mentor or supervise.
Economic Stability Key issues
Employment, Food Insecurity Housing Instability, Poverty
oral glucose tolerance (OGTT) ranges:
At 2 hours, a blood sugar level of normal: 140 mg/dL or less pre-diabetes: 140 to 199 diabetes: 200 + mg/dL
treatment for anxiety includes
CBT (Cognitive Behavioral Therapy), meds, talk therapy
BMI will give you, while your waist measurement will give you:
BMI the best estimate of your total body fatness, best estimate of your visceral fat and risk of obesity-related disease.
ways of evaluating obesity include:
BMI, waist to hip ration, waist circumference
Sleep hygiene tips:
Be consistent, Make your bedroom quiet, dark, relaxing, and a comfortable temperature Remove electronic devices, get some exercise Avoid large meals, caffeine, and alcohol before bedtime
In general, for a person to be diagnosed with an anxiety disorder, the fear or anxiety must:
Be out of proportion to the situation or age inappropriate and hinder your ability to function normally
Self Efficacy
Belief in the possibility of change is an important motivator. The client is responsible for choosing and carrying out personal change. There is hope in the range of alternative approaches available.
Discover (AI):
Best experience, core values, generative conditions, hopes/dreams for the future. most important phase, elevates self-confidence
Factors that contribute to mental health problems, include:
Biological factors, such as genes or brain chemistry Life experiences, such as trauma or abuse Family history of mental health problems
Type 2 diabetes
Body doesn't use insulin well. 90-95% of people with diabetes have type 2. slowly develops, usually adults no symptoms, get blood sugar tested can be prevented/delayed with losing weight, eating healthy food, and being active.
When you do self-disclose it should be:
Brief, to the point of the discussion and relevant to the client. Always, always tie it back to the client's experience immediately.
Offering solutions:
By immediately offering solutions, you're not only telling them to move on, you're also implying they're not mature or intelligent enough to make the right decisions on their own.
Cardiac catheterization
Checks the inside of arteries for blockage by inserting a thin, flexible tube through an artery in the groin, arm, or neck to reach the heart. measures blood pressure and the strength of blood flow, and blood samples are collected and/or dye is injected into the coronary arteries.
Social and Community Context key issues:
Civic Participation, Discrimination Incarceration, Social Cohesion
Client's: Share personal info/experience/recommendations only when: Observe, name, and refer to client's: Convey the belief that client is: Adjust approach according to:
Client's agenda, needs, interests, and preferences drive the relationship. appropriate or when specifically asked/given permission to do so :beliefs and values. :resourceful, expert in own experience. :client's health literacy
Ethics: Continuing development
Commit to the need for continued and ongoing development of my professional skills.
Osteoarthritis (OA) is the most ______ form of arthritis. Some people also call it ____ ____ _____ or "wear and tear" arthritis. It occurs most frequently in the ____, ____, & ______.
Common/degenerative joint disease/hands, hips, and knees.
Genetics:
Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
Environmental factors:
Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
communication roadblock: making judgments
Criticizing, name-calling, diagnosing, or even praising someone can make negative impacts on your ability to communicate.
Some illnesses/drugs lead to weight gain/obesity. These include
Cushing's disease, and polycystic ovary syndrome. Drugs such as steroids and some antidepressants may also cause weight gain.
signs of discord: 4 total
Defending, Squaring off, Interrupting, Disengagement.
The 5D model of AI includes:
Define, Discover, Dream, Design, Destiny.
developing discrepancy:
Developing awareness of consequences helps clients examine their behavior. A discrepancy between present behavior and important goals motivates change. The client should present the arguments for change.
behaviors that increase risk of high cholesterol: non Hdl cholesterol is:
Diets high in saturated fat, being inactive, smoking total cholesterol minus hdl cholesterol
Biochemistry:
Differences in certain chemicals in the brain may contribute to symptoms of depression.
The purpose of goal setting:
Directive, energizing, persistence, affect action, increases self-efficacy
Some resources for Immediate Help for stress
Disaster Distress Helpline, National Suicide Prevention Lifeline, Youth Mental Health Line, Child-Help USA
Education: Key issues:
Early Childhood Education and Development Enrollment in Higher Education High School Graduation Language and Literacy
What behaviors increase the risk of heart disease?
Eating a diet high in saturated fats, trans fat, and cholesterol, inactivity, smoking, drinking
Early warning signs of mental health problems (physical)
Eating or sleeping too much/too little low/no energy Feeling numb, unexplained aches and pains Smoking, drinking, or using drugs Inability to perform daily tasks
Social determinants of health-5 key areas.
Economic Stability, Education Social and Community Health and Health Care Neighborhood and Built Environment
CAD is diagnosed using the following tests
Electrocardiogram(ECG, EKG) Echocardiogram, exercise stress test, chest x-ray,cardiac catheterization, coronary angiogram, Coronary artery calcium scan
Type 1 diabetes risk factors
Family history: direct relations with Type 1 Age: any age, but more likely as a child, teen. whites are more likely to develop type 1 diabetes than African Americans and Hispanic/Latino Americans.
Early warning signs of mental health problems (feelings/mental)
Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared, ruminating, hearing voices, Drama with friends/family, severe mood swings Thinking of harming yourself or others social isolation, Feeling helpless/ hopeless
Adequate sleep is necessary to:
Fight off infection Support the metabolism of sugar to prevent diabetes Perform well, work effectively and safely.
Diet for diabetes
Fruits and vegetables Lean meats and plant-based sources of protein Less added sugar Less processed foods
Acting F.A.S.T. Is Key for Stroke and stands for:
F—Face: Ask the person to smile. Does one side of the face droop? A—Arms: Ask the person to raise both arms. Does one arm drift downward? S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange? T—Time: If you see any of these signs, call 9-1-1 right away.
managing RA and improving quality of life (5 total)
Get physically active. Go to effective physical activity programs. Join a self-management education class. Stop Smoking. Maintain a Healthy Weight.
Goal Setting Theory
Goals need to be specific, challenging, accepted and used to evaluate performance, Feedback must be provided on goal attainment; Deadlines and a learning goal orientation leads to higher performance, group/individual goals are important
sleep disorders and chronic short sleep are associated with an increased risk of:
Heart disease, high blood pressure, depression Obesity, diabetes, All-cause mortality
self-esteem, grief vs depression.
In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
Your body needs more water when you are:
In hot climates, More physically active, Running a fever, Having diarrhea or vomiting
actions to end tobacco use:
Increasing the price, controlling access of tobacco products Enacting smoke-free policies Expanding cessation treatment anti-tobacco media campaigns funded tobacco control programs Reducing advertising and promotion directed at children
risk factors for OA (Osteoarthritis) 6 total are:
Joint injury or overuse— Being older, female, obese, family history not asian
Water helps your body:
Keep your temperature normal, Lubricate and cushion joints, Protect your spinal cord and other sensitive tissues, Get rid of wastes through urination, perspiration, and bowel movements
Social factors thought to influence diet include:
Knowledge, attitude, skills, social support Societal and cultural norms Food and agricultural policies Food assistance programs Economic price systems
Make observations (NVC model) not evaluations
Limiting our descriptions to what can be perceived by the 5 senses.
Shaming
Listening with judgment directly impacts your behaviors and responses to this person. Put yourself in their shoes if you feel tempted to impart shame, and try to listen without judgment.
CG or EKG (electrocardiogram):
Measures the electrical activity, rate, and regularity of your heartbeat.
Exercise stress test
Measures your heart rate while you walk on a treadmill. This helps to determine how well your heart is working when it has to pump more blood.
The most common treatment for stroke is:
Medication or drug therapy: anti-thrombotics and thrombolytics
Fibromyalgia is treated with
Meds, exercise, patient education, Stress management, improving sleep, and CBT for depression
Men and waist circumference risk
Men risk: low 37 in. mod: 37.1-39.9, high 40 and above
The most common drugs involved in prescription opioid overdose deaths include:
Methadone, Oxycodone (such as OxyContin®) Hydrocodone (such as Vicodin®) and Benzodiazepines: alprazolam (Xanax®), diazepam (Valium®), and lorazepam (Ativan®).
Rolling with Resistance:
Momentum can be used to good advantage. Perceptions can be shifted. New perspectives are invited but not imposed. The client is a valuable resource in finding solutions to problems.
Coronary angiogram
Monitors blockage and flow of blood through the coronary arteries. Uses X-rays to detect dye injected via cardiac catheterization.
Complications of fibromyalgia
More hospitalizations (2x likely), Lower quality of life. Higher rates of major depression. (3x likely) Higher rates of suicide and injuries. Often co-occurs with other types of arthritis.
Identify needs, not strategies (NVC model)
Needs represent our values, wants, desires, and preferences for a happier/meaningful experience as a human and are universal, i.e. competence, connection, and safety.
Nonviolent communication model
Observations, feelings, needs, requests. All actions are motivated by attempts to meet needs.
Risks for CAD (Coronary Artery Disease)
Overweight, physical inactivity, unhealthy eating, and smoking tobacco, family history of heart disease, especially a family history of having heart disease below 50 years of age
Stroke and ethnicity
POCs are more likely to have a stroke than whites or Asians.
The most common symptoms of fibromyalgia are
Pain and stiffness, Fatigue and tiredness. Depression and anxiety, Sleep problems. Problems with thinking, memory, and concentration. Headaches, including migraines.
Signs and symptoms of RA include:
Pain or aching/stiffness/tenderness/swelling in more than one joint, similar symptoms on both sides of the body , Weight loss, fever, fatigue, tiredness, weakness.
signs and symptoms of OA(Osteoarthritis)
Pain, aching, stiffness, swelling decreased range of motion
Guided imagery
People are taught to focus on pleasant images to replace negative or stressful feelings. Can be self-directed, a recording, or led by a teacher.
Personality:
People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
Cardiac rehab includes:
Physical activity Education about healthy living, healthy eating, taking meds as prescribed, support with quitting smoking Counseling to relieve stress and improve mental health
prescription opioids can have a number of side effects, even when taken as directed:
Physical dependence, Increased sensitivity to pain, Constipation, Nausea, vomiting, and dry mouth Sleepiness and dizziness, Confusion, Depression lower sex drive, Itching and sweating
The poetic principle (from AI)
Positive anticipation of the future STEMS from : Positive FOCUS on the PRESENT base of pyramid or level 1
The Simultaneity Principle (from AI)
Positive conversations and interactions STEM from: Positive INQUIRY & reflections, level 3 of pyramid
The Constructionist Principle (from AI)
Positive energy and emotions STEMS from: Positive CONVERSATIONS & interactions , level 4 of pyramid
The Anticipatory Principle (from AI)
Positive inquiry STEMS from: Positive ANTICIPATION of the future , level 2 of pyramid
Factors positively associated with adult physical activity include:
Postsecondary education, Higher income Enjoyment of exercise, Expectation of benefits Belief in ability to exercise (self-efficacy) History of activity in adulthood Social support , Access to and satisfaction with facilities Enjoyable scenery, Safe neighborhoods
complications of RA
Premature heart disease, obesity, employment
Abnormalities in the neurotransmitter dopamine have often been associated with
RLS (Restless leg syndrome)
random blood sugar test
Random, no fast. diabetes: 200 mg/dL or higher
Avoiding Concerns
Similarly to the impact of simply trying to problem-solve, diverting or utilizing logic in response to someone's concerns can be invalidating.
Types of Reflections
Simple, Double-sided, amplified, feeling, and meaning
coping with anxiety disorders:
Stress management techniques, meditation, support groups, Learning more about it, avoiding caffeine, taking meds
physical activity levels are positively affected by:
Structural environments, such as the availability of sidewalks, bike lanes, trails, and parks Legislative policies that improve access to facilities that support physical activity
signs and symptoms of stroke (5)
Sudden: numbness/weakness in face, arm, or leg, especially on one side of the body confusion, trouble speaking, difficulty understanding speech trouble seeing in one or both eyes trouble walking, dizziness, loss of balance, or lack of coordination, severe headache with no known cause
Threatening
Threatening that you'll implement some kind of consequence if they don't do what you suggest makes you appear controlling.
Other symptoms of fibromyalgia include:
Tingling or numbness in hands and feet. Pain in the face or jaw, Digestive problems
To do physical activity safely and reduce risk of injuries and other adverse events, people should:
Understand the risks Choose appropriate physical activity Increase physical activity gradually over time Protect themselves by using appropriate gear/equip f/u with a provider if they have chronic conditions
Diabetes symptoms
Urinate frequently, Are very thirsty Lose weight without trying, very hungry blurry vision, feel very tired, numb or tingling hands or feet, very dry skin, sores that heal slowly more infections than usual
Echocardiogram
Uses ultrasound to create a picture of the heart.
Define (AI):
What is the topic of inquiry? (topic choice/method choice)
Abdominal obesity, using waist to hip ratio.
With abdomen relaxed, measure waist at the navel. Next, measure hips at their widest point. divide your waist size by your hip size: Waist (in inches) / Hips (in inches) = ratio
Women and waist circumference risk
Women risk: low 31.5 , mod: 31.6-34.9 , high 35 and above
Great coaching framework
You have what it takes to succeed my certainty is greater than your doubt speak the truth in love AI to handle self sabotage coach the client/environment stay in positive frame trial & correction acknowledge success
A hemorrhagic stroke occurs when
a blood vessel bursts in the brain. Blood builds up and damages surrounding brain tissue.
The coach facilitates a conversation that balances
a client's exploratory thinking with action oriented focus.
The coach's primary role does NOT include:
a content expert or educator who diagnoses, advises, or instructs the client on what to do.
When the coach notices a discrepancy in the client's words, emotions, or behavior, a _______ __________ reflection
a double sided/may raise the client's awareness of the discrepancy.
Fear is an emotional response to an immediate threat and is more associated with
a fight or flight reaction - either staying to fight or leaving to escape danger.
There are two ways to de-identify information; either:
a formal determination by a qualified statistician; or the removal of specified identifiers of the individual and their relatives, household members, and employers is required, and is adequate only if the covered entity has no actual knowledge that the remaining information could be used to identify the individual.
To calculate BMI:
a person's weight in kilograms divided by the square of height in meters. kg/m(squared)
In self-hypnosis programs, people are taught to produce the relaxation response when prompted by
a phrase or nonverbal cue, i.e. 'suggestion'.
most types of meditation have four elements in common:
a quiet location, comfortable posture, a focus of attention, and an open attitude
Squaring off is:
a signal that the client feels like he or she is in an adversarial relationship with the coach. Typically, squaring off statements come in the form of "you" statements, such as: "You don't understand," "You don't know what it's like to be me" or "You are wrong."
A conflict of interest is
a situation in which a coach has a private or personal interest sufficient to appear to influence the objective of his or her professional role or responsibilities as a coach, faculty, or mentor.
older adults should do multi-component physical activity that includes:
balance training as well as aerobic and muscle-strengthening activities and should be as physically active as their abilities and conditions allow.
Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect
a wide range of health, functioning, and quality-of-life outcomes and risks.
HDL (high-density lipoprotein), or "good" cholesterol,
absorbs cholesterol and carries it back to the liver, which flushes it from the body. High levels of HDL can lower your risk for heart disease and stroke.
Reflections convey _______ ____________ and give clients the powerful ___________ to __________ the sound of their own words, perspectives, and beliefs.
active listening/ opportunity/ witness
stress hormones include:
adrenaline, noradrenaline, and cortisol
My plate fruit recommendations
adults: 2 cups generally, unless female > 30 years of age, then 1.5 cups
When the coach uses an _____________ reflection, the client may reconsider aspects of ___________________ when they hear the ______________ reflection.
amplified/ resistance/exaggerated
When someone perceives a situation to be challenging, threatening, or uncontrollable, the brain initiates a cascade of events involving the hypothalamic-pituitary-adrenal (HPA) axis. This ultimately results in:
an increase in the production of steroid hormones called glucocorticoids, which include cortisol, often referred to as the "stress hormone".
Identifying information alone, such as personal names, residential addresses, or phone numbers, would not necessarily be designated as PHI. If such information was listed with health condition, health care provision or payment data, such as
an indication that the individual was treated at a certain clinic, then this information would be PHI.
Restless Legs Syndrome (RLS) is characterized by
an unpleasant "creeping" sensation, and is often associated with aches and pains throughout the legs.
Anxiety refers to
anticipation of a future concern and is more associated with muscle tension and avoidance behavior.
session close
appreciates client's work, reflects what client learned, asks for feedback on coaching, schedules next session
High blood pressure can also causes strokes, which happen when
arteries that supply blood and oxygen to the brain burst or are blocked. Brain cells die during a stroke because they do not get enough oxygen.
goal setting
ask client to choose a goal, explores support needed to ensure success, refine goal to be SMART, use confidence ruler, client restates goal, affirm client's ability to achieve goals
session opening
ask how the client is, use reflections. Ask positive inquiry about previous week, reflect something positive, ask client to select goal to review
Prevent or manage hypertension (high blood pressure)
at least 150 minutes of physical activity each week Not smoking, Eating a healthy diet, limit salt/alcohol healthy weight, manage/lower stress
Type 1 diabetes:
autoimmune reaction- body doesn't make insulin. 5-10% of people have type 1 symptoms develop quickly diagnosed in children, teens, young adults take insulin every day no way to prevent this type of diabetes
Low-impact aerobic activities do not put stress on the joints and include
brisk walking, cycling, swimming, water aerobics, light gardening, group exercise classes, and dancing.
Heart failure is a condition that means your heart:
can't pump enough blood and oxygen to your other organs.
Tobacco use causes:
cancer, heart disease, stroke, lung diseases, reproductive effects, eye issues, arthritis, impaired immune function, overall diminished health.
Self-efficacy refers to an individual's belief in their
capacity to execute behaviors necessary to produce specific performance attainments Self-efficacy reflects confidence in the ability to exert control over one's own motivation, behavior, and social environment.
Most refined grains are enriched which means
certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing.
Resistance is a signal to and offers opportunities for:
change direction, listen more carefully, or respond in a new way; expressing empathy and encouraging the client to talk and stay involved.
change talk vs sustain talk:
change talk: "any self-expressed language that is an argument for change" sustain talk as "the person's own arguments for not changing, for sustaining the status quo"
Angina is and is the:
chest pain and discomfort, most common symptom of CAD.
Routine Ongoing Sessions general order:
client self assesses state goal review topic of importance short term smart goals new action steps take-aways appreciating client's work feedback on coaching
NBHWC scope of practice: coaches work with individuals and groups in a:
client-centered process to facilitate and empower the client to develop and achieve self-determined goals related to health and wellness.
A common disability that results from stroke is: A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis.
complete paralysis on one side of the body, called hemiplegia. A less debilitating one is hemiparesis or one-sided weakness.
Without sleep health education, individuals often prioritize other activities over sleep and accept
constant sleepiness and sleep disruption as inevitable.
By definition, health and wellness coaches are not: and do not:
content experts in health or disease/ diagnose or prescribe, unless a coach has credentials in another profession that allow expert advice to be given.
Women who habitually engaged in vigorous-intensity aerobic activity or who were physically active before pregnancy can
continue these activities during pregnancy and the postpartum period.
It may be effective to treat sleep apnea with gentle air pressure typically in the form of a
continuous positive airway pressure device (CPAP)
Common and well-studied conditions associated with chronic inflammation include:
coronary artery disease, diabetes, obesity, arthritis, cancer, and Alzheimer Disease.
Destiny (AI) is:
creating 'what will be', fulfilling their destiny, elevating positive energy and makes being appreciative the norm
Positive psychology has demonstrated the value of positive resources in improving:
creativity, open-mindedness, strategic thinking, resilience, connection, and health.
The coach helps the client develop positive psychological resources by
cultivating meaning, reflecting positive emotions, applying strengths, and affirming self-worth and efforts.
The coach helps the client expand possibilities by asking
curious questions that evoke deeper thinking and self-reflection.
Defending is when a client begins to:
deflect blame ("It's not my fault"), minimizes the situation ("It's no big deal") or justifies decisions ("This just makes the most sense"). People become defensive when they feel threatened.
For adults physical activity also reduces the risk of:
dementia* (including Alzheimer's disease*), Early death, CAD, Stroke, High blood pressure Type 2 diabetes, Falls, Depression
Design (AI) is:
determining 'what should be', in terms of habits, systems, roles, relationships, etc, and is detailed and personal. Giving the dream LEGS
Individuals who are at a healthy weight are less likely to:
develop chronic diseases and related risk factors, Experience complications during pregnancy. Die at an earlier age
Adults with diabetes, high blood pressure, or both have a higher risk of
developing chronic kidney disease than those without these conditions.
Health and wellness coaches commit to the same level of professionalism as all health care providers. This includes ongoing
development of skills, staying up-to-date with relevant research, and following recertification procedures established by NBHWC. Coaches also "walk the talk" and model healthy behavior skills, particularly prioritizing self-care.
Gestational diabetes
develops in pregnant women your baby could be at higher risk for health problems. Gestational diabetes goes away after your baby is born but increases your risk for type 2 diabetes later in life. Your baby is more likely to have obesity as a child or teen, and more likely to develop type 2 diabetes later in life too.
People who are overweight or obese are more likely to have
diabetes, heart disease, stroke, and some types of cancer, and depression
Scope of practice: While health and wellness coaches per se do not:
diagnose conditions, prescribe treatments, or provide psychological therapeutic interventions, they may provide expert guidance in areas in which they hold active, nationally recognized credentials, and may offer resources from nationally recognized authorities such as those referenced in NBHWC's Content Outline with Resources.
Stress and bowels:
diarrhea, constipation, muscle spasms, digestion, weakens intestinal barrier
Refined grains have been milled, a process that removes the bran and germ. This is done to give grains a finer texture and improve their shelf life, but it also removes: examples include:
dietary fiber, iron, and many B vitamins. white flour, de-germed cornmeal, white bread, and white rice.
MI: Motivation for change is enhanced when clients perceive ___________ between their current situation and their hopes for the future. Your task is to help focus your client's attention on how current behavior_______from ideal or desired behavior.
discrepancies/differs
Humans are wired for social connection. Without social ties,
distress emerges and health fails. In this sense, social connection seems to be a biological imperative.
If you have diabetes, your body either:
doesn't make enough insulin or can't use it well, which leads to too much blood sugar in your bloodstream.
RLS: Healthcare providers often combine a medication to help correct the underlying
dopamine abnormality along with a med to promote sleep continuity
glucose screening test
drink a liquid that contains glucose, test one hour later: normal: 140 mg/dL or less. higher than 140 mg/dL, requires a glucose tolerance test
Depression can strike at any time, but on average, first appears: and _____ are more likely than ___ to experience depression. Some studies show that _____ of women will experience a major depressive episode in their lifetime.
during the late teens to mid-20s, women/men, 1/3
conditions under which confidentiality may not be maintained
e.g., illegal activity, pursuant to valid court order or subpoena; imminent or likely risk of danger to self or to others
Biofeedback techniques measure body functions and give you information about them so that you can learn to control them. Biofeedback-assisted relaxation use
electronic devices to teach you to produce changes in your body that are associated with relaxation, such as reduced muscle tension.
The coach builds trust by attending to the client's
emotions as well as words and behaviors; i.e., when the coach senses conflict, discomfort or confusion, the coach acknowledges what is happening with curious interest.
The Privacy Rule excludes from protected health information:
employment records that an entity maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act.
Active listening refers to a pattern of listening that keeps you
engaged with your conversation partner in a positive way. It is the process of listening attentively while someone else speaks, paraphrasing and reflecting back what is said, and withholding judgment and advice.
Women are _______as likely as men to develop high blood pressure at some point during their lives.
equally
For adults, physical activity helps prevents 8 types of cancer:
esophagus, lung, breast, stomach, kidney, bladder, endometrium, colon
Decisional balance helps the client
evaluate pros and cons of changing or not changing a behavior
Persons with sleep apnea characteristically make periodic
gasping or "snorting" noises, during which their sleep is momentarily interrupted.
behavior change strategies that are absent in most fitness technology include
goal setting, environmental restructuring, attitude adjustment, barrier identification, and social support
many free smartphone apps lack strategies like
goal setting, self-monitoring, rewards, social support, and coaching
Stage 2 Hypertension range is:
greater than or equal to 140/90
At their best, health & wellness visions are
grounded, bold, desired, palpable, and participatory
Metabolic syndrome is the name for a
group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.
High blood pressure can damage your arteries by
hardening them, decreasing blood flow, and making your heart work harder
Gestational diabetes risk factors
has had it before Birth to baby 9 lbs +, overweight 25+ years of age family history of type 2 diabetes Have polycystic ovary syndrome (PCOS) POC
High blood pressure
has no warning signs or symptoms, and many people do not know they have it. Measuring your blood pressure is the only way to know whether you have high blood pressure.
Individuals who are fearful of pain and re-injury, and who seek only a physical cause and cure for the injury, generally :
have a worse recovery than individuals who maintain a certain level of moderate, physician-supervised activity.
Fitness tracker apps expensive vs. free
have more behavior change elements, not always accurate if worn on wrist, great w steps, but can make errors with older adults who walk slower.
Having high blood pressure, especially in midlife, is linked to
having poorer cognitive function and dementia later in life.
Social ties influence health in part through
health behavior, and this influence plays out across the life course.
scope of practice: As partners and facilitators, health and wellness coaches support their clients in achieving
health goals and behavioral change based on their clients' own goals and consistent with treatment plans as prescribed by individual clients' professional health care providers.
Among older adults, the cognitive and medical consequences of untreated sleep disorders decrease
health-related quality of life, contribute to functional limitations and loss of independence, and are associated with an increased risk of death from any cause.
beneficial stress mgmt strategies include:
healthy social support network, regular exercise, adequate sleep
chronic inflammation is a common factor in most chronic diseases. Whereas acute inflammation is a ______ response to injury, chronic inflammation causes ________ over time.
healthy/problems
How stress affects the esophagus:
heart burn, acid reflux, spasms, difficulty swallowing, or increased air intake: gas, burping, bloating
Over time, too much blood sugar in your bloodstream can cause serious health problems such as:
heart disease, vision loss, and kidney disease.
High blood pressure can damage the following organs:
heart, brain, kidneys, and eyes.
Mexican Americans have the __________ rate of metabolic syndrome, followed by _______ & _________.
highest/whites/blacks
Improving self-efficacy requires eliciting and supporting
hope, optimism, and the feasibility of accomplishing change. This requires you to recognize the client's strengths and bring these to the forefront whenever possible.
High blood pressure is called: and it increases risk for:
hypertension heart disease, heart attack, and stroke, kidney disease and TIA
What health conditions increase the risk of heart disease?
hypertension, hyperlipidemia, diabetes, obesity
Generative moment
identify topic, ask permission to explore, client describes what they want, explore strengths, environments to move forward, including pros/cons, develop discrepancy, brainstorming, express confidence in client's ability to move forward
Part 1. An objective of coaching is for the client to be well-informed of the status of his/her health and well-being. This process begins with:
identifying what the client understands.
Dream (AI) is:
imagining 'what could be', using both left and right brain. exploring pt's Calling, excitement, positive core
chronic stress can result in impaired communication between the: and has been linked to the future development of conditions like:
immune system and the HPA axis/ chronic fatigue, metabolic disorders, depression, and immune disorders.
For those who develop chronic pain conditions, stress-relieving activities have been shown to
improve mood and daily function.
If you have arthritis, participating in joint-friendly physical activity can
improve your arthritis pain, function, mood, and quality of life.
In grief, painful feelings come: In major depression, mood and/or interest (pleasure) are decreased
in waves, often intermixed with positive memories of the deceased/ for most of two weeks.
chronic stress and cardiovascular system
increased heart rate, stress hormones, increased blood pressure, i.e. (flight or fight response)
Black people and high blood pressure
increased likelihood compared to other groups of people and happens earlier in life.
Your risk for metabolic syndrome_______with age.
increases
Risk factors for RA
increases w age, high in adults 60's, 2-3 x higher in women. people born with genes called HLA smoking, never giving birth, mom smoked, low income, being obese
Meditation is a mind and body practice that has a long history of use for
increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being.
OA is treated
increasing exercise, physical therapy, weight loss Meds, OTC pain relievers, crutches/canes, surgery
Dissonance can also be evoked when: An example that has received research attention is meat eating, which may evoke dissonance because
individuals engage in other behaviors that might be inconsistent with their values or moral concerns. eating meat is inconsistent with having concern for the welfare for animals.
RA commonly affects joints in the hands, wrists, and knees. In a joint with RA, the lining of the joint becomes
inflamed, causing damage to joint tissue. This damage can cause long-lasting or chronic pain, unsteadiness, and deformity
Diagnosis and effective treatments, particularly treatment to suppress or control
inflammation, can help reduce the damaging effects of RA.
anti-inflammatory diet, moderate exercise, and effective stress management are thought to be central in preventing
inflammatory disease.
If your BMI is 18.5 to 24.9
it is within the normal or Healthy Weight range.
If your BMI is 30.0 or higher
it is within the obese range.
If your BMI is 25.0 to 29.9
it is within the overweight range.
Flaws of BMI
it may inaccurately reflect body fat in adults who have lost substantial amounts of muscle mass. It reflects total body fat without regard to how the fat is distributed.
High blood pressure is called the "silent killer" because
it usually has no warning signs or symptoms, and many people do not know they have it.
Brainstorming is more effective when:
it's bold, visual, and lots of ideas are generated, it's fast, specific clarify topic/output
Older adults may have additional factors that keep them from being physically active, including
lack of social support, lack of transportation to facilities, fear of injury, and cost of programs.
Fitness technology has the potential to revolutionize physical activity research, allowing
large-scale interventions to be conducted that gather real-time data about activity levels, sleep, and nutrition across the globe
The coach's confidence in the client's ability to______, ________, &________ supports the client's_________.
learn, grow, and change / self-efficacy.
A normal blood pressure level is
less than 120/80 mmHg.1
preventing type 2 diabetes
losing 5-7% of your body weight. getting 150 minutes a week of physical activity
sex drive/fertility and stress for women:
low libido, PMS, difficult menses, increased infertility, depression, anxiety
sex drive/fertility and stress for men:
low libido, erectile dysfunction, impotence, sperm health
Statins are a group of medicines that can help lower the level of
low-density lipoprotein (LDL) cholesterol in the blood.
Women who have breastfed their infants have a ______risk of developing RA.
lower
LDL (low-density lipoprotein), sometimes called "bad" cholesterol,
makes up most of your body's cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.
12 roadblocks to communication
making judgements, offering solutions, avoiding concerns, preaching, commanding, moralizing, threatening, one-upping, shaming, interpreting, interrogating, kidding
Your waistline/circumference may be telling you that you have a higher risk of developing obesity-related conditions if you are:
male and more than 40 in. A non-pregnant woman, more than 35 in.
Excessive abdominal fat may be serious because it places you at greater risk for developing
obesity-related conditions like: Type 2 Diabetes, high blood pressure, and CAD
Anti inflammatory foods include:
olive oil, fruits, vegetables, nuts, fatty fish, citrus
Autonomy is a person's ability to act
on one's own values and interests.
Fasting blood sugar test
overnight fast normal: below 99 mg/dL prediabetes: 100 to 125 diabetes: 126 mg/dL or more
Fibromyalgia is a condition that causes:
pain all over the body, sleep problems, fatigue, and often emotional and mental distress, and increased pain sensitivity. (abnormal pain perception processing)
Stress can affect this brain-gut communication, and may trigger:
pain, bloating, and other gut discomfort and it affects the microbiome which can alter mood/emotion.
Termination Stage of change
people have no desire to return to their unhealthy behaviors and are sure they will not relapse and have maintained behavior for at least 2 years
the goal of coaching is to encourage
personal responsibility, reflective thinking, self-discovery, and self-efficacy.
Obesity is a complex health issue resulting from a combination of causes and individual factors such as behavior and genetics. Factors include
physical activity and inactivity, dietary patterns, meds, food and physical activity environment, education and skills, and food marketing and promotion.
In autogenic training, you learn to concentrate on the
physical sensations of warmth, heaviness, and relaxation in different parts of your body.
The six dimensions of wellness are (Hettler):
physical, intellectual, emotional, occupational, social, spiritual
"Holding space" means being ____, ____, &______present for someone.
physically, mentally, and emotionally. putting your focus on someone to support them as they feel their feelings. and managing judgment while you are present
Foods that cause inflammation and should be limited in an anti-inflammatory diet include:
refined carbohydrates, fried foods, soda sweetened beverages, red meat, processed meat margarine, shortening, and lard
The coach _________the client's ________and asks ________-__________questions to enhance the client's _______-_________ and foster new ________________.
reflects/views/open-ended/ self-awareness/ perspectives.
the coach helps the client to build a support system, which is:
relationships, tools, resources, environments that enable ongoing success after the coaching program ends and developing supportive relationships
Coach prep for session- overview (prior to session prep)
review materials, eliminate distractions, be mindful calm, and present.
RA is diagnosed by
reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests.
The coach should be able to identify
risk factors for chronic disease, commonly used biometric measures, and current lifestyle recommendations for optimizing health.
individuals who are low on conscientiousness ("prudent, planful, persistent, dependable) or high on hostility engage in more:
risky health behavior
Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include
safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins.
Healthy diets limit the intake of
saturated and trans fats, cholesterol, added sugars, sodium (salt), and alcohol.
Body Mass Index (BMI) and waist circumference are:
screening tools to estimate weight status in relation to potential disease risk.
Benzodiazepines are central nervous system depressants used to:
sedate, induce sleep, prevent seizures, and relieve anxiety.
Health care providers may treat chronic insomnia with a combination of
sedative-hypnotic or sedating antidepressant medications, along with behavioral techniques
domains of Emotional Intelligence
self-awareness, self-management, social awareness, relationship management
The coach encourages the client to foster: and harsh self criticism tends to lead to:
self-compassion and acceptance of emotions, since these qualities allow a more honest appraisal of one's behaviors and better self-care./ avoidance and undermines insight.
The coach facilitates behavior change by empowering the client to:
self-discover values, resources, and strategies that are individualized and meaningful.
Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for patients with_____ and it involves _____.
severe major depression or bipolar disorder who have not responded to other treatments/a brief electrical stimulation of the brain while the patient is under anesthesia.
Stress and strong emotions can present with respiratory symptoms, such as
shortness of breath and rapid breathing, and asthma attacks.
Active listening involves using _________ appropriately to _____ ___ _____ and allowing clients time to _____, _______, and _______what emerges.
silence/ "hold the space" / reflect, process, and identify
The coach supports the client in choosing goals and action steps carefully, since ______ and ________ successes predict long-term _________.
small/ gradual/engagement.
The effects of substance abuse are cumulative, significantly contributing to costly
social, physical, mental, and public health problems.
Social determinants for health-related issues include
socioeconomic status, transportation, housing, access to services, discrimination by social grouping, and social or work-related stressors.
Express feelings, (not thoughts) NVC model
some feelings masquerade as thoughts, i.e. I feel like a failure, useless, inadequate, etc. not helpful
the student is
someone enrolled in an NBHWC-approved coach training program or working with an NBHWC-approved faculty member or coach mentor, in order to learn the coaching process or to develop and enhance his /her coaching skills.
Stroke can cause serious disabilities in _____, _____, and other basic ________. And a stroke can also _____you.
speech, movement,activities/ kill
The healthcare provider may treat narcolepsy with
stimulant medications and behavioral interventions, such as regularly scheduled naps,
Stroke treatments work best when
stroke is recognized diagnosed w/in 3 hours of the first symptom
abdominal fat comes in two different forms:
subcutaneous: fatty tissue just beneath the skin. visceral: Fat inside the abdomen around organs
Interpreting
taking the approach of "you're just saying this because you're feeling guilty about what happened yesterday," is a major communication barrier and one you're conversation partner is not likely to get over quickly. Don't try to interpret and explain their actions to them as if you are their therapist.
Stress affects the musculoskeletal system by causing chronic muscle tension. Some examples are:
tension-type headache and migraine headache , low back pain and upper extremity pain.
BMI can be used as a screening tool but is not diagnostic of
the body fatness or health of an individual.
"Individually identifiable health information" is information, including demographic data, that relates to:
the individual's physical or mental health or condition, the provision of health care to the individual, or the payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe can be used to identify the individual. (past, present, or future)
During a stressful event, an increase in cortisol can provide the energy required to deal with prolonged or extreme challenge. Cortisol increases :
the level of energy fuel available by mobilizing glucose and fatty acids from the liver.
The 'client' is
the person(s) being coached. (May also be referred to as "coachee," "patient," or "member" in some settings.)
Cognitive behavioral therapy (CBT) has been found to be effective in treating depression and is focused on
the present and problem solving. CBT helps a person to recognize distorted thinking and then change behaviors and thinking.
Blood pressure is
the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.
The knowledge and experience of the client—vs __________, are:
the raw materials for coaching conversations that facilitate lasting change.
Adults with Chronic Health Conditions and Adults with Disabilities should do at least:
the same recommendations for adults for physical activity, but can modify as appropriate for their condition under the care of a doctor.
The HIPAA Security Rule operationalizes the protections contained in the Privacy Rule by addressing:
the technical and non-technical safeguards that organizations called "covered entities" must put in place to secure individuals' "electronic protected health information" (e-PHI).
Studies suggest that regional variation in use of prescription opioids cannot be explained by
the underlying health status of the population.
If stroke symptoms go away after less than 5 min
then it is probably a transient ischemic attack (TIA). or mini stroke,
Ways to maintain positive mental health include:
therapy, social connection, Staying positive, physical activity, helping others, sleep, coping skills
Interrupting may be a sign that the client:
thinks that the trainer or coach is talking too much, does not understand or is not listening.
Desirable cholesterol levels:
total cholesterol: Less than 200 mg/dL of LDL ("bad") : less than 100 mg/dl HDL ("good"): Greater than or equal to 60 mg/dL non HDL cholesterol: less than 130 mg/dl Triglycerides:Less than 150 mg/dL
Adequate sleep is necessary for proper immune, endocrine, and neurological functioning. Lack of sleep is also linked to
traffic accidents, work errors, and decreased productivity
A multidisciplinary approach to promoting physical activity brings about traditional partnerships, such as that of education and health care, with nontraditional partnerships representing:
transportation, urban planning, recreation, environmental health, and other fields.
Psychotherapy, or "talk therapy," is sometimes used alone for: and is often used along with antidepressant medications.
treatment of mild depression; for moderate to severe depression,
Coping with stress after traumatic event
• Follow a normal routine as much as possible. • Take care of yourself. • Talk about your feelings and accept help. • Turn it off and take a break. Get out and help others.
