Natalie Digate Muth, MD, MPH, RD, is the ACE senior consultant for healthcare solutions, a practicing pediatrician and registered dietitian. Recognized as a Certified Obesity Specialist, Natalie has written for more than 50 publications and, in 2012, published her first book, 'Eat Your Vegetables' and Other Mistakes Parents Make: Redefining How to Raise Healthy Eaters.
Coaching Behavior Change: Why Self-monitoring Is a Key Ingredient in Successful Behavior Change
Self-monitoring has long been recognized as critical to success across many areas of behavior change, including weight loss, diabetes and blood pressure control, fitness and athletic performance, and any number of other desired changes. In fact, self-monitoring serves as the most important behavioral strategy for both increasing awareness of current behaviors for people starting out on a behavior-change journey (which hopefully helps to spark a change in future behaviors) and developing a baseline from which to set goals and monitor progress.
Self-monitoring includes the regular recording of food intake, physical activity and weight in weight-loss programs. It may include blood sugar and blood pressure in the management of chronic diseases, such as diabetes and hypertension, or regular heart-rate monitoring and other physiological parameters in performance training. Historically, most self-monitoring has come in the form of written records and most individuals are pretty lousy at doing it. This is true for many reasons, but especially because it is burdensome. In fact, self-monitoring of dietary intake is particularly effective for people trying to lose weight in that people will eat less just so that they have less food to write down.
Ultimately, how consistently a person tracks key parameters is strongly predictive of whether or not he or she will achieve a goal (Laitner, Minski and Perri, 2016). For example, a person who records dietary intake and exercise minutes and intensity at least three times per week and tracks weight at least once per week is very likely to lose substantial amounts of weight. Thus, if you want your clients to achieve success with any health-related intervention rooted in behavioral change (and spread the success of your program by word of mouth), a solid plan for self-monitoring must be built in.
A Coaching Approach to Support Self-monitoring
Apps, Trackers and Other Devices
Fortunately, with advancing technologies, health and fitness professionals can better support client self-monitoring than in the past when paper and pencil, and possibly an Excel spreadsheet, were the only options (Hutchesson et al., 2016). Direct clients to easy-to-use apps like MyFitnessPal; trackers like FitBit, Jawbone or the Apple Watch; and other devices such as electronic digital scales, as appropriate, to ease the burden of self-monitoring. For a full listing, check out the website www.quantifiedself.com, which includes detailed information about hundreds of apps, trackers and devices that can help track and share any number of behaviors or physiological parameters.
A Nudge and Feedback
While many apps may send clients reminders and provide some degree of feedback on weight, dietary intake and exercise, a more personal reminder from a health and fitness professional can serve as an effective nudge to self-monitor. It can also help the client increase accountability for monitoring and strengthen the client-coach relationship. Automate personal emails and text messages to remind clients to self-monitor and to turn in their self-monitoring journals or reports. Provide some degree of feedback (within one’s scope of practice) to the client. The feedback is important in helping the client increase adherence to self-monitoring. (And the increased self-monitoring is important for the client to achieve his or her goals.)
A Systematic Approach
When providing direction to clients on how best to self-monitor, consider the following parameters for best results:
- Aim to record dietary intake and physical activity at least three days per week, ideally two weekdays and one weekend day. Ask the client to comment on the log and how intake stacks up to goals. Help the client identify areas of strength and areas for improvement. Use the current behaviors as a starting point to establish goals to help close the gap between the present and the client’s overall vision or ideal.
- If a client is trying to lose weight, ask him or her to monitor weight at least one time per week. This helps the client identify patterns of weight gain early on, or provide motivation for continued progress over time. While weight is a significant marker of success in a weight-management program, be sure to remind clients that it is not the only parameter, and that trends in weight are more important than isolated measurements.
- Include a particular focus on self-monitoring in the early stages of behavior change (it is especially critical in the first four weeks), but also keep some degree of self-monitoring throughout, as it is associated with increased success in sustaining the behavior change.
Ultimately, routine monitoring of one’s own behaviors and patterns helps to close the gap between a person’s current reality and the vision, or dream, of what could be. As a health and fitness professional, you can help your clients achieve their “dreams” by teaching them how to develop a solid habit of frequent and continued self-monitoring.
Hutchesson, M.J. et al. (2016). Enhancement of self-monitoring in a web-based weight loss program by extra individualized feedback and reminders: Randomized trial. Journal of Medical Internet Research, 18, 4, e82.
Laitner, M.H., Minski, S.A. and Perri, M.G. (2016). The role of self-monitoring in the maintenance of weight-loss success. Eating Behaviors, 2, 21, 193-197.
Earn an ACE Behavior Change Specialty Certification
No matter how you work with clients and patients, effective coaching can further heighten the impact of your program. As an ACE Behavior Change Specialist, you will possess the knowledge of behavior-change philosophy and emotional intelligence and, most importantly, the practical, hands-on skills to put it to use. Our comprehensive learning experience incorporates expertise from renowned experts and pioneers in psychology and coaching to help you learn how to develop rich, productive relationships and guide people toward sustainable change in one-on-one, group and virtual settings.