WELCOME TO THE INDEPENDENT LIVING RESEARCH UTILIZATION PROJECT.
WEBCAST NO. 3.
OCTOBER 31, 2001
2:00 P.M.


>> LAUREL:  GOOD AFTERNOON.
THIS IS LAUREL RICHARDS WITH ILRU IN HOUSTON.
AND WE'RE WELCOMING YOU TO A PRESENTATION ON THE APPLICATION OF THE CONCEPT OF HEALTH AND WELLNESS AS IT PERTAINS TO PEOPLE WITH DISABILITIES.
AND IT'S SUB TITLED FROM ACADEMIA TO REAL LIFE.
AND I WANT TO FIRST OF ALL THANK NIDRR AND ACKNOWLEDGE THEIR SUPPORT FOR THIS INITIATIVE WHICH IS TO PRESENT OUR RESEARCH FINDINGS TO THOSE OF US WHO ARE NONRESEARCHERS AND WORK IN THE DISABILITY RIGHTS, REHABILITATION AND INDEPENDENT LIVING FIELDS.
WE'RE DOING THIS PROJECT IN ASSOCIATION WITH THE RESEARCH FOR INFORMATION FOR INDEPENDENT LIVING, THE RIIL PROJECT, AND SPECIFICALLY TODAY WITH THE RESEARCH AND TRAINING CENTER ON HEALTH AND WELLNESS AND DISABILITY.
WE'RE GOING TO BE SPENDING ABOUT AN HOUR OR AN HOUR AND A HALF, MAX.
WE'LL BE DONE WITHIN 90 MINUTES ON THIS SUBJECT, AND A COUPLE OF THINGS I WANTED TO BRING YOUR ATTENTION TO.
NO. 1, THROUGHOUT THE PRESENTATION, WE'LL BE ASKING FOR YOU TO -- IF YOU HAVE A COMMENT OR QUESTION TO PLEASE SUBMIT IT AND YOU'LL SEE ON THE SCREEN A SECTION WHERE IT SAYS TO SUBMIT A QUESTION, CLICK HERE OR CLICK ON THE WEBCAST AT ILRU.ORG AND WHEN YOU CLICK ON THAT, YOUR E-MAIL SERVER WILL COME UP AND IT WILL BE PREADDRESSED TO US, AND YOU CAN JUST SUBMIT YOUR QUESTION THAT WAY.

AND THEN YOU CAN -- AND THEN THE QUESTION WILL BE FIELDED BY A PERSON AT ILRU AND POPPED ON CARLA IN REALTIME.

I WANT TO WELCOME YOU TO THIS PRESENTATION.
THE ISSUE OF HEALTH AND WELLNESS IS JUST REAL IMPORTANT TO THOSE OF US WITH DISABILITIES, AND CARLA IS THE PROJECT COORDINATOR OF THE RESEARCH AND TRAINING CENTER ON HEALTH AND WELLNESS, WHICH IS LOCATED AT THE OREGON -- IS IT -- CARLA IS THE SCIENCE -- HEALTH SCIENCES UNIVERSITY
>> CARLA:  YES, HEALTH AND SCIENCES UNIVERSITY.

>> LAUREL:  IN OR DONE, AND SHE OVERSEES -- WELL, COORDINATES THE PROJECTS AND THEY ARE A REMARKABLE RANGE OF RESEARCH PROJECTS THAT ARE EXAMINING THE ISSUES THAT ARE MOST IMPORTANT TO FOLKS WITH DISABILITIES, EVERYTHING FROM ISSUES PERTAINING TO HEALTH AND WELLNESS AND PHYSICAL ACTIVITIES TO HEALTH AND WELLNESS AS IT'S SEEN BY PEOPLE WITH CULTURALLY DIVERSE BACKGROUNDS AS WELL AS HEALTH AND WELLNESS AS PERCEIVED BY FOLKS WITH DISABILITIES.
AND WE'LL BE HAVING PRESENTATIONS LATER ON THIS YEAR OF THE ONE ON PHYSICAL ACTIVITIES AS WELL AS THE PERCEPTION OF HEALTH AND WELLNESS BY PEOPLE WITH DISABILITIES.

SO RIGHT NOW I'M HAPPY TO TURN IT OVER TO CARLA CULLEY AND TO WELCOME HER TO THIS PRESENTATION.
THANK YOU SHALLING CARLA AND IT'S ALL YOURS.

>> CARLA:  OKAY.
WELL, THANKS.
AS LAUREL SAID, I'M CARLA CULLEY AND I'M THE CENTER COORDINATE FOR FOR THE REHABILITATION AND RESEARCH TRAINING CENTER ON HEALTH AND WELLNESS LOCATED IN PORTLAND, OREGON.
AND TODAY I'M GOING TO BE TALKING ABOUT HEALTH AND WELLNESS AND BASICALLY MORE -- I WANT TO START OUT WITH WHAT IS WELLNESS, AND THE OVERVIEW OF THE DIMENSIONS OF WELLNESS AND WHAT THE CONNECTION BETWEEN WELLNESS AND DISABILITY IS, AND THEN MOVE ONTO MORE REAL LIFE APPLICATION, WHAT ARE SOME TIPS THAT PEOPLE CAN USE TO MAKE POSITIVE CHANGES IN THEIR LIVES.
SO THAT'S THE BASIC FORMAT THAT I'M GOING TO GO ON.
AND AS I GO, I'LL BE ASKING FOR QUESTIONS AND WE'LL STOP AND ANSWER AS I GO ALONG.


SO TO START OUT, WHAT IS WELLNESS?
IT'S A WORD THAT'S USED A LOT THESE DAYS AND I'M SURE YOU HEAR IT ALL THE TIME.
IT'S KIND OF A BUZZ WORD ALMOST, AND TRADITIONALLY, HEALTH AND WELLNESS HAVE BEEN THOUGHT OF AS THE MERE ABSENCE OF DISEASE AND DISABILITY, AND THIS IS NOEN AS THE MEDICAL MODEL, AND THE PROBLEM WITH THIS IS THAT IT PROMOTES THE IDEA THAT ONE CANNOT BE WELL WHILE LIVING WITH A DISABILITY.


SO IN RECENT YEARS THERE HAS BEEN NEW THINKING IN THIS AREA AND IT HAS LED TO THE DEVELOPMENT OF NEWER MODELS OF HEALTH AND THERE ARE NUMEROUS DIFFERENT MODELS, AND TODAY I'LL BE TALKING ABOUT MORE OF A GENERAL ONE THAT IS USED IN HEALTH PROMOTION PROGRAMMING AND PLANNING, AND DIFFERENT SORTS OF ARENAS LIKE THAT.

BASICALLY, THE WELLNESS MODEL THAT PEOPLE ADHERE TO TODAY IS THAT IT MOVES BEYOND THAT TRADITIONAL NOTION OF HEALTH AND WELLNESS AS BEING THE MERE ABSENCE OF DISEASE TO THE OPTIONAL FUNCTIONING OF EACH INDIVIDUAL REGARDLESS OF CURRENT HEALTH STATUS OR DISABILITY.

SO BASICALLY WELLNESS IS MORE EXISTING ON A CONTINUED UE UM AND IS UNIQUE TO EACH INDIVIDUAL PERSON.
SO EACH OF US DEFINES OUR OWN WELLNESS.
IT'S HARD TO SAY, YOU KNOW, YOU'RE WELL OR YOU'RE NOT WELL.
THAT'S NOT THE WAY IT WORKS.
IT'S A UNIQUE THING BASED ON OUR INDIVIDUAL CIRCUMSTANCES AS INDIVIDUALS.
AND WELLNESS IN THIS VIEW IS ALSO SEEN AS A HOLISTIC CONCEPT.
IT'S LOOKING AT THE WHOLE PERSON AND NOT JUST AT, SAY, YOUR BLOOD PRESSURE LEVEL OR HOW MUCH YOU WEIGH OR HOW WELL YOU MANAGE YOUR STRESS.
IT'S NOT ONE THING, IT'S ALL OF THESE THINGS CONNECTED.


WELLNESS IS -- INVOLVES SPIRITUAL, THE BODY, THE MIND AND THE CONCEPT DIMENSIONS AND THESE DIFFERENT DIMENSIONS SUCH AS -- I'LL EXPLAIN THEM A LITTLE BIT MORE HERE.
THERE IS A THEORY PUT TOGETHER BY A MAN LAST NAME OF CROSS, AND ACCORDING TO HIM, THE DIMENSIONS -- THE FIRST ONE IS SPIRITUAL THAT I MENTIONED.
IT INVOLVES SEEKING MEANING AND PURPOSE IN ONE'S LIFE AS WELL AS DEVELOPING OUR CREATIVITY.

SO, IN OTHER WORDS, BUILDING THINGS, CREATING THINGS, PAINTING, SOLVING PROBLEMS, PLAYING THE PIANO, ANYTHING USING YOUR CREATIVE SELF OR SPIRITUAL SELF WOULD BE IN THAT DIMENSION OR ARENA OF THE WHOLE SELF, IF THAT MAKES SENSE.
AND THEN ANOTHER ASPECT WOULD BE THE BODY, AND THAT IS ALL PHYSICAL ASPECTS SUCH AS YOUR PHYSICAL CONDITION, YOUR GENDER, YOUR NUTRITION INTAKE, THE FOODS YOU EAT, SUBSTANCE USE AND ABUSE, AND THIS ALSO INCLUDES MEDICAL CARE AND APPROPRIATE USE OF HEALTH CARE AND ACCESS AND THOSE ISSUES.


ANOTHER DIMENSIONS, THE THIRD DIMENSION THAT I MENTIONED WAS THE MIND, AND THAT INCLUDES COGNITIVE PROCESSES SUCH AS YOUR THOUGHTS, MEMORY, KNOWLEDGE, AND THAT TYPE OF THING, ALONG WITH THE EMOTIONAL ASPECTS SUCH AS YOUR FEELINGS, SELF-ESTEEM, AND THIS DIMENSION ENCOURAGES CREATIVE, STIMULATING MENTAL ACTIVITIES AS WELL AS AWARENESS OF YOUR FEELINGS AND, IN OTHER WORDS, THINK OF IT AS YOU'RE MOTION AL WELLNESS AND YOUR INTE LEK UEL WELLNESS COMBINED.


THE FOURTH DIMENSION IS THE CONTEXT AND THIS IS VERY IMPORTANT BECAUSE THIS IS KIND OF A NEWER IDEA, AND THAT IS THAT THE ENVIRONMENT PLAYS A MAJOR ROLE IN OUR HEALTH AND WELLNESS.
IN OTHER WORDS, THE CULTURE THAT WE'RE IN, THE COMMUNITY WE LIVE IN, THE PHYSICAL ENVIRONMENT, AND THEN THE SOCIAL NETWORKS THAT WE DEVELOP ALL AFFECT OUR HEALTH AND WELLNESS.
OUR WORK THAT WE DO, WHETHER IT BE VOLUNTEER WORK, PAID WORK, WHATEVER THAT MIGHT BE ALL AFFECTS OUR WELLNESS.
SO BASICALLY WE CAN THINK OF WELLNESS AS BEING A WEB WITH ALL OF THESE DIFFERENT ASPECTS CONNECTING TOGETHER, AND EACH ONE IS INTERDEPENDENT ON EACH OTHER AND EACH ONE IS IMPORTANT FOR THE WHOLE WELLNESS OF THE INDIVIDUAL.

AND SO IF WE'RE THINKING ALONG THESE LINES OF THIS WELLNESS MODEL, THE BASIC IDEA IS THAT WELLNESS IS HOLISTIC, IT EXISTS ON A CONTINUUM FOR EACH MUCH US AND IS UNIQUE AND DEPENDS ON EACH OF OUR OWN CIRCUMSTANCES AND IT ENCOMPASSES MANY DIMENSIONS AS I JUST -- THE MIND, BODY, SPIRIT AND THE CONTEXTS.
AND I THINK IF WE THINK OF WELLNESS IN THIS WAY, IT HELPS US TO COMBAT THIS MYTH THAT EXISTS, I THINK, TO SOME EXTENT THAT PEOPLE WITH DISABILITIES ARE SICK OR THAT, YOU KNOW, DISABILITY AND WELLNESS ARE MUTUALLY EXCLUSIVE AND CAN'T COEXIST TOGETHER, WHICH IS NOT TRUE.
I THINK THIS NEW MODEL AND THIS NEW WAY OF LOOKING AT HEALTH AND WELLNESS CAN HELP IN COMBATING THIS MYTH AND HELP IN MAYBE ADDRESSING SOME OF THE ATTITUDENAL AND ENVIRONMENTAL BARRIERS THAT CAN BE BUILT UP BY GOING WITH THE OLD MODEL OF, YOU KNOW, YOU'RE NOT WELL IF YOU HAVE A DISABILITY, AND THIS NEW WAY OF LOOKING AT THINGS CAN HELP IN FOSTERING A MORE POSITIVE LOOK ON THAT.


SO WITH THAT, I KNOW THAT WAS A LOT OF INFORMATION.
IS THERE ANY QUESTIONS SO FAR ON THAT THAT WE HAVE?

>> RACHEL:  CARL LASHINGS WE HAVE TWO QUESTIONS THAT RELATE SO FAR.
ONE IS GOING BACK TO -- YOU MENTIONED THE THEORY ABOUT IT WAS EITHER FROM CROSS OR CROFT, CAN YOU SPELL THAT PERSON'S NAME AND THE PERSON ASKING THE QUESTION WANTS TO KNOW WHERE THEY CAN READ ABOUT HIS THEORY?
AND I'LL ALSO JUST INTERJECT THAT CARLA IS GOING TO BE AVAILABLE AFTER THIS WEBCAST FOR TWO WEEKS ON OUR DISCUSSION BOARD AND IT'S A LIST SERVE, AND SO SHE WILL BE AVAILABLE TO ANSWER QUESTIONS AND POST ADDITIONAL INFORMATION THERE.
SO, CARLA, I DON'T KNOW IF YOU HAVE THIS AVAILABLE OR IF IT'S SOMETHING YOU'RE GOING TO REFER PEOPLE TO.

>> CARLA:  RIGHT, IT IS CROSS, C-R-O-S-S-, AND IT'S FROM 95 AND I CAN PUT THE WHOLE CITATION UP ON THE BOARD THAT YOU'RE TALKING ABOUT.
THAT WOULD BE THE EASIEST WAY TO DO IT AND IT'S ACROSS CULTURAL MODEL OF RESILIENCE AND WELL-BEING IS WHAT HE CALLS IT.
I CAN PUT IT UP LATER, THE ENTIRE CITATION AND WHERE TO FIND IT AND EVERYTHING.

>> RACHEL:  OKAY, THAT WILL BE GREAT.
THERE IS SOME INTEREST IN THAT.

>> CARLA:  SURE.

>> RACHEL:  AND THEN THE OTHER QUESTION HAS TO DO WITH YOUR EE TALKING ABOUT THE DEFINITION OF WELLNESS SPECIFICALLY FOR PEOPLE WITH DISABILITIES AND SO WHAT YOU'RE TALKING ABOUT TODAY, WILL IT APPLY TO PEOPLE WITHOUT DISABILITIES AS WELL OR IS WELLNESS DIFFERENT FOR PEOPLE WHO ARE LIVING WITH DISABILITIES THAN PEOPLE WHO ARE NOT LIVING WITH DISABILITIES?

>> CARLA:  THAT'S AN EXCELLENT QUESTION.
REALLY, THE WELLNESS -- THE WAY I'M DESCRIBING IT IS DESCRIBING IT FOR EVERY ONE, AND THE MAIN FOR PEOPLE WITH DISABILITIES ARE PEOPLE NOT LIVING WITH DISABILITIES, THE MAIN POINT AND SOMETHING I REALLY WANT TO GET ACROSS IS THAT IT IS UNIQUE.
WELLNESS IS UNIQUE TO EACH INDIVIDUAL AND THEIR OWN INDIVIDUAL CIRCUMSTANCES.
SO THE THINGS WE'RE GOING TO BE TALKING ABOUT ARE APPLICABLE TO BOTH.
DOES THAT ANSWER THE QUESTION?

>> RACHEL:  YES, I THINK THAT DOES AND I JUST WANT TO TELL PEOPLE WE HAVE GOTTEN A COUPLE OF INQUIRIES HERE FOR TECHNICAL ASSISTANCE.
IF YOU'RE TRYING TO E-MAIL IN, YOU CAN EITHER JUST E-MAIL TO WEBCAST AT ILRU.ORG, OR ON THE PAGE THAT DIRECTED YOU TO THE WEBCAST, YOU CAN GO TO STEP 2 AND IT WILL TELL YOU TO CLICK THERE TO GO AHEAD AND E-MAIL IN.
SO I HOPE THAT HELPS SOME OF THE OTHER FOLKS.

OKAY, CARLA, BACK TO YOU.

>> LAUREL:  CARLA, I'VE GOT A QUESTION RELATED TO THE CONCEPT OF HEALTH AND WELLNESS.
IN THE CONTINUUM OF RESEARCH THAT'S BEEN CONDUCTED ON THIS WHOLE CONCEPT OF WELLNESS, WHEN DID IT SHIFT FROM BEING ABSENCE OF SICKNESS OR ABSENCE OF ILLNESS TO THIS NEW PARADIGM OF THE FIVE DOMAINS?

>> CARLA:  WELL, ACTUALLY THE CONCEPT OF WELLNESS ITSELF IS RELATIVELY NEW, AND, YOU KNOW, I DON'T REALLY KNOW.
I CAN'T SAY A CERTAIN YEAR, BUT I KNOW IT'S PRETTY NEW AND IT'S BEEN A SLOW SHIFT OVER, AND ACTUALLY IT'S NOT EVEN COMPLETELY SHIFTED OVER.
A LOT OF PEOPLE ARE STILL USING THE OLD MEDICAL MODEL VIEW IN SOME CASES, BUT IT HAS CHANGED AND THEN WELLNESS AS IT -- FOR PEOPLE LIVING WITH DISABILITIES IS EVEN MORE NEW.
AND SO IT'S JUST SOMETHING I WOULD SAY WITHIN RECENT YEARS THAT IT'S BEING MORE RECOGNIZED, THE IMPORTANCE OF HEALTHS AND WELLNESS AND THE IMPORTANCE OF PREVENTION AND THE WHOLE CONCEPT ITSELF.

>> LAUREL:  OKAY, THANK YOU.

>> CARLA:  SURE.
OKAY, WELL, NOW THAT WE'VE TALKED ABOUT THE THEORY OF WELLNESS AND MORE THE ACADEMIC TYPE OF THING, I WANT TO TALK MORE ABOUT HOW -- HOW TO SUPPLY -- YOU KNOW, WHAT DOES ALL THIS MEAN?

AND THE FIRST QUESTION THAT I ALWAYS GET, AND I'VE DONE A LOT OF COUNSELING AND WHAT WE CALL LIFE COACHING WITH INDIVIDUALS WHO WANT TO MAKE BEHAVIOR CHANGES, WHO WANT TO, YOU KNOW, CHANGE SOMETHING ABOUT THEIR WELLNESS, SOMETHING IN ONE OF THOSE DIMENSIONS I JUST TALKED ABOUT, SO THE QUESTION IS HOW DO I GET STARTED?
HOW DO I GET MOTIVATED TO CHANGE?
I MIGHT KNOW THAT I WANT TO, SAY, EAT BETTER, BUT WHERE DO I GO?
HOW DO I DO THAT?
SO I THOUGHT A GOOD THING TO DO TODAY IS TO TALK ABOUT SOME TIPS THAT I'VE PUT TOGETHER ON BUILDING MOTIVATION TO MAKE CHANGES.
AND I THINK IT'S ONE -- IT SHOULD BE ON THE SITE.
IT'S CALL THE TEN TIPS TO BUILDING MOTIVATION TO CHANGE.
IT WAS A HANDOUT.
SO WHAT I'M GOING TO DO IS GO OVER THIS IN A LITTLE BIT MORE DETAIL AND, AGAIN, I'LL BE STOPPING AND WAITING FOR QUESTIONS AS WELL.


SO THE FIRST THING IS -- ON THIS HANDOUT IS, NO. 1, CHOOSE A TARGET BEHAVIOR AND BASICALLY THIS IS JUST GETTING STARTED.
AND THIS IS A QUOTE THAT I HAD AND I'M NOT SURE WHO SAID IT, THE QUOTE IS THERE ARE ONLY TWO WAYS TO FAIL AT ANYTHING YOU DO, QUIT OR DON'T START.
AND I'VE ALWAYS LIKED THAT BECAUSE IT'S SO TRUE.
A LOT OF TIMES WE SAY WE WANT TO DO ALL THESE THINGS TO BE HEALTHIER, BUT YET WE NEVER QUITE GET THE BALL GOING.
AND I THINK ONE OF THE MAIN THINGS THAT I HAVE SEEN WHY THAT HAPPENS IS THAT PEOPLE TEND TO TAKE ON MORE THAN ONE THING AT ONCE.
THEY SAY -- A NEW YEAR'S RESOLUTIONS ARE GOOD EXAMPLES.
PEOPLE SAY I'M GOING TO BECOME HEALTHY THIS YEAR.
WELL, THAT'S GOOD, BUT WITH YOUR SAYING IN GENERAL HEALTHY, WHAT DOES THAT MEAN?
SO IT'S IMPORTANT TO FIGURE OUT ONE BEHAVIOR THAT YOU WANT TO CHANGE, AND IT SHOULD BE SOMETHING THAT YOU'RE HIGHLY MOTIVATED TO CHANGE, ESPECIALLY IF YOU HAVEN'T REALLY DONE A LOT OF CHANGING -- YOU KNOW, CHANGED A LOT OF YOUR BEHAVIORS AND YOU'RE KIND OF GETTING STARTED WITH THIS WHOLE THING.
I THINK IT'S IMPORTANT TO PICK SOMETHING THAT'S EASY OR EASIER I SHOULD SAY TO CHANGE AND SOMETHING THAT'S SPECIFIC.
SO, IN OTHER WORDS, INSTEAD OF SAYING I'M GOING TO BE HEALTHIER, YOU WANT TO NARROW THAT DOWN A LITTLE BIT.
WHAT IS SOMETHING YOU CAN DO?
WHAT IS ONE THING YOU CAN DO?
BECAUSE IF YOU START OUT WITH SMALLER THINGS, AND YOU BUILD ON THAT, THAT'S HOW YOU BUILD YOUR CONFIDENCE AND THAT'S HOW YOU CAN MAKE THE BIGGER CHANGES IN THE LONG RUN.


AND SO THAT'S KIND OF THE -- I USED THE WORD TARGET BEHAVIOR.
YOU WANT TO TARGET IN ON ONE THING TO START WITH.

AND THEN NO. 2 I HAVE GATHER INFORMATION ABOUT YOUR TARGET BEHAVIOR.
BASICALLY, WHAT I'M TALKING ABOUT HERE IS YOU WANT TO LOOK AT WHATEVER IT IS YOU WANT TO CHANGE.
SAY YOU WANT TO -- YOU REALIZE THAT YOU'RE NOT DRINKING ENOUGH WATER, SAY, AND YOU WANT TO DRINK MORE.
SO WHAT YOU NEED -- WHAT YOU CAN DO IS LOOK AT WHY DO YOU WANT TO DRINK MORE WATER?
HOW WOULD THAT AFFECT YOUR LEVEL OF WELLNESS?
WHAT WOULD THIS -- HOW WOULD THIS HELP YOU?
IN OTHER WORDS, WHAT BENEFITS ARE YOU GOING TO GET FROM DRINKING MORE WATER?
AND LIST THOSE UP, SAY, OKAY, I'M NOT GOING TO BE AS DEHYDRATED, AND NOT BEING AS DEHYDRATED, MAYBE I'M GOING TO HAVE MORE ENERGY.
IT'S BETTER FOR MY SKIN.
IT'S BETTER FOR URINARY TRACT INFECTIONS.
IT'S BETTER FOR -- ALL THESE REASONS WHY DRINKING LOTS OF WATER IS GOOD FOR YOU.
LIST THEM OUT AND POST THOSE UP SOMEWHERE WHERE YOU CAN SEE THEM, AND IT'S AMAZING, IT'S JUST A LITTLE REMINDER TO YOURSELF OF WHY IT'S IMPORTANT TO DO WHATEVER IT IS YOU WANT TO DO AND IT HELPS IN BUILDING MOTIVATION.

THE THIRD THING I HAD DOWN, AND AFTER WE GO THROUGH THIS ONE I'LL ASK FOR SOME QUESTIONS, IS SETTING SMART GOALS, WHICH WAS ANOTHER HANDOUT ON THE SITE.
AND BASICALLY WHAT I'M TALKING ABOUT IS SETTING GOALS, SO YOU'RE GOING -- THIS IS REALLY THE PART THAT'S REALLY CRITICAL, AND IT KIND OF GOES BACK TO CHOOSING A TARGET BEHAVIOR AND THAT TYPE OF THING AS I SAID BEFORE, BECAUSE WHEN YOU SET GOALS THAT ARE TOO LARGE AND TOO GRANDIOSE AND TOO BIG, YOU'RE SETTING YOURSELF UP TO FAIL.
AND WHEN YOU SET YOURSELF UP TO FAIL AND YOU KEEP FAILING, THEN OFTEN YOU GET FRUSTRATED AND THAT'S WHEN YOU DON'T WANT TO DO ANYTHING ANYMORE ANY WAY.

SO SMART GOALS STANDS FOR SPECIFIC, MEASURABLE, ATTAINABLE, REALISTIC, AND TIMEBOUND.

SPECIFIC, I HAVE AN EXAMPLE DOWN I WILL WALK FOR 20 MINUTES THREE TIMES A WEEK INSTEAD OF I WILL EXERCISE MORE THIS WEEK.
SO, IN OTHER WORDS, IF YOU'RE GOING TO SET A GOAL, YOU NEED TO BE SPECIFIC IN WHAT YOU'RE GOING TO DO.
SO SAY ANOTHER EXAMPLE WOULD BE WITH THE WATER.
WE CAN GO BACK TO THAT.
I WILL DRINK -- INSTEAD OF SAYING I WILL DRINK MORE WATER, YOU WOULD SAY I'M GOING TO DRINK FIVE GLASSES OF WATER PER DAY THIS WEEK.
YOU KNOW, SO IT'S JUST BEING MORE SPECIFIC AND EXACT OF WHAT YOU'RE GOING TO DO RATHER THAN A GENERAL STATEMENT.

THE SECOND THING, MEASURABLE, YOU'RE GOING TO WANT TO KNOW -- KEEP A MEASURE OF HOW YOU'RE DOING.
SO THEN YOU CAN LOOK BACK AND SEE YOUR PROGRESS AND IT CAN BE VERY REWARDING TO HAVE A MEASURE OF HOW YOU'RE DOING.
ONE EASY WAY TO DO THIS IS IF YOU HAVE A CALENDAR, EACH DAY ON YOUR CALENDAR MARK, YOU KNOW, I'LL JUST GO BACK TO SAY YOU WANT TO INCREASE YOUR WATER INTAKE.
YOU WOULD PUT HOW MANY GLASSES OF WATER YOU HAD EVERY DAY, AND THEN YOU CAN SEE OVER TIME WHERE YOU'RE INCREASING AND THE OTHER THING IS IF YOU'RE POSTING THAT IN A PLACE WHERE YOU CAN SEE IT AND OTHER PEOPLE CAN SEE IT, THAT ALSO KEEPS YOU ACCOUNTABLE, AND THERE IS JUST SOMETHING ABOUT HAVING TO WRITE IT DOWN AND KEEP RECORD THAT HELPS IN BUILDING MOTIVATION.

THE THIRD THING, YOUR GOAL SHOULD BE ATTAINABLE, AND THE FOURTH BE REALISTIC.
THESE ARE SORT OF RELATED IN THAT IT SHOULD BE SOMETHING THAT YOU CAN DO.
YOU HAVE TO BE REALISTIC.
IT'S NOT -- I THINK A LOT OF TIMES PEOPLE WOULD SAY I'LL USE FRUITS AND VEGETABLES FOR EXAMPLE BECAUSE A LOT OF PEOPLE -- I HAVE SEEN, THAT'S ALWAYS A THING WITH PEOPLE, THEY WANT TO EAT MORE FRESH FRUITS AND VEGETABLES FOR THEIR DIET.
NOW I EAT NONE OR I EAT ONE SERVING A DAY, AND THEN I SAY, OH, I'M GOING TO EAT, YOU KNOW, I'M GOING TO EAT TEN NOW.
I'M GOING TO EAT TEN SERVINGS A DAY.
WELL, ARE YOU REALLY GOING TO DO THAT?
IS THAT REALLY SOMETHING?
ARE YOU BEING REALISTIC, SOMETHING YOU'RE GOING TO COME MRISH?
AND YOU'VE JUST GOT TO THINK ON THOSE TYPE OF TERMS.


THE LAST THING, TIMEBOUND, IS THAT HAVE A START DATE AND A COMPLETE DATE.
AND THE REASON I SAY THAT IS, SAY, BY FOUR WEEKS FROM NOW I'M GOING TO BE UP TO FIVE GLASSES OF WATER A DAY, OR THAT TYPE OF THING.
IT'S BECAUSE THEN YOU HAVE AN ENDING DATE AND YOU KNOW YOU'VE ACCOMPLISHED WHAT YOU WANT TO ACCOMPLISH AND YOU GET THAT SENSE.
BECAUSE IF IT'S JUST INDEFINITE, THEN IT JUST KIND OF GOES ON AND ON AND YOU CAN LOSE MOTIVATION AS YOU GO.
SO WHEN YOU'RE SETTING YOUR GOALS, IT'S IMPORTANT TO SET REALISTIC AND ATTAINABLE GOALS AND HAVE IT BE TIMEBOUND.
SO WHAT YOU WANT TO DO IS -- IS HAVE YOUR GENERAL GOAL, MORE WATER.
BREAK THAT DOWN INTO, OKAY, I'M GOING TO BE REALISTIC, I'M NOT GOING TO GO FROM NO GLASSES OF WATER PER DAY TO 8 GLASSES THAT ARE RECOMMENDED A DAY.
SO WHAT I'M GOING TO START OUT WITH IS THIS WEEK I'M GOING TO DRINK, SAY, TWO GLASSES PER DAY, AND THEN MAYBE NEXT WEEK I'M GOING TO ADD AND I'M GOING TO HAVE THREE GLASSES PER DAY AND THEN MAYBE THE NEXT WEEK, YOU KNOW, THAT TYPE OF THING AND SLOW INCREMENTS YOU WANT TO KIND OF BUILD UP AND THEN SO YOU KNOW AT THE END OF THE FIRST WEEK, YEAH, THIS WEEK I DIDN'T HAVE MY FIVE OR MY EIGHT GLASSES A DAY, BUT I DID HAVE TWO, WHICH IS BETTER THAN BEFORE.
SO YOU WANT TO HAVE AN ENDING DATE SO YOU KNOW THAT YOU'VE ACCOMPLISHED AS YOU'RE GOING ALONG TO REACH THE ULTIMATE GOAL OF WHATEVER IT IS THAT YOU'RE WANTING TO DO.

SO I WILL SEE IF THERE ARE ANY QUESTIONS ON THIS RIGHT NOW.

>> RACHEL:  OKAY, YES, I THINK WE HAVE FOUR QUESTIONS.
I THINK AT LEAST THREE OF THEM DEFINITELY RELATE TO WHAT YOU'VE JUST BEEN TALKING ABOUT.
TWO OF THEM HAVE TO DO WITH EXERCISE.
THE FIRST ONE IS I KNOW THAT EXERCISE IS GOOD FOR ME, BUT IT'S REALLY HARD BECAUSE OF MY DISABILITY.
I HAVEN'T HAD GOOD LUCK WITH CLASSES OR GYM AND I NEED SOME IDEAS ABOUT EXERCISE THAT I CAN DO WITH MY DISABILITY.
CAN YOU HELP?

>> CARLA:  THAT'S A GOOD QUESTION, AND THAT IS SOMETHING THAT IS -- I'VE BEEN HEARING A LOT OF, AND I KNOW THAT WE NEED MUCH MORE -- I MEAN MUCH MORE RESEARCH IN THIS AREA DEPENDING ON WHAT THE DISABILITY IS FOR EACH INDIVIDUAL AND IT'S A QUESTION THAT'S ASKED OVER AND OVER AND OVER AGAIN, ALONG WITH ACCESS TO GYMS AND THINGS LIKE THAT.

I WOULD SUGGEST THAT YOU TRY GOING TO YOUR HEALTH CARE PROVIDERS.
I WOULD SUGGEST AND SEEING WHAT THEY KNOW, WHAT IS SPECIFIC FOR YOU BECAUSE I CAN'T REALLY SAY WHAT, YOU KNOW, SPECIFIC EXERCISES THAT YOU SHOULD DO.

I WOULD GO FROM THERE AND TRY AND FIND REFERRALS FROM THEM IF THEY DON'T KNOW.
IF YOUR PROVIDER DOESN'T KNOW, IT'S IMPORTANT TO BECOME A STRONG ADVOCATE FOR YOURSELF AND FIND OUT WHERE YOU CAN FIND OUT AND ASK THEM, AND JUST KEEP ASKING UNTIL WE CAN FIND THE ANSWERS FOR YOU.


>> LAUREL:  CARLA, I'VE GOT A -- EXCUSE NEED -- THE RESEARCH AND TRAINING CENTER'S PROJECTS ON PHYSICAL ACTIVITIES, I'M TRYING TO RECOLLECT IF -- I KNOW THEY ARE COLLECTING DATA FROM PEOPLE WITH DISABILITIES ON DIFFERENT KINDS OF -- I DON'T KNOW IF IT'S JUST EXERCISE OR ACTUAL PHYSICAL ACTIVITIES, AND I KNOW THAT THEY'RE GOING TO HAVE SOME OF THE PRELIMINARY FINDINGS READY SOON.
DO YOU KNOW IF ANY OF IT ADDRESSES -- CAN BE PARTICULARIZED TO DIFFERENT DISABILITY TYPES?

>> CARLA:  YOU KNOW, I KNOW THAT A LOT OF THE INFORMATION FROM THAT IS GOING TO BE MORE ON PROMOTING HEALTH WELLNESS AND KIND OF THE BARRIERS AND THAT TYPE OF THING, BUT THERE MAY BE SOME MORE INFORMATION IN THERE; BUT I HAVE BEEN SEEING OVER AND OVER AGAIN THAT THERE NEEDS TO BE MORE RESEARCH AND THERE NEEDS TO BE MORE AWARENESS AND MORE INFORMATION FOR PEOPLE LIVING WITH DISABILITIES ON THIS EXACT TOPIC.

>> LAUREL:  BOY, THAT'S TRUE.
BY THE WAY, ANOTHER RESOURCE IS THE -- I KNOW THAT RSA FUNDS SOME RECREATIONAL PROGRAMS RELATING TO FOLKS WITH DISABILITIES, AND I ASSUME THAT ON THE RSA WEB SITE THERE MAY BE CONTACT INFORMATION FOR THESE PROJECTS AND ONE WOULD ASSUME THAT THEY WOULD -- IF NOT ADDRESS THE QUESTIONER'S SPECIFIC DISABILITY TYPE, ONE WOULD ASSUME THEY CAN MAKE A GOOD REFERRAL.

>> CARLA:  RIGHT.
THAT'S A GOOD -- YEAH.
SO IT'S THE RSA WEB SITE.

>> LAUREL:  YEAH.

>> CARLA:  WE CAN GET PEOPLE HOOKED UP WITH.

>> LAUREL:  AND ON YOUR BOARD THAT'S GOING TO BE SET UP, WE'LL HAVE THE ADDRESS THERE.

>> CARLA:  OH, GOOD.

>> LAUREL:  OR GOOGLE WILL HAVE IT.

>> CARLA:  AND I KNOW ALSO JUST TO INFORM PEOPLE WHO ARE SENDING IN QUESTIONS, IF YOU'RE A LITTLE MORE SPECIFIC THEN WE MIGHT BE ABLE TO HOOK YOU UP WITH SOME SPECIFIC RESOURCES BECAUSE IN THIS CASE WE'RE NOT SURE WHAT KIND OF DISABILITY THIS PERSON HAS, BUT YOU MIGHT WANT TO -- SOME DISABILITY SPECIFIC ORGANIZATIONS LIKE THE ARTHRITIS FOUNDATION, FOR EXAMPLE, ACTUALLY SPONSORS AND THEY HOLD THEIR OWN EXERCISE PROGRAMS FOR PEOPLE WITH THAT KIND OF DISABILITY.
SO THAT'S ANOTHER IDEA.

OKAY, WE HAVE ANOTHER QUESTION THAT'S RELATED TO EXERCISE.
IT SAYS WHERE CAN I FIND INFORMATION ABOUT THE BENEFITS OF EXERCISE?
I THINK I HEARD ONCE ON A NEWS CAST OR SOMETHING IT WOULD LENGTH ENMY LIFE SPAN BY SEVERAL YEARS, I THINK IF I KNEW SOME SPECIFIC LIKES THAT I'D BE REALLY MOTIVATED.

>> CARLA:  OH, THAT'S A GOOD QUESTION, TOO.
THERE ARE SO MANY BENEFITS TO EXERCISE, BUT IT SOUNDS LIKE THIS PERSON WANTS SOMETHING SPECIFIC.
THEY WANT THE EXACT.
OFF THE TOP OF MY HEAD, I CAN'T GIVE AN EXACT WEB SITE BUT I KNOW THERE ARE LOTS OF PLACES YOU CAN GO TO FIND OUT THE BENEFITS, YOU KNOW.
IN GENERAL, I KNOW, YOU KNOW, IT'S GOOD FOR CARDIOVASCULAR FITNESS, DECREASING BLOOD PRESSURE AND CONTROLLING CHOLESTEROL.
IT'S GOOD FOR DIABETES MANAGEMENT, WEIGHT MANAGEMENT, WHICH HAS ALL THE BENEFITS THAT GO ALONG WITH THAT.

AGAIN, WHAT I CAN DO, IF YOU'RE LOOKING FOR SOMETHING SPECIFIC, LIKE MORE SPECIFIC LIKE A LIST OF HERE IS WHAT EXERCISE CAN BE GOOD FOR YOU, I CAN DEFINITELY PUT SOMETHING LIKE THAT TOGETHER AND POST THAT AS WELL IF THAT WOULD BE HELPFUL.

>> RACHEL:  THAT SOUNDS LIKE IT WOULD BE FROM THIS WAY THIS QUESTION IS PHRASED.
OKAY, GREAT.
OKAY, I HAVE ONE MORE QUESTION THAT KIND OF RELATES TO WHAT WE'VE BEEN TALKING ABOUT HERE.
IT SAYS, CARLA, WHAT IDEAS DO YOU HAVE FOR HOUSE SERVICES PROGRAMS WHERE PEOPLE CAN DO A BETTER JOB OF HELPING ME BE HEALTHY AND/OR WELL LIKE HEALTH PROVIDERS?

>> CARLA:  WHAT WAS IT AGAIN?

>> RACHEL:  THEY SEEM TO BE ASKING ARE THERE THINGS THAT THEY CAN TALK TO THEIR HEALTH CARE PROVIDERS ABOUT HOW CAN THEY HELP THEIR HEALTH CARE PROVIDER REALLY HELP THEM DO A BETTER JOB BEING HEALTHY AND WELL?

>> CARLA:  HOW CAN THEY HELP THEIR HEALTH CARE PROVIDER HELP THEM DO A BETTER JOB?

>> RACHEL:  THEY WOULD LIKE THEIR HEALTH CARE PROVIDER BE MORE INVOLVED AND WHAT CAN THEY EXPECT OR WHAT COULD THE HEALTH PROVIDER DO?

>> CARLA:  I THINK THE IMPORTANT THING AND WHAT I ALLUDED TO BEFORE WAS BEING A STRONG ADVOCATE FOR ONE'S SELF, AND THAT IS GOING IN AND DISCUSSING WITH YOUR HEALTH CARE PROVIDER WHAT YOUR SPECIFIC NEEDS ARE, AND HOW THEY CAN HELP YOU OR WHAT YOU'RE LOOKING FOR AND COMMUNICATE WITH THEM ON WHAT SPECIFICALLY YOU'RE LOOKING FOR, DEPENDING ON WHAT IT IS.
BECAUSE THEY -- AS WE ALL KNOW, THEY HAVE A TENDENCY TO BE VERY BUSY.
THEY HAVE A TENDENCY TO NOT ALWAYS HAVE A LOT OF TIME TO SPEND AND I THINK IT'S IMPORTANT IF YOU CAN GO IN AND HAVE -- EVEN WRITE DOWN WHAT YOU WANT AND GIVE IT TO THEM OR HAVE A CLEAR SET OF QUESTIONS OUT THAT YOU'RE GOING TO WANT FROM YOUR HEALTH CARE PROVIDER AND TRY AND WORK WITH THEM AND ASK FOR REFERRAL, YOU KNOW, TO SOMEONE ELSE IF THEY DON'T KNOW.
I WOULD START THERE BASICALLY.


>> RACHEL:  AND ALSO I MEAN I WOULD REFER PEOPLE TO THE WEBCAST FROM LAST WEEK WITH PAMELA DAUTEL BECAUSE THERE WERE SOME MORE IN DEPTH SUGGESTIONS THERE ABOUT INTERACTING WITH HEALTH CARE PROVIDERS.

>> CARLA:  OH, GOOD, YEAH.

>> LAUREL:  CARLA, ALONG THOSE LINES, I WONDER IF -- I KNOW IT'S DIFFICULT FOR SOME FOLKS WHO ARE UNDER MANAGED CARE TO GET REFERRALS, BUT I WONDER IF THIS WOULD BE ONE THAT COULD BE ADDRESSED TO PHYSICAL THERAPISTS.
I KNOW THAT AT TIRR, WHICH REAL HUMBLY SPEAKING IS ONE OF THE PREMIER MEDICAL REHAB FACILITIES IN THE COUNTRY, HAS THE PHYSICAL THERAPISTS SEEM TO -- APPEAR TO HAVE A REALLY UNIQUE UNDERSTANDING OF NOT JUST EXERCISE, BUT RANGE OF MOTION ACTIVITIES, ET CETERA, THAT WOULD BE BENEFICIAL TO HEALTH AND THAT WOULD BE A PARTICULAR TO A CERTAIN DISABILITY TYPE.
SO IT MAY BE THAT WE CAN POSE THIS QUESTION TO A PHYSICAL THERAPIST OR TO THE FIST PHYSICAL THERAPIST ASSOCIATION TO SEE IF THEY HAVE INFORMATION TO COMMUNICATE ON THIS WHOLE ISSUE.

>> CARLA:  OH, THAT SOUNDS GOOD, YEAH.
AND IN REFERRALS I MEANT REFERRALS TO OTHER HEALTH CARE PROVIDERS THAT ARE APPROPRIATE BUT ALSO REFERS FOR INFORMATION, WHERE ELSE THEY CAN GO TO FIND THE INFORMATION THE THEIR HEALTH CARE PROVIDER DOESN'T KNOW.
ARE THERE ORGANIZATIONS THAT THEY KNOW OF?
ARE THERE PLACES THAT WILL PROVIDE INFORMATION FOR CONSUMERS?

>> LAUREL:  GOOD.


>> RACHEL:  CARLA, WE'VE GOT ONE MORE QUESTION THAT KIND OF RELATES TO THIS THAT MIGHT ACTUALLY NEED YOU KNEWSLY INTO THE NEXT SECTION.
I CAME UP WITH A REALLY GOOD DIET FOR MYSELF.
I CONSULTED WITH MY DOCTOR AND OTHER PEOPLE BUT I'M REALLY AFRAID I'M NOT GOING TO BE ABLE TO STICK TO IT.
HOW CAN YOU HELP ME STICK TO MY DIET?

>> CARLA:  THAT'S A GOOD QUESTION.
THIS PERSON IS AFRAID THAT THEY'RE NOT GOING TO BE ABLE TO STICK TO IT.
THAT MAKES ME THINK THAT PERHAPS THEY HAVE HAD PROBLEMS IN THE PAST STICKING TO THEIR DIET.
AND IF THAT IS THE CASE, WHAT I WOULD SUGGEST IS REALLY -- IF YOU HAVE TRIED BEFORE TO DO SOMETHING, SAY STICK TO YOUR DIET, AND YOU HAVE FAILED.
REFLECT BACK ON WHAT IT WAS THAT MADE THAT HAPPEN.
WAS THERE SOMETHING THAT HAPPENED THAT MADE -- LIKE YOU WERE GOING ALONG FINE AND THEN SOMETHING HAPPENED AND THEN YOU STOPPED EATING WELL, SAY, AND SEE IF YOU CAN IDENTIFY WHAT THOSE ARE.
WHAT IT IS THAT IS STOPPING YOU FROM GETTING TO WHAT YOU WANT AND TRY TO MAKE A PLAN TO ADDRESS THOSE.
YOU KNOW, FOR EXAMPLE, SAY YOU'RE DOING JUST FINE.
YOU'RE ON YOUR DIET AND EVERYTHING IS GREAT, AND THEN THE HOLIDAYS COME WHICH IS A HUGE THING.
IT'S VERY HARD FOR PEOPLE TO EAT WELL DURING THE HOLIDAYS AND A LOT OF PEOPLE GAIN THEY SAY FIVE TO SEVEN POUNDS DURING THE HOLIDAYS, AND IS IT THE HOLIDAY PERIOD THAT COMES, SO WHAT SPECIFICALLY IS IT ABOUT IT?
IS IT THE STRESS OF IT?
ARE YOU REACTING TO STRESS AND STARTING TO EAT EMOTIONALLY?
FROM THE STRESS YOU START TO EAT NOT WHAT YOU SHOULD BE OR IN LARGER QUANTITIES OR MORE JUNK FOOD AND THAT TYPE OF THING.
AND IF YOU DO I HAVE THAT THAT'S WHAT IT IS THAT'S STOPPING YOU, THEN YOU NEED TO MAKE A PLAN TO TRY AND STOP THAT FROM HAPPENING.
SO IF YOU KNOW THAT WHEN YOU GET STRESSED YOU'RE BOUND TO LOOK FOR, YOU KNOW, THE CHIPS OR WHATEVER IT MIGHT BE, THEN TRY -- OKAY, I'M STRESSED I KNOW I USUALLY DO THIS SO INSTEAD I'M GOING TO DO SOMETHING ELSE OR I'M GOING TO EAT SOMETHING ELSE OR I'M GOING TO LIMIT THE AMOUNT, THAT TYPE OF THING.
AND THEN ALSO I'LL TALK ABOUT THAT A LITTLE BIT MORE AS I GO HERE.
SO FAR WE TALKED ABOUT CHOOSING A TARGET BEHAVIOR, AND THEN, YOU KNOW, DOING SOMETHING SPECIFIC, AND THEN GATHERING INFORMATION ABOUT IT, AND THEN BEING SMART ABOUT YOUR GOALS AND WHAT YOU'RE GOING TO DO, AND THEN THE NEXT THING ON THE LIST HERE IS REWARD YOURSELF.

AND THAT HAS TO DO WITH IF YOU ARE DOING WELL, GIVE YOURSELF A PAT ON THE BACK AND BE PROUD OF YOURSELF.
EVEN FOR THOSE SMALL, LITTLE CHANGES THAT I THINK A LOT OF TIMES IF WEIGHT MANAGEMENT IS AN ISSUE, AND YOU HAVE 20 POUNDS THAT YOU WANT TO LOSE, YOU DON'T FEEL LIKE YOU SHOULD BE HAPPY UNTIL YOU LOSE 20.
WELL, THAT'S NOT AT ALL THE CASE.
I THINK YOU LOSE ONE POUND, GOOD JOB, YOU'VE LOST ONE POUND OR EVEN IF THIS WEEK YOU DIDN'T LOSE ANY WEIGHT, BUT YOU DID, YOU KNOW, NOT HAVE THE -- YOU DIDN'T GO AND HAVE THE EXTRA WHATEVER IT WAS, THE EXTRA COOKIE OR WHATEVER, AND YOU DID, YOU KNOW, EAT IN MODERATION THIS WEEK, EVEN THOUGH A POUND DIDN'T COME OFF, THAT'S OKAY.
YOU NEED TO REWARD YOURSELF AND I INCLUDED ON THE SITE A LIST OF DIFFERENT REWARDS JUST AS IDEAS FOR PEOPLE, AND THE ONE THING ABOUT REWARDS, IT'S FUNNY, THOUGH, THEY SHOULD BE APPROPRIATE.
IT'S FUNNY THAT PEOPLE SOMETIMES, ESPECIALLY WITH DIET OR WEIGHT MANAGEMENT, THEY'VE DONE WELL SO THEY REWARD THEMSELVES WITH CANDY WHICH IS KIND OF DEFEATING YOUR PURPOSE OF THE WHOLE THING ANY WAY.
SO JUST KEEP THAT IN MIND IS GOOD.
AND THEN KIND OF WHAT I WAS REFERRING TO IN ANSWERING THE QUESTION, NO. 5 IS BREAK YOUR BEHAVIOR CHAINS, AND BASICALLY WHAT I'M TALKING ABOUT IS REFLECT AND IDENTIFY WHAT LEADS UP TO YOUR TARGET BEHAVIOR AND WHAT FOLLOWS IT.
SO WHAT LEADS UP TO YOU, YOU KNOW, EATING A WHOLE BAG OF CHIPS, SAY?
WHAT LEADS UP TO THAT HAPPENING AND WHAT FOLLOWS IT?
AND THEN BY TRACKING THAT CHAIN OF EVENTS, THEN MAYBE YOU CAN IDENTIFY POINTS IN THE CHAIN WHERE YOU CAN STOP IT.
AND THEN I HAVE ON HERE SOME GENERAL STRATEGIES FOR BREAKING BEHAVIOR CHAINS.
YOU WANT TO CONTROL OR ELIMINATE ENVIRONMENTAL CUES THAT PROVOKE THE BEHAVIOR.
SO, IN OTHER WORDS, SAY YOU SIT IN FRONT OF THE TV AND THIS HAPPENS TO A LOT OF PEOPLE.
YOU WATCH TV AND YOU EAT AND SNACK AS YOU'RE WATCHING AND WHAT HAPPENS IS YOU'RE NOT PAYING ATTENTION TO WHAT YOU'RE EATING.
YOU'RE JUST -- IT'S KIND OF A MINDLESS SORT OF THING.
SO WHAT YOU MIGHT WANT TO DO IS WHEN -- YOU WANT TO CHANGE THAT ENVIRONMENT, NOT HAVE THE FOOD THERE WHEN YOU'RE WATCHING TV OR TRY NOT TO WATCH AS MUCH TV, THAT TYPE OF THING.

AND THEN I HAVE ON HERE CHANGE BEHAVIORS OR HABITS THAT ARE LINKED TO YOUR TARGET BEHAVIOR.
YOU KNOW, THE IDEA IS LOOKING AT THE ENVIRONMENT AND IS THERE SOMETHING THAT PROVOKES YOU TO DO CERTAIN BEHAVIORS OR DO YOU ALWAYS HAVE -- LIKE SMOKING IS AN EXAMPLE.
DO YOU ALWAYS HAVE A CIGARETTE FIRST THING IN THE MORNING?
WELL, YOU NEED TO CHANGE YOUR ROUTINE SO YOU'RE NOT DOING THE SAME THING RIGHT WHEN YOU WAKE UP.
DO SOMETHING ELSE.
IT'S KIND OF THAT IDEA.

THE NEXT THING, NO. 6, TIP I HAD IS COMPLETE A CONTRACT FOR BEHAVIOR CHANGE.
AND BASICALLY WHY I HAVE THIS ON HERE IS THE IDEA OF INCORPORATING OTHER PEOPLE INTO WHAT YOU WANT TO DO.
AND WHAT I MEAN IS TELL OTHER PEOPLE.
TELL, YOU KNOW, YOUR SIGNIFICANT OTHER OR YOUR FRIEND OR YOUR MOM OR WHOEVER IT IS THAT YOU WANT TO DO -- YOU WANT TO CHANGE YOUR DIET.
YOU'RE GOING TO START EATING WELL BUT YOU'RE GOING TO BE MORE SPECIFIC, YOU'RE NOT GOING TO SAY EAT BETTER.
THAT'S TOO GENERAL.
YOU NEED TO STATE SPECIFICALLY WHAT YOU'RE GOING TO DO AND WHAT YOU CAN DO IS IT HELPS SOME PEOPLE.
THIS IS BY NO MEANS A REQUIREMENT OR ANYTHING.
THIS IS JUST AN IDEA.
WHAT SOME PEOPLE DO IS ACTUALLY WRITE OUT WHAT THEY'RE GOING TO DO USING THE SMART GOALS, I'M BEING SPECIFIC ABOUT WHAT I'M GOING TO DO, IT'S MEASURABLE AND BY THIS AMOUNT OF TIME, TIMEBOUND THAT TYPE OF THING AND THEY HAVE SOMEBODY ELSE SIGN OFF ON IT WITH THEM.
AND INCLUDE IN THAT AT THE END OF TWO WEEKS I'M GOING TO HAVE DONE WHATEVER IT IS YOU'RE GOING TO DO AND THEN I'M GOING TO REWARD MYSELF BY WHATEVER IT IS YOU HAVE IDENTIFIED HOW YOU'RE GOING TO REWARD YOURSELF AND THEN HAVE SOMEONE ELSE LOOK AT IT AND I THINK JUST THE ACCOUNTABILITY FACTOR ITSELF IS A BIG MOTIVATING FACTOR.

THE NEXT THING, THE NEXT TIP WAS NO. 7, IS BUILD MOTIVATION AND COMMITMENT.
AND THERE IS ANOTHER HANDOUT THAT COULD BE DOWNLOADED ON THAT, AND BASICALLY WHAT THIS HAS IS A CHECKLIST, AND ON THIS CHECKLIST YOU CHECK OFF WHAT'S TRUE FOR YOU.
SO IT SAYS I FEEL RESPONSIBLE FOR MY OWN BEHAVIOR AND CAPABLE OF MANAGING IT.
IS THAT TRUE FOR YOU?
IF SO, YOU CHECK THAT OFF.
I AM NOT EASILY DISCOURAGED.
I ENJOY SETTING GOALS AND WORKING TO ACHIEVE THEM.
I AM GOOD AT KEEPING PROMISES TO MYSELF.
I LIKE HAVING A STRUCTURE AND SCHEDULE.
I VIEW MY NEW BEHAVIOR AS A NECESSITY AND NOT AS AN OPTION AL ACTIVITY AND I THINK THAT'S IMPORTANT.

PREVIOUS ATTEMPTS TO CHANGE MY BEHAVIOR I'M MORE MOTIVATED.
MY GOALS ARE REALISTIC, I HAVE A POSITIVE MENTAL PICTURE OF MY BEHAVIOR.
AND THIS IS IMPORTANT BECAUSE I THINK A LOT OF TIMES PEOPLE WANT TO CHANGE AND DO A WHOLE BUNCH OF THINGS AT A TIME IN THEIR LIFE WHEN THEY HAVE A LOT GOING ON AND SAY, YOU KNOW, THE STRESSORS IN PEOPLES LIVES, THEY HAVE MOVED, THEY'VE STARTED A NEW JOB, HAD A DEATH IN THE FAMILY, THEY'VE HAD A BUNCH OF STRESS AND ON TOP OF THAT THEY'VE DECIDED THEY WANT TO LOSE 30 POUNDS.
WELL, YOU KNOW, SOMETIMES THAT'S NOT ALWAYS REALISTIC.
YOU REALLY NEED TO LOOK AT THE WHOLE -- LOOK AT YOUR LIFE AND IS RIGHT NOW A GOOD TIME TO TRY AND MAKE A MAJOR BEHAVIOR CHANGE.
BECAUSE OTHERWISE AGAIN IT'S EASY TO SET YOURSELF UP FOR FAILURE AND FRUSTRATION.

I FEEL PREPARED FOR LAPSES AND UPS AND DOWNS IN MY BEHAVIOR CHANGE PROGRAM.
I FEEL MY PLAN IS ENJOIPABLE, AND I FEEL COMFORTABLE TELLING OTHER PEOPLE ABOUT THE CHANGE I AM MAKING IN MY BEHAVIOR.

NOW, UNDER THAT IT SAYS DID YOU CHECK OFF MOST OF THESE STATEMENTS?
AND IF NOT, THEN THESE ARE THINGS THAT YOU CAN IDENTIFY THAT YOU MIGHT WANT TO WORK ONTO BOOST YOUR MOTIVATION OR THINGS TO THINK ABOUT IN BUILDING YOUR MOTIVATION.
AND THEN BELOW THAT ARE SOME STRATEGIES THAT YOU CAN USE AND YOU CAN LOOK THIS OVER IN HELPING YOU TO BOOST YOUR MOTIVATION BASED ON IF YOU'RE NOT FEELING -- THAT SOMETHING IS LACKING.
SO I WILL OPEN IT UP FOR QUESTIONS AGAIN.


>> RACHEL:  OKAY, I THINK WE HAVE TWO QUESTIONS, ONE I THINK RELATES TO THIS.
EVERYONE IN MY FAMILY IS OVERWEIGHT.
I HAVE BEEN OVERWEIGHT ALMOST MY ENTIRE LIFE.
IS IT REALLY POSSIBLE FOR ME TO LOSE WEIGHT?

>> CARLA:  YEAH.
I WOULD SAY SO.
IT SOUNDS LIKE THIS PERSON MAY FEEL THAT IT'S A LITTLE DISCOURAGED ABOUT IT, THAT MAYBE PERHAPS THEY FEEL IT'S A GENETIC THING OR SOMETHING, EVERYONE IN THEIR FAMILY IS OVERWEIGHT AND IT'S ALWAYS BEEN THAT WAY.
EVERYBODY CAN LOSE WEIGHT.
I THINK -- THIS BRINGS UP A GOOD POINT THOUGH OF LOOKING AT YOUR ENVIRONMENT AND YOUR CULTURE THAT YOU LIVE IN.
SO, SAY, YOU WANT TO EAT HEALTHIER, BUT EVERYONE IN YOUR FAMILY DOESN'T EAT THAT WAY, AND EVERYBODY -- THAT'S THE CULTURE OF YOUR FAMILY IS TO GET TOGETHER AND EAT BIG MEALS, SAY, OR HIGH FAT FOODS OR THAT TYPE OF THING.
I THINK A LOT OF TIMES THAT PROMOTES IT IN EACH OF US, IF THAT'S THE WAY WE'VE GROWN UP AND THAT'S THE WAY WE LIVE TO CONTINUE THAT.
AND IT'S HARD IF JUST YOU WANT TO CHANGE AND YOU'RE STILL IN THAT ENVIRONMENT.
IT CAN BE VERY DIFFICULT, BUT -- AND THAT ALSO BRINGS, YOU KNOW, THE IMPORTANCE OF BRINGING IN OTHER PEOPLE AND TELLING THEM WHAT YOU WANT TO DO AND ASKING FOR THEIR SUPPORT, BUT ALSO BEING AWARE THAT SOMETIMES OTHER PEOPLE ARE NOT ALWAYS SUPPORTIVE EITHER, AND IDENTIFYING IF OTHER PEOPLE ARE GOING TO BE A BARRIER TO YOU REACHING YOUR GOALS, YOU NEED TO HAVE A PLAN OF HOW YOU'RE GOING TO HANDLE THAT.

IS THERE ANOTHER QUESTION?

>> RACHEL:  I HAVE ANOTHER QUESTION HERE, BUT I THINK I'LL HOLD IT UNTIL THE END BECAUSE IT'S NOT DIRECTLY CONNECTED TO WHAT YOU'RE TALKING ABOUT AND I DO HAVE A QUESTION TO THE PERSON WHO IS TYPING OUT THE REALTIME TRANSCRIPT.
WHEN YOU ARE A IANSING QUESTION YOU'RE TALKING AT A GREAT PACE AND DURING SOME OF THE PRESENTATION COULD YOU SLOW DOWN JUST A TOUCH SO SEE CAN KEEP UP.

>> CARLA:  ALL RIGHT.
SO NO. 8, TIP NO. 8, ON THE HANDOUT WAS DEVELOP REALISTIC SELF-TALK AND THIS REMINDS ME OF ANOTHER QUOTE THAT YOU PROBABLY HEARD OF MAYBE BEFORE IS WHETHER YOU THINK YOU CAN OR YOU CAN'T, YOU'RE RIGHT.
AND THAT WAS BY HENRY FORD.
THIS IS -- SELF-TALK IS HUGE.
IT'S HOW WE -- OUR UNER TEN AL DIALOGUE OF WHAT WE SAY TO OUR SELFS.
IT'S THE I CAN'T DO THIS TYPE OF THING.
YOU KEEP TELLING YOURSELF YOU CAN'T OR, YOU KNOW, THERE IS NO POSSIBLE WAY OR I'M JUST GOING TO FAIL ANY WAY OR THAT TYPE OF THING.
AND IT'S THE IDEA OF NOTICING AND KEEPING STOCK OF HOW YOU TALK TO YOURSELF ABOUT WHATEVER IT IS YOU'RE WANTING TO CHANGE, AND TRYING TO STOP YOURSELF FROM DOING THAT AND REPLACING THAT WITH MORE POSITIVE INTERNAL DIALOGUE WITH YOURSELF.

THAT'S THE GENERAL IDEA WITH THAT ONE.
AND THEN THE NEXT ONE WAS INVOLVE THE PEOPLE AROUND YOU, WHICH I'VE SAID MANY TIMES, AND THAT IS, YOU KNOW, LIKE I SAID, YOU NEED TO -- YOU'LL BE MORE SUCCESSFUL IF YOU INCLUDE SUPPORTIVE PEOPLE, BUT THEN ALSO BEING AWARE OF OTHERS THAT MIGHT SABOTAGE YOU AS WELL.
AND ANOTHER THING ALONG WITH JUST NOT ONLY TELLING PEOPLE ABOUT WHAT YOU WANT TO DO IS MAKING, YOU KNOW, A COMMITMENT WITH SOMEBODY.
SAY YOU WANT TO -- YOU'RE INTO STRESS MANAGEMENT, YOU WANT TO MANAGE YOUR STRESS BETTER SO YOU WANT TO LEARN SOME DEEP BREATHING EXERCISES TO HELP YOU BECOME MORE CALM IN CERTAIN SITUATIONS.
SO YOU COULD, YOU KNOW, MAKE A COMMITMENT WITH SOMEONE ELSE TO GO TO A CLASS ON DEEP BREATHING OR YOU COULD, YOU KNOW, THE TWO OF YOU COULD LEARN TOGETHER OR THAT TYPE OF THING.
THE IDEA OF JUST DOING IT -- AN ACTIVITY WITH SOMEONE ELSE AND HAVING THEM HELP YOU DO IT, WHATEVER IT IS YOU WANT TO CHANGE CAN HELP.

AND THEN THE LAST THING I HAVE ON HERE IS PREPARE FOR RELAPSE.
AND I HAVE ANOTHER QUOTE HERE AND I DON'T KNOW WHO SAID IT.
BUT THE QUOTE IS THOUGH NO ONE CAN GO BACK AND MAKE A BRAND NEW START, ANYONE CAN START FROM NOW AND MAKE A BRAND NEW ENDING.
AND THE IDEA HERE IS IT'S SO -- IT'S THE WHOLE IDEA.
IT'S SO EASY TO RELAPSE WHEN YOU'RE TRYING TO CHANGE YOUR HEALTH BEHAVIORS.
SAY YOU ARE WANTING TO EAT BETTER AND YOU RELAPSE AND YOU'VE GONE OFF YOUR HEALTHY EATING PLAN AND A LOT OF TIMES I THINK PEOPLE JUST THROW THEIR HANDS UP AND SAY, THAT'S IT.
BUT THAT'S GOING TO HAPPEN.
IT'S ALWAYS GOING TO HAPPEN NO MATTER WHAT.
IT'S UNREALISTIC TO THINK THAT YOU'RE NEVER GOING TO RELAPSE WHEN YOU'RE TRYING TO MAKE A BEHAVIOR CHANGE.
SO IDENTIFYING THAT YOU KNOW THAT THAT'S GOING TO HAPPEN AND BEING READY FOR IT AND THEN JUST GED GETTING BACK ON IT AND GOING AND TRYING AGAIN AND GOING BACK TO WHAT WE STARTED OUT WITH, WHAT WERE THE GOALS OF YOUR PROGRAM.
WHY DID YOU EVEN START THIS?
WHAT WERE THE BENEFITS?
WHY ARE YOU DOING THIS ANY WAY?
GO BACK TO YOUR LIST, WHY AM I DOING THIS AND THEN IDENTIFYING THOSE BEHAVIOR CHAINS THAT I TALKED ABOUT.
WHAT WAS IT THAT HAPPENED THAT MADE ME RELAPSE, WHAT -- TRY TO IDENTIFY WHAT THE PROBLEMS WERE, WHAT MADE THAT HAPPEN AND THEN COME UP WITH SOME SOLUTIONS TO TRY TO ADDRESS THOSE PROBLEMS.
AND THE THING IS TO JUST REMEMBER THAT, YOU KNOW, RELAPSE IS NORMAL AND IT HAPPENS AND JUST THE IMPORTANT THING IS TO KEEP TRYING AND TO GO BACK.

AND SO THAT'S BASICALLY THE TEN TIPS THAT I PUT TOGETHER AND ARE THERE ANY QUESTIONS ABOUT ANY OF THOSE SO FAR?

>> RACHEL:  WELL, WE'VE GOT A QUESTION THAT MIGHT ASK YOU TO KIND OF RECAP, BUT IT SAYS I LOST WEIGHT AND I LOWERED MY CHOLESTEROL, BUT THEN SLOWLY I LOST IT.
NOW I'M ALMOST BACK TO WHERE I STARTED.
MY LIFE IS VERY STRESSFUL, BUT THIS IS REALLY STRESSING ME OUT, TOO.
I DON'T KNOW IF I HAVE IT IN ME TO DO IT ALL OVER AGAIN.
CAN YOU GET ME STARTED?

>> CARLA:  SO, FIRST OF ALL, I WANT TO SAY GOOD JOB ON YOUR ORIGINAL EFFORTS OF, YOU KNOW, SOUNDS LIKE YOU DO A GOOD JOB.
YOU LOST WEIGHT AND GOT YOUR CHOLESTEROL DOWN AND THAT TYPE OF THING SO YOU SEE THAT YOU DO HAVE CONTROL AND POWER TO DO WHAT IT IS YOU WANTED TO DO.

SOUND LIKE YOU STARTED GAINING THE WEIGHT BACK.
I THINK WHAT MIGHT HELP IS TO IDENTIFY WHY THAT MIGHT HAVE HAPPENED, WHAT WAS -- WAS YOUR DIET TOO STRICT?
WAS IT -- YOU KNOW, WAS IT NOT REALISTIC THAT TO MAINTAIN OVER TIME.
YOU KNOW, A LOT OF TIMES WITH FAD DIETS, A LOT OF THESE NEWER DIETS, IT'S HARD TO STICK TO THEM FOR YOUR LIFETIME, AND YOU REALLY, WHEN IT COMES TO EATING AND THAT TYPE OF THING, YOU'VE GOT TO THINK OF SOMETHING THAT YOU'RE GOING TO DO FROM HERE ON OUT.
IT'S NOT A SHORT, YOU KNOW, I'M GOING TO EAT THIS WAY ONLY UNTIL I LOSE MY WEIGHT BECAUSE THAT'S NOT THE WAY IT WORKS.
IT NEEDS TO BE SOMETHING OVER THE LONG HAUL SO YOU NEED TO BE REALISTIC ABOUT THAT.

AND I THINK, YOU KNOW, IF YOU HAVE A LOT OF STRESS GOING ON, AND THIS IS ADDING STRESS, THAT'S NOT GOOD.
YOU DON'T WANT TO BE ADDING TO YOUR OWN STRESS.
WHAT I WOULD DO IS IDENTIFY RIGHT NOW WHAT'S ONE SMALL THING YOU CAN DO.
DON'T THINK OF THE BIG PICTURE, DON'T THINK I ALREADY FAILED AND I HAD NEED TO LOSE THIS AND MY CHOLESTEROL AND THIS AND THIS AND THIS.
I WOULD THINK -- TRY AND THINK OF ONE SMALL, SMALL, SMALL THING THAT YOU CAN DO THIS WEEK.
AND START WITH THAT.
AND AT THE END OF THIS WEEK, YOU KNOW, SEE HOW IT WENT, AND IF YOU HAVE REACHED THAT THEN GIVE YOURSELF A REWARD AND THEN GO BACK AND SAY, OKAY, I'VE DONE THIS AND NOW I'M GOING TO TRY THIS, BUT DON'T TRY TOO MUCH AND ESPECIALLY IF YOU HAVE A LOT OF STRESS GOING ON YOU DON'T WANT TO STRESS YOURSELF OUT BY TAKING ON A HUGE THING.
I GUESS I JUST WANT TO EMPHASIZE THAT YOU CAN DO IT, BUT JUST BE REALLY SMART BIT AND BE REALISTIC ABOUT WHAT YOU CAN ACCOMPLISH.

IS THERE ANOTHER QUESTION?

>> RACHEL:  YEAH, THERE IS ANOTHER QUESTION.
YOU MENTIONED THE HOLIDAYS.
OH, BOY, I'M NERVOUS ABOUT THEM.
MY SCHEDULE CHANGES, THEN THE TEMPTATIONS ARE SO GREAT, YOUR TIPS HAVE BEEN HELPFUL.
CAN YOU PLEASE GIVE ME TIPS THAT ARE SPECIFIC FOR THE HOLIDAY SEASON?

>> CARLA:  OH, YEAH.
WITHOUT KNOWING EXACTLY WHAT THEY'RE NOT WANTING TO DO, I'M ASSUMING THEY ARE TALKING ABOUT TEMPTATIONS OF FOOD AND THAT TYPE OF THING.
AND I THINK A LOT OF WHAT HAPPENS IS THERE IS MORE SOCIAL INTERACTION, THERE IS LOTS MORE PARTIES AND THERE IS LOTS MORE BAD FOOD, QUOTE-UNQUOTE, EVEN THOUGH IS NOT REALLY ANY BAD FOOD, BUT THERE IS MAYBE FOODS THAT WE SHOULD EAT IN MORE MODERATION AROUND, AND I THINK THE IMPORTANT THING IS JUST IF YOU ARE GOING TO AN EVENT, AND THERE IS GOING TO BE A LOT OF FOOD AND YOU KNOW YOU'RE GOING TO WANT TO TRY ALL THE DIFFERENT KINDS, THERE IS DIFFERENT IDEAS, DIFFERENT TIPS YOU CAN USE.
SO SAY YOU'RE GOING AND THERE IS A BUFFET SAY.
WELL, WHAT DO YOU LIKE?
WHAT IS THE ONE THING THAT YOU LOVE DURING THE HOLIDAY SEASON?
IS THERE A CERTAIN TYPE OF CAKE THAT YOU LIKE?
WELL, DON'T RESTRICT AND SAY YOU'RE NOT GOING TO HAVE IT BECAUSE AS SOON AS YOU SAY I'M NOT ALLOWED, THEN THAT'S ALL YOU'RE GOING TO WANT TO HAVE.
WHAT YOU NEED TO DO, EAT THAT, BUT DON'T HAVE ALL THE OTHER, YOU KNOW, STUFF THAT YOU MIGHT THINK IS OKAY BUT YOU CAN HAVE ANY TIME OF THE YEAR, THAT JUST ADDS CALORIES AND ADDS MORE AND MORE AND MORE.
JUST REALLY TREAT YOURSELF TO THE THINGS YOU DO LIKE IN A SMALL AMOUNT, OF COURSE, BUT NOT JUST GOING -- BECAUSE EVERYTHING IS THERE AND YOU CAN HAVE IT.
AND THE OTHER THING IS WATCHING THE STRESS LEVELS, TOO.
IT GETS TO BE SO HECTIC AND WE START TO EAT ON THE RUN AND A LOT OF TIMES PEOPLE ARE MORE LIKELY TO EAT MORE FAST FOOD AND THAT TYPE OF THING DURING THE HOLIDAYS BECAUSE WE'RE MAYBE BUYING GIFTS OR, YOU KNOW, GOING WHATEVER WE'RE DOING, AND SO JUST WATCHING OUR STRESS LEVEL AND IDENTIFYING, YOU KNOW, REALIZING, YES, OKAY, I AM STRESSED AND MAYBE HAVING SNACKS WITH YOU THAT AREN'T HIGH IN FAT SO THAT YOU'RE NOT MORE AS LIKELY TO GRAB WHATEVER IS AROUND WHEN YOU'RE RUSHING AROUND.
YOU KNOW, PACK SOME LOW FAT GRANOLA THAT YOU MIGHT LIKE, MAYBE SOME FRUIT AND THAT TYPE OF THING BECAUSE THAT CAN HELP.
AND ALSO THE EMOTIONAL COMPONENT, TOO.
A LOT OF PEOPLE GET DOWN DURING THE HOLIDAYS, AND JUST BEING REALLY AWARE OF, YOU KNOW, ESPECIALLY IF YOU'RE PRONE TO WHAT PEOPLE CALL EMOTIONAL EATING, YOU'RE STRESSED OR SAD OR DOWN OR BORED OR WHATEVER, AND YOU REACH FOR FOOD.
IT'S JUST KNOWING THAT, YEAH, I DO THAT SO WHAT'S SOMETHING ELSE I CAN DO INSTEAD.

AND HAVING REALISTIC EXPECT ASIANS CAN HELP WITH THE HOLIDAYS.
WE THINK A LOT OF TIMES IT SHOULD BE THIS PERFECT ROCKWELL PAINTING AND EVERYONE GETS ALONG AND NO ONE FIGHTS AND THAT IS THEN ALWAYS NECESSARILY THE CASE, IF EVER, SO I THINK HAVING REALISTIC EXPECTATIONS OF THE HOLIDAYS AND MAKING YOUR OWN TRADITIONS AND KNOWING THAT IT'S OKAY THAT YOUR HOLIDAYS DOESN'T NECESSARILY HAVE TO BE THIS IDEAL IT'S PARTICULAR COMMERCIALIZED VERSION THAT IS SOMETIMES PROMOTED IN OUR SOCIETY.

SO THOSE JUST SOME IDEAS I HAVE OFF THE TOP OF MY HEAD.
AND WE CAN GET INTO THAT MORE ON THE BOARD LATER IF THIS PERSON WOULD LIKE TO.

>> RACHEL:  OKAY.
I HAVE ONE OTHER QUESTION HERE.
IT'S ACTUALLY KIND OF A MULTIPART QUESTION, BUT IT TAKES US IN A LITTLE BIT DIFFERENT DIRECTION.

>> CARLA:  OKAY.

>> RACHEL:  ARE YOU READY FOR THAT
>> CARLA:  YEAH, THAT'S FINE.

>> RACHEL:  ARE THERE ANY POLICIES AFFECTING PEOPLE WITH DISABILITIES THAT ARE ENABLING PEOPLE TO BE HEALTHY AND WELL, FOR EXAMPLE MEDICAID OR SOCIAL SECURITY.
IS THAT SOMETHING THAT YOUR PROJECT IS LOOKING INTO?
WHAT ELSE IS YOUR PROJECT DOING?

>> CARLA:  OH, THAT'S A GOOD QUESTION.
YEAH, THERE ARE LOTS OF DIFFERENT POLICIES THAT COULD BE CHANGED, THAT COULD IMPROVE THE HEALTH AND WELLNESS IN MY OPINION OF PEOPLE LIVING WITH DISABILITIES.
OUR PROJECT, OUR PROGRAM IS DOING A NUMBER OF DIFFERENT STUDIES ON POLICY WITH MEDICAID AND MEDICARE AND THAT TYPE OF THING AND THEY ARE JUST NOW GETTING STARTED AND GETTING ROLLING, AND I THINK A LOT OF THE ACCESS ISSUES ARE IMPORTANT TO LOOK AT AS FAR AS -- AS FAR AS POLICY ISSUES GO, AND MAKING SURE THAT THOSE MECHANISMS ARE IN PLACE.


>> LAUREL:  YOU KNOW, CARLA, I WONDER IF ONE SUCH POLICY RELATES TO MANAGED HEALTH CARE AND THE RESTRICTIONS PLACED ON THE INDIVIDUAL TO GET REFERRALS TO SPECIALISTS IN DIFFERENT AREAS AND WITH HEALTH AND WELLNESS BEING -- I'M NOT SURE HOW, YOU WOULD KNOW BETTER THAN I, ABOUT HOW MANAGED HEALTH CARE PROGRAMS ADDRESS THAT?
ARE THEY OPEN TO IT?
ARE THEY CLOSED?
OR IS THIS SOMETHING THEY WOULDN'T FINANCE?

>> CARLA:  THAT'S A GOOD QUESTION, YOU KNOW, AND I DON'T REALLY HAVE AN EXACT ANSWER.
I THINK IT'S -- AND I DON'T THINK THEY HAVE AN EXACT ANSWER EITHER, REALLY.
I THINK THAT THERE IS A LOT MORE NEEDS TO BE DONE ON THAT.
I'M NOT REAL SURE.

>> LAUREL:  YOU WOULDN'T SAY THAT THIS NECESSARILY COMES UNDER PREVENTATIVE MEDICINE, WOULD YOU?

>> CARLA:  IT COULD, YEAH.

>> LAUREL:  THAT MIGHT SLIGHTLY OPEN THE DOOR.

>> CARLA:  YEAH, I WAS THINKING OF AS FAR AS POLICY GOES, I WAS THINKING, TOO, OF YOU KNOW LIKE THE -- YOU KNOW, MAKING SURE THAT THE BASICS THAT PEOPLE THAT DOCTOR'S OFFICES ARE ACCESSIBLE, THAT PEOPLE CAN GO IN AND GET THEIR YEARLY EXAMS OR THEY CAN GET THE THINGS THAT THEY NEED TO GET HEALTH CARE-WISE AND ALSO MONEY IS ALWAYS -- FUNDING IS ALWAYS AN ISSUE WHEN YOU'RE TALKING ABOUT PREVENTION AND WELLNESS PROGRAMS AS WELL WHEN IT COMES TO -- SEEMS LIKE A LOT OF TIMES IT JUST TENDS TO GO TO CUREATIVE RATHER THAN PREVENTING.

>> LAUREL:  YOU'RE RIGHT THERE ABOUT THE PHYSICIAN'S OFFICES.
PEG AND HER COLLEAGUES DID A STUDY RECENTLY OF WOMEN WITH DISABILITIES AND THEIR ABILITY TO ACCESS SERVICES, AND A NUMBER OF WOMEN WERE NOT RECOMMENDED -- IT WASN'T RECOMMENDED TO THEM TO RECEIVE SCREENSING WITH REGARD TO PAP SMEARS OR TO MAMMOGRAMS AND SO FAR.
IN PART, IT WAS THAT THE EQUIPMENT -- IT WAS DIFFICULT TO POSITION THE EQUIPMENT BECAUSE OF THE PERSON'S DISABILITY, AND IN OTHER CASES BECAUSE -- WELL, JUST ASSUMPTIONS BEING MADE ABOUT THE NEED.

>> CARLA:  RIGHT.
YEAH.

>> LAUREL:  SO YOU'RE RIGHT.
THERE ARE BARRIERS THERE THAT ONE COULD NOT NECESSARILY ANTICIPATE.

>> CARLA:  I AGREE.

>> LAUREL:  BUT PEG'S GUYS HAVE -- I THINK THEY ARE WEB SITE IS WWW.CROWD AND THEY HAVE MARVELOUS ISSUES RELATED TO WOMEN AND HEALTH ISSUES AND BARRIERS AND POLICY.

>> CARLA:  YEAH.
DEFINITELY.
AND I THINK THIS WHOLE -- THE RESEARCH AND THE WHOLE IDEA OF HEALTH AND WELLNESS AND PEOPLE WITH DISABILITIES IS REALLY GOING IN THE RIGHT DIRECTION AND I THINK THERE IS A LOT MORE TO BE STUDIED AND A LOT MORE TO BE FOUND OUT, BUT I THINK THAT WE'RE MOVING IN THE RIGHT DIRECTION AND HOPEFULLY SOME POSITIVE CHANGES CAN COME OUT OF THE WORK WE'RE DOING AS WELL, TOO.
TO MAKE SURE THAT SOME OF THESE BARRIERS ARE ADDRESSED AND IDENTIFIED AND POLICIES MADE.

>> LAUREL:  WOULD YOU SAY THAT WITH THE RESEARCH AND TRAINING CENTER THAT -- I KNOW THAT IT'S LIKE A HUGE NUMBER OF PROJECTS BOTH RESEARCH AND TRAINING, BUT IT SEEMED AS THOUGH THEY -- I BELIEVE IT'S THE FIRST RESEARCH AND TRAINING CENTER IN THIS AREA, IS IT NOT, WITH REGARD TO DISABILITY?

>> CARLA:  YES.

>> LAUREL:  AND SO THE RESEARCH PROJECTS THAT ARE BEING UNDERTAKEN ARE SORT OF GROUND BREAKING IN THAT RESPECT, BUT IS THERE NOT ANTICIPATED -- THE FINDINGS WOULD LEAD TO DIRECT POLICY IMPLICATIONS?
I WONDER IF THAT'S THE DIRECTION THAT GLORIA AND HER COLLEAGUES ARE LOOKING TOWARD?

>> CARLA:  YEAH, THE ONE THING ABOUT OUR RESEARCH AND TRAINING CENTER IS THAT WE REALLY WANT TO TAKE THE RESEARCH THAT WE FIND AND THEN TAKE THAT AND PUT INTO A FORMAT WHERE IT CAN BE DISSEMINATED OUT TO TRAININGS FOR DIFFERENT FOLKS, WHETHER IT BE POLICY MAKERS, CONSUMERS, HEALTH CARE PROVIDERS AND THEN TAKE THAT AS WELL AND HAVE POLICY.
WE HAVE A POLICY FORUM THAT WE ARE GOING TO HAVE ONCE A YEAR WHERE WE'RE GOING TO BE DISCUSSING SPECIFIC ISSUES HAVING TO DO WITH HEALTH AND WELLNESS AND POLICY AND THAT TYPE OF THING AND I THINK THIS YEAR IT MAY BE ON MANAGED CARE.
AND SO, YEAH, THAT IS A GOAL IS TO ACTUALLY IMPLEMENT WHAT WE'RE LEARNING IN RESEARCH AND TO -- AND TO PRACTICE BASICALLY.

>> LAUREL:  AND IF I RECALL CORRECTLY, FORMULATING RECOMMENDATIONS TO FOLKS AT NIDRR AND I GUESS HHS WITH REGARD TO POLICY AND CHANGES THAT MIGHT NEED TO BE IMPLEMENTED.
I MUST SAY JUST FROM MY PERSPECTIVE THAT THE WEB SITE, YOUR WEB SITE IS QUITE GOOD.
USEFUL TO NAVIGATE, BUT THE DESCRIPTIONS OF THE PROJECTS ARE VERY INTERESTING, AND FOR THOSE OF US WITH DISABILITIES, IT'S -- THE CENTER IS TRULY DEALING WITH THE ISSUES THAT ARE MOST PERTINENT TO OUR LIVES, AND I THINK WE'LL BE INTERESTED TO SEE THE OUTCOMES AS WE PROGRESS IN THE PROJECT CYCLE.

>> CARLA:  YEAH.
I A GREE. I THINK -- I ENCOURAGE PEOPLE TO VISIT OUR WEB SITE, IT'S WWW.HEALTHWELLNESS.ORG AND WE HAVE DESCRIPTIONS OF OUR PROJECTS AND OUR TRAINING INITIATIVES AS WELL.

>> LAUREL:  IT'S PRETTY AMBITIOUS ACTUALLY
>> CARLA:  YEAH, IT IS, (LAUGHTER) BUT THAT'S GOOD.
SO -- WELL, ARE THERE ANY OTHER QUESTIONS AT THIS TIME?

>> RACHEL:  NO, THAT'S ALL THE QUESTIONS THAT I'VE GOT OVER HERE.

>> CARLA:  WELL, GOOD.
SO BASICALLY I JUST WANTED TO CONCLUDE AND SAY THAT -- GO BACK TO WHAT I TALKED ABOUT IN THE BEGINNING WHEN I WAS TALKING ABOUT WHAT IS WELLNESS, AND BASICALLY WELLNESS IS HOLISTIC AND IT'S ON A CONTINUUM, IT'S SOMETHING THAT'S UNIQUE TO EACH INDIVIDUAL AND THEIR OWN CIRCUMSTANCES AND IT ENCOMPASSES MANY DIMENSIONS IN EACH OF OUR LIVES, THE MIND, BODY, SPIRIT AND CONTEXT AND THEN ALSO WE TALKED ABOUT SOME SPECIFIC STRATEGIES OR TIPS TO HELP ONE BUILD MOTIVATION TO CHANGE AND THE IDEA HERE IS JUST, YOU KNOW, THAT IT CAN BE DONE AND I ENCOURAGE ALL OF YOU TO GO FOR IT IF YOU'RE READY, BUT, YOU KNOW, YOU NEED TO BE READY AND BE REALISTIC AND USE SOME OF THESE TIPS AND GOOD LUCK.

AND THAT'S ALL I HAVE FOR TODAY.

>> LAUREL:  CARLA, THANK YOU VERY MUCH FOR THE INFORMATION.
SOME OF IT WAS A TAD DISTRESSING, THAT CHART THAT ONE HAD TO FILL OUT WAS JUST ONE OF THE MOST DISTRESSING THINGS I HAVE EVER READ PERSONALLY.
I DON'T THINK I WAS ABLE TO CHECK OFF MORE THAN TWO.

>> CARLA:  OH, (LAUGHTER).

>> LAUREL:  I WANTED TO FOLLOW UP HERE WITH SAYING THAT WE WILL HAVE A FOLLOW-UP TO THIS PRESENTATION IN PART THROUGH A NEWS GROUP THAT WILL BE SET UP AS WE MENTIONED AND WE INVITE YOU TO SUBMIT QUESTIONS AND COMMENTS ON AN ONGOING BASIS AND WE WILL NOTIFY YOU OF THE U. R. L. AS SOON AS IT'S SET UP, AND AT THE SAME TIME WE WILL HAVE THIS PRESENTATION ARCHIVED SO THAT THE AUDIO WILL BE AVAILABLE AS WELL AS THE HANDOUT MATERIALS ALL IN ONE LOCATION SO THAT FOLKS WHO MAY HAVE MISSED IT OR THOSE OF YOU WHO WANT TO HEAR IT AGAIN WILL HAVE THAT OPPORTUNITY.

IN ADDITION, I WANT TO LET YOU KNOW THAT WE -- OUR PARTNERS ON THE RESEARCH INFORMATION FOR INDEPENDENT LIVING PROJECT AT THE RESEARCH AND TRAINING CENTER ON INDEPENDENT LIVING IN KANSAS HAVE A DATABASE OF RESEARCH -- REALLY REVIEWS OF RESEARCH ABSTRACTS.
WELL, THEY ARE ABSTRACTS OF RESEARCH PROJECTS AND WRITINGS ON A VARIETY OF ISSUES RELATING TO DISABILITY AND REHABILITATION.
AND ACCESSING THAT THROUGH THE DATABASE, YOU GO TO THE WEB SITE, THE WWW.GETRIIL.ORG, AND YOU CAN TYPE IN YOUR KEY WORDS OR SEARCH WORDS AND ALL KINDS OF DOCUMENTS AND RESOURCES THAT ARE AVAILABLE HAVE BEEN ABSTRACTED AND ARE QUITE GOOD, AND ON THIS SUBJECT AS WELL AS OTHERS IF YOU WANT TO GET ADDITIONAL INFORMATION, THERE IS THAT RESOURCE.

AND I ALSO WANT TO PLUG A COUPLE OF UPCOMING PRESENTATIONS THAT WE'LL BE HAVING ON THE WEBCAST BECAUSE THEY ARE -- THEY HAVE BEEN MENTIONED IN THIS PRESENTATION, AND ONE IS LAURIE POWERS IS GOING TO PRESENT ON FINDINGS FROM THE -- A SERIES OF FOCUS GROUPS OF CONSUMERS WHO TALK ABOUT WHAT HEALTH AND WELLNESS MEANS TO THEM.

AND IT'S RATHER REMARKABLE FINDINGS, AND THEN A LITTLE BIT LATER WE'RE GOING TO HAVE A PRESENTATION FROM THE SAME RESEARCH AND TRAINING CENTER ON HEALTH AND WELLNESS ON THE PROJECT THAT ADDRESSES PHYSICAL ACTIVITIES, AND SO WE INVITE YOU TO EXAMINE THE CALENDAR AND TO MARK THOSE DOWN AND PLEASE TRY TO JOIN US.

BEFORE WE CLOSE, I ALSO WANT TO AGAIN THANK THE NIDRR FOR PROVIDING THE SUPPORT FOR THESE KINDS OF INITIATIVES WHEREBY INFORMATION THAT'S GATHERED IN RESEARCH ACTIVITIES AND DEMONSTRATION ACTIVITIES CAN BE COMMUNICATED TO THOSE OF US WHO AREN'T RESEARCHERS BUT HAVE -- THAT ARE HIGHLY -- BUT WE ARE HIGHLY VESTED IN THE FINDINGS FROM THESE PROJECTS.
I ALSO WANT TO THANK OUR PARTNERS AT GET RIIL AND AT THE UNIVERSITY OF KANSAS AND THE RESEARCH AND TRAINING CENTER ON INDEPENDENT LIVING, JIM BUDDY AND GLENN WHITE AND ARN ANY AND CINDY HIGGINS AND PALM -- TWO PAMS.
AND I ALSO WANT TO THANK CARLA, THANK YOU AND YOUR COLLEAGUES AT THE HEALTH AND WELLNESS RTC, AND FINALLY, I WANT TO EXPRESS APPRECIATION TO OUR TEAM, NO. 1, YOU WILL HAVE NOTICED ON YOUR WEB SITE THAT IN THE VIDEO SECTION OF THE REALPLAYER OR THE MEDIA PLAYER, THERE HAS BEEN WORDS ENTERED ALONG THERE, AND THIS IS WHERE -- THIS IS A REALTIME CAPTIONING WHICH IS BEING DONE BY OUR COLLEAGUE MARIE BRYANT, AND IF YOU HAVE SAT IN ON OTHER PRESENTATIONS THAT HAVE BEEN CAPTIONED YOU KNOW HOW GOOD MARIE IS, EVEN THOUGH SHE CAN'T ALWAYS KEEP UP WITH PEOPLE WHO TALK JUST A TAD BRISKER THAN SHE'S DOES.
I ALSO WANT TO THANK OUR PRODUCTION SPECIALIST WHICH IS ROB DICKEHUTH AND THESE PRESENTATIONS ARE POSSIBLE BECAUSE OF HIS UNDERSTANDING OF THE TECHNOLOGY AND HIS ABILITY TO COMMUNICATE TO THOSE OF US WHO HAVE LESS UNDERSTANDING OF TECHNOLOGY, AND FINALLY, I WOULD THANK MY TEAM PLAYERS AT ILRU AND THEY INCLUDE SHARON FINNEY, MARJ GORDON, RACHEL KOSOY WHO IS ALSO OUR QUESTION GIVER AND DAWN HEINSOHN.
SO WITH THAT SAID, I WANT TO THANK YOU FOR HAVING PARTICIPATED IN THIS WEBCAST.
I HOPE YOU'LL CHECK OUT THE ARCHIVES AND ALSO COME VISIT THE NEWS GROUPS AND WE'LL NOTIFY YOU AS SOON AS THEY GET UP AND THEN PLEASE CHECK THE CALENDAR OF UPCOMING EVENTS AND JOIN US WHEN POSSIBLE.
WE LOOK FORWARD TO YOUR PARTICIPATION AND YOUR QUESTIONS AND YOUR INTEREST AND IF YOU HAVE RECOMMENDATIONS FOR OTHER TOPICS WE SHOULD ADDRESS, WE WOULD APPRECIATE RECEIVING THEM VERY MUCH.

SO CARLA, THANK YOU.

>> CARLA:  THANK YOU.

>> LAUREL:  AND RACHEL AND THE GUYS THERE, THANK YOU, AND WE WILL SIGN OFF FOR NOW.
THANK YOU VERY MUCH.