The phases of evaluation.
How do you use lead and lag measures to evaluate health change?
There are phases of evaluation which can cover each aspect of change. They include:
In essence, you choose a mini goal, decide how and when you’ll achieve it, make the required change for the set time, measure the difference you managed in that time and then assess how easy or hard the process was.
Remember Joyce and her goal to become smoke free? Let's look at Joyce using the life segment method of breaking up a goal to quit smoking. This is where she makes a change in one aspect of her life before continuing it into other areas, for example stopping smoking at work before at home.
She decides to stop smoking at work for one month by substituting cigarettes for gum and patches and going for a walk during lunch breaks with a colleague who dislikes smoking (planning phase).
She notes down the distance and minutes walked as her lead measure and the cigarettes smoked as her lag measure (implementation phase).
After the month is complete she evaluates the time spent thinking about smoking at work and notes any changes like weight gain or irritability as a result of this effort (completion and feedback phases).
This evaluation helps her decide whether quitting at work only, using gum or patches or getting outside and walking is the best way to work towards the full goal of stopping smoking for good.
Let’s use David as another example. David must lose weight to avoid becoming diabetic.
He plans to bring in his own lunch for six weeks to avoid over eating at the staff canteen (planning phase).
Every day he makes fresh salads and eats them in the garden outside.His lead measure is his ability to make the salad each morning and his lag measure is the final weight loss. (implementation phase).
After the six weeks he records his success and reflects on the enjoyment of his new lunch, the time he spends making the salads, the difference of eating outside and his actual weight loss (completion and feedback phases).
Evaluation helps David decide whether this alone is enough to help him achieve his desired goal, whether it is a satisfying method of making change or whether he should seek extra help to speed up his weight loss.
It’s important to note how using lead measures and a strong evaluation process help remove the fear of failure from the change process. Neither Joyce nor David is heaping all their fears and expectations on this mini change. Instead, they are following a plan and measuring the effects.
They can follow a different plan next month with the same detached perspective.
By breaking down their goals and honestly considering the effects of each change they are better informed about what works for them.
Long term lifestyle change means never feeling as if you’re ‘doing without’. It means feeling satisfied with what you eat and at ease with activity. It means saying yes to events, days out and holidays without worrying that you’ll hold others back. It means less reliance on medication and less time spent in medical appointments. In many cases it can mean less pain or discomfort.
Most of all, it means more choice, the choice to do more things, to be part of more peoples’ lives, to discover new interests and hobbies, to reclaim the freedoms that have incrementally waned over years of tiny compromises to illness, pain or fatigue.
Although we are unlikely to recover the first flush of youth, 70% of health issues experienced by people aged 55+ are lifestyle related. This means that they can be avoided with good quality food, exercise and strong social connections. Even if you’re younger than 55 this still gives insight into how much can be done right now to prevent you from limiting your lifestyle through ill health. Add a little evaluation into your day and enjoy the positive health results.