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Sleep Challenges Strategy: Gradual sleep routine adjustments, relaxation exercises, and blue-light filters on devices.

Benefit: Increases patient compliance, and improves sleep quality through realistic, step-by-step changes.

Nutrition Access

Strategy: Virtual dietitian consultations, local resources, food label education.

Benefit: Enhances accessibility to nutrition guidance and empowers patients to make informed dietary choices.

Exercise Limitations

Strategy: Low-impact exercises (stretching, swimming), realistic goals.

Benefit: Makes exercise plans achievable, reduces risk of injury, and improves patient motivation and consistency.

Mental and Emotional Wellness

Strategy: Use mental health apps, self-care activities (journaling, gratitude), and accessible relaxation techniques.

Benefit: Provides support for stress and anxiety management, especially when professional resources are limited.

Social Wellness

Strategy: Low-pressure socialization options, and gradual engagement in virtual groups.

Benefit: Encourages social connections without overwhelming patients, improving social wellness gradually.

Spiritual Wellness

Strategy: Personalized spiritual practices (nature, reflective journaling).

Benefit: Respect diverse beliefs, providing meaningful spiritual support aligned with individual values.

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Physical Wellness: maintaining consistent sleep habits - difficult for patients who face obstacles like irregular schedules, stress-related insomnia, or noncompliant with avoiding screen time before bed.

Nutrition: Dietician - Cost, availability, or transportation issues.

Exercise: Physical limitations, chronic pain, or lack of motivation.

Mental and Emotional Wellness: Long wait times or stigma around mental health.

Social Wellness: encouraging participation in social activities can be difficult if patients are experiencing social anxiety or isolation. They may resist engaging in new relationships.

Spiritual Wellness: Meditation or mindfulness.

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Sleep: Establish healthy sleep habits and address any sleep disorders.

Key Health issues:

Decreased cognitive function, mental health and immune system.

Increased weight, chance of accidents, incidence of chronic disease (ie. cancer)

Assessment:

Assess sleep hygiene habits via sleep journal/tracker.

How many hours of sleep per night?

Factors disrupting sleep (ie. phone before bed, bright or noisy environment, etc.).

Lifestyle (ei. shift work)

Underlying conditions

Are medication and/or devices for sleep disorders properly addressed and adhered to?

CPAP machine for sleep apnea

insomnia

restless leg syndrome

Nutrition: Develop balanced diet plans that meet the individual’s dietary needs and preferences.

Key Health issues:

Malnutrition, overnutrition, nutrient deficiencies.

Assessment:

Track eating habits by completing a food diary.

Assess current well-being (BP, weight, BMI, blood work, energy levels)

Identify nutritional goals and health concerns.

Plan:

Consult with a registered dietician.

Educate on food literacy (ie. macronutrients, foods to avoid, reading food label, healthy plate ratios).

Create an individualized and realistic meal plan based on age, sex & activity level.

Exercise: Create personalized physical activity programs to improve fitness and health.

Key Health issues: Muscle atrophy, cardiovascular health, joint health.

Assessment:

Identify personal goals, motivation & fears.

Determine current physical capabilities, energy levels, nutritional status, & vital signs to ensure safety of activities.

Address any underlying cause of physical intolerance (ie. fatigue due to sleep deprivation).

Plan:

Consult with PhysioTherapist (if applicable).

Set realistic and achievable goals for age, sex, weight and activity level.

Optimize pain management prior to activity (if applicable).

Holistic Health Therapies: Incorporate alternative therapies such as acupuncture, massage, or herbal medicine.

Key Health issues: pain

Assessment:

Identify what medications, supplements and herbal medicines are being taken. Check for contraindications.

Plan:

Working synergistically with Western medicine:

Mutual goal-setting with patient.

Patient education.

Collaboration with other healthcare professionals (ie. Chinese Medicine, Chiropractors, Naturopaths).

Complementary and alternative therapies (ie. acupuncture, light therapy, massage, and meditation).

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Mental Health: Strategies to manage stress, anxiety, and depression, including counseling and mental health therapies.

Key Health issues: stress, anxiety, and depression

Assessment:

Identifying triggers, coping mechanisms (healthy vs unhealthy), & goals

Assess awareness of unhealthy habits or behaviours (utilize mood journal).

Assess past & current achievements.

Assess support system.

Plan:

Promoting mindfulness & relaxation exercises (ie. deep breathing, meditation, positive affirmations).

Engaging in physical activities (walking, yoga, jogging).

Establishing healthy boundaries.

Referral to psychiatry or mental health professional (if applicable) & education on Dialectictal Behaviour Therapy. (DBT)

Promote methods to build coping skills & tolerance to stressors.

Emotional Health: Techniques to enhance emotional resilience, self-awareness, and emotional regulation.

Key Health issues: emotional imbalance contributing to stress, anxiety, and depression

Assessment:

Listen with empathy & compassion.

Identify stressors

coping mechanisms (healthy vs unhealthy), & goals

Assess awareness of unhealthy habits or behaviours (utilize mood journal).

Assess past & current achievements (perceived self-worth).

Assess support system.

Plan:

Promoting mindfulness & relaxation exercises (ie. deep breathing, meditation, positive affirmations).

Engaging in physical activities (walking, yoga, jogging).

Promoting self-compassion

Strengthening support system & making social connections.

Setting healthy boundaries.

Promote methods to build coping skills & tolerance to stressors.

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Relationships: Building and maintaining healthy relationships with family, friends, and the community.

Key Health issues: Social stress: social withdrawal, isolation or overwhelm.

Assessment:

Assess for support systems/groups.

Quality of relationships (superficial vs deep, healthy vs strained).

Patient's feelings or perceptions of relationships.

Plan:

Scheduling regular social/family gatherings, finding activities that promote bonding or engaging in new activities to make new bonds.

Schedule regular check-ins.

Joins local organization or clubs, reingage.

Setting healthy boundaries.

Social Activities: Encouraging participation in social activities and community engagement to enhance social connections.

Key Health issues: Social stress: social withdrawal, isolation or overwhelm.

Assessment:

Determine barriers to participating, patient’s feelings & perceptions.

Assess for self-esteem and social behaviours.

Does patient have social support?

Plan:

Listen, collaborate with speech or behavioural therapy

Encourage joining groups or online/apps

Encourage volunteering or even attending social places without the pressure to be social.

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Spiritual Practices: Incorporating practices such as meditation, prayer, or mindfulness.

Key Health issues: lack of deeper “connectedness” to rely on in times fo stress

Assessment:

Assess for spirituality (atheist, agnostic, spiritual, religious). And what it means to them.

What is your relationship with your spirituality and how do you rely on it in times of stress.

Plan:

Encourage mindfulness and meditation activities.

Join groups or retreats, alliances that align with your values.

Nature connections, outdoor activities.

Joyous movement.

Scriptural texts and study.

Values and Beliefs: Encouraging alignment of personal values and beliefs with daily actions and decisions.

Key Health issues: moral conflict, stress

Assessment:

Self reflect and assess for moral conflict or other stressors.

Respectfully listen to and support individuals with differing beliefs.

Cultural sensitivity and humility.

Plan:

Provide continuous, high quality care (until safe transfer of care if applicable).

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Self-Esteem: Developing strategies to improve self-esteem and body image.

Key Health issues: loss of function/appearance (mastectomy, amputation, scarring, acne), eating disorder, gender identity (conflict)

Assessment:

Assess meaning of change/loss to patient and what perceived effect it will have on relationships and social activities.

Assess patient’s remarks, feelings and behaviours towards perceived or actual changes to their body (whole body, body part, function or size).

Assess accuracy of self-perception/visualization. Repeat assessment for perceptions of how they view self and how others view them.

Plan:

Establish rapport with patients through appropriate grief processing, limiting maladaptive behaviours and promoting separation of feelings of “self-worth” from feelings of changes to the body.

Promote self-esteem and positive coping.

Promoting social interactions.

Initiating health teachings.

Personal Development: Setting and achieving personal goals, and engaging in continuous learning and self-improvement.

Key Health issues: self-satisfaction, personal growth

Assessment:

Identify goals and aspirations.

Assess past behaviours and coping mechanisms (positive and negative) contributing to past goal achievement or failure.

Assess self-awareness and readiness for change.

Plan:

Self-affirmations, mindfulness exercises, celebrate accomplishments.

Develop coping strategies (motivational phrases, people), set short and long term goals.

Set goals with realistic expectations.

Referral to mental health and inter-team collaboration (if applicable).

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Preventive Care: Regular health check-ups, screenings, and vaccinations.

Key Health issues: Preventing or slowing chronic diseases

Assessment:

Assess patient’s health literacy and familiarity with preventative care measures.

Plan:

Educating patients.

Providing immunizations, encouraging screenings, prescribing medications (if applicable),.

Encouraging monitoring and managing of conditions before they progress to chronic diseases.

Public health education.

Health Education: Providing information on healthy lifestyle choices and disease prevention.

Key Health issues: Preventing or slowing chronic diseases

Assessment:

Assess patient’s health literacy: Assess learning needs (patient’s experiences, perspectives, motivation, abilities, health literacy, and culture),

Plan:

Use appropriate teaching method for patient’s learning style for health promotion.

Setting SMART goals (specific, measurable, achievable, relevant, time-bound).

Plan is holistic, equitable, participative, patient-focused.

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Stress Management: Techniques to manage and reduce stress, such as relaxation exercises, time management, and coping strategies.

Key Health issues: Stress as a contributing factor of health issues and chronic health issues, PTSD and anxiety disorders (GAD, OCD, Panic disorder, phobic disorders)

Assessment:

Identify stressors. Assess level of stress, verbalized and physical signs of stress (behaviour observation).

Assess patient self-awareness of triggers to stress.

past coping mechanisms (successful vs unsuccessful coping) .

ability to express feelings.

Plan:

Assist patient with relaxation techniques (deep breathing, music therapy, imagery)

maintaining positive coping strategies.

Avoiding triggers.

Stress management techniques (time management).

Adaptation: Developing resilience and the ability to adapt to life changes and challenges.

Key Health issues: Stress due to inability to cope with life changes as a contributing factor of health issues and chronic health issues

Assessment:

Identify aspects of patient’s life they identity are challenging to adapt to.

Assess level of stress to adapting, verbalized and physical signs of stress (behaviour observation).

Assess patient self-awareness of why they may be failing to adapt, past coping mechanisms (successful vs unsuccessful coping) and ability to express feelings about adapting.

Identify ineffective behaviour(s) and probable cause.

Plan:

Seat realistic SMART goals with patient to improve their behaviour.

Collaborate with patient to build new habits.

Be gentle with yourself.

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Wellness Plan Implemented in  Educational Setting

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Wellness Plan Implemented in  Educational Setting

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Step 1: Evaluation of Requirements

To identify goal behaviours (e.g., physical activity, healthy eating, stress management), conduct focus groups or surveys.

Evaluate the staff's and students' present behaviour change stage.

Step 2: Development of the Program

Develop a thorough wellness program that addresses the behaviours that have been identified.

Create interventions tailored to each stage:

-Pre-contemplation: educational sessions and awareness initiatives.

Reflection: Motivational interviewing and goal-setting.

-Preparation includes training to develop skills and the availability of resources.

-Action: Accountability partners and support groups.

-Maintenance: Incentives and reinforcement.

Step 3: Strategies for Intervention

Including health and wellness in the curriculum:

- Health education courses.

- Including exercise in everyday activities.

Campus-wide projects:

Healthy meal options.

Workshops on stress management.

- Exercise courses.

Rewards and incentives:

- Gym membership discounts.

Scholarships for wellness.

Step 4: Assessment and Input

Evaluate program effectiveness on a regular basis.

Collect participant feedback.

Revise interventions in response to evaluation findings.

Step 5: Sustainability and Maintenance

Form a committee for wellbeing.

Safe administrative assistance.

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Methods of Evaluation:

Surveys and questionnaires: Evaluate participants' motivation, self-efficacy, and level of change.

Assess perceived effectiveness and program satisfaction.

Monitoring participation:

Maintain updated on adhesion, engagement, and percentages of attendees.

Monitor the completion of program factors, for example fitness classes and workshops.

Monitoring Development:

Regular updates on progress:

Monitor involvement, participation, and health results.

Determine what needs to be improved.

Weekly assessments:

Evaluate participant satisfaction and program success.

Collect input from participants and attendees.

Making Modifications:

Data-driven decision-making: Utilize assessment results to guide program modifications.

Address areas where effectiveness or involvement are poor.

Participants input: Take into account the opinions of educators, people, and participants.

Ensure that the program is responsive and relevant.

Adjustment Strategies:

Improve communication:

Make the objectives, advantages, and expectations of the program clear.

Improve awareness and promotion.

Make things more accessible:

Provide incentives, online choices, or flexible schedule.

Resolve obstacles to involvement.

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Physical Wellness: Recommend gradual changes.

-Suggest using blue-light filters or setting their device to night mode.

Nutrition: Connect patients with virtual dieticians.

-Teaching patients about food label reading and basic macronutrients.

Exercise: Recommend low-impact exercises.

-Encourage small realistic goals, focusing on gradual progress.

Mental and Emotional Wellness: Explore digital mental health apps that offer guided meditation, breathing exercises, or CBT-based activities.

-Educating patients about basic self-care practices.

Social Wellness: Suggest activities that promote socialization in low-pressure environments.

-Encourage gradual engagement.

Spiritual Wellness: Work with patients to identify practices that align with their personal values.

-Suggest spiritual practices they may find meaningful.

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Questions:

1. Which part of the wellness domain was the strongest? Which part was the weakest? What recommendations for improvement to the plan do you have?

2. For our wellness plan, do you believe the transtheoretical model is an effective theory for behaviour change, and if so, why?

3. Given the proposed solutions to our potential challenges with the wellness care plan, are there still any weaknesses, or what could be added to improve the result of these challenges?

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Transtheoretical Model (TTM) Applied to The Wellness Plan -6 Stages

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Transtheoretical Model (TTM) Applied to The Wellness Plan -6 Stages

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Stages 1 & 2: Pre-contemplation/Contemplation:

Raise awareness about the importance of wellness

List the benefits and disadvantages of implementing healthy habits

Assess readiness to change

Stage 3.Preparation:

Set specific, measurable goals.

Develop an action plan

Determine potential obstacles

Stage 4.Action:

Implement wellness strategies

Monitor progress.

Address difficulties

Stage 5.Maintence:

Strengthen newly acquired habits

Prevent relapse

Celebrate accomplishments

Stage 6.Termination:

Combine achievements

Develop long-term maintenance plan.

Evaluate overall progress.

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