We are saddened to learn that our guest blogger, Bob Boardman, recently passed away. Our hearts and thoughts go out to Bob's family and friends. His final blog post is below.

Hi again. Nice to be back.

One of the things I like most about the Conversation Map tools is their flexibility. You can expand and modify Map sessions to reflect participant needs and your own experience. Today I want to talk about action plans and how we use them as part of a Conversation Map session.

I like action plans. They're where the rubber meets the road in self-management... a more structured sort of goal setting. A Conversation Map session involves a lot of facts, ideas, handouts, teaching, learning and sharing. An action plan translates all those elements into real-world change.

According to the Stages of Change model, readiness for change is a continuum; from "never" (pre contemplation) to "someday" (contemplation) to "soon" (preparation) to "now" (ACTION!!) and finally "always" (maintenance).

It's estimated that only 20% of people are at the action stage for any suggested change. (This may also explain why somewhere between 50% to 75% of patients ignore their providers advice.) Action plans improve the odds for forward motion.

Here's how we use action plans within a Conversation Map session. I always allow 15-20 minutes at the end of a session to devote to the plans. The first week I'll explain the ground rules.

• The plan should be something they're interested in working on. I may bring up some of the things we've talked about in the session as possible areas to consider.
• The plan should be specific. It could be S.M.A.R.T. (Specific, Measurable, Action oriented, Realistic, Time limited) or answer the questions, What?, When?, Where?, How often? Etc.
• Once the goal is set, how confident are they, on a scale of 1-10, that they can actually do it? We're looking for a confidence of 7 or higher. If it's less, is there a way they could modify their plan (usually making it easier) to boost their confidence? The real idea here is to SUCCEED. We want to build on success.

The facilitator goes first. My own plan models the ground rules and it's usually something any of the participants could do.

Then everyone works through his or her goals for next week. If a plan is too vague, could it be more specific? If his or her confidence is low, what would it take to bump it up over 7? Any ideas from the group?

Next week's Map session, starts with last week's action plans. Again, the facilitator goes first and we work our way around the table. Did they succeed? Change their plan? What got in the way? How might they have worked around that? Would they like some ideas from their always helpful fellow participants? The weekly exercise becomes another opportunity for group problem solving and support.

In our post-session evaluations, action plans get credit as the tool patients will continue to use as they progress on their diabetes journey.

What's your experience with helping patients set goals? Do you use action plans as part of your Conversation Map session? What worked and what didn't work so well? Keep us posted.

Thanks! Bob