Setup each station with one table, two chairs, one to three privacy screens, and all of the necessary paperwork that needs to be distributed. Try to place the tables against a wall and make the stations as private as possible. It is recommended that the chairs face each other, without the table in between.

Calling up Participants

When calling participants to counseling, announce the individual’s first name and have the individual provide you with their last name and date of birth. It is important to verify at least three participant identifiers (first name, last name, date of birth, and/or unique ID) prior to sharing values with the participant. Ensure the participant is not provided with any values (verbal or written) until their identity has been verified.

Definition & Purpose

Results review is designed to provide the participants with an overview of their results and what their results mean. Results review is intended to be positive and informative for the participant.

Implementation

Welcome

• Welcome the participant and introduce yourself.
• Explain that you will be “explaining the meaning of the participant’s numbers today.”
• Ensure both the handout and consent form/iPad include all of the participant’s values.

Review Results

• Use the handout or onsite data collection results review page to guide the participant through each result.
  • Make sure to point to the results, never voice actual values out loud and avoid visible, verbal or nonverbal cues as to what health data you might be discussing.
• Explain what each reading is and if the participant is doing well or needs work. 

Next Steps

• Make sure the participant knows exactly what to do next.
  • Complete the satisfaction survey – either online using the iPad or via a paper form.
  • Complete their health assessment, if applicable and utilize other available client programs.

Question

• Close the conversation by asking if the participant has any questions.
  • Is there anything else I can go over?
  • Do you have any questions for me before you go?

Paperwork

• Participant should leave with their handout, and any client specific paperwork.
• Keep the TotalWellness consent form. Be sure to store upside down.

Important Points

Duration

Results review should be limited to 3-5 minutes of conversation. If you are providing services in a pod setting, be sure the entire screening duration, including results review, is between 10-15 minutes long.

Screening vs. Diagnosing

TotalWellness services are for screening and education purposes only. We never diagnose at a screening. If an individual has elevated or at risk values, they should always be referred to their primary care provider for follow-up.

Body Mass Index (BMI)

When discussing BMI avoid using the words overweight or obese. Instead, utilize the language “at higher risk” or “at a lower risk”. Point to the categories on the handout and indicated where the participant currently is and where the participant should aim to be. Keep in mind that BMI is not always a reliable measure of health. BMI may overestimate body fat in athletes and others who have a muscular build. BMI may underestimate body fat in older persons and others who have lost muscle mass.

Waist Circumference

When talking about waist circumference remember to incorporate BMI. Individuals who carry weight in their abdomen are at higher risk of health conditions than individuals who carry weight in their hips. If an individual has a BMI in the overweight category, but has a waist circumference in the normal category, their risk for health conditions will likely be lower because they aren’t carrying their weight in their abdomen.

Blood Pressure

Blood pressure fluctuates, and tends to be higher in a health screening setting. Stress, anxiety, temperature, caffeine, alcohol, and nicotine can all affect an individual’s blood pressure. It is important to ensure the participant feels that he/she received an accurate reading. If an individual is unhappy with their blood pressure results, offer to test the participant’s blood pressure again. If the participant has a blood pressure of 130/80 mmHg or higher make sure you recommend that they follow up with their primary care provider to evaluate their blood pressure.

Cholesterol & Triglycerides

When discussing cholesterol it is important to look at whether the individual fasted. Total cholesterol (TC), HDL cholesterol, and TC/HDL ratio are all accurate without fasting. LDL and triglycerides may be inaccurate if the individual is non-fasting. If an individual has fasted LDL and triglycerides can be discussed as normal. If the individual has not fasted, still review the LDL and triglyceride values but be sure to indicate that the results may not be accurate because the individual did not fast. Generally, if the values are in the normal range you can say that even though the individual did not fast their values look good. If the individual has elevated values, disclose that the values may be inaccurate because the individual did not fast and the participant should not utilize the values provided.

Glucose

When reviewing glucose results with the participant, be sure to look at the participant’s fasting status and use the appropriate results chart, either fasting or non-fasting. Results for glucose are accurate if the participant did or did not fast, but the results ranges vary according to fasting status. Elevated glucose values can be an indicator for diabetes. Encourage participants who know they have diabetes to manage their diabetes according to their doctor’s recommendations and continue to see their doctor regularly.

Finger-Stick vs. Venipuncture Blood Draw

Participants often question if finger-sticks are as accurate as blood draws. The answer is yes, both finger-stick and venipuncture blood draw samples are required to meet certain criteria for the analyzers to be approved. All analyzers utilized by TotalWellness meet the set criteria. One of the main differences between the two is that finger-stick tests are used for screening only, while venipuncture blood draw samples are utilized for diagnostic purposes. TotalWellness generally encourages finger-stick tests because they provide instant results and an opportunity for a teachable moment with the participant.

Weight Management

Weight management can be a difficult topic to discuss with participants. It is important to address the participant’s chief concern first, independent of weight. You can assume that most participants already know that they are not at their optimal weight. Generally participants do not want health care professionals to place blame or attribute all of their health problems to weight. We recommend that you encourage healthy behaviors such as eating healthy and increasing physical activity, but don’t specifically recommend weight loss or weight gain.

Healthy Eating

Nearly all of the values assessed can be improved with healthy eating habits. Be sure to keep recommendations generic. Recommend increasing fruit, vegetable, and whole grain consumption and decreasing foods high in fat, salt, and sugar.   Give participants tips about choosing low-fat or non-fat dairy products over full fat versions. Encourage moderation.

• DO NOT encourage participants to eat a specific food or avoid a specific food, be general.
• DO NOT recommend vitamin supplements or diet plans.

Physical Activity

Physical activity is also a great way to improve values. National recommendations are to get at least 30 minutes of exercise per day, most days of the week. Encourage participants to start with something easy like walking. Also encourage participants to make exercise fun. They can do anything that interests them, gardening, dancing, yoga, etc.

• DO NOT recommend a specific type of physical activity. Make sure you provide general examples, not specific recommendations.