Pathways to Change Game

Health behaviors and behavior change are key components of many, if not most health initiatives. However, getting individuals to change a behavior that puts their health at risk is frequently more difficult than it might initially seem. While many of us may assume that once people understand the risks, they will make the necessary changes in their behaviors, this is often not true. People, being human beings after all, may well continue risky health behaviors even after the potential consequences of those behaviors are pointed out to them. Various health behavior theories account for the personal, social and environmental barriers and facilitators of behavior change that can influence an individual’s willingness to change. One problem is that health experts sometimes assume they know what those barriers and facilitators of behavior change are within a particular community, when they may well be missing pertinent information. However, surveys and other means of soliciting information from the community may not be the best ways to increasing such understanding. What to do?

Pathways to Change Game


Pathfinder International has introduced a Pathways to Change board game, available free online at in various languages and in a low literacy version for health outreach workers to use with communties to prompt discussion of behavior change barriers and facilitators. It is fun and noncompetitive – the object is to increase awareness, both on the part of the players and the moderators leading the discussions, about the sometimes hidden factors that may influence people to adopt less risky behaviors (or not). The low literacy version uses pictograms in place of words and letters on the spaces of the board, so that only the moderator must be literate in the language. Working from a brief “character profile” (ideally developed by local community health workers or peer educators so that it is locally relevant) with work, social and educational characteristics and a specific health behavior change objective, each team of 3-6 players rolls a dice to advance on the board and lands on either a Barrier or Facilitator (in either the personal, social or environmental realm), or a Setback space. Depending on which space the team  ends up on, it must propose a relevant barrier or facilitator that might influence the behavior change. Of course, if it is a Setback square, the team must move back a certain number of spaces. The moderator’s function is to explain the game and ensure thoughtful discussion among the participants, and keep notes on that discussion. The Moderator’s Handbook includes other related activities to spur discussion.

It is easy to see the use for this type of fun, engaging activity, wherever the geographic locale or  whatever the health behavior in question. It also seems easily adaptable to various age groups, even among schoolchildren. While it is a decidedly low tech approach to raising awareness of health behavior change factors, the online availability of the game increases its ease of adoption considerably. How might you use such a tool in your work?

Now where was I….?

Does everyone struggle with distraction these days?  We all have so many things to do and whether you are trying to AVOID doing something or you have SO MANY things to do that you jump from one to another, getting them all done seems impossible.  Especially this time of year when there actually IS something shiny over there beckoning to you. So how to stay focused and get things done?

Know WHAT it is you need to get done

I’m a firm believer in to-do lists.  There are so, so many available now and we’ve covered this topic (use the blog search feature to find previous posts) before so I won’t go into great detail here but as I tell my kids, how do  you get stuff done when you don’t know what actually needs to get done?

Pick the right TIME to do it

I have better focus in the morning but my son isn’t even fully awake until afternoon, I don’t think.  I have learned that 7 to 9 am is my best shot at getting any writing for the day done.  Look at your own schedule and preferences.  You can’t always set your own schedule but when you can, use your time most productively.

Create the right ENVIRONMENT

If I’m trying NOT to do something it is amazing how being hot/cold/hungry/restless can throw me off.  I could get this post written if only had a cup of coffee.  Set the stage as best you can.  If you are really struggling try standing or exercise. Standing desks apparently can make you more productive.  I’m not sure if I can say that I believe this is true but I do agree that if I sit too long I get fidgety and want to get up and wander around.  In fact exercise can help you focus and remember it seems.  So maybe a few minutes of wandering around can help me get back to work.  You can also try music if that isn’t just another distraction.  Spotify has some great playlists for work. (Browse or search playlists.)

Let TECHNOLOGY help not hinder

If you can’t be trusted not to be on Facebook when you opened a browser to do research try an app blocker on your computer set to limit what you can use.  Cold Turkey is a new one designed to block certain apps at certain times.  (Since this one is SO hard to get around I’m afraid to try it.  It is tempting though.)  The app is user supported–pay what it is worth to you.  There are lots of others depending on the tool/operating system/app you want to block.

Is it important to manage distractions?  Yes.  Yes, it is.  Is it hard to manage distractions?  Yes, it is.

Lifehacker addresses this question often, they have some great advice.

Stay focused on the current task with a “procrastination pad”

Don’t do research when  you hit your writing groove

How can I improve my short attention span?

Master the art of the to-do list by understanding how they fail

How to focus and stay productive when you’re expected to always be available

Good luck and make 2014 your most productive yet!


3D Printing and the Future

Ever since I first started watching Star Trek I have wanted a replicator. The thought of coming home and saying “Computer, wine, Merlot” just makes me smile. And the clean up! You just put the empty class back and it disappears.

Tea, Earl Grey, Hot.

As it turns out we may not be far away from having that replicated cup of tea or wine. In fact, we may be really close to things a lot more important.

3D-printing has been around since mid-eighties but it was expensive and no one could think of really cool ways to use it except for things like architectural models and prototypes.

3D printers create solid 3-dementional objects by adding layers from the bottom up called an additive process. For a couple of thousand bucks you can buy a 3D printer that can happily “print” plastic thingies for you. Break your sun glasses? Just scan the pieces and print out a new pair.

Now this is all nice but what if the printer used other materials besides plastic thingamabobs? We are in the health sciences so let’s consider some of the applications that folks are researching right now.

  • Made to order prosthetic limbs.
  • Your custom prosthetic limbs can also be printed to be more like an actual arm or leg with moving joints even in the toes.
  • Chemicals smaller than a grain of sand are also being printed. Thus, your drugs can be made custom as well.
  • Bio-Ink can used to print tissue. Cartilage and bone has already been developed and skin for burn victims is being developed.

Imagine for a moment what 3D printing means for people needing an organ…..

Want to know more? Check out these two videos.


I Quantify, Therefore I am

As we roll toward the end of the year, we start thinking about New Year’s resolutions. 2014 is coming!!! It is the year I’m going to be more conscious about self-tracking. Yes, I know it sounds crazy and obsessive (and maybe it is) but I’m a librarian and I think data is cool! You know that some of us already track food using apps like Lose it and MyFitnessPal so this post will focus on activity devices and apps.

Self-tracking and using data are part of a new movement called Quantified Self (QS). This movement creates new opportunities to promote consumer engagement in health and wellness. There is not a generally accepted definition of “Quantified Self” however; Wikipedia states “QS is a movement to incorporate technology into data acquisition on aspects of a person’s daily life in terms of inputs (e.g. food consumed, quality of surrounding air), states (e.g. mood, arousal, blood oxygen levels), and performance (mental and physical).” The most concise definition can be found at, which has the tagline of “self knowledge through numbers.”

The QS movement has gained prominence due to the number of patient and consumer friendly technologies readily available. We have posted previously on Fitbit so you may be familiar with that device already but there are other comparable devices. These technologies track steps taken, sleep patterns, or calories burned. Tracking devices have several  similar features so in addition to reviewing standard features, differences in the most popular activity tracking devices are highlighted:  Fitbit, Body Media, Jawbone, Nike+™ FuelBand, and the new Basis B1 Band. All of these devices track the number of steps taken and calories burned. In addition to these measurements, Fitbit, Body Media, Jawbone and Basis track sleep patterns and sleep efficiency. Each tracking device offers a suite of complementary web applications or mobile apps allowing the user to upload data from their device. Additionally, some devices have a built in display. The Fitbit Force can display steps taken, distance traveled, calories burned, and stairs climbed. The Body Media family of armband devices does not have a built-in display but there is an optional display device that wirelessly communicates with the armband to show you calories burned, steps taken, and activity as it happens. The display also alerts you when daily targets are met features armband data from today and yesterday.  The Nike+™ FuelBand has a minimal display that tracks steps taken and calorie burned. One of the latest entrants into this market is the Basis B1 Band. Distinctive features of this device are measurement of optical blood flow (heart rate data), perspiration, skin temperature, and gamification (the use of game thinking and game mechanics to engage individuals in healthy habits).Basis B1 Band

Some device makers offer specialized services, e.g. Lark a sleep tacking device which helps people understand and enhance their sleep quality through monitoring and online counseling. This device is unique from the other devices previously mentioned that track sleep patterns since it features a wristband that wakes the user silently and gently with vibration. More recently, Lark recently released the Lark Life, which is comparable to the Fitbit family of devices feature-wise.

These devices range in price from $60 – $200, with some requiring additional monthly fees to access a Web dashboard interface to data and counseling.

In addition to these tracking devices, there are several activity-tracking apps for smartphones. For example, activity-tracking running apps include the popular  Runkeeper and Map My Run. Both are mature apps and provide distance, calories burned, maps using a Smartphone’s GPS, social features and goal setting. The social features of the running apps allow individuals to motivate friends and share running routes. The goal setting features act like a personal trainer by setting up a training plan to run anything from a 5k to a marathon. Moves similar to the running apps, tracks additional activities such as walking and cycling, using the smartphone’s ability to measure movements (e.g., accelerometer) and is less intrusive. The app runs in the background continuously and tracks everything the individual does with his smartphone in tow. The app displays the distance, duration, steps, and calories burned for each activity.

More specialized apps focus on specific activities. In addition to the LARK sleep-tracking device noted above, free or very low cost sleep tracking apps with similar features include Sleep As Android, Sleep Cycle, and SleepBot.

While all these devices and apps help consumers establish healthy habits and quantify their lives, there is a lot of room for improvement in the interoperability of data between these different devices and apps. Despite the issues… I am still choosing to quantify myself in 2014. Will you join me?

365 days of thanksgiving


(Photo Credit: Rustiqueart on FLICKR)

What do you appreciate most about Thanksgiving?  Time off from work or school to spend with family or friends?  Turkey & stuffing or pumpkin pie? Family traditions around football or shopping? The thing I like most about Thanksgiving (besides pumpkin pie with lots of whipped cream) is the focus on being thankful. It’s a holiday that reminds us of everything we have — enough food on the table and someone to enjoy it with. This is not to dismiss the losses many of us feel during holidays but sometimes these losses can remind us how important it is to appreciate what we have while we have it.

I always plan to celebrate #30daysofThanksgiving but somehow the beginning of November catches me by surprise. This year I’m trying a year of thanksgiving beginning on the 28th.  I’ve found helpful advice on creating a habit of gratitude from Leo Babauta’s Zen Habits, Robert Emmons’ Greater Good posts (and his book Thanks!) and Neil Pasricha’s The 3 A’s of awesome.

There is always always always something to be thankful for

(Photo Credit: Pretty Organized)

Here is some of the advice I will try to follow:

Paying attention to the present moment – this means not living my life on autopilot but noticing the cool clouds, great song on the radio, or cute babies in line at Publix.

Counting my blessings — this means counting all of the things I have to be grateful for — from waking up each morning to the warm water in the shower to the food I eat — and not taking them for granted. (Creating a ritual for this activity is helpful –whether it’s each morning with coffee or before a meal or at bedtime — in this case autopilot in the form of ritual is good!)

 Writing down what I’m thankful for — I’ve seen this advice in several places and have tried it on and off.  I’ve had friends post their daily lists on Facebook during November and been inspired by strangers’ lists on blogs like 3 Beautiful Things.   According to this article on keeping a gratitude journal, it’s actually more effective to do this once or twice a week instead of every day.  If you can’t do it every week, you can do it once a year — our Christmas card includes a hand written list of all things we’re thankful for as a border for the picture of our kids (and sometimes dogs).

Saying thank you to others –  telling my family thank you is something I try to do every day but I know I’m not as good at this with my coworkers or friends.  To be effective, the thank-you needs to genuine and specific. With all the cool thank you cards out there, there’s no excuse not to send a thank you note to someone who has been a help. And sending a hand written note really stands out in the world of emails and text messages.

Giving others something to be thankful for by being kind or patient or extra encouraging to someone I know.  I’ll be more mindful about giving my coworker or child my full attention and find time to share something funny or uplifting with a friend. (If you’re my coworker or child reading this, feel free to remind me if I fall short : – )

Need inspiration? Check out this TED talk by Louie Schwartzberg on Nature.Beauty. Gratitude or Neil Pasricha’s The 3 A’s of awesome.

Thank you for sharing any comments or tips you have on practicing gratitude. Happy Thanksgiving!  Valerie

(Photo Credit: Louie Schwartzberg)

(Photo Credit: Louie Schwartzberg)

3G Watchdog

watchdogMost people have no idea how much data they use monthly on their cellphone until they get a dreaded overage message. I’m still on the unlimited data plan with Verizon, but  soon it will be time to stop clinging to the past.  To help me with my transition, I’ve been using an app called 3g Watchdog.


The app has helped me track how much data I’m actually using. You can set your quota limits and billing dates;  for example, set a limit of 2G per month starting on the 18th and you can get a notification when you are at 75% of the quota. You can view daily, weekly or monthly usage and see how much time you have left before your monthly plan resets.

The icon in your notification bar will advise you of your status from a glance by changing from green to yellow to red. It will also send you notifications when you are getting close to your limit and it can even be set to auto disable your mobile data to prevent overage. 3G Watchdog Pro gives you many advanced features like exporting a CSV file of your usage, viewing your usage by application or even restricting apps. I’ve found that the basic functions of the free version are enough to give me a good handle on what I’m using. This app is only available on Google Play but other similar applications Onavo Count and My Data Manager are available on Itunes.

PubMed Commons

Would you like to see a discussion by other scientists about new findings when you read a paper abstract?  Do you wish you could join in the discussion?  Do you enjoy the commentary and letters to the editor sections of journals and newspapers?  If so, read on…


PubMed Commons

PubMed Commons is a new service that will allow researchers to post comment on specific papers in PubMed. It is designed to be a forum that will encourage constructive criticism and high quality discussions that may enhance understanding and spark collaborations.  The screenshot below shows how the discussion displays in PubMed’s abstract view. (Click to enlarge image.)


During the time the Commons is a pilot project, participation is via invitation. If you are an author with a paper in PubMed and have eRA Commons credentials, you can invite yourself. Learn how to join PubMed Commons here.

You will need to have a My NCBI account and log into it when using PubMed.  That will allow you  to both see and post comments. To see all articles with comments on a specific topic, add AND has_user_comments[sb]  to your PubMed search.  Learn more about your My NCBI account here.

According to the NCBI, comments from the first few days after the site went live included “critique or pointed to other studies or reviews with the potential to change people’s interpretations or conclusions. Some authors posted corrections or changed their own conclusions in the light of others’ subsequent work. Authors also used PubMed Commons to update people on their work – including links to databases that have moved, providing contextual information and backstories as well as new, relevant work.

Many PubMed Commons participants took the opportunity to add links to relevant papers and data, sometimes in the non-PubMed academic literature or data repositories – including complete datasets, data re-analyses, blog posts and full text pre-prints of the article.”

PubMed Commons can be viewed as another tool in an emerging field sometimes labeled “post-publication peer-review.”  Two other options for reading commentary and adding your views to the discussion on published articles follow:

  • UAB licenses Faculty of 1000 which uses experts to identify and comment on noteworthy articles.
  • PubPeer is a free website striving to create an online community for discussion of scientific papers organized into a searchable online database.  PubPeer has released a browser plugin so users can identify articles with comments when searching PubMed.

Where PubMed Commons has requirements for the people posting commentary, PubPeer encourages anonymity.  Each has strong reasons for its requirements. If you are interested in these issues, both Nature News and Retraction Watch have discussed the PubMed Commons initiative.

Medical Technology, Caregiving and Health Literacy – Issues to Consider

The Affordable Care Act encourages the use of technology in making health care more efficient and less administratively complex. (This emphasis on technical efficiency may strike some as ironic, considering the initial online snafus plaguing the Marketplace registration site.) There have been other recent legislative efforts to address the adoption of electronic medical record keeping especially. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is particularly concerned about protecting the privacy of individuals’ health records in electronic transactions. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 established federal support for investment in health technology, including of course electronic health records. It seems that the impetus for medical technology is widespread in this particular point of our history.

At the same time, “patient engagement” has also become a key focus among health care providers. Patient engagement is defined as the process by which a patient is actively involved in maintaining or improving his or her health often in partnership with health care providers. (See For those patients whose conditions may necessitate their dependence on others to help them with their daily care, a caregiver can and should be recruited to act as partners in this patient engagement process. However, the family caregiver’s important role is sometimes overlooked by promoters of patient engagement. In addition, while many articles in the literature and online seem to naturally conclude that patient engagement and technology go hand in hand, there is a danger that those without technical means and/or know-how will be left further behind in this ever more “linked in” society.

As I write this, Health Literacy Month , which is observed in October of each year, is wrapping up. As a consumer health librarian, I encounter people every day who struggle with making sense of health and health care information, not to mention the complex health care system we all must navigate the best we can. Often these are folks who are caregivers for others in their families, a vital role not only for their own loved ones but generally speaking for all of us in society. Suzanne Mintz, blogging for Engaging the Patient, makes a credible case for regularly documenting who it is in a family that performs any primary caregiving role in the medical records of a patient. In so doing, not only is the role of caregiver highlighted and promoted to partner status with the healthcare team, but the caregiver’s health literacy skills might also be considered in any provider/patient communication, online or otherwise. The patient’s and caregiver’s preferences should be solicited in terms of how they want to receive information. Naturally, one would hope and expect that no provider would make assumptions about a patient’s or caregiver’s access to technology in communicating with him or her without checking first. Still, it is true as Ms. Mintz suggests that caregivers are often not given their due either system-wide, from insurers for example, or individually from providers. This is due for a change – and now seems to be the time!

How I work: tips and tricks

This week we are having an open discussion session around the How I Work series.  This is a series we’ve run on on this blog based on the Lifehacker series.  Here are some of the great things I’ve learned about from reading and posting my own entry.

Dual monitors–After seeing person after person with (at least) two monitors I made the switch and I can’t believe what a difference it makes.  I would say it is most helpful for managing chat reference but for most things you need to look at two things at once; email and a document, document and a powerpoint, email and a browser window, on and on.  If you can possibly get another monitor you won’t regret it.



YouTube Spotlight

A great place to find the most popular videos for the week.  Take a quick look at this so your teen doesn’t make fun of you for being the only person on earth who doesn’t know what that fox song is about.


Goaltracker app for web and iOS.  Has recently added groups for the 4 hour body and GTD.


To-do app for web, Android and iOS.  We have a post on this as well.  I like it because I can share to-do lists with others.


The founder of this site was included in the series and I now love this site to find the best tech.  I’m kinda lazy about the research so I love a site that does it for me.


Even better than Wirecutter since I buy a lot more of this stuff.  I don’t have to figure out which paper towels are better, they’ve done that for me!


Because SO many people say this site saves them I’ve given it another go.  The key I’ve read is to use it for everything so I’m going to do that for a month and if it still seems cumbersome I’ll give up

Evernote Clearly

A must-use if you want the stuff you put into Evernote to be clutter free.


Why use Pocket and Evernote both?  Pocket is for stuff that I want to read but not keep.  Throw that article into Pocket and when I’m waiting for the kids to finish band practice I have something to do.


In the hunt for the perfect cup of coffee this is the winner, hands down.  Cheap, easy, fast.  Buy one now.


how much time I am spending reading blogs you ask?  RescueTime will tell you.  Then you will be glad that keeping up with this stuff is PART of your job, not instead of your job.


I love this app since all the other people in my family like to ask me stuff like, when did the dog last go to the vet? Or when did we change the air filter for the HVAC?  They are impressed when I tell them (even if I am not right…)


Ok, I already knew about and used Spotify (though don’t use the web app, I thought it was TERRIBLE until I downloaded the desktop version, makes more sense now) but I have found lots of artist and playlists that I enjoy by reading what others listen to while at work.  Same goes for Podcasts.

I think it is interesting that the people who participate are so Mac heavy…I wonder what that means.  Since I switched to an iPhone since I did my post I guess that has influenced me as well.

Update:  Other things that came up in the session include:

Merriam-Webster Dictionary Apps

TED app iOS Android

Dropbox To share/save files

TransLoc To track the UAB buses

Doodle To schedule meetings


Google Hangouts Free conference calls

Thanks to everyone who participated!



I’m Jill Deaver, and this is how I work at Lister Hill Library

See also:  Lisa, Gabe & Pat

My badgeLocation: Lister Hill Library, Reference Department, Room 110

Current Gig: I started as an Intern for credit toward my MLIS in January 2013, but I’ve been on the payroll (Library Associate I), as of May 1, 2013.  I’m the newbie.

Current Mobile Device: iPhone 5s, silver.  I just upgraded from a 4s and it’s a big difference.  This one is so light weight and I’m digging the fingerprint scanner–bring the future!

Current Computer:  At the office, a DELL.  At home, a Macbook Air.

One word that best describes how you work: Everyday is a different day, so I’d have to say…Flexible.  If you’re a librarian, you pretty much have to be flexible with your time, your space, and your attitude.Epicurious App

What apps/software/tools can’t you live without: My Epicurious iPhone app. I love to cook, so it’s the one I use the most. Sometimes I worry that my life revolves around the next meal…such is the plight of a foodie, I guess.

What’s your workspace like:  It’s a lovely cubicle located in the Reference Department office suite, conveniently by the copy machine.  Yes, I could do the whole SNL “ma-kin’ cop-ies” routine–but I don’t.

I like to keep my desk clean, but if things are hectic you can tell by my desk.  To regain control, I often go into “delete mode” with everything on my desk and everything in my email.  It’s a gut-reaction decision process about what stays and what goes.

I have a few purposeful knickknacks: a chunk of brick for the streets of my Alma Matter, the University of Montevallo (to remind me of where I’ve been), a UAB, Blazer green, plastic ball which was thrown at me by a co-ed on University Blvd on day 2 of my Internship (I took it as a good omen), a picture of my husband playing an accordion (because he’s talented & I love him), and card with Wonder Woman prying open the mouth of a monster (to remind myself that I can do hard stuff too).

My work space

A pretty typical work situation–working on a project on screen left, and answering multiple chats on screen right. We get lots of APA style questions. And I drink lots of coffee.


What is your best life hack? Take the 10 minute break.

What’s your favorite to-do list manager? nothing fancy: iPhone calendar synced with my Outlook calendar.

Besides your phone and computer, what gadget can’t you live without? My hairdryer? (Well, that was embarrassing.)

What everyday thing are you better at than anyone else? Practicing patience, at least with everyone other than myself.

What are you currently reading? Who has time to read when there’s so much good TV on?  …I’m still getting over the end of Breaking Bad!  I read to learn (after all, I was an English major twice), and when I read I read heady novels & poetry.  I have to be in the right frame of mind to begin a novel.  For me, reading is more about dedication than escape & relaxation.

What do you listen to while at work? Mostly I listen for Reference Chat alerts.  Also the copy machine, and people talking to the copy machine ;)

As far as music at work goes, to quote John Cusack in High Fidelity, “I just want something I can ignore.”  Music is too distracting for Reference work.  Most of the time, I’m trying to help users find the information they need for their projects, or I’m trying to help them think through some pretty complicated search strategies.  Music gets in the way.  If I did listen to music at work, I’d pull up Birmingham’s own Substrate Radio. 

Are you more of an introvert or an extrovert?

I feel like I balance the two pretty well, but I’m an extrovert.  There are times that enjoy being alone—I like to put music on loud and cook something elaborate.  Most of the time I want to be around people.

What’s the best advice you’ve ever received?

After some less than stellar geography tests were handed back, my freshman-year History teachers scrawled this across the chalkboard: Hope is not a form of action.

You can hope all day long, but most things require effort, and a lot of it.

Fill in the blank: I’d love to see ­­­­­­­­­­­__________ answer these same questions.

Cara Wilhelm, with her multiple work spaces