Challenge Spotlight: Transforming Wellness in Diabetes with Alexis Steptoe
Alexis works as the Assistant Director of Thrivewell at NC State. Her work focuses on advancing the well-being of students, faculty, and staff through strategic planning and creative programming to help shape the culture of wellness. Alexis received a Bachelor of Science degree with a concentration in Health Education and Health Promotion from Radford University and obtained her Master of Public Health in Community Health Education from The University of North Carolina at Greensboro. She is a Nationally Board Certified Health and Wellness Coach (NBC-HWC) and a Certified Health Education Specialist (CHES.) In 2020, Alexis was awarded the National Wellness Institute’s Emerging Wellness Professional award. On Framework, she builds and runs wellness challenges for Dr. B Paul's patients who are looking to manage their diabetes with lifestyle changes.
What inspired you to start working as a lifestyle coach?
If I had to put a name to what I do, I would say I’m a behavior change specialist and lifestyle coach. I got started because I was looking for an outlet to help others be successful. I really like this quote from Arthur Ashe that says, “Start where you are, use what you have, do what you can." And I feel like that is the essence of a coach: they help you start somewhere, look within for the things that you have inside of you, use the things that you have, and not try to buy something—because we do have a lot within us already. Then start where you are, use what you have, do what you can, because what I can do today may be different than what I had two weeks ago and may be different than what it will be a year from now, because life is ever-changing. I was really looking for an opportunity to be able to work with individuals in a way that allows them to be the driver and their health and wellbeing like the GPS that’s like, “Oh, did you know there's an alternative route ahead?” Or, “Did you know that there's a road closure, so maybe we can forecast that for tomorrow's drive and plan accordingly.” So, in that way, helping individuals actualize their life and get what they want to get out of it.
I'm so passionate about health and wellness coaching is because it's so impactful. I think every single person can benefit from having someone that's in their corner. Because a lot of times we have our blinders on and we can't see past what we already know to be true until somebody says it back for us. So that's kind of it's fun. It's like a puzzle piece for me. And I love seeing people's breakthroughs, whether they're small or large.
Are there any unique or unusual approaches you take in your coaching?
I explain coaching and counseling in two different buckets. Counseling is like your heavy bag that you load on and off the plane. You need help getting it somewhere. You don't want that bag to open up and you know, your underwear to be out there—you don't want that. But coaching is your backpack, and your backpack is your utility—it's got all the things that you need to get through the day.
So I would say that coaching is a unique way of working with individuals—really focusing on that backpack. For me, for example, I really like to use trackers—which is why I like Framework: there are trackers that are built in. But if trackers aren’t for you, what are some other things that you can do? Maybe it’s physically taking a pebble and putting it in a jar or taking a pen and crossing out that day that you did that thing. It's not enough to just sit there; there has to be something that lets you interface with the goal while you're doing it. Because sometimes we have a goal that we set far off, and there's nothing concrete that we have to do along the way. We can make them SMART or SMARTER—adding the ER for Evaluating and Reward—we can add all those things, but unless you're doing something in between start to end, the likelihood of you actually achieving that goal is is not high.
So, why challenges? What appeals to you about them?
I think because by nature we're temporal—we're time based. So if we know that there's something that is coming, or that we are anticipating something, especially with technology, we can nudge people, we can have our notification pop up from challenges to me to give me a nudge. I also think that the the follow through of knowing that you're in it for a short duration. Doing something that is seven days, fourteen days, thirty days—that's a bite sized piece of something that feels manageable. You build confidence along the way and you say, “You know what, every small drop in the bucket is getting me closer to this thing.” And once you have a few drops and you start seeing that first little layer covering the bottom of the bucket, you say, “Whoa, something's happening.” And the more the more it rises and rises, and you think, “I'm doing good things,” which is where the internal intrinsic motivation in the learning comes in.
And then of course, the community element: when you're doing it as part of a group you're more inclined to do that thing. If we know that other folks are doing the same thing that we're doing, we're more likely in those times where you think, “I'm not really feeling it,” but then, neither was this person! And you see that they, you know, they even just went outside to stretch. And you think, “Okay, that still counts. Yeah, that is that is a step in the right direction.” So if I'm doing a challenge as part of a team, there might be times where I feel like I'll give myself a pass, but because I'm participating in this bubble of a challenge, I'm going to be more likely to do that thing for the group.
What specifically are you trying to help Dr. Paul's patients achieve with your challenges?
Dr. Paul is just looking to engage her patients, but she's doing it to engage them truly for the betterment of the individuals—trying to give people as many opportunities to find their fit. And by that, I mean, if you like coming and visiting with her in the office, there's a space for that. If you want to join a community, there's a space for that. If you want to just learn, you know, by course, by topic, there's a space for that. So I think she's trying to give her patients different avenues, because there's so many different ways that people enter into their health care. There might be someone whose diabetes is really uncontrolled, or somebody who just needs help with carb counting. How do you have a medium for that range of people?
So in this most recent challenge, we tried a Healthy Habits Challenge with the inspiration that you can pick and choose what you're doing. And it’s kind of redundant—it repeats itself, so you can work on sleep for two weeks, and then the next week, you can work on something else if you want. And it’s helping us really figure out what our patient population wants and needs. So we've tried this overarching approach of, “Come as you are, pick what you need.”
But now, I want to see if we take the approach of a challenge targeted at a specific topic, what the what the difference is there, if there's more engagement, if there's more submissions, if there's more tracking, so we're going from that kind of like large umbrella of like “You do you,” to, “We're all doing this one thing together.” So that was what we have for coming up for July, with a Hydration Challenge we’ll be running. And it's going to be seven days real quick and simple. It’s mostly about getting feedback, because again, this isn't something that has been done in her kind of world before with the patients that she serves. So we're kind of guinea pig in a lot of ways, getting lots of feedback along the way.
So what’s your challenge formula? What did you choose to include in your day to day?
Yeah, so definitely always love to have some bit of education. I think that that's really important to have something educational that frames it, so we're all on the same page. Then I always think that there should be some type of call to action: this is what we're doing all together. I would also say, offering spaces where people can offload and reflect reflection is key. Giving a space where people can talk and communicate about what's going on with them specifically, because people love to talk about themselves I appreciate that in Framework, you can do the little slider bar. For some people, that's enough, like, “Today was a five,” but somebody might want to write and explain why. So we should give a reflection opportunity for both of those types of learners and offer them different mediums. And then, ultimately, the tracker piece: How am I doing day by day and how is it building? That helps us bring it all together. And then, of course, at the end, celebrating the success that is even trying, even attempting. And if we can incentivize, if there's some type of incentive that brings people back—a water bottle, a massage—something that people are working towards that enhances engagement. And finally, resources: What can I connect them to that helps them outside of here that's reputable? So that way they have somewhere to go and can find more information on their own.
So I would say those are the main components, 1) education, 2) call to action, 3) some type of space for reflection, 4) some type of tracking, and then 5) resources.
How did the experience go for the patients?
The main feedback was that it's very nice to have a reminder of my goal to be well. We often want to put the onus on individuals to be well, however, we all have incredibly busy lives, and there's a lot that's going on in the world, and we're just doing our best to survive. So where do we bridge that survival and taking care of you know, like our basic needs with our aspirational selves? So, I think the group really found that community experience of being able to share individually really helpful. And then having those nudges built in that reminds them that their wellness does matter.
Are there any goals that you've set for yourself as a coach that you're hoping to reach?
So definitely spending more time in Framework with Dr. Paul’s patients, because I think truly, deeply to my heart, think this is the future of health care. Even though I am not providing the care of their diabetes management, I'm the lifestyle piece that helps them manage their diabetes more effectively. So I would say, in that regard, I want to grow the challenges and provide two layers: the challenge piece, but then also a general drop in, because I think that will provide opportunity for people to tap in when they need to have that specified time, okay, I'm doing a challenge versus I'm just tapping in because, you know, I need a reminder of my health and my well being whether that's a webinar or whether that is an article that is something that you can digest you can interact with, you can comment on and then move on about your day. And then the ones that are like the true challenges where I'm setting myself up for the next seven days, or the next 14 days with these, this group of people. So those are the two kind of goals that I have, but definitely increasing participation, and really learning the the back end to be able to provide product in a way that is most usable for this population. So yeah, those would be the things that I'm working towards.
If someone out there is curious about building a challenge but not sure how to get started or whether or not to take the leap, what advice would you give them?
The goal that Dr. Paul and I had was to just do something. So, just do something, put something out there. Even if it's three days, even if it's a one day, even if it's seven days, put something out there, because that is what gets you over the hump of the fear of doing it and doing it wrong. If you just do it, then it's done. And I don't say that to minimize the amount that it takes to like put something out there. But just play around with it, have an idea, use a whiteboard, draft it out, see what it would kind of look like on paper and then go to Framework and work on building out those components. Like Nike, just do it. Just do it. Because the more you think about it, the more you'll tell yourself that it can't happen. Even if nobody even takes the challenge you took the time to build, for me, it was an accomplishment for myself. Because I saw a digitized form of my thought process and my practice as a as a health and wellness coach, and that made me feel like “Oh, wow, that's a cool thing that you did, Alexis.” So you have to say, go for it. Just do it.
Do you have any final thoughts that you'd want to share?
Yeah, have fun with it, too. I think that's an important part—having fun and doing it for the fun of it.