A cutting edge movement in medicine—and especially in Community Health Centers—focusses on what patients can do to manage and improve their own health. It starts with the assumption that the choice people make in such areas as exercise, diet, smoking, and alcohol are as consequential to health as is all of medical technology. This moves medicine to the change management field and to understanding how to help patients move from passively receiving services to actively managing their health. In many cases, the inability of people to create success for themselves is seen as associate with low self-confidence and self-efficacy. People have to know that they can change their behavior and that the change will lead to better health before they will take great initiative.

In many social and human service areas activating clients, consumers, or customers by another name would seem to fully apply. Do participants see themselves as receiving a service or as getting help to make intentional change? I am impressed with one promising step that takes the idea of setting targets from organizations and programs to participants.The national program called School Turnaround, a division of The Rensselaerville Institute (TRI) uses an intervention approach to reverse decline in failing schools. One of its tactics in the strategy around compelling outcome clarity is student target-setting.  Each student in the school knows what he or she is trying to achieve. I want to learn 5,000 new words…I want to learn how to spot the main idea and separate it from the theme of a book I read…I want to know how to make inferences—not just what is written but what it means. And—yes—I will move from a score of 63% to 78% on this test and here are the October and December benchmarks I will reach.     

When you go into a traditional classroom and ask students what they are doing you hear that they are reading a story. When you go into a School Turnaround classroom you hear that students are trying to learn how to spot the main idea on each page. What difference intentionality makes! How purposeful are your participants in your programs? Are they sitting through the session or are they looking to achieve something in each and every hour with you?  Perhaps “patient activation” can help.