Truth, Desire, and Habit: Animating Community as Medicine. How often have we heard doctors deliver behavior change instructions (“Eat better! Exercise more! Reduce your stress!”) followed by something like “Good luck with that! I’ll see you in 6 months?” For our patients who lack access to the boutique ($$) wellness industry, these kinds of “Behavioral Prescriptions” are a prescription to nowhere. Open Source Wellness (OSW) is the nation’s first “Behavioral Pharmacy:” a democratized delivery system for the universal and trans-diagnostic behaviors and experiences that potentiate human health and wellbeing. The model leverages the power of community to animate a very simple platform: MOVE (physical activity), NOURISH (healthy meals,) CONNECT (social support), and BE (stress reduction). Adaptable to diverse populations, OSW addresses the behaviorally- and socially-mediated conditions that are driving human suffering and astronomical healthcare spending by animating clinical, community, housing, and corporate contexts as platforms for health and wellbeing. Join us for an experience (80% direct engagement, 20% keynote on methodology and outcomes) of the OSW Truth, Desire, and Habit human technologies, and leave ready to creatively apply the active ingredients of this model to your work your world!

1. E L I Z A B E T H M A R K L E , P H . D .
H E A LT H C A R E E X P E R I E N C E D E S I G N
4 / 2 / 1 9
Truth, Desire, and Habit:
Animating Community
as Medicine

2. Chronic, Progressive, and
Preventable health conditions
are driving human suffering and
skyrocketing health costs.
• Depression
• Diabetes
• Cardiovascular Disease
• Social Isolation
Things you already know . . .
Source: www.truehealthinitiative.org
86%of our nation’s healthcare costs are
spent treating people with chronic diseases.
100+ MILLION Americans are projected
to be diabetic by 2050.
70MILLION Americans have hypertension,
with elevated risk for stroke and heart attack.
70%of all Americans are overweight or obese.
130+MILLION Americans are affected by
chronic diseases – that’s 40% of the population!

3. GOOD LUCK
WITH THAT,
I’LL SEE YOU
IN 6 MONTHS!

4. The Behavioral Pharmacy

5. What’s Different?
1. Experiential: We don’t just TALK about
health behaviors, we DO them.
2. Trans-diagnostic: Diabetes, Obesity,
Cardiac Disease, Depression, Metabolic
Syndrome, Social Isolation . . .
3. Culturally-flexible: Turnkey
implementation
4. Powered by Connection: Coaching,
Small-group relationships, Peer
Leadership
5. Democratized: <1/5 the cost of the highly-
effective Ornish Lifestyle Medicine
program.
6. Place-Based (!!)

6. MOVE

7. TRUTH
DESIRE
HABIT

12. Work Performance
Work Relationships
Work-life Balance
Exercise
Mental / Emotional Health
Personal Relationships
Nutrition
Stress Management
Social Life
Spiritual Well Being
Meaning, Purpose
Recreation
1
GET HONEST

13. “Desire is the only
power source
potent enough to
effect change.”

14. SHIFT FROM
“WHAT’S
THE MATTER
WITH ME?”
STEP 2
SOURCE
DESIRE

15. TO
“WHAT MATTERS TO ME?”

16. TRUTH +
DESIRE =
VITALITY

18. Are we done here?

19. Your LIFE is composed of habits.
Your current habits won’t get you what you WANT;
they will get you what you HAVE.
Change requires a structure for fulfillment.
STEP 3
HACK YOUR HABITS

20. What Habit Do You
Most Want to

21. THE GOOD NEWS
1.GET HONEST
2.SOURCE DESIRE
3.HACK YOUR HABITS
THE GOOD NEWS
GE T HONE S T
S OURCE DE S IRE
HACK YOUR HABIT S
1
2
3

22. Implementation to Date
§ Clinically-Integrated: Hayward
Wellness Center, Alameda Health
System
§ Community-Based: In Oakland,
CA, with Prevention Institute
§ Low-Income Housing: Alameda
Point Collaborative
§ Corporate Employee: Genentech,
Alameda Alliance for Health

23. Diet and Exercise
Clinical model, n = 55
5.0
5.9
0
1
2
3
4
5
6
7
d = .34
Fruits and Vegetables
Daily Servings
Pre Post n = 55
81.9
122.9
0
20
40
60
80
100
120
140
d = .43
Exercise
Weekly Minutes
Pre Post n = 55

24. Depression, Anxiety, and Isolation
(PHQ-9, GAD-7, UCLA Loneliness Scale)
PHQ-9 GAD-7 UCLA
14.4
10.4
6.4
9.8
8.3
5.6
0
2
4
6
8
10
12
14
16
Depression Anxiety Isolation
Pre Post

25. Blood Pressure
PHQ-9 GAD-7 UCLA
150
82
131
77
0
20
40
60
80
100
120
140
160
BP Sys BP Dia
Pre Post

26. Acute Care
PHQ-9 GAD-7 UCLA
22
5
0
5
10
15
20
25
d = -.53
ED Visits/Hospitalizations
6 months prior to group
6 months following group n = 49

27. A Model and a Movement

28. What Does It Look Like?

29. C O M M U N I T Y
I S M E D I C I N E

30. ELIZABETH MARKLE, PH.D.
LIZ@OPENSOURCEWELLNESS.ORG
THANK YOU!