In much the same way that we repeatedly heard that we cannot expect people to act against their financial interests, we were also regularly reminded that people are unlikely to make changes perceived as inconvenient or disruptive to daily life. Dr. Polonsky said that people will rarely lower their other priorities, so we need to focus on health in ways that don’t come at the expense of other things people value. Many said the secret lies in repetition—reminding and reaching out to people often enough to make attention to health unavoidable, while still limiting the message predictability that could lead people to tune out these messages.
We were also frequently reminded that the best interventions reach people in the places and routines of their daily lives: go to people instead of asking them to come to you. This need is closely tied to the importance of environmental change. Prevention efforts need to take place in schools, community centers, workplaces, social groups, city streets, and the other places where people spend the majority of their time, not just in the hospitals and medical centers that most people only occasionally visit. In particular, any added steps that are expected of individuals, especially extra medical appointments, will almost certainly serve as a barrier to engagement. The most effective screening, education, and motivation are integrated into the existing structures of daily life and normal care that people receive. This is especially important given that, as noted earlier, prediabetes is not “felt” in a physical way. The key thus lies in convenience and even desirability. Dr. Darin Olson, Assistant Professor of Medicine in the Division of Endocrinology, Metabolism, and Lipids at Emory University School of Medicine, said that the health innovator’s role is in finding what people want that simultaneously makes them healthier.