“Change is hard at first, messy in the middle and gorgeous at the end.”
— Robin Sharma
Chronic illnesses such as diabetes, hypertension, heart disease, and chronic obstructive pulmonary disease (COPD) are among the leading causes of death and disability worldwide. While medical treatments are essential, long-term outcomes for these conditions largely depend on prevention and lifestyle management—consistent medication use, proper nutrition, physical activity, stress reduction, and regular medical follow-ups.
Unfortunately, achieving lasting behavior change among chronically ill patients is one of the biggest challenges in healthcare. People often start strong, but old habits creep back, motivation fades, and relapses occur. This is where the principles outlined in Kerry Patterson and colleagues’ influential book, Influencer: The Power to Change Anything, offer fresh insights.
The authors argue that meaningful change requires more than willpower—it requires a systematic approach that taps into both motivation and ability across multiple levels. Their framework highlights six sources of influence that drive lasting behavioral change. By applying these principles, healthcare providers, families, and communities can build more effective health prevention strategies for those living with chronic conditions.
The Six Sources of Influence and Their Application in Health Prevention
1. Personal Motivation: Make the Undesirable Desirable
At the heart of change is wanting to change. For many chronically ill patients, preventive behaviors such as diet modification, exercise, or quitting smoking feel unpleasant, restrictive, or overwhelming. The key is to help patients reframe these choices as personally meaningful.
For example, instead of merely saying, “Eat less sugar,” healthcare providers can guide patients to connect dietary changes with something deeply valuable—like being able to play with grandchildren, avoiding hospitalization, or living independently longer. Storytelling, visualization exercises, and celebrating small milestones can help patients see preventive actions as steps toward their own goals rather than obligations imposed by others.
Application:
Use motivational interviewing to uncover what matters most to patients.
Share relatable success stories of people who have managed their illness well.
Encourage patients to envision the positive future they can create through prevention.
2. Personal Ability: Surpass Your Limits
Even when patients are motivated, they may lack the skills or knowledge needed to act. For instance, a patient with hypertension may want to cook healthier meals but doesn’t know how to prepare low-sodium dishes. Another may struggle to incorporate exercise into their schedule because they lack confidence or safe routines.
Building personal ability involves training, education, and skill development. Healthcare professionals can organize cooking demonstrations, teach proper medication management, or introduce simple at-home exercise routines tailored to each patient’s condition. By making skills accessible and achievable, patients become empowered to turn good intentions into sustainable habits.
Application:
Provide hands-on workshops (meal prep, grocery shopping guidance, exercise routines).
Teach patients how to use digital tools such as medication reminders or health apps.
Role-play scenarios (e.g., how to decline unhealthy food in social situations).
3. Social Motivation: Harness Peer Pressure for Good
Humans are social creatures, and our behaviors are strongly shaped by the people around us. Patients often struggle when friends, family, or colleagues undermine their healthy habits by encouraging unhealthy eating or dismissing the importance of medical check-ups.
To drive positive change, patients need supportive social networks that reinforce good behavior. Peer groups, patient support circles, and family involvement can create an environment where healthy behaviors are the norm rather than the exception.
Application:
Encourage patients to join support groups for diabetes, heart disease, or smoking cessation.
Involve family members in consultations so they become partners in prevention.
Highlight role models within the community who demonstrate successful lifestyle changes.
When patients see that “people like me” are succeeding, their motivation to stick with prevention strategies grows stronger.
4. Social Ability: Find Strength in Numbers
Sometimes, patients want to change but lack access to social support that helps them succeed. Social ability means giving patients practical help from others to overcome barriers. This could involve a spouse helping with meal planning, a walking buddy for exercise, or community health workers assisting with clinic follow-ups.
By building a team-based approach, prevention becomes more achievable. Instead of facing challenges alone, patients benefit from shared accountability and assistance.
Application:
Pair patients with “health buddies” who check in regularly.
Train family caregivers to support medication adherence and healthy routines.
Partner with community organizations to provide resources like free exercise programs, cooking classes, or transportation for clinic visits.
5. Structural Motivation: Change the Rewards and Incentives
Behavior change is often reinforced (or discouraged) by the incentives and consequences built into the environment. For many patients, unhealthy foods are cheap and accessible, while preventive care feels costly or inconvenient.
Healthcare systems and communities can shift this by creating positive incentives for healthy behaviors. Insurance providers might reduce premiums for patients who meet preventive care milestones. Clinics can recognize patients who maintain target blood sugar levels or quit smoking. Even small rewards, such as public acknowledgment or discounts for gym memberships, can reinforce healthier choices.
Application:
Offer discounts or subsidies for healthy food purchases.
Implement reward programs for medication adherence or attendance at check-ups.
Use gamification strategies in health apps to make progress visible and rewarding
6. Structural Ability: Change the Environment
Finally, lasting change often depends less on personal willpower and more on how the environment is structured. If a patient’s surroundings make unhealthy choices easy and healthy choices hard, prevention efforts will falter.
Structural ability involves designing environments that make the right choice the easy choice. For example, removing vending machines with sugary drinks from hospitals, designing neighborhoods with safe walking paths, or ensuring medication refills are delivered automatically.
Application:
Advocate for workplace wellness programs (healthy meals in cafeterias, standing desks, walking breaks).
Simplify access to care with telehealth, pharmacy delivery, and community clinics.
Help patients reorganize their homes (e.g., keeping fresh fruit visible, placing pillboxes in convenient locations).
By shaping the environment, healthcare providers can reduce reliance on sheer willpower and instead build systems that support prevention naturally.
Integrating the Six Sources: A Holistic Strategy
The genius of the Influencer framework lies in recognizing that lasting change rarely comes from a single intervention. People don’t change just because they’re motivated, or because they learn new skills, or because they receive rewards. They change when all six sources of influence align to support new behaviors.
For chronically ill patients, this means:
Tapping into their personal values (motivation).
Giving them the skills and tools they need (ability).
Surrounding them with a supportive social network.
Building system-level incentives and environments that make prevention natural and rewarding.
When healthcare providers and communities apply these principles together, the likelihood of achieving sustained lifestyle changes multiplies dramatically.
Preventing complications in chronic illness requires more than medical prescriptions—it requires lasting behavior change. By applying the six sources of influence described in Influencer by Kerry Patterson and colleagues, healthcare professionals can move beyond lectures and short-term fixes to create systematic, multi-level strategies that empower patients to succeed.
Ultimately, effective prevention is not just about treating disease—it’s about building lives where healthier choices feel natural, rewarding, and supported. When chronically ill patients are influenced through motivation, ability, social support, incentives, and environment, they don’t just comply with medical advice—they thrive.