Principles & Practice of Health Evangelism
Chapter 19
The Program is Not the End
Textbook pages 223-232
Follow-up has been the weakest component in all the health evangelism programs. Follow-up is as important as the program itself. Follow-up is often more time consuming than conducting the program. It takes effort and planning.
In planning to include follow-up activities in a health evangelism program it is important to inform the small group helpers that you require their help for follow-up activities as well as their help during the program. Follow-up should occur at least quarterly for a period of one year.
Follow-up means you do not let go of people once you get to know them. Participants have been coming to your church week after week. You know them by their first names. They have become educated. They have new health practices. Many of them will slip back into their old ways of living if you do not keep in touch with them to encourage them.
The easiest but least effective way to conduct follow-up activities is to hold them at the church. At the last session of any program there is a spirit of fellowship and gratitude. People want the effect to last. There is always a sincere desire to continue meeting on a regular basis for follow-up.
But follow-up meetings at the church do not work well. They are always poorly attended. There are two reasons for this. One reason is that your participants are successful in maintaining their new behavior. They do not need follow-up meetings. They are doing just fine so they do not come to follow-up.
The second reason people do not return to follow-up meetings is because they have relapsed into their old habits and are too ashamed to return. So, whether your participants experience success or failure, few of them will ever return to follow-up meetings at the church. They are more likely to return to your next regular program for more encouragement or a second try if they have failed.
The most effective type of follow-up is in each participant’s homes. Though some church members dread house-to-house work, in-home follow-up is pleasant and not difficult. These are not “cold calls.” You know the people you are reaching out to. You saw these people from day to day and from week to week during your program. You are friends.
The same two small group leaders should be the ones to call on the members of their own small group. This means that they will only have to make six or seven calls to complete each round of follow-up.
This in-home follow-up activity should not be a surprise to your program participants. During the program you told them there was going to be this kind of follow-up. Your program participants will be expecting you to call them. Most participants will be glad to see you.
There are important reasons for doing your follow-up in the home. One reason is to help reinforce the participant’s new behaviors. Smokers will be less likely to relapse if they know you will be calling to check on them soon.
Another reason to do follow-up is to document the long-term effectiveness of your health evangelism program. You need to document what they are doing. This information will go into your database and fulfills one of the scientific purposes of your program.
This scientific evaluation is the perfect “official” reason for a follow-up visit. You are dropping by for data collection. That is non-threatening and will not be a barrier to your home visit. You need a clipboard, pencil, and follow-up forms with you; they should be in your hand when you knock on the door.
The most important reason for an in-home follow-up visit is that this is probably the very first time you will be one-on-one with an individual member of your small group. This creates a type of contact in which spiritual issues can be explored.
The polite thing to do is to call ahead and make a definite appointment for a follow-up visit. In this way participants can have their houses in order and will not be embarrassed as they could be if you make an unannounced visit.
If you call for an appointment and the participant says that he or she would like to skip the follow-up visit you can ask if they would be willing to complete the follow-up questionnaire over the phone. The participant will almost always say, “Yes,” and you can obtain your follow-up data. It should be noted in your database that the follow-up was a phone visit and not a face-to-face interview.
While you are on the phone, after the participant has answered the questions for the questionnaire, you can then assume a more casual voice and make inquiry as to how the person is doing spiritually. I like to use the same approach whether I am in the home or conducting the interview over the phone.
How is the in-home visit structured? After initial casual comments, you announce the desire to obtain follow-up information you need for the study. Ask the few questions on your follow-up questionnaire. Then you put your clipboard down, sit back, relax, and casually ask three more “unofficial” questions which should not appear to be related to the purpose of data collection.
The first question I like to ask is, “How are you doing physically since you . . .” (quit smoking or lost weight or finished the program)? The usual answer is, “Your program has helped me so much, etc.”
The second question has to do with mental issues. I ask, “How are you doing mentally/psychologically? Is it still a struggle? How are you keeping it up?”
The third question is the most important, “How are you doing spiritually with regard to your habit?” This is the key moment of your entire health evangelism program. You are one-on-one in the privacy of a person’s home. There are no other group members watching or listening. If a participant is thinking about spiritual things, if they want to talk about what God is doing in their lives, they will talk to you about it right now.
Health evangelism programs should be evangelistic. They are made evangelistic during the program when you explain the ways in which God helps with behavior change. Health evangelism programs are most evangelistic when you get to ask a person about his or her personal relationship with God in the quietness of their own home.
What kind of responses will you get to this question? A common response is, “Oh, fine, just fine. What did you think about the football game last weekend?” This indicates a reluctance to speak to you directly about spiritual things. Do not press the point. These people think a lot of you and your health evangelism program. They are not offended that you brought up the subject. There was a spiritual emphasis in the program, and it was conducted by religious people in a church.
Without a connection with God, participants are not likely to maintain their new behavior very long. Perhaps the Holy Spirit will impress them to come to another program. Do not push the people into a discussion of spiritual things if they do not want to go there.
Many people will respond positively to your question about spiritual things. They will gladly confess that they are maintaining their new behaviors through a relationship with God. They will rejoice that they have a new and more practical understanding about what the Christian life is all about. They will praise your church for having such a practical religion that helps people with real problems.
Others will be anxious to know more about your church and what you believe. They will want to know about such things as the Sabbath and other distinctive doctrines. You should be prepared for anything and everything. I like to keep a variety of pamphlets, Bible study lessons and several books and Bibles in the car to use under these circumstances. If a person expresses an interest in spiritual things, and wants to begin a discussion with you, be prepared.
It will not appear to the participant that spiritual concerns were the real reason you came calling. Spiritual issues came up after you obtained your scientific data. The religious materials you are going to leave weren’t under your arm when you came to the door. You go back out to your car to get the extra materials.
If you have a positive spiritual interaction with a former program participant, it is important to offer a prayer before you leave the home. It is important for you to pray again once you return to your car. Thank God for the developing spiritual relationship and ask for continued guidance.
Follow-up activities should be initiated soon after the end of a program. I suggest intervals of one month, three months, six months, and a year. Most people who relapse do so fairly quickly. An early follow-up visit will be helpful in preventing relapse. There is room for flexibility here. You may want to conduct follow-up activities even more frequently than I have suggested. Negotiate this with your small group leaders who will be doing most of the follow-up.
If two small group leaders cannot go together for some reason, it may be necessary for the pastor, a health professional, or some other helper to go with one of the helpers. Remember, two-by-two is a Biblical principle and is the appropriate way to make follow-up calls.
A follow-up newsletter and additional “alumni” meetings at the church are good ideas but not a substitute for in-home visits. In a newsletter the success of various individuals can be reviewed, spiritual messages about overcoming can be included, and the dates for the next programs at the church can be announced.
In planning to include follow-up activities in a health evangelism program it is important to inform the small group helpers that you require their help for follow-up activities as well as their help during the program. Follow-up should occur at least quarterly for a period of one year.
Follow-up means you do not let go of people once you get to know them. Participants have been coming to your church week after week. You know them by their first names. They have become educated. They have new health practices. Many of them will slip back into their old ways of living if you do not keep in touch with them to encourage them.
The easiest but least effective way to conduct follow-up activities is to hold them at the church. At the last session of any program there is a spirit of fellowship and gratitude. People want the effect to last. There is always a sincere desire to continue meeting on a regular basis for follow-up.
But follow-up meetings at the church do not work well. They are always poorly attended. There are two reasons for this. One reason is that your participants are successful in maintaining their new behavior. They do not need follow-up meetings. They are doing just fine so they do not come to follow-up.
The second reason people do not return to follow-up meetings is because they have relapsed into their old habits and are too ashamed to return. So, whether your participants experience success or failure, few of them will ever return to follow-up meetings at the church. They are more likely to return to your next regular program for more encouragement or a second try if they have failed.
The most effective type of follow-up is in each participant’s homes. Though some church members dread house-to-house work, in-home follow-up is pleasant and not difficult. These are not “cold calls.” You know the people you are reaching out to. You saw these people from day to day and from week to week during your program. You are friends.
The same two small group leaders should be the ones to call on the members of their own small group. This means that they will only have to make six or seven calls to complete each round of follow-up.
This in-home follow-up activity should not be a surprise to your program participants. During the program you told them there was going to be this kind of follow-up. Your program participants will be expecting you to call them. Most participants will be glad to see you.
There are important reasons for doing your follow-up in the home. One reason is to help reinforce the participant’s new behaviors. Smokers will be less likely to relapse if they know you will be calling to check on them soon.
Another reason to do follow-up is to document the long-term effectiveness of your health evangelism program. You need to document what they are doing. This information will go into your database and fulfills one of the scientific purposes of your program.
This scientific evaluation is the perfect “official” reason for a follow-up visit. You are dropping by for data collection. That is non-threatening and will not be a barrier to your home visit. You need a clipboard, pencil, and follow-up forms with you; they should be in your hand when you knock on the door.
The most important reason for an in-home follow-up visit is that this is probably the very first time you will be one-on-one with an individual member of your small group. This creates a type of contact in which spiritual issues can be explored.
The polite thing to do is to call ahead and make a definite appointment for a follow-up visit. In this way participants can have their houses in order and will not be embarrassed as they could be if you make an unannounced visit.
If you call for an appointment and the participant says that he or she would like to skip the follow-up visit you can ask if they would be willing to complete the follow-up questionnaire over the phone. The participant will almost always say, “Yes,” and you can obtain your follow-up data. It should be noted in your database that the follow-up was a phone visit and not a face-to-face interview.
While you are on the phone, after the participant has answered the questions for the questionnaire, you can then assume a more casual voice and make inquiry as to how the person is doing spiritually. I like to use the same approach whether I am in the home or conducting the interview over the phone.
How is the in-home visit structured? After initial casual comments, you announce the desire to obtain follow-up information you need for the study. Ask the few questions on your follow-up questionnaire. Then you put your clipboard down, sit back, relax, and casually ask three more “unofficial” questions which should not appear to be related to the purpose of data collection.
The first question I like to ask is, “How are you doing physically since you . . .” (quit smoking or lost weight or finished the program)? The usual answer is, “Your program has helped me so much, etc.”
The second question has to do with mental issues. I ask, “How are you doing mentally/psychologically? Is it still a struggle? How are you keeping it up?”
The third question is the most important, “How are you doing spiritually with regard to your habit?” This is the key moment of your entire health evangelism program. You are one-on-one in the privacy of a person’s home. There are no other group members watching or listening. If a participant is thinking about spiritual things, if they want to talk about what God is doing in their lives, they will talk to you about it right now.
Health evangelism programs should be evangelistic. They are made evangelistic during the program when you explain the ways in which God helps with behavior change. Health evangelism programs are most evangelistic when you get to ask a person about his or her personal relationship with God in the quietness of their own home.
What kind of responses will you get to this question? A common response is, “Oh, fine, just fine. What did you think about the football game last weekend?” This indicates a reluctance to speak to you directly about spiritual things. Do not press the point. These people think a lot of you and your health evangelism program. They are not offended that you brought up the subject. There was a spiritual emphasis in the program, and it was conducted by religious people in a church.
Without a connection with God, participants are not likely to maintain their new behavior very long. Perhaps the Holy Spirit will impress them to come to another program. Do not push the people into a discussion of spiritual things if they do not want to go there.
Many people will respond positively to your question about spiritual things. They will gladly confess that they are maintaining their new behaviors through a relationship with God. They will rejoice that they have a new and more practical understanding about what the Christian life is all about. They will praise your church for having such a practical religion that helps people with real problems.
Others will be anxious to know more about your church and what you believe. They will want to know about such things as the Sabbath and other distinctive doctrines. You should be prepared for anything and everything. I like to keep a variety of pamphlets, Bible study lessons and several books and Bibles in the car to use under these circumstances. If a person expresses an interest in spiritual things, and wants to begin a discussion with you, be prepared.
It will not appear to the participant that spiritual concerns were the real reason you came calling. Spiritual issues came up after you obtained your scientific data. The religious materials you are going to leave weren’t under your arm when you came to the door. You go back out to your car to get the extra materials.
If you have a positive spiritual interaction with a former program participant, it is important to offer a prayer before you leave the home. It is important for you to pray again once you return to your car. Thank God for the developing spiritual relationship and ask for continued guidance.
Follow-up activities should be initiated soon after the end of a program. I suggest intervals of one month, three months, six months, and a year. Most people who relapse do so fairly quickly. An early follow-up visit will be helpful in preventing relapse. There is room for flexibility here. You may want to conduct follow-up activities even more frequently than I have suggested. Negotiate this with your small group leaders who will be doing most of the follow-up.
If two small group leaders cannot go together for some reason, it may be necessary for the pastor, a health professional, or some other helper to go with one of the helpers. Remember, two-by-two is a Biblical principle and is the appropriate way to make follow-up calls.
A follow-up newsletter and additional “alumni” meetings at the church are good ideas but not a substitute for in-home visits. In a newsletter the success of various individuals can be reviewed, spiritual messages about overcoming can be included, and the dates for the next programs at the church can be announced.
Spirit of Prophecy Quotations on Follow-up Activities
Follow-up will result in baptisms.
If we do not do follow-up, the gains may unravel. This advice applies to health evangelism activities as well as to other ministerial activity.
Follow-up activity is mandatory and not optional. This would apply to health evangelists as well as pastors.
A follow-up letter can be mailed. Tracts and Bible study guides can be distributed at follow-up visits.
Follow-up activities should be aggressive. It will be appropriate to chase people down under some circumstances. Do not give up.
Medical missionaries are true evangelists. They should always go out two-by-two. This is especially important in urban areas.
Follow-up activities create the opportunities to cultivate spiritual interests. Do not forget to take with you pamphlets, Bible Study guides, and books which can be handed out when the chance comes up.
We are to follow Christ’s example and find our ways to the fireside, with families in their own homes. This is so personal and creates opportunities for witness that will not come up in the health evangelism activity at the church.
Follow-up in the home should not be for the purpose of doctrinal presentations but from time-to-time doctrinal issues will come up and can be addressed. Doctrinal presentations should not be the primary purpose of in-home visits, but doctrines can be discussed if they are brought up by those with whom you are visiting.
The in-home visits allow personal appeals to behavior change and personal appeals to accept Christ as the agent of behavior change in human life.
- “For years light has been given upon this point, showing the necessity of following up an interest that has been raised, and in no case leaving it until all have decided that lean toward the truth, and have experienced the conversion necessary for baptism, and united with some church, or formed one themselves.” Evangelism 324
If we do not do follow-up, the gains may unravel. This advice applies to health evangelism activities as well as to other ministerial activity.
- “I hope you will look at things candidly and not move impulsively or from feeling. Our ministers must be educated and trained to do their work more thoroughly. They should bind off the work and not leave it to ravel out. And they should look especially after the interests they have created, and not go away and never have any special interest after leaving a church. A great deal of this has been done.” Evangelism 324
Follow-up activity is mandatory and not optional. This would apply to health evangelists as well as pastors.
- “There are no circumstances of sufficient importance to call a minister from an interest created by the presentation of truth. Even sickness and death are of less consequence than the salvation of souls for whom Christ made so immense a sacrifice. Those who feel the importance of the truth, and the value of souls for whom Christ died, will not leave an interest among the people for any consideration. They will say, Let the dead bury their dead. Home interests, lands and houses, should not have the least power to attract from the field of labor.” Evangelism 324
A follow-up letter can be mailed. Tracts and Bible study guides can be distributed at follow-up visits.
- “When at our large gatherings, make all the discourses highly reformative. Arouse the intellect. Bring up the talents possible into the efforts made, and then follow up the effort with tracts and pamphlets, with articles written in simple form, to make the subjects brought before them distinctly stated, that the word spoken may be repeated by the silent agent. Short, interesting articles should be arranged in cheap style, and scattered everywhere. They should be at hand upon every occasion where the truth is brought before the minds of those to whom it is new and strange.” Counsels to Writers and Editors 126
Follow-up activities should be aggressive. It will be appropriate to chase people down under some circumstances. Do not give up.
- “We must not think of such a thing as discouragement, but hold fast to souls by the grasp of faith. Do not give up those for whom you are working. Go out in the mountains and seek the lost sheep. They may run from you, but you must follow them up, take them in your arms and bring them to Jesus. Pulpit effort should always be followed by personal labor. The worker must converse and pray with those who are concerned about their soul’s salvation. Those who listen to discourses should see in those who believe, an example in life and character that will make a deep impression upon them.” The Home Missionary, February 1, 1890.
Medical missionaries are true evangelists. They should always go out two-by-two. This is especially important in urban areas.
- “It is medical missionaries that are needed all through the field. Canvassers should improve every opportunity granted them to learn how to treat disease. Physicians should remember that they will often be required to perform the duties of a minister. Medical missionaries come under the head of evangelists. The workers should go forth two by two, that they may pray and consult together. Never should they be sent out alone. The Lord Jesus Christ sent forth His disciples two and two into all the cities of Israel. He gave them the commission, "Heal the sick that are therein, and say unto them, The kingdom of God is come nigh unto you." Medical Ministry 249
Follow-up activities create the opportunities to cultivate spiritual interests. Do not forget to take with you pamphlets, Bible Study guides, and books which can be handed out when the chance comes up.
- “Now, when we go into the house we should not begin to talk of frivolous things, but come right to the point and say, I want you to love Jesus, for He has first loved you. . . . Take along the publications and ask them to read. When they see that you are sincere they will not despise any of your efforts. There is a way to reach the hardest hearts. Approach in the simplicity, and sincerity, and humility that will help us to reach the souls of them for whom Christ died.” Welfare Ministry 91
We are to follow Christ’s example and find our ways to the fireside, with families in their own homes. This is so personal and creates opportunities for witness that will not come up in the health evangelism activity at the church.
- “To all who are working with Christ I would say, wherever you can gain access to the people by the fireside, improve your opportunity. Take your Bible, and open before them its great truths. Your success will not depend so much upon your knowledge and accomplishments, as upon your ability to find your way to the heart. By being social and coming close to the people, you may turn the current of their thoughts more readily than by the most able discourse. The presentation of Christ in the family, by the fireside, and in small gatherings in private houses, is often more successful in winning souls to Jesus than are sermons delivered in the open air, to the moving throng, or even in halls or churches.” Gospel Workers 193
Follow-up in the home should not be for the purpose of doctrinal presentations but from time-to-time doctrinal issues will come up and can be addressed. Doctrinal presentations should not be the primary purpose of in-home visits, but doctrines can be discussed if they are brought up by those with whom you are visiting.
- “There are many souls yearning unutterably for light, for assurance and strength beyond what they have been able to grasp. They need to be sought out and labored for patiently, perseveringly. Beseech the Lord in fervent prayer for help. Present Jesus because you know Him as your personal Saviour. Let His melting love, His rich grace, flow forth from human lips. You need not present doctrinal points unless questioned. But take the Word, and with tender, yearning love for souls, show them the precious righteousness of Christ, to whom you and they must come to be saved.” Welfare Ministry 92
The in-home visits allow personal appeals to behavior change and personal appeals to accept Christ as the agent of behavior change in human life.
- “Personal, individual effort and interest for your friends and neighbors will accomplish more than can be estimated. It is for the want of this kind of labor that souls for whom Christ died are perishing. . . . Your work may accomplish more real good than the more extensive meetings, if they lack in personal effort. When both are combined, with the blessing of God, a more perfect and thorough work may be wrought; but if we can have but one part done, let it be the individual labor of opening the Scriptures in households, making personal appeals, and talking familiarly with the members of the family, not about things of little importance, but of the great themes of redemption. Let them see that your heart is burdened for the salvation of souls”. Welfare Ministry 93-94