How do We Create Healthy Behaviors?

Erin Staples MPH, CHES, LWC Clark College

OBJECTIVES
Examine behavior change theory and its role in changing health habits

Health Belief Model

INDIVIDUAL PERCEPTIONS MODIFYING FACTORS
Demographic Variables Socio-psychological Variables Perceived susceptibility Perceived severity Perceived benefits Perceived barriers Perceived threat Likelihood of making healthy change

LIKELIHOOD

OF ACTION

Cues to Action Information

Reminders
Persuasive communications Experience

( Rosenstock, 1990 )

CATEGORIES OF BELIEF
Perceived Seriousness
Perceived Susceptibility

Perceived Benefits
Perceived Barriers

( Rosenstock, 1990 )

CATEGORIES OF BELIEF
Seriousness
Relative severity of the health problem.
E.g. If I dont stop eating fried food, I could get heart disease. Thats really scary!

Susceptibility
Nature and intensity of perceptions affect willingness to take preventive action.
E.g. My father dies of heart disease. I feel vulnerable.

( Rosenstock, 1990 )

CATEGORIES OF BELIEF
Benefits
Anticipated value of the recommended course of action. Must believe recommended health action will benefit you. E.g. If I am more active, I will be more fit and have more energy.

Barriers
Perception of negative consequences

Greatest predictor of whether behavior will be practiced. E.g. Its hard to stay active when the weather is bad.
E.g. Ive tried a million times and I just cant do it!
( Rosenstock, 1990 )

OTHER FACTORS
Cue to Action Demographic Variables
Society, culture, family values, peer pressure, where you live. E.g. Im a little uncomfortable. My family thinks yoga is weird.

what convinced consideration of change

E.g. My friend told me that yoga helped with her stress. Im going to go with her tomorrow!

( Rosenstock, 1990 )

Stages of Change Model (Prochaska & DiClemente)

Precontemplation

Preparation Contemplation Action

Relapse

Maintenance

Stable Behavior Prochaska & DiClemente, 1994)

Stages of Change Model

I cant! I wont!

I might!

I will!

I AM!

I still AM! Oops!

Prochaska & DiClemente, 1994)

KEY FEATURES OF THE STAGES OF CHANGE TRANSTHEORETICAL MODEL

Created to explain intentional behavior change Considers change a process rather than an event The change process involves a series of stages In attempting to change a behavior a person typically cycles through these stages of change

Prochaska & DiClemente, 1994)

PRECONTEMPLATION
Definition
Not considering changing your behavior Lack of awareness or desire Ways to Move Forward

New information Persuasive communications Experiences Change in perceived risks and benefits
Prochaska & DiClemente, 1994)

CONTEMPLATION
Definition
Person is beginning to consider behavior change Weighing the pros and cons Ways to Move Forward Motivated by role modeling and persuasive communications Receptive to learning more about potential benefits and skills needed to succeed

Prochaska & DiClemente, 1994)

PREPARATION/ DETERMINATION
Definition
Person is starting to imagine what the healthy behavior would look or feel like, and might be trying it out Planning to overcome barriers Learning about ways to succeed Ways to Move Forward

Information, skill development, attitude change

Prochaska & DiClemente, 1994)

ACTION
Definition
Actually DOING the new behavior How to Move Forward Skill Development Reinforcement Support Self-management Confidence growth from little successes
Prochaska & DiClemente, 1994)

MAINTENANCE
Definition
Establishment of the new behavior Taking on the new attitudinal and environmental supports How to Move Forward Practice relapse prevention skills Self-management Social and environmental support
Prochaska & DiClemente, 1994)

PRACTICE TIME
Identify one of your health behaviors that may not be entirely healthy and place it in the model.
What might move you to change your behavior?

SUMMARY
Behavior change involves many factors. Several theoretical models help explain health behavior, and how we change. Understanding your readiness to change is an important aspect of your potential for success in behavior change.

CREATING SMART GOALS

Specific
Measurable Achievable

Realistic Time-Frame

CREATING SPECIFIC GOALS

A specific goal has a much greater chance of being accomplished than a general goal.
NOT SPECIFIC: I will get in shape. SPECIFIC: I will run Monday, Wednesday, and Friday after school for 30 minutes.

(Meyer, 2003)

CREATING SPECIFIC GOALS

To set a specific goal you should consider the six "W" questions:

Who: Who is involved? What: What do I want to accomplish? Where: Identify a location. When: Establish a time frame. Which: Identify requirements and constraints. Why: Specific reasons, purpose or benefits of
accomplishing the goal.
(Meyer, 2003)

CREATING MEASURABLE GOALS

Establish concrete criteria for measuring progress toward the attainment of each goal you set.
NOT measurable: I will eat better. Measurable: I will eat 3 servings of vegetables Monday Thursday, one at each meal.

(Meyer, 2003)

CREATING MEASURABLE GOALS

To determine if your goal is measurable, ask questions such as:
How much? How many? How frequently?

(Meyer, 2003)

CREATING ACTIONABLE GOALS

Focus on actions, not outcomes.
NOT an Action: I will lose 20 lbs. in the next 2 months. Not an Action: I will lower my cholesterol by 20 points. Action: I will run 1 mile per day Monday, Wednesday, and Friday. I will add a mile/day every 2 weeks. Action: I will replace one animal source of protein per day with a vegetarian option. (Meyer, 2003)

CREATING REALISTIC GOALS

To be realistic, a goal must represent an objective toward which you are both willing and able to work, and have the resources to complete.
Do I truly believe that it can be accomplished?
Not Realistic: I will cut out all coffee and soda everyday Realistic: I will have only one cup of coffee each morning.
(Meyer, 2003)

CREATING REALISTIC GOALS

Do you have the resources to meet your goal?
NOT Realistic: I will run the marathon this weekend. Realistic: I will run 1 mile per day Monday, Wednesday, and Friday. I will add a mile/day every 2 weeks.
(Meyer, 2003)

CREATING REALISTIC GOALS

To determine if your goal is realistic, ask questions such as:
Have I accomplished anything similar in the past? Can I identify the conditions that would have to exist to accomplish this goal?

(Meyer, 2003)

CREATING TIME-BOUND GOALS

A goal should be grounded within a time frame. With no time frame tied to it, there is no sense of urgency. You should see your SMART Goal as setting an appointment with yourself.
Not Time-Bound I will breath more this week. Time-Bound I will do breathing exercises each night for 5 minutes before bed.
(Meyer, 2003)

CREATING SMART GOALS

Specific
Measurable Achievable

Realistic Time-Frame

APPLYING THE THEORIES

SCENARIO: I am feeling very stressed and realize that I need to practice new techniques for stress management. The benefits strongly outweigh the barriers. I will be more relaxed, and I know that stress can lead to health problems in the future. I already have headaches caused by my stress. Ive heard that yoga can help, and want to give it a try.

APPLYING THE THEORIES

My SMART goal: I will practice yoga Monday, Wednesday, and Fridays for 1 hour in the mornings right after I get out of bed. I will use Comcast on Demand videos. My action plan:

I will go to bed by 10pm each night so that I can get up earlier. I will set my alarm for 7am to fit in my yoga. My roommate, Sara, has agreed to do yoga with me. I will journal my stress levels weekly to see how the program is working. I will reward myself with a Redbox movie each week I am successful.

SOURCES
1. Rosenstock, I. M.; Strecher, V. J., Becker, M. H. (1 January 1988). "Social Learning Theory and the Health Belief Model". Health Education & Behavior 15 (2): 175183.DOI:10.1177/109019818801500203.
2. Prochaska, JO; Norcross, JC; DiClemente, CC. Changing for good: the revolutionary program that explains the six stages of change and teaches you how to free yourself from bad habits. New York: W. Morrow; 1994. ISBN 0-688-11263-3. 3. Meyer, Paul J (2003). "What would you do if you knew you couldnt fail? Creating S.M.A.R.T. Goals". Attitude Is Everything: If You Want to Succeed Above and Beyond. Meyer Resource Group, Incorporated, The. ISBN 9780-89811-304-4.

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