1. Promoting Healthy Behavior Change1
Promoting Healthy Behavior Change

2. Objectives Understanding health promotion programs
Examine how predisposing factors, beliefs, attitudes, and significant others affect a person’s behavior changes.
Assess behavior change techniques, and learn how to apply them to personal situations.
Recognizing the benefits of healthy behaviors
Establishing motivation to change health behaviors

3. Figure 1.1 The Dimensions of Health and the Wellness Continuum

4. Figure 1.2 Key Determinants of Health

5. Health Promotion
Health promotion – combined educational, organizational, policy, financial, and environmental supports to reduce risk factors and promote healthy lifestyles
Objective of Healthy People 2010
Assist individuals in their pursuit of specific behavior changes
Identify healthy people who are engaged in risk behaviors
Motivate people to change their actions
Provide support that increases chance of success

6. Health Promotion
Educational support: provides info. about risk behaviors and consequences, helps facilitate learning
Organizational support: provide programs and services that encourage participation and set up systems of social support
Environmental supports: provide rules that govern behaviors and support behavior change
Financial support: provide monetary incentives to motivate change toward healthy behaviors
Health promotion increases likelihood of long term success on the road to health and wellness

7. Disease prevention:
Primary prevention – reduce risk and avoid health problems before they start
Secondary prevention – interventions that take action to stop risk behaviors before an actual illness
Tertiary prevention – treatment/rehabilitation after an illness
2 out of 3 deaths in the U.S. and 1 out of 3 hospitalizations are linked to preventable lifestyle behaviors
i.e. tobacco use, sedentary lifestyles, alcohol consumption and overeating
Chronic diseases from these behaviors leads to financial & societal burden
70% of deaths and 75 % of the nations annual healthcare cost

8. Disease prevention:
Primary and secondary prevention best chance to reduce incidence and prevalence of disease and disability
Incidence: # of new cases of an illness in a given time period
Prevalence: # of existing cases of an illness in a given time period
Certified Health Education Specialists (CHESs): trained health workers with special credentials and competencies to help plan, implement, and evaluate prevention programs

9. Health Disparities
When it comes to health we are not all created equal
Improvements in health and life span of Americans have not been experienced uniformly by all the diverse populations in the U.S.
Factors include: who we are, where we live, the differences in our populations social and economic status, as well as the social and economic policies of our government

10. Contributors to Health Disparities
Having no health insurance or inadequate insurance
Racism and other “isms” that reduce opportunities or cause discrimination
Inadequate transportation
Lifestyle behaviors
Cultural influences
Diet
Lack of exercise
Obesity/overweight

11. Contributors to Health Disparities (continued)
Sexual behaviors
Stress
Mental health issues
Systemic barriers
Access to health care
Poverty
Environmental factors

12. Changing Your Health Behaviors
Change depends on the individual:
Identify what is most important to you or what poses the most immediate threat to health; for example:
Diet
Relationships
Stress management
Safe sex
Drug/alcohol use
Exercise
Use of tobacco

13. Factors That Influence Behavior Change
Predisposing factors:
Knowledge, beliefs, and attitudes based on life experiences as well as gender, age, race, socioeconomic background
Enabling factors:
Skills and abilities, resources available; can be positive or negative
Reinforcing factors:
Presence or absence of support, encouragement or discouragement from those around you

14. Factors That Influence Behavior Change
Motivation
Wanting to change is important to begin the change process
Must be combined with common sense, commitment and realistic understanding of the process
Rewards or incentives can be good tools for motivation to change

15. Factors That Influence Behavior Change
Beliefs and attitudes
Belief : appraisal of the relationship between some object, action, or idea and some attribute of that object, action or idea
May develop from direct experience (you experience health changes from behavior), or indirect experience (someone you know experienced changes)
Attitude: relatively stable set of beliefs, feelings, and behavioral tendencies in relation to someone or something

16. Factors That Influence Behavior Change
Health Belief Model: developed in 1966 by psychologist I. Rosenstock
Show when beliefs affect behavior change; several factors must support a belief before change occurs
Perceived seriousness of health problem
Immediate pleasures outweighs the consequences
Perceived susceptibility to the health problem
What happens to others will not happen to me
Cues to action
Direct and indirect experiences cue people to make changes

17. Factors That Influence Behavior Change
Intentions to change
Theory of Reasoned Action
Behaviors result from our intentions to perform actions
The more you verbalize your commitment, the more likely you are to succeed.
Significant others as change agents
We are influenced by approval or disapproval of close friends, loved ones, and social groups
Influence from others can be a powerful social support for positive and negative behavior changes

18. Figure 1.3 Factors That Influence Behavior-Change Decisions

19. Choosing a Behavior Change Strategy
Select a technique or combination of techniques that is best suited to you:
Shaping – start slowly, keep steps small and achievable, be able to change the plan if it is not working, be committed
Visualization – mental practice of the planned action to become better prepared for the actual event
Modeling – learning behaviors through observation of others performing that behavior

20. Choosing a Behavior Change Strategy (continued)
Controlling the situation – putting yourself in a situation that will positively influence your behaviors
Reinforcement – promotes behavior by providing a reward upon completion of the behavior
Consumable, Activity, Manipulative, Possessional, and Social Reinforcers
Changing self-talk – improving one’s self-image to encourage the behavior change
Rationale-Emotive Therapy, Meichenbaum’s Self Instructional Methods, and Blocking/Thought Stopping

21. Changing Your Behavior
Self-assessment:
Antecedents and consequences – identify situations that cue a behavior and acting to modify them
Analyzing personal behavior – determine the specific behavior you want to change
Frequency, duration, seriousness, basis for problem behavior, antecedents
Decision making – be prepared to make decisions for positive change
Setting realistic goals – keeps goals challenging but also attainable

22. Figure 1.4 Overcoming Obstacles to Behavior Change

23. Taking Charge
Make assessment – identify the specific behavior change you would like to make
Make change – follow these steps to make that change:
Evaluate behavior and identify patterns
Select one pattern of behavior to change
Use the Behavior Change Contract (Figure 1.5) to formulate a plan
Chart your progress in a journal
Revise your plan as needed

24. Figure 1.5 Behavior Change Contract