Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved. Chapter 2 - Positive Choices/ Positive Changes

Coming Up in this Chapter □Identify the factors that influence health behaviors. □Learn strategies for increasing motivation to change. □Gain techniques to match your stages of change. □Develop a plan for behavior change. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Likely threats to health □Despite bioterrorism and the global spread of new viruses: The real threats to human life involve □ diet □ lack of physical activity □ personal health habits Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

The Wellness Challenge □Cigarette smoking □The risk factor most strongly associated with preventable death and chronic disease □Diet and physical inactivity □Next highest risk factor for smokers □Highest risk factor for nonsmokers Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Health Behavior and Behavior Change □Why is behavior change so hard? Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Achieving Lifestyle Change □Health behavior is learned, and can be changed □Forces that shape behavior □Family, role models, and social norms □Advertising □Psychological needs □Reactance motivation Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Fig 2-2 Factors affecting behavior change Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Can I bribe myself to make a change? □Reinforcing factors □External factors □Internal factors □Motivation □Locus of control □Self-efficacy □Goal setting □Decisional balance Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Do You Feel in Charge? □What is the point of all my efforts? □Internal locus of control □Outcomes depend on what is done □External locus of control □Outcomes depend on other factors Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Self-Efficacy □How do I keep motivated? □Self-Efficacy Quiz □Increasing Self-Efficacy □Past Performance □Observational Learning □Persuasion □Interpreting Internal Cues Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Goal setting □What are you trying to achieve ? □When setting goals: be SMART Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

SMART □SMART □Specific □Measureable □Achievable □Realistic □Time-Bound Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Decisional Balance □What are the pros and cons of change? □Pros □All the benefits of change □Focus on those most personally relevant to you □Cons □Barriers to change that hold you back Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Fig 2-3 Sample pros-versus-cons analysis for behavior change Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Behavior Change □Practical Prevention-What’s My Stage? □The Transtheoretical Model □Precontemplation □Contemplation □Preparation □Action □Maintenance Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Fig 2-4 Stages of change in the transtheoretical model of behavior change Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Precontemplation □Consciousness raising □Increasing knowledge about the behavior and its causes and consequences □Emotional arousal □Experiencing negative emotions associated with an unhealthy behavior □Environmental reevaluation □Imagining the effects of behavior on the physical and social environment Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Contemplation □Contemplation stage □Aware of problem behaviors □Not willing to commit effort to change at this time □Self-reevaluation □Imagining the effects of current behavior on your life cognitively and affectively Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Preparation □Commitment □Making a firm commitment to change Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Preparation Preparation stage—Planning to take action within the next month; seeing that the positives of change outweighing negatives □Assess current behavior □Set specific, realistic goals : be SMART □Realize that change is permanent □Making a firm commitment to change Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Action □Helping relationships □Seeking out and using social support □Countering □Identifying healthy behaviors that can substitute unhealthy behaviors Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Maintenance □Helping relationships □Enforcing consequences for behavior to increase the reward for the desired behavior □Environment control □Changing cues and triggers so they prompt the healthy behavior Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Last Process of Change □Social liberation □Not tied to any particular stage □Seeking social alternatives to the unhealthy behavior Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Overcoming Common Barriers □I don’t have enough time. □I can’t get motivated. □I’ll get around to changing—later. □I don’t know how. □I don’t know have enough money. □I lack will power. □It is too hard---and no fun. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Overcoming Common Barriers Continued □I’m too tired. □I can’t say “no.” □I have a negative outlook. □All-or-Nothing Thinking □Blaming Others □Over generalizing □Jumping to conclusions □Dwelling on negatives □I don’t feel supported. □I do OK at first and then backslide. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Getting Serious □Have you considered how your current lifestyle is affecting your health? □Choose a target behavior- keep it simple □Make a plan □Put it into action-stay with it □Relapse can be expected Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Planning and Implementing Change □Complete pros versus cons □Monitor your current behavior □Set SMART goals and plan rewards □Develop strategies for overcoming obstacles Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Planning for change □Identify helpers □Put together a plan □Make a commitment □Track progress and make changes Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Personalize the Process □Where to start? □New Year’s Resolutions? Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

How Do I Help Others? □Encouragement □Recommendations □Discuss specific problems □Discuss specific successes □Acknowledge positive behavior change for healthy behavior Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.