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Positive Choices / Positive Changes
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COMING UP IN THIS CHAPTER
Identify the factors that influence your wellness behaviors Develop strategies for increasing your motivation to change for the better Apply techniques that match your stage in the change process Develop a personalized plan for successful behavior change, including appropriate goals and strategies for overcoming barriers
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Factors Influencing Health Behavior and Behavior Change
Why is behavior change so hard? Behavior is influenced by many factors Behavior: an observable action or response Habit: a behavior that recurs, often unconsciously, and develops into a pattern
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Factors Inside and Outside Your Control
Behavioral influences include: Heredity/genetic makeup Sex Childhood and past experiences Knowledge, skills, and abilities Age Beliefs Attitudes Values Religious and cultural norms and practices Socioeconomic status (income, education, occupation) Environment
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Figure 2-1 Factors that influence health behaviors
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Predisposing, Enabling, and Reinforcing Factors
Is there some way I can bribe myself into making a change in my habits? Predisposing factors: those factors that you bring to the table Enabling factors: those factors that help you change your behavior Reinforcing factors: those factors that follow a behavior and either encourage or discourage your new behavior Internal or external
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Figure 2-2 Factors affecting behavior change
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Motivation for Behavior Change
How can I find motivation? Motivation: energized state that directs and sustains behavior Increased or decreased based on internal and external factors Factors affecting motivation: Locus of control Self-efficacy Goal setting Decisional balance
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Locus of Control: Do You Feel in Charge?
What’s the point of all the effort? Practically everyone in my family gets diabetes when they hit age 40. Internal locus of control: belief that one’s personal outcomes largely depend on what one does and how hard one tries External locus of control: belief that factors outside one’s control largely determine the outcomes of what one does
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Self-Efficacy: Do You Anticipate Success?
I start a workout program for 2 weeks, and then just stop. How do I keep motivated? Optimism: the expectation of success SELF-EFFICACY EXPECTATIONS Self efficacy: belief in one’s capability to perform a task that leads to a specific outcome
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Self-Efficacy: Do You Anticipate Success?
How Self-Efficacy Develops— And Can Be Increased Past performance Direct experience is the most powerful influence on self-efficacy expectations Observational learning Persuasion Interpreting internal cues
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Self-Efficacy for Behavior Change
I’m discouraged because I have failed at my exercise goals in the past. Is there a way to improve my chances of success? Start by rating your degree of confidence in reaching your goal Set realistic goals and monitor your behavior Identify obstacles Find a role model, and ask for support Visualize and celebrate success
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Goal Setting: What Are You Trying to Achieve?
How do I come up with a good goal that fits me as an individual? Use the SMART principle: Specific Measurable Achievable Realistic Time-bound
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Figure 2-3 Sample SMART goals
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Decisional Balance: What Are the Pros and Cons of Change?
What if I don’t have any motivation to do anything? Self-defeating behaviors accomplish one goal (usually a short-term one) but interfere with more important goals (usually long-term) Analyze pros and cons of changes you want to make
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Stages of Change How do I get organized, motivated, and focused to change my behavior? Transtheoretical model (TTM) Precontemplation Contemplation Preparation Action Maintenance
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Stages of Change PRECONTEMPLATION CONTEMPLATION PREPARATION
Not yet actively thinking about change; rationalizing behavior CONTEMPLATION “Thinking” stage Weighing pros and cons PREPARATION “Planning and getting ready” stage Move from thinking to doing
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Stages of Change ACTION MAINTENANCE Implementing the plan
Behavior change begins MAINTENANCE Working to maintain new behavior and to avoid relapse Seeking out and using social support
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Stages of Change Is it possible to modify behavior beyond the point of relapse? Termination Zero temptation and total self-efficacy Not realistic for most Considering oneself in a lifetime maintenance stage is a better option Lapses and relapses are common
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Figure 2-4 Stages of change in the transtheoretical model of behavior change
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Processes and Techniques of Change
According to the questionnaire, I’m in the contemplation stage. Now what? Consciousness raising Emotional arousal (dramatic relief) Self-reevaluation Environmental reevaluation Commitment (self-liberation) More…
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Processes and Techniques of Change
Helping relationships Seek social support Countering Substitute the healthy behaviors Reinforcement management (rewards) Environment control Remove cues and triggers Social liberation Seek different or additional social alternatives
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Overcoming Common Barriers to Change
What is the greatest obstacle to overcome in dealing with behavior change? I don’t have enough time Practice time management I can’t get motivated Pros vs. Cons I’ll get around to changing—later Don’t procrastinate More…
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Overcoming Common Barriers to Change
I don’t know how Seek reliable information I don’t have enough money Healthy lifestyles are generally less expensive than unhealthy ones I lack will power Avoid temptation It is too hard—and no fun Personalize your goal and develop a realistic goal Make new health habits pleasurable More…
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Overcoming Common Barriers to Change
I’m too tired Know your rhythms I can’t say “no” Be more assertive I have a negative outlook Reframe your self-talk I don’t feel supported Utilize support groups, family, friends More…
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Overcoming Common Barriers to Change
I do OK at first and then backslide Know that lapses are a normal part of the process Schedule check-ins with yourself
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TABLE 2-2: EXAMPLES OF NEGATIVE AND POSITIVE PATTERNS OF SELF-TALK
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Developing a Personalized Behavior-Change Program
What is the best way to start if I am trying to change a behavior? Complete a pros-versus-cons analysis Monitor your current behavior Set SMART goals and plan rewards Develop strategies for overcoming obstacles and supporting change Identify helpers and resources More…
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Developing a Personalized Behavior-Change Program
What is the best way to start if I am trying to change a behavior? Put together your program plan Make a commitment and act on it Track your progress and modify your plan as needed
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FIGURE 2-5: SUMMARY OF BEHAVIOR-CHANGE STEPS
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Figure 2-6 Sample pros-versus-cons analysis for behavior change
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Figure 2-8 Sample behavior-change log
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Developing a Personalized Behavior-Change Program
How much can I say or do to encourage a family member to quit smoking or lose weight? Encourage, but don’t push Recommend change frequently, but be patient Discuss specific past instances of the problem Acknowledge positive behavior change for healthy behavior
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