1. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Michael Hall Chapter 1 Promoting Healthy Behavior Change

2. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Objectives  Discuss health in terms of its dimensions and historical perspectives.  Discuss health status of Americans, the factors that contribute to health and illness, the importance of Healthy People 2010, and other national initiatives.  Evaluate the role of gender in disparities in health status, research and risk.  Explain the importance of developing a global perspective on health.

3. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Objectives  Evaluate sources of health information, particularly the internet, to determine reliability.  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.

4. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings ABC News: Promoting Healthy Behavior Change Play Video Play Video | Promoting Healthy Behavior Change

5. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings ABC News: Promoting Healthy Behavior Change Discussion Questions:  Do you have an obstacle or barrier in your own life that is interfering with your adoption of a positive health behavior?  Can you identify with Sara as you think about the fear that you have in making a positive behavior change?  What fears or risks will you need to address to set goals to make this change happen?  Devise a health behavior change plan of your own and describe how you would change behaviors to positive health actions in 12 weeks.

6. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Health  What is Health and Wellness? Health – The ever-changing process of achieving individual potential in the physical, emotional, social, mental, spiritual and environmental dimensions. Wellness – The achievement of the highest level of health possible in each of the dimensions of health.

7. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings The Dimensions of Health and the Wellness Continuum Figure 1.1

8. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Health through the years  1800’s – health was associated with poor hygiene and unsanitary conditions. Medical Model – health status focuses on the individual and a biological or diseased organ perspective. Episodic care – seeking treatment for injury or illness  1900’s – health was associated with an individual’s interaction with their social/physical environment Ecological or Public Health Model – viewed diseases and health outcomes as a result of: air/water pollution, working conditions, substance abuse, stress, diet, lifestyle, access to healthcare for both individuals and entire populations Prevention – identify risk factors to reduce risk of injury or illness

9. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Health through the years – cont.  1947 – World Health Organization (WHO) defined health as: “Health is the state of complete physical, mental, and social well-being, not just the absence of disease or infirmity.”  1960-1970 – Comprehensive Ecological or Public Health Model adds to the definition of health: the physical, social, and mental elements of life, as well as environmental, spiritual, emotional, and intellectual dimensions  Today – we consider quality of life just as important as years of life

10. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings The Evolution Towards Wellness  Many people have adopted a holistic approach to wellness, or a balance between mind, body, and spirit  This approach allows one to achieve wellness for any given limitation or strengths; i.e., someone that is physically handicapped may still have a high degree of wellness if they are able to find holistic balance

11. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings How Many of These Healthy Behaviors Do You Practice? Table 1.2

12. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings New Directions for Health  Healthy People 2010 Goal 1: Increase quality and years of healthy life. Goal 2: To eliminate health disparities Health disparities are when one group (gender, race, ethnicity, community) has a higher disposition for an illness  New focus on wellness, health promotion & disease prevention

13. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings What is Healthy People 2010? Table 1.3

14. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings  Health Promotion – combined educational, organizational, procedural, social, financial, and environmental supports to reduce risk factors and promote healthy lifestyles  Disease Prevention – actions or behaviors designed to keep people from getting sick: 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 Health Promotion

15. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings 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

16. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Contributors to Health Disparities – cont.  Sexual Behaviors  Stress  Mental Health Issues  Systemic Barriers  Access to Healthcare  Poverty  Environmental Factors

17. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Better Health in the 21 st Century  Focusing on global health issues  Today’s global economy expands health concerns beyond borders  Focusing on personal choices to achieve your optimal health as well as the health of those around you  Cultural competency  New diseases, natural disasters, bioterrorism, food safety

18. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Gender Differences and Health Status  Women live longer than men, but don’t necessarily enjoy better quality of life.  Health disparities due to gender are possibly related to exclusion of women from many clinical trials due to reproductive or menstrual concerns.  Research on women’s health after 1990: Women’s Health Initiative (WHI)-focused research on uniqueness of women’s health

19. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings 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 Examples: Diet Relationships Stress Management Safe Sex Drug/Alcohol Use Exercise Use of Tobacco

20. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Motivation and Readiness to Change  READINESS is the state of being that precedes behavior change.  Self-efficacy: a person’s belief that he or she is capable of achieving certain goals – have a sense of personal control over situations.  External LOC (locus of control) – people who lack personal control and confidence in their ability to succeed in a particular behavior.  Internal LOC – people who are confident that their behavior will influence the outcome

21. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Beliefs and Attitudes  Belief: on opinion or conviction  Attitude: a relatively stable set of beliefs, feelings, and behavioral tendencies  Health Belief Model: Model for explaining how beliefs may influence behaviors  Theory of Reasoned Action: Model for explaining the importance of our intentions in determining behaviors

22. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings DiClemente’s Stages of Change Model  Pre-contemplation: no current intention of changing  Contemplation: recognition of a problem and contemplation the need to change  Preparation: close to taking action  Action: people begin to follow their action plan  Maintenance: long term commitment and vigilance  Termination: the behavior is ingrained

23. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Leading Causes of Death in the United States by Age (Years), 2002 Table 1.4

24. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Key Determinants of Health Figure 1.2

25. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings 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

26. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Factors That Influence Behavior-Change Decisions Figure 1.4

27. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings  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 Choosing a Behavior Change Strategy

28. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Choosing a Behavior Change Strategy – cont.  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  Changing Self-Talk – improving one’s self-image to encourage the behavior change

29. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings 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  Decision Making – be prepared to make decisions for positive change  Setting Realistic Goals – keeps goals challenging but also attainable

30. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Overcoming Obstacles to Behavior Change Figure 1.4

31. Copyright © 2008 Pearson Education, Inc., publishing as Pearson Benjamin Cummings Taking Charge  Assessment – Identify the specific behavior change you would like to 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 to formulate a plan Keep a journal of use progress Revise your plan as needed