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 LIKELIHOOD

OF ACTION Demographic Variables

Socio-psychological

Variables

Perceived susceptibility

Perceived severity

Perceived benefits

Perceived barriers

Perceived threat Likelihood of making

healthy change

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 don’t stop eating

fried food, I could get

heart disease. That’s

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. “It’s hard to stay active when the weather is bad.”

• E.g. “I’ve tried a million times and I just can’t do it!”

( Rosenstock, 1990 )

OTHER FACTORS

Cue to Action

• what convinced

consideration of

change

• E.g. “My friend told me

that yoga helped with her

stress. I’m going to go

with her tomorrow!”

Demographic Variables

• Society, culture, family

values, “peer pressure”,

where you live.

• E.g. “I’m a little

uncomfortable. My family

thinks yoga is weird.”

( Rosenstock, 1990 )

Stages of Change Model (Prochaska & DiClemente)

Precontemplation

Stable Behavior

Contemplation

Relapse Maintenance

Action

Preparation

Prochaska & DiClemente, 1994)

Stages of Change Model

I can’t!

I won’t!

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

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.”

CREATING SPECIFIC GOALS

(Meyer, 2003)

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.

CREATING SPECIFIC GOALS

(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)

To determine if your goal is measurable, ask

questions such as:

• How much?

• How many?

• How frequently?

CREATING MEASURABLE GOALS

(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. I’ve 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): 175–183.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 couldn’t 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 978-

0-89811-304-4.

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