Promoting Healthy Behaviour

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Chapter 1

• Promoting Healthy Behaviour

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Promoting Healthy Behaviour Change

• Personal Health?
• A Choice?
• Your Responsibility?
• Health Lifestyle - A Life Long Process.

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What is Health?

• Prior to the late 1800s the opposite of sickness
• if disease didnt kill you then you were
  healthy/lucky
• 1900s
• victims of microorganisms
• water, air, human waste.

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Health and the Math (statistics)

• Medical Research - causes of diseases
• 1900s - most deaths infectious diseases
  (tuberculosis, pneumonia, influenza)
• Life Expectancy
• Men 58.84 years
• Females 60.60 years

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With improved sanitation...

• And antibiotics and vaccines
• Life Expectancy Increased
• Mortality Statistics - People living longer (70s
  to 80s)
• Morbidity Statistics - people are less ill
• Common Infections Diseases
• Faded Away..

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Living Longer.. Different Health Concerns (!) ?

• World Health Organization (WHO)
• the attainment by all peoples of the highest
  possible level of health
• How - by better professional training, promoting
  cooperation, education, research..
• . A wider view of HEALTH

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Absence from Disease to Holistic Health!

• People Are multidimensional
• Health must reflect the whole person
• heath is a dynamic, ever-changing lifelong
  process
• Successful health Addresses ..

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Health and Wellness to its Highest Degree is
Achieved Through...
All of the Dimensions of Health!
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The Dimensions of HealthMind Body Spirit

• Social Health
• interpersonal relationships
• daily behaviours
• interactions
• satisfying
• positive
• supportive
• variety of situations

HOLISTIC HEALTH
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I Need to Learn and to Grow.

• Intellectual Health
• learning
• personal develop
• growth from life experiences
• Healthy DECISISION MAKING
• Age - not an issue
• Ability - knowing limits
• Motivation - like to learn

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Express Yourself!! for Health and Peace of Mind!

• Emotional Health
• expressing emotions appropriately
• emotional expression decrease pressure
• Emotion matches the Action
• self-esteem
• self confidence
• self-efficacy
• stress reduction

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Health Dimensions

• Environmental Health
• appreciation for the environment, clean, recycle
  and respect.
• your personal living environment - safe / quite /
  comfortable

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Believing in Something.

• Spiritual Health
• believing in something
• belonging / sense of purpose
• higher being
• community
• feeling - pain, love, sorrow, peace, contentment,
  and wonder.about life!

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Physical HealthPersonal Physical
Characteristicsbody size, shape, sensory acuity,
susceptibility to disease/disorders, recuperation
form illnessOverall Health and Physical Well
BeingStress ManagementLife Value
AddedAttitudeExerciseActive LivingNutrition
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Feeling Good About Myself...

• Honest with their
• personal limitations
• capabilities
• attempt to change within their control
• try to achieve Balance in mind, body and spirit!
• Health is Relative not Absolutee.g. disabled
  people can be healthy

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Health Throughout The Dimensions of Health

• Looking healthy and being healthy..are they the
  same?
• Some Thoughts
• Fit-looking (body image!, Media!)
• Social Behaviours
• Emotional Intelligence
• Committed and Caring
• responsibility
• other stuff..

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HEALTH PROMOTIONHelping you stay healthy. And
the message is ?

• Health Promotion Programs
• educational
• organizational
• procedural
• environmental
• financial Support
• Provide a consistent message for all!

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Disease PreventionProcess to Reduce Occurrence
and Severity of Disease

• Goal Reduce/eliminate behaviours that increase
  risk
• Three levels of Prevention
• Taking actions to prevent sickness

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Health Promotion Helps Positive Change

• Learn more (educational support)
• provide supportive specific programs
• facilitate behaviour change
• monetary incentives subsidized programs
• (cost savings from not smoking)

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PREVENTION.. Is the key to excellent health!!!!

• Best Solution!
• Promote healthy lifestyles before health problem
  exists
• Cost Effective less medical intervention
• Start young!
• Teach all dimensions of health
• CONTINUE THROUGHOUT LIFE

• -

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Primary Prevention

• Stop Smoking
• physical activity
• stress management
• nutrition
• education
• practice life skills
• psychosocial health
• Counselling

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SECONDARY
...I have a health problem, now what do I do
before it gets worse?
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TERTIARY

• AFTER THE ILLNESS or HEALTH EVENT
• REHABILITATION
• Clinical Setting
• HEART ATTACK
• STROKE
• DIABETES
• CANCER

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HEALTH TRENDS IN North America!Overwhelming
conclusions are that...

• ..the Leading Cause of
• Death in Canada is Related to behavior/lifestyle
  choices!!!
• Thinking about...
• Personal Responsibility for
• Health????
• Is it promoted?
• Knowledge of Prevention? Are we failing to
  provide appropriate education?
• Why arent Canadians responsible for their
  health?

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Gender Bias

• Androcentricity
• a male perspective
• Over -generalization
• research findings from one sex is applied to
  both
• Gender Insensitivity
• Over looking gender as an important variable
• Double Standards
• evaluation, treatment, or measurement applied to
  both genders equally

• An example.1/9 women are diagnosed with breast
  cancer - yet little research!
• 1993 - research needs assessed
• 1996 - 6.5 million
• 1997 - 35 million
• equality of research fund allocation

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The Process of Behaviour Change From the
Individual to an Entire Population

• Integrative model - to help Individuals
• Research leading toward programs for entire
  populations
• Behaviour Health Problems
• smoking, unhealthy diet, alcohol abuse,
  inactivity, obesity, stress, chronic hostility,
  depression...

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Making A ChangeAre You Prepared for Behaviour
Change??

• Change is a process not a quick fix
• positive change should be a lifelong goal
• change takes time
• it needs a plan
• you may fall back sometimes and that is alright
• because you are HUMAN

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What do I Want to Change and Why?

• Why do I do, what I do? well lets see!
• Predisposing Factors
• life experiences
• education/knowledge
• culture/ethnic inheritance
• current beliefs/values
• sex, age, race, income
• who you are. Right now!

Mental Training is Easy!
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Enabling Factors

• skills / abilities
• physical capacity
• emotional status
• intellectual capacity
• facilities / resources
• Urban vs. Rural life
• make decisions more or less difficult
• enablers help (fun)
• - enablers inhibit ()

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Reinforcing Factors

• Presence or Absence of
• support
• encouragement discouragement
• Significant Social Contacts!
• Smoking - friends and family continue and dont
  support you
• Exercise - effort diminished people who influence
  you

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On Being Human.

• Occasional
• ice-cream / treats
• missing an exercise session
• flare ups of anger
• other deviations less than optimal behaviours
• are human and should be considered on an
  individual basis...

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Personal Beliefs and Attitudes

• Risky health behaviours
• common thinking. rational/educated people will
  make changes to reduce the risk
• some people do and many dont
• Doctors who smoke
• health professionals who over work - stressed!
• Knowing is not Doing!

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Do Beliefs and Attitudes Influence Behaviour?

• A Belief
• an appraisal of the
• relationship between
• some object, action, or idea
• and some
• attribute of that object,
• action, idea.
• Belief - smoking and whether is it expensive,
  dirty or causes cancer

• An Attitude
• a relatively stable set of
• beliefs
• feelings
• behaviors towards something or someone
• ?. Do your beliefs Attitude influence your
  health...

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Health Behaviour ModelOur Perception is
Everything!

• Perceived Seriousness of the Health Problem
• what is the problem? How serious do I perceive
  it?
• Perceived susceptibility to the health problem
• Am I likely to develop this health problem?
• Cues to Action
• reminded or alerted

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Your Intention to Change

• Attitudes reflect
• emotional responses to situations
• follow our beliefs
• Theory of Reasoned Action
• behaviour results intentions to perform actions
• An Intention is a product of our attitude and
  what people may want us to do
• Exercise, Smoking, Alcohol .

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Significant Others as Change Agents

• Influenced by people
• approval / disapproval
• real or imagined
• friends / loved ones
• social groups / cultural groups
• Support for healthy change
• Negative interference reduces chance for change

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Social NetworksFamily and Friends

• Your Family
• influence who you are!
• Many components of
• personal development
• Social Bonds
• School
• Work
• Positive / Negative

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Behaviour Change Techniques

• Shaping well defined small steps towards a goal
• Visualizing imagined rehearsal - seeing yourself
  succeed
• Modelling learning behaviours by observing
  successful people
• Controlling the Situation Situational
  Inducement - using situations or occasions to
  control behaviour
• Positive Reinforcement If I do this I will get
  .?

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Changing Self-Talk The way I think and talk to
yourself ( -)!

• Rational-Emotive Therapy
• how we feel and what we say!
• Irrational statements - events are
• different then we want.
• Meichenbaums Self-Instructional
• Methods -
• Instruction / positive
• affirmations Stress Management
• Blocking/Thought Stopping - consciously stop
• thinking negative thoughts...

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Making Behaviour Change

• Self-Assessment
• what happens before the event what happens
  after
• Antecedents cue to action / events - physical
  events, thoughts, emotions, actions of other
  people
• Consequences results of the behaviours - whether
  they are repeated behaviours
• can be physical events, thoughts, emotions,
  actions of other people

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Analyzing the Behaviour You Want to Change

• Frequency
• Duration
• Seriousness
• Basis for problem behaviour
• Antecedents

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Decision MakingChoices for Change

• D.E.C.I.D.E. one method to consider.
• Decide in advance what the problem is????
• Explore the alternative
• Consider the consequences
• Identify your values
• Decide and take action
• Evaluate the consequences

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Goal Setting. Starting Tomorrow Ill...

• be realistic
• be flexible
• provide alternatives
• not all or nothing / Black or white
• behaviour change is a process cant just be
  switched off
• seek support, help and appropriate information.

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Behaviour Health Problems 60 of All Health
Problems

• 1 Health Problem 35 years. smoking
• Free Action-Oriented Programs produced 1
  success rate
• Behaviour Change is a Process..

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Unfolding Over TimeThe Stages of Change

• It Takes Time!

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
• Termination

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Precontemplation

• NO Intention to change.
• No Action in the near Future!
• Noncompliant
• resistant
• unmotivated

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Contemplation

• Intention to CHANGE - 6 Months
• Aware of Benefits/Merits
• Acutely \ Aware of the Disadvantages / Costs of
  Change
• Giving Up (food, smoking, drinking etc)
• Pros vs. Cons and Ambivalence

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Preparation

• Intention to take ACTION
• Soon???
• Have a Plan
• Convinced that Change Benefits Outweighs Cost
• Ready for Action-Orientated Treatments

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ACTION

• Specific overt modification
• Improved lifestyle
• 6 months to set pattern

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Maintenance

• Preventing Relapse
• Continue Effective Action
• Lasts 6 Months to 5 Years
• Self-Efficacy and Temptation

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Termination

• Measured by Total Confidence and Zero Temptation
• Minority From Chronic Condition
• Triggers (causes)
• Emotions
• Environment(place/people)

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This Stage Paradigm can be A Success Predictor
for Intervention

• Recruitment of people for behaviour change are in
  different stages
• gt20 are in preparation stage
• lt40 are in Precontemplation Stage
• lt40 are in contemplation

• What Does this Mean?
• The best predictor of premature termination is
  the persons stage of change
• Program Success is a measure of the individuals
  entry stage of change

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Progress Change

• Time-Effective Therapy
• Drop-out prevention - Match person to stage
• Help individuals or populations move through one
  stage at a time

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Progress From Stage to StageResults

• of Behaviour Change
• Stages Achieved
• One Stage
• Two Stages
• Three Stages
• ETC, ETC

• Success in six months
• Freedom from Problem
• 66 to 100
• 166 to 200
• 266 to 300
• Chances get Better!!!