Health Behaviors

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Health Behaviors
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Health Behaviors

• Exercise
• 60 of Americans are not regularly active
• 25 of adult population are not regularly active
• Center for Disease Control and Prevention

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Barriers to Modifying Poor Health Behaviors

• Independent of each other
• Unstable
• Different health habits are controlled by
  different factors
• Different factors may control the same health
  behaviors for different people
• Factors controlling a health behavior may change
  over the history of the behavior
• Factors controlling the health behavior may
  change across a persons lifetime
• Health behavior patterns and their developmental
  course will vary substantially among individuals

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When to Intervene?

• Children and adolescence
• Socialization
• Teachable moment
• goal of primary intervention
• Cognitive ability
• Window of vulnerability

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The importance of prevention

• Reduce the behaviors that contribute towards
  disease
• Efficient way to reduce health care costs
• Allows for the identification of other risk
  factors

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Problems with prevention

• Inaccurate perception of ones risk
• Some assume that the health-impairing behavior is
  more prevalent than it really is
• Some assume that because they believe a behavior
  to be prevalent, it cannot be that bad
• Some minimize the importance of the health
  behavior

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Ethnicity and Health Risks/Habits

• Black and Hispanic women exercise less than anglo
  women
• More likely to be overweight
• Anglo and Black women are more likely to smoke
  than Hispanic women

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Sources of Health Information

• 1960s and Cigarette Smoking
• Surgeon General (1964)
• The Media
• Too much, conflicting information
• Poor and uneducated (DiMatteo DiNicola, 1999)
• Inadvertent health messages
• Inaccurate health beliefs and TV (Signorielli,
  1998)
• The Internet

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Sources of Health Information

• Medical Interaction
• Physician and Prevention?
• 44 of smokers
• Approaching smokers (Butler et al., 1998)
• 38 with HIV

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Educational Appeals in Prevention

• Colorful communications
• Avoid jargon/stats
• Try to include a case-example
• Communicator must be expert, trusting, likeable
  similar to audience
• Strong arguments should be presented at the
  beginning and end of a message not buried in the
  middle
• Message should be brief, clear, and direct
• More extreme message produce more attitude change
  up to a point
• For illness detection behaviors, emphasize
  problems that may occur
• For health promotion behaviors, emphasize
  benefits to be gained
• If audience is receptive to changing a health
  habit, communication should include only
  favorable points
• If audience is resistant, both sides of the issue
  should be presented

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Fear Appeals

• Becker and Janz (1987)
• Excessive fear may actually undermine health
  behavior change
• If fear messages do produce change, it is
  generally short-lasting
• Best to couple fear message with recommendations
  for action

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Persuasion

• The message must
• Be attention-grabbing
• Be understandable
• Be something acceptable and worth considering
• Be retained and remembered
• Present both sides of an issue

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Persuasion

• Person being persuaded must
• Thoroughly integrate the new message with older
  beliefs
• Review why he or she has certain beliefs
• Be inoculated against conflicting arguments

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Persuasion Person Must

• Be a communicator that is liked
• Be enthusiastic, interested, dynamic and
  confident
• Believe what he/she is doing
• Be perceived as trustworthy, dependable,
  predictable, honest, and as having the receivers
  best interest at heart

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Preventing Relapse

• Relapse
• Recurrence of a symptoms after a period of
  improvement
• Backsliding
• Returning briefly to the past behavior
• Lapse
• Mistake, error, or a slip-up that involves a
  reemergence of the previous habit

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Preventing Relapse

• Attribution to relapse
• Internal, character-based explanations
• Brownell et al, 1986
• Negative emotional states
• Inadequate initial motivation
• Lack of coping skills to cope with pressures of
  relapse
• Physiological factors (e.g., craving)
• Lack of social support
• Environmental stimuli that favor the behavior
• Avoidance high-risk situations
• Booster Sessions

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Relapse

• Stages in the Prevention of Relapse
• Enhancing ones motivation to continue the health
  behavior by providing oneself with regular
  rewards and/or by focusing on the rewarding
  consequences of the behavior
• Acquiring and practicing skills to prevent and to
  deal with lapses, which probably will occur
• Maintaining the health behavior by continued
  careful monitoring, general lifestyle change and
  seeking out social support

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Cognitive Behavioral Approaches to Health
Behavior Change

• CBT focuses on the conditions that elicit and
  maintain the health behavior
• Self-Observation and Self-monitoring
• Classical Conditioning
• Operant Conditioning
• Modeling
• Stimulus Control
• Self-Reinforcement
• Contingency Contracting
• Covert Self-Control
• Behavioral Assignments
• Relaxation Training