Chapter 1 Promoting Healthy Behaviour Promoting Healthy Behaviour

Chapter 1 Promoting Healthy Behaviour

Promoting Healthy Behaviour Change Personal Health? A Choice? Your Responsibility? Health & Lifestyle - A Life Long Process…….

What is Health? • Prior to the late 1800’s the opposite of sickness • if disease didn’t kill you then you were healthy/lucky • 1900’s • victims of microorganisms • water, air, human waste………….

Health and the Math (statistics) • Medical Research causes of diseases • 1900’s - most deaths infectious diseases (tuberculosis, pneumonia, influenza) • Life Expectancy Men 58. 84 years Females 60. 60 years

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

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

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 …………. .

Health and Wellness to its Highest Degree is Achieved Through………. . .

The Dimensions of Health Mind + Body+ Spirit Social Health • interpersonal relationships • daily behaviours • interactions • satisfying • positive • supportive • variety of situations HOLISTIC HEALTH

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

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

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

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!

Physical Health Personal Physical Characteristics body size, shape, sensory acuity, susceptibility to disease/disorders, recuperation form illness Overall Health and Physical Well Being Stress Management Life Value Added Attitude Exercise Active Living Nutrition

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 Absolute……e. g. disabled people can be healthy

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………. .

HEALTH PROMOTION Helping you stay healthy…. And the message is ? • Health Promotion Programs: • educational • organizational • procedural • environmental • financial Support • Provide a consistent message for all!

Disease Prevention: Process to Reduce Occurrence and Severity of Disease • Goal: Reduce/eliminate behaviours that increase risk • Three levels of Prevention • Taking actions to prevent sickness

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)

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 • -

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

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

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

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 aren’t Canadians responsible for their health?

Gender Bias • Androcentricity a male perspective • Over -generalization research findings from one sex is applied to both • An example…. 1/9 women are • Gender Insensitivity Over looking gender as an • important variable • Double Standards evaluation, treatment, or measurement applied to both genders equally • • • diagnosed with breast cancer - yet little research! 1993 - research needs assessed 1996 - 6. 5 million $$ 1997 - 35 million $$$$$$$ equality of research fund allocation

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……. . .

Making A Change Are 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

What do I Want to Change and Why? • Why do I do, what I do? …… well let’s see! • Predisposing Factors • • • life experiences education/knowledge culture/ethnic inheritance current beliefs/values sex, age, race, income who you are…. Right now! now Mental Training is Easy!

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 ($$)

Reinforcing Factors • Presence or Absence of • support • encouragement discouragement • Significant Social Contacts! • Smoking - friends and family continue and don’t support you • Exercise - effort diminished people who influence you

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…. . .

Personal Beliefs and Attitudes • Risky health behaviours • common thinking…. rational/educated people will make changes to reduce the risk • some people do and many don’t • Doctors who smoke • health professionals who over work stressed! • Knowing is not Doing!

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………. . .

Health Behaviour Model Our 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

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 ….

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

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

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 ……. ?

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…. Meichenbaum’s Self-Instructional Methods • Instruction / positive • affirmations…… Stress Management Blocking/Thought Stopping - consciously stop thinking negative thoughts……. . .

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

Analyzing the Behaviour You Want to Change • • Frequency Duration Seriousness Basis for problem behaviour • Antecedents

Decision Making: Choices 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

Goal Setting…………. Starting Tomorrow I’ll……. . . • • be realistic be flexible provide alternatives not all or nothing / Black or white • behaviour change is a process…… can’t just be switched off…… • seek support, help and appropriate information.

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………. .

Unfolding Over Time… The Stages of Change • It Takes Time! • • • Precontemplation Contemplation Preparation Action Maintenance Termination

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

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

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

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

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

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

This Stage Paradigm can be A Success Predictor for Intervention • Recruitment of people for behaviour change are in different stages • >20% are in preparation stage • <40% are in Precontemplation Stage • <40% 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 individual’s entry stage of change

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

Progress From Stage to Stage Results • # 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!!!