Promoting Healthy Behaviour: A Lifelong Process of Personal Responsibility

1. Chapter 1 Promoting Healthy Behaviour

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

3. 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………….

4. 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

5. 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…..

6. 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

7. 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 …………..

8. Health and Wellness to its Highest Degree is Achieved Through………... All of the Dimensions of Health!

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

10. 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

11. 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

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

13. 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!

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

15. 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

16. 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………..

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

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

19. 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)

20. Best Solution! Promote healthy lifestyles before health problem exists Cost Effective… less medical intervention Start young! Teach all dimensions of health & CONTINUE THROUGHOUT LIFE - PREVENTION….. Is the key to excellent health!!!!

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

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

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

24. 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?

25. 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 Gender Bias

26. 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……...

27. 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

28. What do I Want to Change and Why? Mental Training is Easy! • 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!

29. 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 ($$)

30. 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

31. 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…...

32. 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!

33. 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………... Do Beliefs and Attitudes Influence Behaviour?

34. 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

35. 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 ….

36. 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

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

38. 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 …….?

39. Changing Self-TalkThe 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……...

40. 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

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

42. 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

43. 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.

44. 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………..

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

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

47. 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

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

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

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