Changing Health- related behavior

Although some health concerns can be successfully addressed collectively though local, state, national, or international efforts such as those just outlined, most are ultimately based on the willingness and ability of persons to change aspects of their own behavior.

Why Behavior Change Is Often Difficult

Several factors can strongly influence a person’s desire to change high health-risk behaviors, including those listed below.

1.        A person must know that a particular behavioral pattern is clearly associated with (or even causes) a particular health problem.  For example: Cigarette smoking is the primary cause of lung cancer.

2.       A person must believe (accept) that their behavioral pattern will make (or has made) them susceptible to this particular health problem.  For example: My cigarette smoking will significantly increase my risk of developing lung cancer.

3.       A person must recognize that risk-reduction intervention strategies exist and that should they adopt these in a compliant manner they too will reduce their risk for a particular health condition.  For example: Smoking cessation programs exist, and following such a program could help me quit smoking.

4.       A person must believe that benefits of newly adopted health-enhancing behaviors will be more reinforcing than the behaviors being given up.  For example: The improved health, lowered risk, and freedom from dependence resulting from no longer smoking are better than the temporary pleasure provided by smoking.

5.       A person must feel that significant others in their lives truly want them to alter their high-risk health behaviors and will support their efforts.  For example: My friends who are cigarette smokers will make a concerted effort to not smoke in my presence and will help me avoid being around people who smoke.

When one or more of the conditions listed above is not in place, the likelihood that persons will be successful in reducing health-risk behaviors will be greatly diminished.

Stages of Change

The process of behavioral change unfolds over time and progresses through defined stages.  James Prochaska, John Norcross, and Carol DiClemente outlines six predictable stages of change.  They studied thousands of individuals who were changing long-standing problems such as alcohol abuse, smoking, and gambling.  While these people used different strategies to change their behavior, they all proceeded through six consistent stages of change in the process referred to as Prochaska’s Stages of Change

Precontemplation Stage

The first stage of change is called precontemplation, during which a person might think about making a change, but ultimately finds it too difficult and avoids doing it.  For example, during this phase a smoker might tell friends, “Eventually I will quit,” but have no real intention of stopping within the next 6 months.

Contemplation Stage

For many, however, progress toward change begins as they move into a contemplation stages, during which they might develop the desire to change but have little understanding of how to go about it.  Typically, they see themselves taking action within the next 6 months.

Preparation Stage

Following the contemplation stage, a preparation begins, during which change begins to appear to be not only desirable but possible as a well.  A smoker might begin making plans to quit during this stage, setting a quit date for the very near future (a few days to a month), and perhaps enrolling in a smoking cessation program.

Action Stage

Plans for change are implemented during the action stage, during which changes are made and sustained for a period of 6 months.

Maintenance stage

The fifth stage is the maintenance stage, during which new habits are consolidated and practices for an additional 6 months.

Termination Stage

The sixth and final stage is called termination, which refers to the point at which new habits are well established and so efforts to change are complete.