Behaviors and Diseases

Behaviors and Diseases

• Human beings can control their conduct, leading to overall behavior and public health improvements.
• Behaviors impact diseases with behavior changes resulting in an overall healthier life.
• Smoking, alcohol consumption, poor dietary choices, physical inactivity, sexual activity, substance abuse and rash driving are health-compromising behaviors
• These behaviors lead to diseases like non-communicable diseases (NCDs) like diabetes, obesity, hypertension, cancers, HIV, STDs, hepatitis, mental disorders and road traffic accidents.
• Health-compromising behaviors can be eliminated through self-regulatory efforts combined with adopting health-enhancing behaviors.

Behavioral Pathogens and Immunogens

• A behavioral pathogen is a health-compromising behavior or habit.
• Examples of behavioral pathogens: smoking, excessive eating, inactivity, substance abuse, dangerous driving, and risky sexual behavior.
• A behavioral immunogen is a health-enhancing behavior or habit.
• Examples of behavioral immunogens: exercising regularly, using sunscreen, healthy eating, practicing safe sex, and wearing seatbelts.

Influences on Health Behaviors

• Biological factors: genes, physiology, age, gender, fitness, and weight.
• Psychological factors: personality, rewards and punishment, cognitive biases, and emotion/motivation.
• Societal factors: social support and socioeconomic status (SES).
• Healthy behaviors include eating well, getting physical activity, not smoking, and sleeping well.

Barriers to Healthy Behavior Change

• Individual barriers: inertia and optimistic bias: believing you are less likely to become ill than others.
• Optimistic bias involves the invincibility fallacy, but optimism conveys health advantages within limits.
• Family Barriers: Health habits are often acquired from parents.
• Obese parents are more likely to have obese children.
• Family support is important to implement change.
• Health System Barriers: medicine focuses on treatment, rather than prevention.
• Health System Barriers: A significant percentage of Americans lack health insurance.
• Health System Barriers: Unrealistic or confusing recommendations.
• Community barriers: poor access to recreational facilities and healthy food.

Factors that Influence Behavior Change

• Predisposing factors: knowledge, beliefs, and attitudes based on life experiences, as well as gender, age, race, and socioeconomic background.
• Enabling factors: skills and abilities, and available resources.
• Reinforcing factors: social support, encouragement, or discouragement from those around.

Transtheoretical Model on Behavior Change

• Five stages of behavior change: precontemplation, contemplation, preparation, action, maintenance.
• Stage 1: Precontemplation, there is no current intention of changing.
• Stage 2: Contemplation, the individual recognizes a problem.
• Stage 3: Preparation, the individual makes a plan close to taking action.
• Stage 4: Action, the individual begins to implement the plan.
• Stage 5: Maintenance, an action plan is in place with potential for relapses.
• Stages of Behavior Change for Diabetes
• In Precontemplation, an individual has no disease.
• In Contemplation, an individual is not happy and worried about having diabetes; they want to live and save themselves with prevention.
• In Preparation, an individual is ready to change and to learn about healthy practices.
• In Action, an individual is doing dietary changes, physical activity, and taking meds.
• In Maintenance, an individual continues with positive and negative reinforcement.

Shortcomings and Other Issues with Theories

• People don't always do what they intend ("the intention-behavior gap").
• Predictive power is not uniform for all groups.
• Theories tend to ignore past experience.
• Past behavior is often the best predictor.
• Theories say little about translating intentions into action.
• Health habits can be unstable over time.
• For the very young, old, and ill, health care decisions may be made by others.
• Stage theories may not apply as behavior change can be continuous and non-linear.

Diffusion of Ideas Model

• People adopt new behaviors when respected individuals endorse them.
• Opinion leaders influence an initial group, establishing a new social norm.
• The rest of the community follows.

Strategies to Enhance Exercise and/or Physical Activity Adherence

• Behavior modification approaches.
• Reinforcement approaches.
• Cognitive/behavioral approaches.
• Decision-making approaches.
• Social-support approaches.
• Intrinsic approaches.

Behavior Modification Approaches: Prompts

• Prompts are verbal, physical, or symbolic cues that initiate behaviors such as posters or running shoes.
• Participants enter into a contract with their exercise leader.

Reinforcement Approaches: Feedback and Monitoring

• Providing feedback to participants on their progress has positive motivational effects.
• Participants keep written records of their physical activity.

Cognitive/Behavioral Approaches: Goal Setting

• Goal setting should motivate individuals.
• Exercise-related goals should be self-set rather than instructor-set. Exercise-related goals should be flexible rather than fixed.

Decision-Making Approaches: Balance Sheets

• Involve exercisers in decisions regarding program structure.
• Completing a decision balance sheet increases awareness of the costs and benefits, enhancing adherence.
• Changing exercise would mean increased control, support from family, decreased job problems and health
• Changing exercise would mean increased stress, depression, boredom and sleep problems
• Not changing exercise would mean more relaxation, fun at parties, but disapproval from relationships, money problems and health risks

Social Support Approaches

• Social support is an individual's favorable attitude toward another individual's involvement in an exercise program.
• Social support can be enhanced by participating in a small group, using personalized feedback, and using a buddy system.

Intrinsic Approaches

• Focus on the experience.
• Involve Self-monitoring practices.
• Consider Tangible vs. Intangible benefits

Incentives; Behavioral Economics

• Incentives typically result in significant participation rates for worksites if insurance benefits are offered.
• Incentives may not translate to long-term behavior change.

Tips for Being More Active

• There are 1440 minutes in every day; schedule 30 for physical activity.
• Use leg power for small trips, walking, cycling, or skating to work or school.
• Park the car farther away or get off the bus several blocks away.
• Take the stairs instead of the elevator or escalator.
• Play with children or pets.
• Perform gardening or home repair activities.
• Avoid labor-saving devices, turning off self-propel options.
• Exercise while watching TV, using hand weights, a stationary bicycle, or stretching.

Tips for inactive People

• Use a sensible approach by starting out slowly.
• Choose moderate-intensity activities you enjoy because you will be more likely to stick with them.
• Gradually build up the time and intensity.
• Vary your activities for interest and a broader range of benefits.
• Explore new physical activities.
• Reward and acknowledge your efforts.