Behavior ModificationBehavior Modification

Chapter 2

Objectives Objectives Learn the effects of environment on human

behavior. Understand obstacles that hinder the ability to

change behavior. Explain the concepts of motivation and locus of

control. Identify the stages of change. Describe the

processes of change. Explain techniques that will facilitate the process of

change. Describe the role of SMART goal setting in the

process of change. Be able to write specific objectives for behavioral

change.

Behavior ModificationBehavior Modification

Introduction Why is it so hard for people to

change?

What triggers the desire to change?

Exercise/Exercise dropout cycleExercise/Exercise dropout cycle Research has

documented the benefits of physical activity and healthy lifestyles

Most Americans accept that exercise is beneficial to health

70% of new and returning exercisers are at risk for early dropout

Living in a Toxic Health and Living in a Toxic Health and Fitness EnvironmentFitness Environment

Most behaviors we adopt are a product of our environment

Environment includes family, friends, home, school, workplace, television, radio, movies, community, country, and culture

We live in a “toxic” fitness and wellness environment

We overlook the ways our environment influences our behaviors, lifestyle, and health

Living in a Toxic Health and Living in a Toxic Health and Fitness EnvironmentFitness Environment

We incorporate learned behaviors into our own lifestyle

Children watch adults Drive short distances Automatically use elevators, remote controls, etc. Order super-sized fast foods Use recreational time to watch TV or surf the

Internet Smoke, drink, and abuse other drugs Engage in risky behaviors, such as not wearing

seat belts

Environmental Influences on Environmental Influences on Physical ActivityPhysical Activity

Physical inactivity and poor diet are among the leading causes of death in the United States

Most daily activities require almost no effort and negatively impact health, fitness, and body weight

Examples: short car rides that replace walking/biking decrease energy expenditure by 50-300 calories, TV viewing 200 calories or more

Our environment is not conducive to Our environment is not conducive to a healthy, physically active lifestylea healthy, physically active lifestyle

Environmental Influences on Environmental Influences on Physical ActivityPhysical Activity

A person must accumulate the equivalent of 5-6 miles of walking per day or 10,000-12,000 daily steps to be considered active

People are moving less thanks to cell phones, escalators, automatic doors, intercom systems, television, etc.

Excessive TV viewing is linked to obesity as it is a “snacking setting”

Many cities lack safe places to exercise

Environmental Influences on Environmental Influences on Physical ActivityPhysical Activity

Communities are designed around the automobile, making pedestrians “obstructions”

Walking and biking account for 10% of daily trips and the automobile accounts for 84% in the U.S.

Walking and cycling are priority Walking and cycling are priority activities in many European activities in many European communitiescommunities

Environmental Influence on Environmental Influence on Diet and NutritionDiet and Nutrition

The amount of daily food supply available in the United States is about 3,900 calories per person, before wastage. This figure represents a 700-calorie rise over the early 1980s.

The overabundance of food increases pressure on food suppliers to advertise and try to convince consumers to buy their products.

Many activities of daily living in today's culture are associated with eating.

Environmental Influence on Environmental Influence on Diet and NutritionDiet and Nutrition

As a nation, we now eat out more often than in the past, portion sizes are larger, and we have an endless variety of foods to choose from.

Compared to home meals, restaurant and fast food meals are higher in fat and calories and lower in essential nutrients and fiber.

Most restaurants are pleasurably decorated to enhance comfort, appetite, and length of stay, with the intent to entice more eating.

Restaurants and groceries often appeal to our sense of thrift by using "value marketing," meaning they offer us a larger portion for only a small price increase, or free soft drink refills.

On average, American women consume 335 more daily calories than they did 20 years ago, and men an additional 170 calories.

Barriers to ChangeBarriers to Change Lack of core values

Most people are unwilling or unable to trade convenience for health or other benefits.

Tip: Educate yourself regarding the benefits of a healthy lifestyle and subscribe to several reputable health, fitness, and wellness newsletters.

Procrastination They think: "Tomorrow or sometime later will be a better time to

change." Tip: Ask, "Why not change today?" and find the motivation to do

so.

Preconditioned cultural beliefs They think: "I cannot change because I am merely a product of

my environment." Tip: Find a like-minded partner. Finding people who are willing to

"sail" with you will help overcome this barrier.

Barriers to ChangeBarriers to Change Gratification

They think: "Benefits later are not worth the discomfort now. Instant good feelings outweigh any long-term satisfaction."

Tip: Ask, "What happened last time when I didn't consider the consequences? Is the immediate good feeling really worth it later? Is the long-term satisfaction worth suffering discomfort for a while?“

Risk complacency They think: "If I get heart disease, I'll deal with it then. For now, let

me eat, drink, and be merry." Tip: Ask, "How well do I want to live my last decades of life?“

Complexity They think: "The world is too complicated, with too much to think

about. There are so many things to do to be healthy. I just can't do them all."

Tip: Ask, "Can't I take them one at a time?"

Barriers to ChangeBarriers to Change Indifference and helplessness

They think: "No matter what I do, my genetics will work against me."

Tip: Ask, "Didn't I just read that 84 percent of the risk for disease is based on everyday decisions?“

Rationalization They think: "I'm not as bad as Joe or Sally." Tip: Ask, "Do Joe and Sally's problems improve mine?“

Illusions of invincibility They think: "It might be a bad

choice, but I can handle anything that comes my way."

Tip: Ask, "Will I be able to handle anything when I am older? Might it be better to maintain good health throughout life?"

Self-EfficacySelf-Efficacy The belief in one's own ability to

perform a given task. It exerts a powerful influence on people's

behaviors and touches virtually every aspect of their lives.

The knowledge and skills you possess and further develop determine your goals and what you do and choose not to do.

Self-EfficacySelf-Efficacy Sources of Self-Efficacy

Mastery experiences, or personal experiences that one has had with successes and failures—best contributors of self-efficacy.

Vicarious experiences provided by role models or those one admires also influence personal efficacy.

Verbal persuasion of one's capabilities to perform a task also contributes to self-efficacy.

Physiological cues that people experience when facing a challenge—least significant source of self-efficacy.

Motivation and Locus of Motivation and Locus of ControlControl

Motivation Drive that dictates human behavior Often the explanation given for why some people succeed

and others do not.

Locus of control Internal: when individuals believe they have control over

events in life. These people are usually: Healthier. More successful in adhering to exercise.

External: results when individuals do not believe their behavior will alter events in life; rather, events happen by chance or for some other external reason. These people:

Usually feel powerless and vulnerable. Are at greater risk for illness and slower recovery from illness.

Few people have a completely external or internal locus of control.

Motivation and Locus of Motivation and Locus of ControlControl

Problems with competence Lacking the skills to get a given task done leads to

reduced competence. Solutions?

Problems with confidence Arise when you have the skill but don't believe you can

get it done and/or when the task seems insurmountable. Solutions?

Problems with motivation Individuals have both the competence and the confidence,

but are unwilling to change because the reasons to change are not important to them.

Solutions?

Changing BehaviorChanging Behavior Recognizing that a problem exists Five general categories of behaviors

Stopping a negative behavior Preventing relapse of a negative behavior Developing a positive behavior Strengthening a positive behavior Maintaining a positive behavior

Change Does not occur all at once Usually done without professional help Occurs along a continuum

Changing Behavior – Changing Behavior – Behavior Change TheoriesBehavior Change Theories

Learning theories Behaviors are learned and maintained

Scheduled reinforcement and anticipated outcomes

Problem-solving model Behaviors result from making decisions

as we seek to change problem behavior

Changing Behavior – Changing Behavior – Behavior Change TheoriesBehavior Change Theories

Social cognitive theory Change is influenced by environment,

self-efficacy, and characteristics of behavior

Relapse prevention model Anticipate high-risk situations

Develop action plans Humanistic theory of change

Ultimate goal of self-actualization

Changing Behavior – Changing Behavior – Behavior Change TheoriesBehavior Change Theories

Transtheoretical model Change is gradual and involves stages

Model of Progression and Model of Progression and RelapseRelapse

Relapse• To slip into

unhealthy behavior or to regress in the stages of the transtheoretical model (Figure 2.4).

• May occur at any level after the precontemplation stage.

The Process of ChangeThe Process of Change Using the same plan for everyone does

not work Timing

Apply any number of techniques of change within each process to help go through that specific process.

Applicable Processes of Applicable Processes of Change During Each Stage of Change During Each Stage of ChangeChange

The Process of ChangeThe Process of Change Consciousness-raising

Obtaining information about the problem Stages

Social liberation External alternatives Gain confidence in ability to change

The Process of ChangeThe Process of Change Self-analysis

Develop decisive desire to modify behavior

Emotional arousal Experience and express feelings

“Dramatic release” Positive outlook Commitment

The Process of ChangeThe Process of Change Behavior analysis

Frequency, circumstances, and consequences of behavior to be changed

Goals Motivate change in behavior

Self-evaluation Countering

Substitution of behaviors

The Process of ChangeThe Process of Change Monitoring

Increased awareness of the desired outcome

Environment control Restructuring of physical surroundings

Helping relationships Rewards

The Transtheoretical Model Where am I now?

Techniques of ChangeTechniques of Change Goals motivate behavior

change SMART goals

Specific Measurable Acceptable Realistic Time specific

Perform periodic progress evaluations

Steps for Successful Steps for Successful Behavior ModificationBehavior Modification

Real Life StoriesReal Life Stories

Real Life Stories Real Life Stories Critical Thinking Critical Thinking QuestionsQuestions

1. Describe how lack of self-efficacy was a barrier that kept Aisha from adhering to an exercise program. Can you identify her exercise stage of change prior to understanding the concept of self-efficacy?

2. What stage of change are you at in terms of your own physical activity habits? How about your exercise habits?

3. Can you identify environmental influences in your own life that have kept you from implementing healthy lifestyle habits? If you have made some changes, please indicate what processes of change have worked for you and techniques of change used that helped you adopt healthy behaviors.