Healthy Lifestyle Plan
Selina Watkins
healthplanexample.pdf
65
C h a p t e r 6
Ready, Set, Goal !
When it comes to eating right and exercising, there is no “I’ll start tomorrow.” Tomorrow is disease.
—Terri Guillemets
Change may not happen overnight, but don’t wait until tomorrow to do it. Some life- style changes can take months or even years to achieve. Anyone desiring to change a behavior, big or small, should also construct some sort of plan. The key to affecting positive change is to remain consistent and dedicated.
This chapter guides you through self-directed behavior modifi cation using the Trans- theoretical Model of Change. Before you can even implement your desired behavior change, you have to assess how ready and motivated you are to actually change it. This chapter contains a series of exercises designed to help you identify your level of motivation and potential barriers to change. You also learn how to create a personalized goal statement and behavior change plan. By completing the worksheet at the end of this chapter, you will have your own personalized behavior change plan. A tracking sheet is also included so you can measure your success. Be sure to reward yourself when you accomplish your goal.
C h a p t e r L e a r n i n g O b j e c t i v e s ■ Be able to defi ne Transtheoretical Model of Change. ■ Identify which stage of change you are in with regard to your chosen behavior. ■ Identify potential barriers related to your desired health behavior change. ■ Create a S.M.A.R.T. health-related goal. ■ Develop a plan of action for achieving your health-related goal. ■ Measure the success of meeting your goal using the tracking sheet at the end of
the chapter.
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L I F E S T Y L E A S S E S S M E N T R E V I E W The chapter exercises provide you with an opportunity to identify behaviors that you
would like to change. Begin your assessment by reviewing all of the worksheets from Chapters 1 through 4. Make a list of several behaviors you desire to change. Record the current baselines for your behaviors as well. For example, if you wanted to increase vegetable intake, calculate the average number of servings you are currently eating by reviewing the Chapter 4 food record worksheet. This will help you complete your healthy lifestyle plan.
You may have identifi ed several behaviors or dietary and exercise-related weaknesses. Choose three behaviors that you feel most motivated to modify. Write these behaviors in the circles below.
Examples could be stop eating fast food, drink more water, refrain from watching TV while I eat, exercise more, or others.
Once you have chosen three behaviors to change, you need to consider the barriers associ- ated with changing them. Identifi cation of barriers is done by summarizing all of the potential situations, people, events, or other factors that make achieving behavior change diffi cult. This process also prepares you for some of the diffi culties that lie ahead.
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Many people choose health related resolutions
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C h a p t e r 6 Ready, Set, Goal ! 67
Discovering barriers is essential for determining your level of motivation, which helps you develop a realistic goal. Later in the chapter you will strategize how to cope with the barriers you identifi ed.
For each of the three behaviors you chose, identify at least three potential barriers to accomplishing the behavior. Write your answers in Table 6.1.
Now review your list of potential barriers. Based on the diffi culty of barriers, rank the behaviors in order of most likely to change and least likely to change:
1. _______________________________________ 2. _______________________________________ 3. _______________________________________
You might feel ready to go all-out and change your entire eating and exercise routine; however, you would be more likely to fail due to unrealistic expectations. By choosing one behavior, you will discover how the process of behavior change really works. Once you experi- ment with modifying your chosen behavior, continue making positive changes by working on one or several smaller behaviors at a time. Of the three behaviors written above, choose the one you are most motivated to change.
Behavior to change: ______________________________________________________
A R E Y O U R E A D Y T O C H A N G E ? One of the more popular models for health behavior change is called the Transtheoretical or Stages of Change model. This model has been effectively used for changing and evaluating successful dietary change interventions [1]. Understanding the Stages of Change will help you
Ta b l e 6 . 1 Behavior Barriers
Example: I want to eat more vegetables • I don’t like most vegetables • Vegetables are too expensive • I don’t have access to a variety
of vegetables
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68 C h a p t e r 6 Ready, Set, Goal !
learn about the process of change while assisting you with your lifestyle intervention plan at the end of the chapter. There are six stages, all of which differ depending on an individual’s desire to change. Individuals may start at the fi rst level and slowly graduate to the last stage or move back and forth along the continuum.
1. Precontemplation: Individuals in this stage have no desire to change and resist any efforts to alter their behavior. People in this stage feel impervious to any negative health consequences (for example, they continue to consume a diet high in saturated fat, increasing risk of heart disease) or may have tried to change unsuccessfully in the past and have given up entirely (a common pattern in smokers) [2].
2. Contemplation: Those at this level recognize that they need to change; however, are still hesitant about actually changing. These individuals are likely to consider making change within the next six months. At this point, an individual may be weighing the pros and cons of changing; however, they are still procrastinating and not ready for any action-oriented change.
3. Preparation: Individuals are preparing to make a behavior change at this stage. Prepar- ers may have already taken small steps to change and are committed to taking action within 30 to 45 days.
4. Action: These people are actively changing their behavior for at least one day or up to six months and continue to work on it. They may be taking small steps to make big- ger changes (such as decreasing saturated fat intake by limiting consumption of red meat). Praise and rewards are good at this level of change. Even though an individual may be changing his or her behavior, that person is at the highest risk for relapse at this stage.
5. Maintenance and Relapse Prevention: The maintenance stage begins after the new behavior has been implemented for at least six months [3]. This stage can continue for months and even years until the behavior has been thoroughly integrated into one’s lifestyle. Individuals continue to work actively to change their environment and most importantly, themselves, in order to prevent relapse.
6. Termination: This is an optional sixth stage in which individuals no longer give in to temptation. This is appropriate for addictive behaviors such as smoking or drug addic- tion. In the context of dietary and exercise behaviors, the long-term goal is mainte- nance, since we all have to continue eating [4].
It is not unusual for individuals to be at different stages even for behaviors that are related [4]. For example, an individual wanting to increase vegetable consumption might be in the action stage of eating more vegetables, but contemplating how to get a variety.
What stage of change do you most identify with? Why? (HINT: Review Table 6. 2) __________________________________________________________________________ _________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________
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C h a p t e r 6 Ready, Set, Goal ! 69
Ta b l e 6 . 2 Your behavior: ______________________________________________________________
Stage of Change
Personal Statement *Fill in the blanks with your behavior Action
Precontemplation: You may be thinking of behaviors to change, however, you still are not motivated to change.
• I am not _____________ and do not intend changing within the next six months.
Ask Yourself:
• What would have to happen to you in order to recognize that this behavior is bad for your health?
• Have you tried to change this behav- ior in the past? What happened? Why did you fail?
Stay on Track:
• Establish a baseline of your behavior (for example, complete a food and exercise record).
• Research health risks associated with poor behaviors.
Contemplation: It is crucial at this point to assess your barriers.
• I am not _____________ but intend to change within the next six months.
Ask Yourself:
• Why do you want to change this par- ticular behavior?
• What would prevent you from chang- ing? (What are your barriers?)
• Who or what has helped you in the past?
• Do you need to know anything else about changing your behavior?
• What can further motivate you to work on this behavior?
Stay on Track:
• Identify the health benefi ts to chang- ing the behavior.
• Identify the barriers to changing behavior .
• Make positive statements about your current abilities.
(Continued)
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70 C h a p t e r 6 Ready, Set, Goal !
Preparation: At this point you are experimenting with small changes and learning how to address your barriers.
• I am not _____________ but intend to do so within the next month
Ask Yourself:
• What has worked in making this par- ticular change?
• What or who else could help even more?
• What or who else could help even more?
• Is there anything else you can do or work on even more?
• Is the change challenging enough? Is it too challenging? What can you do?
Stay on Track:
• Write a goal statement. • Start making small changes.
Action: You are actively making change at this time— keep it up!
• I have been _____________ but for less than six months.
Ask Yourself:
• What is helping you? • What situations would you consider
to be high-risk? Why? • Have you ever relapsed? If so, what
did you learn from that experience and what could you do to prevent other lapses in your behavior change?
Stay on Track:
• Start tracking your behavior, compar- ing it to your goal.
• Give yourself small rewards. • Seek out social support face to face or
online
Maintenance: You have been able to maintain your behavior change for at least six months.
• I have been _____________ for more than six months.
Ask Yourself:
• What can you do to continue your behavior change?
• How can you prevent a relapse?
Ta b l e 6 . 2 C o n t i n u e d
Stage of Change
Personal Statement *Fill in the blanks with your behavior Action
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C h a p t e r 6 Ready, Set, Goal ! 71
Stay on Track:
• Plan for potential situations that may cause relapse.
• Reward yourself. • Create a healthy environment for
yourself (control the food in your home, live an active lifestyle, bike to work . . .).
Source: Adapted from: 1. Bauer, K., & Sokolik, C (2002). Basic Nutrition Counseling Skill Development Belmont, CA:
Wadsworth. 2. Zimmerman, G., Olsen, C., & Bosworth, M. (2000). A Stages of Change Approach to Help-
ing Patients Change Behavior. American Academy of Family Physicians. Retrieved May 2011 from : www.aafp.org/afp/20000301/1409.html.
If you are at the precontemplation or contemplation stage, you should consider choosing an alternative behavior that you are more motivated to work on. Those in the maintenance stage should choose a more challenging behavior to work on. In other words, in order to increase the likelihood of success, you should be in the preparation or action stage.
Now that you have determined your current stage of change, use Table 6.2 to develop your personal statement and review any action that should be taken in order to maintain or modify your current stage of change. Record your answers on a separate sheet of paper. If you fi nd that you don’t relate to the questions presented, you may need to reevaluate which stage of change you are in.
Your behavior: ______________________________________________________________
R E A D Y, S E T, G O A L ! Now that you have identifi ed the behavior that you want to change, you are ready to set a goal and get to work. Goals make you accountable and provide you with direction. It also gives you a sense of accomplishment and rewards you for doing something positive in life.
Setting a goal signifi es your commitment to change. You are now at the preparation or action phase of behavior change. Achieving long-term goals, such as eating healthier, often requires the achievement of several smaller goals. Regardless of the level of commitment, the goal should be positive and concise. Refrain from making goals that are weight related. Even if your long-term goal is to lose weight, there are a myriad of behaviors that will actually result in weight loss. That way your success is not measured by whether you lost weight but by how you got there.
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We i g h i n g I n : D o N o t S e t We i g h t - R e l a t e d G o a l s Goals are designed to keep you on track and usually require a timeline. If you need to lose weight, it may be tempting to set a weight-loss-related goal. However, it is more important to choose behavior-related goals that usually result in weight loss. Weight is a numbers game, and if your goal was to lose 10 pounds in three weeks and you only lost fi ve, you would consider yourself a failure. Perhaps you even lose the 10 pounds, chances are you will feel like that is not enough and want to lose more. This undervalues your success. Instead, choose behaviors to increase or decrease that would likely result in weight loss. For example, you could set a goal related to exercising more. When you start to exercise more, you are not only achieving your goal but also getting a huge boost in self-esteem. The weight loss is just an added benefi t. It’s a win-win!
B o x 6 . 1
Setting a goal based on your weight undervalues your success.
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Make sure to set SMART goals. SMART goals are specifi c (S), measurable (M), attainable (A), rewarding (R) and time-bound (T). Review and complete Table 6.3 to make your behav- ior goal SMART.
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C h a p t e r 6 Ready, Set, Goal ! 73
Ta b l e 6 . 3 Yo u r b e h a v i o r t o c h a n g e : Example: Increase my intake of vegetables __________________________________________________________________________
• Specifi c: How are your going to accomplish your goal?
Example: I will eat one serving of vegetables with lunch and another serving with dinner________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________
• Measurable: How will you measure your behavior?
Example: I will eat at least two servings of vegetables per day and keep track of my servings with a food journal ______ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________
• Attainable: Use action verbs (increase, improve, eliminate, implement, maintain, seek, reduce)
Example: I will start by eating a half of a serving most days of the week and gradually increase my total daily servings to two _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________
• Rewarding: Result you can expect to achieve
Example: Once I maintain eating two servings of vegetables per day for at least one month, I will buy myself a new pair of shoes and feel a sense of accomplishment that I am doing something healthy for my body._________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________
• Time bound: Provides a timeline for accomplish- ing the goal, making it more measurable
Example: I will accomplish my goal within four weeks. _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________
(Continued)
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74 C h a p t e r 6 Ready, Set, Goal !
Your Goal:
Example: I will eat at least two servings of vegetables per day within the next four weeks. _____________________________________________________________________ _____________________________________________________________________
Your Plan:
Example: I will make sure to have more vegetables available at home. I will also try preparing vegetables in new and exciting ways and look up recipes on the web. I will start by commit- ting to eat a half of a serving daily, slowly working up to two servings per day. I will keep track of my success with a food journal. _____________________________________________________________________
_____________________________________________________________________ _____________________________________________________________________
Your Reward:
Example: When I accomplish my goal, I will buy a new pair of running shoes. I will also feel a great deal of accomplishment and be empowered to set future health-related goals. _____________________________________________________________________ _____________________________________________________________________
T R A C K I T You are now ready to embark on your journey to a healthier lifestyle! Keeping track of your behavior is an effective tool for successful change. The worksheet at the end of the chapter includes a one-month tracking calendar. If you weren’t able to assess your behavior with the previous worksheets, you may want to use the fi rst week to establish your baseline. Upon establishing your baseline, you may have to modify your goal in order to match your readiness to change.
Y O U R H E A LT H Y L I F E S T Y L E P L A N Use the information compiled in Tables 6.1 to 6.3 to create your personalized healthy behavior plan in the chapter worksheet. Track your success with the four-week tracking sheet provided.
Ta b l e 6 . 3 C o n t i n u e d
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C h a p t e r 6 Ready, Set, Goal ! 75
C H A P T E R 6 W O R K S H E E T : H E A LT H Y L I F E S T Y L E P L A N
Name: ___________________________________ Date: _______________
Professor: _________________________ Course: __________ Section: __________
GOAL
PLAN
Potential barriers and how to manage or prevent them:
Stay on Track My Rewards
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C h a p t e r 6 Ready, Set, Goal ! 77
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78 C h a p t e r 6 Ready, Set, Goal !
R e f e r e n c e s 1. Bauer, K., & Sokolik, C (2002). Basic Nutrition Counseling Skill Development Belmont,
CA: Wadsworth. 2. Zimmerman, G., Olsen, C., & Bosworth, M. (2000). A Stages of Change Approach to Help-
ing Patients Change Behavior. American Academy of Family Physicians. Retrieved May 2011 from : www.aafp.org/afp/20000301/1409.html.
3. Centers for Disease Control and Prevention. (2007). Transtheoretical Stage Model. www. cdc.gov/hiv/topics/prev_prog/acdp/intervention/change.htm
4. Contento, I. (2002). Nutrition Education, Linking Research, Theory and Practice. Boston: Jones and Bartlett Publishers.
5. Prochaska, J. O., & Velicer, W. F. (1997). “The transtheoretical model of health behavior change.” American Journal of Health Promotion, 12, 38–48.
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