HLF 210

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Questions and Answers A Guide to Fitness and Wellness 4th Edition

Gary Liguori │ Sandra Carroll-Cobb

©McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.

CHAPTER 2

Positive Choices/ Positive Changes

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COMING UP IN THIS CHAPTER

Identify the factors that influence your wellness behaviors

Develop strategies for increasing your motivation to change for the better

Apply techniques that match your stage in the change process

Develop a personalized plan for successful behavior change, including appropriate goals and strategies for overcoming barriers

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Factors Influencing Health Behavior and Behavior Change

Question: Why is behavior change so hard?

Behavior is influenced by many factors

Behavior: an observable action or response

Habit: a behavior that recurs, often unconsciously, and develops into a pattern

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Factors Inside and Outside Your Control

Behavioral influences include:

Heredity/genetic makeup

Gender

Childhood and past experiences

Knowledge, skills, and abilities

Age

Beliefs

Attitudes

Values

Religious and cultural norms and practices

Socioeconomic status (income, education, occupation)

Environment

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FIGURE 2-1 FACTORS THAT INFLUENCE HEALTH BEHAVIORS

©Paranamir/Shutterstock.com RF

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Predisposing, Enabling, and Reinforcing Factors

Question: Is there some way I can bribe myself into making a change in my habits?

Wellness: more personalized concept than health

Predisposing factors: those factors that you bring to the table

Enabling factors: those factors that help you change your behavior

Reinforcing factors: those factors that follow a behavior and either encourage or discourage your new behavior

Internal or external

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FIGURE 2-2 FACTORS AFFECTING BEHAVIOR CHANGE

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Motivation for Behavior Change

Question: How can I find motivation?

Motivation: energized state that directs and sustains behavior

Increased or decreased based on internal and external factors

Factors affecting motivation:

Locus of control

Self-efficacy

Goal setting

Decisional balance

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Locus of Control: Do You Feel in Charge?

Question: What’s the point of all the effort? Practically everyone in my family gets diabetes when they hit age 40.

Internal locus of control: belief that one’s personal outcomes largely depend on what one does and how hard one tries

External locus of control: belief that factors outside one’s control largely determine the outcomes of what one does

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Self-Efficacy: Do You Anticipate Success?, 1

Question: I start a workout program for 2 weeks and then just stop. How do I keep motivated?

Optimism: the expectation of success

SELF-EFFICACY EXPECTATIONS

Self efficacy: belief in one’s capability to perform a task that leads to a specific outcome

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Self-Efficacy: Do You Anticipate Success?, 2

HOW SELF-EFFICACY DEVELOPS— AND CAN BE INCREASED

Past performance

Direct experience is the most powerful influence on self-efficacy expectations

Observational learning

Persuasion

Interpreting internal cues

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Self-Efficacy for Behavior Change

Question: I’m discouraged because I have failed at my exercise goals in the past. Is there a way to improve my chances of success?

Start by rating your degree of confidence in reaching your goal

Set realistic goals and monitor your behavior

Identify obstacles

Find a role model and ask for support

Visualize and celebrate success

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Goal Setting: What Are You Trying to Achieve?

Question: How do I come up with a good goal that fits me as an individual?

Use the SMART principle:

Specific

Measurable

Achievable

Realistic

Time-bound

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FIGURE 2-3 SAMPLE SMART GOALS

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Decisional Balance: What Are the Pros and Cons of Change?

Question: What if I don’t have any motivation to do anything?

Self-defeating behaviors accomplish one goal (usually a short-term one) but interfere with more important goals (usually long-term)

Analyze the pros and cons of the changes you want to make

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Stages of Change, 1

Question: How do I get organized, motivated, and focused to change my behavior?

Transtheoretical model (TTM)

Precontemplation

Contemplation

Preparation

Action

Maintenance

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Stages of Change, 2

PRECONTEMPLATION

Not yet actively thinking about change; rationalizing behavior

CONTEMPLATION

“Thinking” stage

Weighing pros and cons

PREPARATION

“Planning and getting ready” stage

Move from thinking to doing

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Stages of Change, 3

ACTION

Implementing the plan

Behavior change begins

MAINTENANCE

Working to maintain new behavior and to avoid relapse

Seeking out and using social support

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Stages of Change, 4

Question: Is it possible to modify behavior beyond the point of relapse?

Termination

Zero temptation and total self-efficacy

Not realistic for most

Considering oneself as being in a lifetime maintenance stage is a better option

Lapses and relapses are common

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FIGURE 2-4 STAGES OF CHANGE IN THE TRANSTHEORETICAL MODEL OF BEHAVIOR CHANGE

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Processes and Techniques of Change, 1

Question: According to the information on stages of change, I’m currently in the contemplation stage. Now what?

Consciousness raising

Emotional arousal (dramatic relief)

Environmental reevaluation

Self-reevaluation

Commitment (self-liberation)

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Processes and Techniques of Change, 2

Helping relationships

Seek social support

Countering

Substitute the healthy behaviors

Reinforcement management (rewards)

Environment control

Remove cues and triggers

Social liberation

Seek different or additional social alternatives

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Overcoming Common Barriers to Change, 1

Question: What is the greatest obstacle to overcome in dealing with behavioral change?

I don’t have enough time

Practice time management

I can’t get motivated

Pros vs. Cons

I’ll get around to changing—later

Don’t procrastinate

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Overcoming Common Barriers to Change, 2

I don’t know how

Seek reliable information

I don’t have enough money

Healthy lifestyles are generally less expensive than unhealthy ones

I lack willpower

Avoid temptation

It is too hard—and no fun

Personalize your goal and develop a realistic goal

Make new health habits pleasurable

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Overcoming Common Barriers to Change, 3

I’m too tired

Know your rhythms

I can’t say “no”

Be more assertive

I have a negative outlook

Reframe your self-talk

I don’t feel supported

Utilize support groups, family, friends

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Overcoming Common Barriers to Change, 4

I do OK at first and then backslide

Know that lapses are a normal part of the process

Schedule check-ins with yourself

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TABLE 2-2 EXAMPLES OF NEGATIVE AND POSITIVE PATTERNS OF SELF-TALK

PATTERN OF DISTORTED THINKING	EXAMPLE OF DISTORTED, NEGATIVE SELF-TALK	EXAMPLE OF MORE REALISTIC, POSITIVE SELF-TALK
ALL-OR-NOTHING THINKING	Since I skipped two workouts this week, my exercise program and I are both complete failures. I give up.	I’m disappointed with myself that I skipped two workouts this week. Part of the problem was that I didn’t make time for them in my schedule. I’ve scheduled them in my calendar next week so that I can do better.
BLAMING OTHERS	I wouldn’t have eaten so much pizza if I hadn’t been with those friends. It’s all their fault.	I’m responsible for my own food choices. Next time, I’ll suggest a different restaurant, or I’ll eat just one piece. I’m a strong person and I can be in control.
OVERGENERALIZING	My roommate was so rude to me this morning. He really hates me.	My roommate was really upset this morning. He’s usually in a much better mood. I’m going to talk to him about what’s upsetting him.
JUMPING TO CONCLUSIONS	Our class TA asked to meet with me tomorrow. I must have done something awful on that last assignment, or maybe I’m failing the class.	Our class TA asked to meet with me tomorrow. It’s the first time that’s happened, but I’ll just wait and see what’s up.
DWELLING ON NEGATIVES	I can’t believe I ate that piece of chocolate this afternoon. That’s an old habit I’m supposed to be breaking. I’m such a loser.	Too bad I ate that chocolate today—that’s one of my old habits. But I’ve done great on my eating plan all week, so I’m not going to stress about it. Next time, I’ll carry a nutritious snack to have instead.

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Developing a Personalized Behavior-Change Program, 1

Question: What is the best way to start if I am trying to change a behavior?

Complete a pros-versus-cons analysis

Monitor your current behavior

Set SMART goals and plan rewards

Develop strategies for overcoming obstacles and supporting change

Identify helpers and resources

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Developing a Personalized Behavior-Change Program, 2

Put together your program plan

Make a commitment . . . and act on it

Track your progress and modify your plan as needed

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FIGURE 2-5 SUMMARY OF BEHAVIOR-CHANGE STEPS

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FIGURE 2-6 SAMPLE PROS-VERSUS-CONS ANALYSIS FOR BEHAVIOR CHANGE

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FIGURE 2-8 SAMPLE BEHAVIOR-CHANGE LOG

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Developing a Personalized Behavior-Change Program, 3

Question: How much can I say or do to encourage a family member to quit smoking or lose weight?

Encourage, but don’t push

Recommend change frequently, but be patient

Discuss specific past instances of the problem

Acknowledge positive behavior change for healthy behavior

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