The Science of Change

Change is Hard

Many of us think about the changes we would like to make in our lifestyle to improve our health and wellbeing. For the most part, we know the basics: Exercise, don’t smoke and eat fruits and vegetables. However, change is hard, really hard. Wellness companies strive to initiate change by helping people develop healthy lifestyles, which in turn offers a long list of benefits to the company. The fact is that change is a process. The goal is to move people through the stages of change from pre-contemplating a behavior change all the way to maintaining that behavior (referring to Prochaska’s transtheoretical model). Ultimately, the best way to accomplish this is through a multifaceted approach, taking aspects from multiple models of motivation and behavior change, which ultimately address intrinsic value, engagement and effective behavior change.

Intrinsic Value

There are two different types of motivation that signal the level of intrinsic value: Intrinsic and extrinsic. Intrinsic involves acting for the fun or the challenge of it in order to feel a sense of satisfaction. This is the person who signs up for a 5k. Extrinsic are behaviors performed to obtain a tangible outcome such as a reward or avoiding punishment. This is the person who starts a walking program to earn an incentive offered to them. Therefore, when trying to foster change, it is helpful to identify the level of self-determination most prevalent in the population. With this information programming can be customized for maximum benefit. To get an idea of what this measures, take a look at the Self-Determination Continuum.

The Self-Determination Continuum

Motivation1
Motivation2

A person who internalizes their motivation is thought to have met all the needs that foster optimal function and growth. These basic psychological needs are competence, relatedness and autonomy. If positive motivation is low, think about how competence, relatedness and autonomy can be further met to help move a person up the continuum.

Engagement

Often times engaging people in an action isn’t based on the content of the message, but by how the message was framed and delivered. Here are some ways to positively deliver a message:

  • Promote new regulation by providing employees with the rationale for wellness programming.
  • Acknowledge that the person might not want to do what you are asking of them.
  • Ensure that the presentation used to initiate participation involves minimal pressure.
  • Promote interest by making uninteresting or boring activities fun.
  • Enhance the challenge by offering an activity to test participant’s skill.
  • Promote competence by providing clear instructions and individualized goals.
  • Make it easy and be forgiving with failures.
  • Provide positive feedback and use extrinsic rewards to mark achievement.

Effective Behavior Change

Effective behavior change can be achieved through motivation, capability and opportunity.  Motivation refers to our unconscious habits and conscious thoughts and goals. Opportunity includes social and physical factors that make behavior possible. Capability is the person’s psychological and physical capacity to engage in an activity including knowledge, skills and tools. This is based off a model by Susan Michie, called the Behavior Change Wheel. It involves utilizing nine categories of interventions. The more interventions in place, the higher the chance for attaining desired outcomes.

  1. Education (ex. Tell them smoking is bad for health.)
  2. Persuasion (ex. Show them pictures of black lungs.)
  3. Incentivisation (ex. Offer money for quitting.)
  4. Restriction (ex. Warn that those who smoke will have higher insurance rates.)
  5. Training (ex. Set up a tobacco cessation class.)
  6. Coercion (ex. Create tobacco free facility regulations.)
  7. Environmental restructuring (ex. Put up signs designating no smoking areas.)
  8. Modeling (ex. Demonstrate no smoking.)
  9. Enabling (ex. Provide nicotine patches.)

Needless to say, a lot of factors contribute to a person’s ability to change behavior, which is exactly why it isn’t easy. The more factors addressed though, the higher the likelihood of seeing change. Don’t let this information overwhelm you, use it to inspire new ways to foster change in yourself or the group you are working for.

 

http://www.aafp.org/afp/2000/0301/p1409.html

http://www.slideshare.net/DiTommaso/motivational-dynamics-in-health-behavior-change

http://www.health.harvard.edu/newsweek/Why-its-hard-to-change-unhealthy-behavior.htm

http://abiesuk.blogspot.com/2013/08/why-behavioural-change-wheel-is_25.html