Post by Quiana Jeffs
If you’re anything like me, you probably have a laundry list of bad habits that you wish you could break. Things like unhealthy eating, way too little physical activity, and even spending too much time on my phone are at the top of my list. These are things I’ve known about myself for years at this point, but knowing about them hasn’t seemed to help me change them. Why? This is a question that bothered me enough to do some research, and I found some interesting and annoyingly obvious answers. Put simply, people are often inundated with information regarding the reasons why they should do something— “Exercise every day because it will protect you from scary things like heart disease!” “Stop smoking because it’ll kill you!”—but psychological and sociological research suggests this kind of messaging has little to no effect on someone’s behavior.
Thinking in terms of my own life, one reason I think this might be is that blanket suggestions that are born directly out of clinical research are often so far from my current actions they feel impossible to reach. For example, I exercise once every few months when I happen to have a day with no plans and feel particularly restless. Comparing this to the suggestion of being active nearly every day is really discouraging to me and, on days when I’m feeling low, makes me feel pretty bad about myself. Beyond this, if I were to actually incorporate those “ideal” behaviors into my everyday life, I would have to drastically change the way that I live, and if I’m being completely honest, I’m pretty happy with the way that I live. I like coming home and eating a whole family-size bag of chips while watching Gilmore Girls for four hours to unwind from my work day. Hearing someone suggest that I cut this out because it would be “good for me” is extremely threatening to my way of life and immediately makes me brush the suggestion off because what does this person know about me and what’s good for me?
Unfortunately, programs aimed at helping individuals change their behaviors often rely heavily, if not solely, on providing information like this. This applies to weight loss programs, sleep improvement programs, drug use prevention programs (I’m looking at you, DARE), and many others. Modelling a health program in this way assumes that individuals partake in bad behaviors because of a lack of information, and although sometimes this is the case, it’s usually not. The habit of smoking is an excellent example of this; you’d be hard-pressed to find a smoker who is clueless to the host of poor health outcomes related to their smoking, and yet…they continue to smoke. Research regarding the efficacy of health intervention programs (so called because they aim to improve behaviors before the onset of health problems) has shown that programs designed in this way have extremely small effects for their participants in the long run, if any at all. However, programs that are instead tailored to provide their participants with information and support for how to change their behaviors have been found to be extremely effective.
This begs the question, “How do you teach someone how to change their behaviors?” The answer lies in theories of behavior change that extend beyond the typical “knowledge-attitudes-behavior” (K-A-B, as I’ll call it) continuum (Semsarian et al, 2021). This K-A-B framework is and has been in the zeitgeist for decades now which may explain why so many health intervention programs are formatted the way that they are. Just as it sounds, the K-A-B framework suggests that a person’s knowledge feeds into their attitudes, and their attitudes feed into their behavior. As discussed previously though, this view is idealistic and does not reflect reality for the vast majority of people. To move beyond this, we must additionally consider that many more factors than just knowledge and attitudes influence behavior. For example, one theory I found in my research is called the COM-B framework, which considers an individual’s capability, opportunity, and motivation to change their behavior (Michie et al, 2011). Of course, it is not enough to simply tell someone to think about these factors and hope that they get the memo.
To improve the current format of health intervention programs, participants must be encouraged to go through the frustrating and difficult work of self-reflection. This does not just mean self-reflecting on their current way of life, considering factors such as those in the COM-B framework, but also on their “desired” way of life. In reality, few people actually want to live the ascetic lifestyle that following best recommendations would lead to (recall my Gilmore Girls example). Reflecting on how new behaviors would change your current way of life is crucial to choosing good habits that will actually stick. Debatably one of the most important steps of self-reflection is planning for inevitable bad days that will crop up—this step has been found to have one of the largest impacts on long-term behavior change (Hardeman et al, 2000; Strong et al, 2017). We’ve all made the New Year’s resolution that lasted for about a week and a half until we missed a day…and then decided to abandon it entirely because we missed a day. Deciding ahead of time how you will react to these days has been found to greatly increase your chances of picking back up the next day, and some researchers even think that these “bad” days are a crucial part of the process of change as, upon self-reflection, they shed a great deal of light on your weaknesses (Semsarian et al, 2021).
Bad habits can be hard to break, but not impossibly so. Knowledge of the benefits of positive behavior change is a crucial part of this process as it contributes to your motivation for change, but as personal experience and theories such as the COM-B framework suggest, this is not all-encompassing. Keeping in mind that human nature is complicated and there is very rarely a simple solution of information in and behavior out can help individuals such as yourself and health intervention program designers alike in determining the best way to encourage positive change.
Quiana Jeffs is a first-year PhD student in the neuroscience program at UWyo studying olfaction in the context of circadian rhythms and Alzheimer’s disease; in the process of performing the research discussed in this article she also developed a sleep workshop for the university Wellness Center using the principles described here.
references
Hardeman, W., Griffin, S., Johnston, M., Kinmonth, A., & Wareham, N. (2000). Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. International Journal of Obesity, 24(2), 131–143. https://doi.org/10.1038/ sj.ijo.0801100
Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1). https://doi.org/10.1186/1748-5908-6-42
Semsarian, C., Rigney, G., Cistulli, P., & Bin, Y. (2021). The impact of an online sleep education program on university students’ sleep knowledge, attitudes, and behaviours. International Journal of Environmental Research and Public Health, 18(19), 10180. https://doi.org/10.1093/sleepadvances/zpab014.172
Strong, C., Lin, C. Y., Jalilolghadr, S., Updegraff, J. A., Broström, A., & Pakpour, A. H. (2017). Sleep hygiene behaviours in Iranian adolescents: an application of the Theory of Planned Behavior. Journal of Sleep Research, 27(1), 23–31. https://doi.org/10.1111/jsr.12566
Engage Laramie Science 