Convincing others to make healthy changes

American Fitness, March-April, 1996 by Peg Jordan

If you've tried expanding your fitness career to include wellness counseling, you may be experiencing health promotion burnout. In other words, you are actively engaged in recruiting, enrolling or assisting others in changing high-risk behavior, but you're running into resistance or finding that people drop out within a few weeks.

What are we doing wrong? Michael O'Donnell, Ph.D., editor of Journal of Health Promotion, brought this issue to the table at his conference, "The Art and Science of Health Promotion" in Colorado Springs, Colorado. A strong advocate of empirical research, O'Donnell has been instrumental in advancing the field of knowledge--thereby upgrading the techniques and programs offered by professionals. He would like to see health promotion encompass social, spiritual and intellectual concerns along with the typical physical ones like fitness, nutrition, smoking cessation, alcohol and drug abuse. O'Donnell feels if we don't include things like meaning of life, community interaction, life planning and emotional care, we are ignoring major components of health.

Everybody seems to be quoting the research of University of Rhode Island professor James Prochaska, Ph.D. His book, Changing for Good, presents the latest model for behavioral change. Prochaska believes success rates are low for health promotion programs because few people living an unhealthful lifestyle are prepared and motivated to change.

By now you've heard this dreary national statistic--about 80% of the population is not doing consistent exercise or maintaining healthy eating habits. Out of those individuals who are currently at risk (practice unhealthy habits and/or have at-risk profiles), the breakdown is as follows: 40% are in a pre-contemplation stage, in which they aren't serious about making any immediate changes; 40% are in a contemplation stage, in which they may make a change within 30 days, but nothing active at present; and 20% are considered in preparation. ,

If you match the intervention to the stage the individual is in, then your effectiveness and success rates take a quantum leap, according to Prochaska. He witnessed this first-hand in a high school program for teenage smoking. The Surgeon General's office basically said forget teenage smokers--they don't participate in smoking cessation classes. But Prochaska and colleagues are now in 26 high schools, getting a 95% participation rate--unheard of! Most of the kids are in an early stage of change. They benefit from multi-media programs like interactive modules that don't preach or lecture, but intrigue the teenagers with appropriately staged questions.

One of the foremost researchers in the field is Larry S. Chapman, president of Corporate Health Designs, who has implemented effective motivational pathways based on financial incentives. Chapman's incentives improve the bottom line for corporations, managed care networks and hospitals, while putting smiles on employees' faces as they look at their decreasing payroll deductions. By participating in simple health risk appraisal and advice phone support programs, employees are able to maintain continued benefit coverage. In some cases, they can work toward decreased payroll deductions for co-payments. Chapman believes we have to move toward proactive technologies, and reach out to people who don't normally enter health promotion programs.

Be encouraged. The top fitness experts in the country have been working hard to transform health promotion. All the advice from these experts is in alignment with AFAA's 1996 campaign for promoting active lifestyles--"Fitness Gets Personal--"[TM] Encompassing a broader definition of health, addressing diversity and customizing incentives--there are a lot of great ideas on the horizon. You are affecting people in positive ways, and now help is on the way to make sure your best efforts are fruitful and rewarding.