The Substance Abuse and Mental Health Services Administration (SAMHSA) launched this week its annual National Wellness Week event, a public health effort in which the agency reminds us to pay attention to our wellness. According to SAMHSA, there are eight dimensions of wellness—some more obvious and others less so—that include physical, emotional, spiritual, intellectual, environmental, financial, occupational, and social aspects of behavioral health. Hypothetically, if we find ourselves wanting to change our behavior and improve one of these vital areas of our lives, how should we go about doing so?
In the past few years, a lot of research has suggested that behavioral changes could dramatically reduce cancer risk. A recent study estimated that if everyone engaged in four healthy lifestyle behaviors—not smoking, consuming moderate or no amounts of alcohol, maintaining a body mass index (BMI) between 18.5 and 27.5, and performing at least 150 minutes of moderate aerobic exercise weekly—it could cut U.S. cancer deaths in half. That could mean saving the lives of close to 300,000 Americans each year!
Most of us are well aware that we should exercise, eat a healthy diet, avoid smoking, and avoid drinking too much. This is not brand-new advice. Unfortunately, public behavior has trended in the opposite direction. The rate of obesity has climbed up while physical activity and eating healthily have gone down. What can we do to reverse these worrying trends?
Health communication efforts have a vital role to play in educating people about healthy behaviors. Michelle Obama’s "Let’s Move!" campaign to reduce childhood obesity is a well-known example. But beyond simply increasing people’s knowledge, we can consider other approaches to changing lifestyles that target multiple psychological components of behavior change.
One theoretical framework from social psychology (the study of how people’s thoughts, feelings, and behavior are affected by others) is particularly useful for identifying targets of behavior change. The theory of planned behavior proposes that people’s attitudes, subjective norms, and perceived behavioral control about an action feed into their behavioral intentions, which could lead to actual behavior. To illustrate this idea, let’s imagine that Karen, a busy working mom, might really love running (positive attitude) and see that running is a popular local activity (positive subjective norm), but thinks that she doesn’t have enough time to do it (reduced perceived behavioral control). All of these factors together could lead her to intend to get into a running habit, but she doesn’t run as often as she’d like.
Many campaigns target the first component of attitudes, increasing people’s knowledge and positivity toward healthy habits. Additionally, we can target subjective norms, which are the rules about which behaviors are acceptable and which aren’t. Antismoking campaigns have targeted teens’ beliefs about the social acceptability of smoking. Smoking bans in public spaces have also reinforced the idea that smoking is less socially acceptable, reducing smoking behavior.
Perceived behavioral control is another important link to consider. Encouraging self-efficacy, the belief in one’s ability to accomplish a task, could increase someone’s confidence in his or her capacities. We can increase self-efficacy by providing people with a progressive plan of goals, sharing others’ success stories as inspiration, and providing positive reinforcement messaging. Encouraging people to adopt a growth mindset as opposed to a fixed mindset could be another approach to increasing their perceived behavioral control and self-efficacy. If Karen thinks that her ability to save money was fixed and she could do nothing to improve it, then she might give up early on. On the other hand, encouraging her to think of her saving ability as changeable and improvable could help lead her to eventually think of herself as a good saver, with practice. A strategy to encourage a growth mindset might include encouraging her to start small, maybe cutting down on how often she buys coffee at work, and to gradually add more and more to her savings account over time.
Changes in attitudes, norms, and perceived behavioral control could lead a person to intend to change his or her behavior; for example, making a New Year’s resolution. But we all know that intending to change behavior doesn’t always lead to actual changes in what we do. Implementation intentions are a powerful tool for developing new habits and achieving goals, making intentions more likely to translate into behavior. An implementation intention strategy involves saying, "When situation X arises, I will perform behavior Y." People who want to spend more time with their family, addressing their social wellness, could form this intention: "When I cook, I will sit down and eat dinner with my family!" Giving oneself a concrete way to take action improves the likelihood of goal attainment beyond simply forming an intention.
Broadening the scope of health communications and identifying additional targets for behavioral change like social norms, perceived behavioral control, and implementation intentions could lead to new insights on effective ways to help people lead healthier lives. More research needs to be done on how these approaches scale up in practice, but there is certainly a lot of promise. Try implementing one of these strategies to kick-start your own habit change today, in honor of National Wellness Week!