January starts as a fresh page, when people are full of the resolve to finally make the positive changes they’ve been meaning to get around to - go to the gym, eat healthy, stop smoking, get control of their time and stress.
By midmonth, many of these resolutions begin to derail, and as the first buds of spring begin to appear, most are only fading memories of good intentions gone awry. People tend to gradually slip back into the routine of the familiar.
Health behaviors are the Achilles heel contributing to modern plagues like diabetes, cancer, heart disease and hypertension. However, a recent study indicated that primary care physicians spend very little time discussing this topic with patients.
The question is, what are the most effective ways for physicians to support their patients in making lasting changes and help them improve the odds for success?
Wanting to Change vs. Knowing How
“Most people don’t fail for lack of motivation. They fail for lack of the skill set they need to make changes,” Josh Klapow, PhD said. An associate professor at UAB’s School of Public Health, psychologist Klapow is known for his expertise in health behaviors and outcomes assessment.
Some behavior changes are about starting and building habits, such as exercise, taking medications on time, and following up on regular checkups. Others require stopping a behavior, such as smoking or other harmful addictions. There are also behaviors that must continue as part of life, but need to change, such as healthy eating and learning to live with stress without being overwhelmed by it.
Klapow says the skill set people need to succeed is essentially the same. He outlines these skills in a book he recently wrote with psychologist Sheri Pruitt, PhD, Living SMART: Five Skills to Change Your Health Habits Forever.
SMART is a mnemonic for five basic skills people can use to be more successful in making changes,” Klapow says.
S is for Set Achievable Goals.
Goals should be specific - not ‘I’m going to walk more’, but ‘I’m going to walk on the YMCA track Monday, Wednesday and Friday, and build up to a 30-minute a day.’ The goal should also be achievable. Don’t say ‘I’m going to lose 50 pounds next year.’ First, that’s a lot to lose. More importantly, that’s a wish for an end result, not a behavior that will help you achieve that result. Achievable goals would be adding three more servings of fruits and vegetables and avoiding simple sugars and starches.
M is for Monitor.
You’re more likely to stick to a behavior if you track it. Write down what you eat, or the days you exercise.
A is about Arranging for Success.
Set up your world to have what you need in place. Get rid of the cigarettes and junk food. Stock up on the fruits and vegetables.
R is for Recruiting Support.
Research shows that a strong support network improves the odds for success. You need encouragement, so go ask for it. And be specific about the kind of support you need. Food police are rarely helpful, but friends who keep junk food out of sight or congratulate you when you’ve made it through coffee without a cigarette can be helpful allies. There are also online support groups who can help.
T is Treat Yourself.
And perhaps one of the most important parts of change. Behavior that is reinforced is more likely to be repeated. Rewards should be frequent and not to far in the future. Plan what the treat will be so you can look forward to it.
Source: Birmingham Medical News, January 2012