Avoiding “pie crust promises”

by Jill L. Fries, Health Educator, MCHD

Over the last two years or so, the staff of the Marquette County Health Department has been working diligently at creating a supportive atmosphere of wellness for its coworkers.

mchd_logoIt is a work in progress, and yet great strides have been made to offer healthier food options at lunch meetings, incentivized Wellness Challenges throughout the year, exercise classes also open to the public and an information board highlighting in-season fruits and vegetables with recipes that change monthly. Upcoming activities in our community are featured, and teams from the health department are encouraged to participate.
As we contemplate entering a new year, we are exploring additional options to support staff making healthy choices. This benefits each individual and the organization as a whole.
If your staff is healthier, then health insurance claims should decline as preventable chronic diseases decline.
As we approach this continuing endeavor, we are asking tough questions… How can we motivate our employees to make healthier choices? What does a healthy and supportive work environment look like?
As with most change, it needs to start with individuals wanting to make a change.
As we approach the New Year and contemplate making New Year’s resolutions, I propose that instead of making a “pie crust promise” (easily made and easily broken), we examine what it takes to make long lasting behavior change.
Let’s not make a resolution on January 1 and have it broken by January 10 (or sooner). What does it take to change behavior? Certainly more than a New Year’s resolution. What if we start the new year with realistic expectations or realistic resolutions?
The first step may be to have a good understanding of human behavior and what it takes to make lifestyle changes.
We know it takes at least twenty-one days to establish a habit. We know ninety days is even better.
We know the faster a person experiences results, the greater chance there is for the person to continue.
We know research indicates addressing too much change lowers the success rate of meeting any goals. Baby steps may take longer to reach a goal, but increase chances of success.
We also know positive reasons for wanting to make the change generally see better and longer lasting results versus guilt, shame or some other negative mechanism forcing the change.
A positive reason for making a change would be: I want to feel better about myself. I want to have a better quality of life.
There are a number of theories regarding behavior change, but my favorite is the “Spiral Model,” first posited by James O. Prochaska, Carlo C. DiClemente and John C. Norcross in the early ’90s.
Their research was focused on trying to understand and create a foundation for behavior change as it applies to addictive behaviors.
Their research certainly has cross applications, and is helpful to understand why it is difficult to keep New Year’s resolutions.
“Precontemplation is the stage where there is no intention to change behavior in the foreseeable future.” (Declemente, Norcross and Prochaska, 1103). Generally, this is the stage where everyone else in a person’s life knows there is a problem and change needs to happen, but the person does not see it. These individuals may be referred to a specialist for some problem, but the individual does not see the need.
“Contemplation is the stage in which people are aware that a problem exists and are seriously thinking about overcoming it, but have not yet made a commitment to take action.” (Declemente et al, 1103)
This is the stage of awareness. Individuals begin to see they have a problem (overweight, too much stress, etc.) but may not be ready to make a change, or do not see any options.
“Preparation is a stage that combines intention and behavioral criteria.” (Declemente et al,1104 )
This is when individuals begin to look at the steps necessary to make a change. They may already have implemented some change. They will conduct research or begin to ask for help and support.
“Action is the stage in which individuals modify their behavior, experiences, or environment in order to overcome their problems.” (Declemente et al, 1104) This is the stage when individuals will begin to modify behavior. The more realistic the action step is, the better chance the individual has in creating the change.
What does a “realistic action step” mean? If a person is an overweight smoker who does not engage in physical activity and decides to quit smoking, to begin being physically active and modifying diet all at the same time, that probably is an unrealistic goal to achieve.
“Maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during action.” (Prochaska et al, pp 1104)
Maintenance has sometimes been viewed as an absence of change stage, but that is not an accurate assessment. This is really a lifetime stage.
As a person addresses one behavior to change, prepares and takes action steps to make that change a reality and experiences success in that endeavor, he or she will be more motivated to address the next behavior to change.
The final stage is identified as termination, the stage where there is no further need for change.
On average, it takes at least seven attempts at changing a behavior before the change takes place and becomes permanent.
According to the Spiral Theory, that’s okay, in that the person may spiral down to the “precontemplation” stage, but generally does not stay there. The person begins to think about making the change and how to achieve greater success the next time.
Utilizing this information, how can a New Year’s resolution be more than a “pie crust promise”?
The first step would be identifying what change you want to make. Second, does this change encompass more than one identifiable behavior (i.e.. overweight, inactive, smoker)? If yes, you may want to prioritize changes and focus on one. Third, what kind of support system do you already have in place, and what would need to change? Fourth, are you making this change for yourself, or is guilt or shame the primary motivator? Fifth, can you be patient and kind with yourself while you make this change? Sixth, do you have twenty-one consecutive days that can be devoted to this change?
If, for example, you are an overweight, inactive smoker, these three identified issues would put you at high risk for a number of chronic diseases. We know from research, attempting to address all three at the same time for most people is not going to lead to a successful outcome. If, however, the person chooses which of those three behaviors to address first, there is a higher level of success rate — which in turn will impact a higher level of motivation when addressing the remaining behaviors at a later date.
What support mechanisms do you already have in place to make that change? What may need to be added to support you in your change? What is motivating you to make the change?
If your current schedule in January does not allow twenty-one consecutive days to devote to a behavior change, maybe you want to look at a different start date.
As we at MCHD contemplate how to continue to motivate and support each other in making healthy choices, we want to encourage others to do the same.
Let’s steer away from pie crust promises, and motivate ourselves and others to create realistic resolutions.
Let’s be kind and supportive to ourselves and others who choose to embark on a behavioral change in 2015 — knowing that even if success is not attained on the first attempt, we are in good company, and there always is another day to start anew.
In that endeavor, we would like to inform the public of fitness classes offered at MCHD: Mondays and Thursdays from 5:00 to 6:00 p.m., PiYo (a combination of Pilates and yoga) is led by certified PiYo instructor Jennifer Maki. Classes are $7.00 per session, or ten for $60.00.
Wednesdays from 5:30 to 6:30 p.m. is Jammin’ with Jay, a cardio boxing type class, led by Janet Pinar. Classes are $5.00 per session, or ten for $35.00. Be well.

— Jill L. Fries
Health Educator, MCHD

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