1.4: Taking Charge of your health- Making Healthy Changes

The choices you make each day can impact your quality and quantity of life. At the beginning of this chapter you were invited to reflect on your health across the Nine Dimensions of Wellness by giving yourself a score from 1-10 that would reflect your health in each dimension from low to high. You were also invited to identify possible behaviors you could change that would positively impact your health in each dimension. This is a very helpful activity for helping you to identify what you can do to stay healthy throughout life. The first step in any behavior change is to recognize what you can and should change.

Are you ready to change your behaviors?

You may be able to quickly identify behaviors your could change to increase your wellness, but you might not be able to quickly begin implementing the change. Are you ready to change your unhealthy behaviors?

The Stages of Change, also called the Transtheoretical model of behavior change, was developed by Prochaska and DiClemente to help understand the stages a person goes through when trying to make changes in their life. It assesses an individual’s readiness to implement a healthier behavior, and provides insight into the decision-making process that leads to action. The five stages include: precontemplation, contemplation, preparation, action, and maintenance. You might not go through the stages linearly, rather you might find yourself moving between them, and regressing. For example, you might first believe you are in the Preparation Stage and then realize you are actually in the Contemplation stage. Or you might jump into the Action stage beginning the change, and then discontinue with your plan stepping back into the Preparation or Contemplation stage.

As you review the five stages of the Stages of Change, along with characteristics and strategies^[9], think about a behavior you’d like to change and identify which stage you are currently in and what you could do to move to the next stage:

Figure \(\PageIndex{1}\): Stages of Change

Precontemplation Stage (not ready to change):

People in the precontemplation stage are not intending to take action in the foreseeable future, are not interested in getting help, and can be unaware or do not believe that their behavior is problematic.

• Characteristics: Ignoring or ignorance of the problem, or denying the problem exists.
• Strategies to move to next stage: Identify the risks to your life if you do not change and take time to analyze or rethink your behaviors and action.

Contemplation Stage (getting ready to change):

People in the contemplation stage are beginning to recognize that their behavior is problematic, be more aware of the consequences of their behavior, and start to look at the pros and cons of either continuing or changing their behavior. They be more accepting or receptive to information about their unhealthy behavior and more open to learn about ways they could change.

• Characteristics: Being doubtful or ambivalence of the change, or having conflicted emotions about the change.
• Strategies to move to next stage: Make a list of the pros and cons of changing your behavior, identify barriers to changing and strategies you could use to overcome the barriers, lastly look for resources that could help you make the change.

Preparation Stage (ready to change):

People in the Preparation stage are intending to take action in the immediate future, they are committed to making changes, and may begin taking small steps toward behavior change by researching to find resources or strategies to help them with their change. This stage likely includes the development of a behavior change plan.

• Characteristics: Experimenting with small changes and collecting information about the change.
• Strategies to move to next stage: Write down your goals, prepare a plan of action, and make a list of motivating statements.

Action Stage (actively changing):

People in the action stage believe they can change and are actively changing their behaviors. They are open to help, seek support, and work to overcome barriers to stay committed.

• • Characteristics: Direct action toward goal.
  • Strategies to move to next stage: Reward your successes and seek out social support.

Maintenance Stage (maintain change):

People in the maintenance stage have been able to sustain action for at least six months and are working to prevent relapse into previous unhealthy behaviors.

• • Characteristics: Maintenance of the new behavior and avoiding temptations.
  • Strategies to prevent relapse: Developing positive coping strategies for overcoming temptations and remember to continue to reward yourself.

Making the Change with SMART Goal Setting

Have you ever tried to change your behaviors? Maybe you set a New Years Resolution? How did it go?

If you have been successful at changing your behaviors it is highly likely that you followed a very specific plan. If you haven’t been successfully, you likely followed a path similar to what many people do around January first each year which is make broad statements such as “I am going to lose weight this year” or “this is the year I am going to work out” or “I am going to get healthy.” Each of these statements have a good intent, but are lacking an actual goal or target to achieve. It is like saying you are taking a vacation but haven’t made any plans, haven’t decided where to go, or how you will get there.

Setting SMART goals can help you to have a better chance at being successful with behavior change by giving you direction and a target to achieve. SMART stands for Specific, Measurable, Attainable/Achievable, Realistic, Time-oriented.

Setting a SMART goal requires the goal setter to think about the factors involved in achieving their goal. Defining each of the five characteristics can help to define a pathway to reaching the goal. The more well-defined that pathway becomes, the easier it is to follow.

Figure \(\PageIndex{2}\): SMART Goals

Specific

Create a goal that has a focused and clear path for what you actually need to do. The goal needs to be concrete, detailed, and well defined so that you know where you are going and what to expect when you arrive. What do you want to accomplish? Why have you set this goal?

Measurable

Create a goal that provides means of measurement and comparison by using numbers and quantities, this enables you to track your progress. Including measurement lets you know whether or not you have met your goal. How will you measure your progress? How will you know when you have successfully achieved your goal?

Attainable/Achievable

Make sure that your goal is within your capabilities and not too far out of reach. For example, if you have not been physically active for a number of years, it would be highly unlikely that you would be able to achieve a goal of running a marathon within the next month. Your goal must be feasible and easy to put into action. Do you have the skills, abilities, or time needed to achieve your goal?

Realistic/Relevant

When deciding on your goal considers constraints such as resources, personnel, and cost. Try to ensure that your goal is something you will be able to continue doing and incorporate as part of your regular routine/lifestyle. For example, if you made a goal to kayak 2 times each week, but don’t have the financial resources to purchase or rent the equipment, no way to transport it, or are not close enough to a body of water in which to partake in kayaking, then this is not going to be feasible. Why do want to achieve the goal? Is your goal in line with your lifestyle?

Time-Oriented/Time-Bound/Timely

A time frame helps to set boundaries around the objective. Give yourself a target date or deadline in which the goal needs to be met. This will keep you on track and motivated to reach the goal, while also evaluating your progress. What is your timeline to change?

Moving from Broad to SMART Goals

Here’s are examples of changing from a vague goal to a SMART goal:

• Change “I will workout” to “I will engage in 30 minutes of aerobic physical activity 5 days a week for the next 4 weeks.”
• Change “I will lose weight” to “I will lose weight by tracking my calories every day for the next 2 months and reducing my calorie intake by 10% each week beginning week 1 with 2,000 calories/day intake, week 2 calorie intake 1,800 calories/day, week 3 calorie intake 1,620 calories/day, etc.”
• Change “I will be happier” to “I will increase my happiness by incorporating positive affirmations into my daily life. For the next two months I will begin week 1 with choosing one positive affirmation that I will repeat to myself five times a day. Each subsequent week I will add another affirmation so that by week 8 I am repeating 8 positive affirmations five times a day.”
• Change “I will go to the gym” to “I will increase my physical activity by doing cardio and weight training at the gym four times a week for the next 10 weeks. I will track my progress by keeping a workout log. I will increase cardio time and weight training reps/sets each week by 5-10%”

Practice Setting SMART Goals

What is a broad goal you would like to achieve? For example, have you said to yourself or others, “I want to lose weight,” or “I want to eat better.”

Identify a broad goal you would like to achieve and practice changing it to a SMART goal that is Specific, Measurable, Attainable/Achievable, Realistic/Relevant, and Time-oriented/time-bound.

Use might find the following template helpful for developing your SMART goals:

“I will [what is your goal?] by [what will you do? where will you do it? when will you do it?]. I will track my progress by [how will you measure the goal?] for [how long will you do this?].”