Adoption of Health Behavior

Health behaviors are personal acts that raise or lower the risk of illness or injury. Behaviors that are performed predictably and often are called habits. Psychologists seek to understand health habits by viewing them as organized systems, composed of highly routinized sequences of actions, consequences, and reactions that lead to a predictable result. For example, dietary habits involve frequently practiced routines, each of which consists of a familiar sequence of behaviors, such as shopping for groceries, planning and preparing meals, and enjoying food in family or other settings. These routines can be viewed as consisting of functional feedback loops in which each behavior in the sequence is strengthened by the consequences it produces, and those consequences, in turn, then set the stage for the next behavior. In the present example, the act of leaving work and stopping at a grocery store on the way home is reinforced by the satisfaction of gathering needed food items, which then enable the hungry shopper to prepare a meal. Preparing and sharing a meal often are accompanied by other activities, such as enjoying the company of friends or family members, which, by increasing the pleasure of eating, may lead to overindulgence. Efforts to alter diet or curb overeating must identify new actions and new outcomes to replace the usual eating routines.

Health behaviors tend to become habitual when they produce effects that are felt to be positive, are experienced reliably and often, and mesh with the routines of other persons with whom one interacts. Therefore, the most effective way to eliminate a health-damaging habit is to replace it with a healthprotective habit that can occur in the same setting, requires similar or less effort, yet produces comparable effects. The first step in health behavior change involves analyzing a health-damaging habit in terms of its action system components (settings, actions, consequences) and identifying an alternative habit and action system components to encourage in its place. For example, those who want to lose weight by limiting consumption of high-calorie snacks might be advised to start by analyzing where, when, how, and why they snack and then to identify low-calorie snacks that could be consumed in the same situations, in similar ways, and with comparable levels of enjoyment.

Here we uncover the Achilles' heel of health promotion: A failure to experience a desired benefit fairly soon after performing a new health behavior lowers the likelihood that the new behavior will become a habit. The great and enduring challenge in health habit change is to ensure that desired consequences will be experienced, immediately and often, whenever and wherever the desired health behavior is performed.

The interpersonal environment plays an important role. Negative reactions by friends or family members can make it difficult to establish new health-protective patterns. The degree of “action linkage,” or the extent to which two people's routines are interconnected, determines how disruptive the behavior change will be for both, and thus how difficult it may be to sustain the routine over time.

So how do people change their habits? It is one thing to know what one should do. But making a sustained effort to change is quite another matter. Several decades of research suggest that the process of change involves enhancing self-motivation, personal competence, and social support (Ewart, 1991, 2003).

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