Changing health behaviours- It's all in our heads - Janette Gale

Anna Kelsey-Sugg

Even if they want to it doesn't mean they can, even if they can it doesn't mean they will.

Health Coaching Australia (HCA) runs programmes to change people's attitude to health. The HCA model for health behaviour change provides a time efficient method for health professionals to facilitate change in clients with chronic disease. The approach provides:

Guidance on how to deal with resistance and reluctance to change by identifying and addressing the barriers that prevent individuals from embracing and maintaining lifestyle changes.

Improved health outcomes and improved productivity.

Janette Gale is the Director of HCA. She notes the statisic that although about 88% of employers usually want to improve the health behaviour of their staff, only approximately 12% usually take up this offer.

This seems to be the result of a work culture where senior executives work long hours and anyone aspiring to a promotion will not want to take parental leave as they may be cast in a 'mummy or daddy' track with the possibility of being sidestepped in their career. Similarly, employees may not want to reduce their working hours to alleviate stress even though the organisation may promote a work life balance as company policy.

Gale also reported that although most people may respond to surveys stating that Yes' they did need to exercise more, eat less fatty foods and reduce stress in their lives, they were unable to put these good resolutions into practice. When interviewed on a one to one basis by a qualified health coach, with an appropriate plan to be implemented, the success rate of an improved healthy lifestyle was greatly increased. For example, she stated that approximately 21% of diabetics don't monitor their sugar levels adequately even though to not do so can be life threatening. She stressed that:

  • Telling someone their risk factors does not help them to improve their health
  • Just telling them what to do about it doesn't mean they want to do it
  • Even when they want to do it, it doesn't mean they think they can
  • Even when they think they can, it doesn't mean they can or will
  • Even when they do make progress, they may/may not persevere

People are generally resistant to change. Making lifestyle changes to address health risks is often very hard for people to do.

Further evidence of inadquate self care is that an estimated 14 - 21% of medical patients do not take up prescriptions given to them by their doctors. Even if they buy the medicine 30 -50% don't take the medicine.

Janette advised that there are 3 main parts to fulfilling lifestyle changes:

  1. Confidence (Self- sufficiency - How will I do it? Do I really need to?)
  2. Readiness (Is it possible right now with my current commitments?)
  3. Timing (How will I manage it?)

One study found a 90% engagement rate in a health programme if the psychologist actually rang the participant at home to follow up that the programme was being followed.

The remainder of the presentation involved a filmed interview between a diabetic smoker and a health coach. It was interesting to see the turn around in the patient's behaviour over the 20 minute session. Firstly, she admitted that smoking was life threatening and really needed to be managed if she wanted to live. Then she brought up all the reasons why she could not give up smoking and start exercising (her sister's wedding preparations, her own commitments, the weather etc.) Only when the health coach discussed some options which were workable did she start to agree that giving up smoking and exercising could be accomplished.

In conclusion, unless there is individual consultation to plan healthy living programmes, it would seem that participants are often unable to improve their lifestyles. For a healthy workforce, corporate well-being programmes need to demonstrate a work/life balance with senior management leading by example. Gale recommends funding should include allocations for individual consultation and health coaching for those with chronic health conditions.

Published 21 September, 2008 | Updated 14 January, 2009