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The Great Decide: Health Promotion in Our Everyday Choices


Our days are made up of thousands of decisions – both big and small, simple and complex. Generally we respond to these decisions by acting in our best interests. Yet have you ever decided to do something you knew would be bad for you?

Pop tart. Image Credit: m01229 via Flikr

Chances are, you have. Usually,  these are small decisions of small consequence, like choosing to eat your favorite sugary Pop-Tart for breakfast instead of healthier, whole wheat toast. You might weigh the pros and cons: the whole wheat toast will offer longer lasting energy, but the Pop-Tart will taste better. In the end you decide that eating this Pop-Tart does not pose a significant threat to your health and, in the grand scheme of things, you are likely correct (unless of course your diet consists solely of Pop-Tarts, but that’s a conversation/intervention for another day).

Yet what about greater, arguably more important health-related decisions, like choosing to get your yearly flu shot? What factors might convince you to do so? 

For health promotion specialists, studying these types of thought processes is important for  understanding and predicting human behavior. Just like a meteorologist warns the public about potential storms by predicting the weather, health promotion specialists have their own tools for predicting and preventing human health complications.

Within the profession of health promotion, these tools are not thermometers and barometers, but theories and models. Developed to help explain how people choose whether or not to adopt a specific health behavior, they can also help identify what additional information is needed to develop a successful health intervention.

For example, in the 1950s a new Tuberculosis screening program was offered by the U.S. Public Health Service to help screen for and treat more Tuberculosis cases. Mobile screening units were even set up in local neighborhoods to make it easier for people to participate in the program. Before implementing the program, the understood logic went something along the lines of: “Tuberculosis is a terrible disease. Free screening programs can help people discover if they have the disease and help them recover faster. Therefore, everyone will want to take part in our program.”

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Image Credit: City of Minneapolis Archives via Flikr

But then something unexpected happened. Participation levels were very low, even though screenings were being offered free of charge and in convenient locations. The researchers came to realize that even though tuberculosis was indeed a real threat to health, participation in screening came down to whether or not people actually perceived tuberculosis to be a threat. Using this information, the researchers went on to create the Health Belief Model to better explain how different human perceptions are largely a driving force in the decision-making process.

The model looks at four areas of interest: whether or not an individual perceives a health problem as a threat to themselves (perceived susceptibility), how severe an individual perceives the threat to be (perceived severity), the perceived benefits of avoiding the threat (perceived benefits), and any of the factors preventing an individual to take action against that threat (perceived barriers). Of the people who did take part in the screening program, most reported that perceived risk for contracting Tuberculosis, along with perceived benefits of taking action were both very high.

Get Your Flu Shot. Image Credit: Juhan Sonin via Flikr 

Perhaps these people had been exposed to others they thought might have TB, or had seen a family member struggle with the disease. For whatever reasons, they felt more compelled to act than others without these same experiences. For health promotion specialists, observing how people are motivated to act is very important when designing outreach programs. Similar to how a soda company will research what makes someone want to buy their product, health  promotion specialists research what factors are effective in getting people to take part in programs to improve health.

Former President Eisenhower once said, “motivation is the art of getting people to do what you want them to do because they want to do it.” Typically, most people will tell you that they would like to be healthy.

However, as seen in the above examples, people don’t always make decisions that reflect this desire. Health promotion specialists understand this, and know that when it comes down to it, oftentimes “life happens” and the best choice is not always the easy choice. But through the use of theories and models, and communicating with people to understand their health needs,  more effective and creative strategies can be developed to make the healthy choice the easier choice.

Natalie Eldredge is an undergraduate student studying Public Health at the University of Georgia. In addition to studying public health, Natalie is an intern for the Southeastern Wind Coalition, a nonprofit organization that supports wind energy development in the southeast. In her free time, you can find Natalie at Taco Stand or watching documentaries with her roommates. Connect with her on Facebook or via email at natalie.eldredge@uga.edu.

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