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Changing One’s Behavior Is Harder Than It Looks

Glenn Laffel, M.D., Ph.D., of Pizaazz hypothesizes about why we often don’t make changes that would benefit our health. He says:

“Somewhere in the course of our daily lives, though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or get the screening tests we’re supposed to.”

He knows multiple complex causes exist for this and questions whether being diagnosed with a chronic condition motivates people to improve health behaviors exploring whether the delay between health behaviors and health outcomes contributes to unhealthy behavior. After looking at attrition rates in a diabetes self-management program, he concludes:

“It calls attention to a key distinction behavioral psychologists like to make in explaining human motivation: there’s a difference between awareness of the need to act, and the volition to act.”

Family doctor Kenny Lin, M.D., previously recommended that people “tackle one behavior at a time.” He says: Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Behavior Vs. Disease: A New Way To Look At Health

What is the leading cause of death in the United States? Heart disease? Cancer? No, it’s smoking. Smoking? Yes, depending on how you ask the question.

In the early 90s, McGinnis and Foege turned the age-old question of what people die of on its head by asking not what diseases people die of but rather what the causes of these are. Instead of chalking up the death of an older man to say lung cancer, they sought to understand the proximate cause of death, which in the case of lung cancer is largely smoking. Using published data, the researchers performed a simple but profound calculation — they multiplied the mortality rates of leading diseases by the cause-attributable fraction, that proportion of a disease that can be attributed to a particular cause (for example, in lung cancer 90 percent of deaths in men and 80 percent of deaths in women are attributable to smoking). Published in JAMA in 1993, their landmark study became a call to action for the public health community.

When looked at the conventional way, using data from the 2004 update of the original study, heart disease, cancer, and stroke are the leading causes of death, respectively. This accounting may help us understand the nation’s burden of illness, but does little to tell us how to prevent these diseases and improve health. Through the lens of McGinnis and Foege we get the actual causes of death (e.g., the major external modifiable factors that contribute to death). This analysis shows that the number one cause of death in America is tobacco use, followed closely by poor diet and lack of physical activity, and then alcohol consumption. Read more »

*This blog post was originally published at BeyondApples.Org*

Can Your Avatar Affect The Way You Live?

If you own a Nintendo Wii, have played World of Warcraft, or seen James Cameron’s cinematic spectacle, then you probably know what an avatar is. And because an avatar is simply a representation of yourself that you design, your avatar’s attributes could be as similar or different to you as you wish. [This editor's avatar is 6' 8", has six-pack abs, wears only fine European clothing, and has the voice of YouTube sensation Ted Williams.]

Do online avatars have any influence on their real-world counterparts? Researchers at the new Virtual Human Interaction Lab (VHIL) at Stanford University think so. According to VHIL, while avatars tend to be idealized versions of their users, evidence has suggested one’s virtual avatar does indeed influence a person.

In one experiment, a female student’s avatar was shown losing weight by running and gaining weight when standing still. As a result, it motivated this student to exercise more over a 24-hour period. In another experiment, watching a student’s avatar progressively age caused him to want to save money instead of spending it on partying.

With advances in technology continually making the world more and more connected with itself, avatars will continue to evolve also. According to Jeremy Bailenson, creator of VHIL, “avatars will soon play an even bigger role in our lives online. How we shape our own avatars and how we interact with others could have profound influences on our behavior.”

Article from the National Science Foundation: Virtual Self…

*This blog post was originally published at Medgadget*

To Change Patient Behavior, Change How You Talk To Them

According to Marshall Becker, PhD, MPH, a one-time professor of mine and prime mover behind the Health Belief Model (HBM), four things must be in place for health behavior change to occur. I am paraphrasing here: 

  1. A person has to know that they have a particular health condition.
  2. A person has to believe that having said health condition is bad.
  3. A person must perceive the benefits of behavior change to outweigh the difficulties of behavior change.
  4. There must be a “call to action” to spark the change.

Absent any one of these steps and the likelihood that behavior change will occur is diminished. Read more »

*This blog post was originally published at Mind The Gap*

Why Educating People Is Rarely Enough To Fix A Problem

Every year it happens: people come to me telling of what they are going to be doing different in this fresh new year.  People are going to stop smoking, start exercising, and (especially) lose weight.  This year, I am among the resolvers.

Every year, most people fail.

Which makes me wonder what it is about us humans that allows us to act against what we know is best.  Why is it that educating people is rarely enough to fix a problem?  Why should we have an obesity “epidemic” when very few people really want to be obese? Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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