Behavior change is hard, but the right support system can lift you to triumph!
Do you find that your current habits and actions just aren’t getting you where you want to be? Or maybe you see your athletic performance slipping because you show up to practice unprepared and hungry. Are you missing from key meetings at work or school? Maybe it’s time for a change… except change is hard. Make it easier with support systems designed to make behavior change faster, easier and more likely to stick.
What is behavior change support?
Support is the ability to bear or hold up, to undergo or endure, through a difficult time.1 People support themselves inherently to varying degrees, relying on willpower, mindfulness and goal setting, but it’s also possible to find external support systems that enhance your inborn determination.
What are the major types of behavior change support?
1. Supporting Yourself
Self-support is taking action to back up your inborn determination through development or change in habits, as well as tracking behaviors that are on the change list. How can you provide support for yourself? Write yourself some rules.
Writing the Rules
When setting rules or guidelines, the easier to follow or less complex they are, the less you have to think to follow the rules. Easier rules –> more compliance! This leads to more self-efficacy, or more confidence that you can meet your goals.2 Then move on to updating your habits!
What are habits?
Habits are maintained behaviors that are supported by automatic responses to relevant cues. A person sees X, which triggers Y to happen – without conscious thought or input. Context matters here, since habits work within a specific setting. A person who sees X and does Y at home probably won’t see X and do Y at the grocery store.
It can take weeks to months to develop a habit; the more complex a habit, the longer it takes to fully develop. The strength of a habit also matters. It’s easier to get rid of a habit with less strength, one that has fewer or weaker automatic responses to relevant cues.
How do you change habits in a practical way? Change the environment, forcing the person to make new decisions and set new patterns of behavior. Set up the new environment in such a way that supports the goal to make huge strides.
Are you flexible?
Behavioral flexibility, the variety of actions you can take in response to a cue, also plays a role. The more options you have, the less likely you are to have developed a habit. Trying new things, going new places, meeting new people – independent of your specific goals – is most likely beneficial to those goals.
2. Social support, either from a single person or a group.
Social support has two parts, structural support and functional support.3 Structural support, the availability of people who can give support, is how many people the person in question can contact for help and reinforcement. Functional support is the support perceived by the person in question; how they feel about the words and actions that reinforce (or don’t) their goal by their support people. Useful functional support is seen as being helpful and beneficial, not demeaning or cruel.
Support in the form of compliments and active participation, as in the support people change their behaviors to join the person in their journey, are beneficial. Instructions and reminders, less so. Messaging matters!
How messages are stated makes a difference
Gain-framed messages, or messages that tell someone what they will get if they do a behavior, tend to work better than loss-framed messages or fear appeals.4
Loss-framed messages tell someone what they’ll lose if they don’t do a behavior.
Fear appeals, or threats, are often used just to break through the noise and get attention, and aren’t effective in health behavior changes.
Even if a message is stated to encourage change, self-efficacy (someone believing they can do something) is a bigger part of success than either encouragement or threats about what someone will lose if they don’t succeed. Still, there’s no need to be nasty or derogatory, people.
In person support
In person support often starts within couples or families. When couples provide support for each other, autonomy support is key. This is asking a partner what they would find useful or helpful, responding empathically to hiccups and setbacks, and respecting and appreciating a partner’s choices and efforts.5
With healthcare practitioners such as dietitians, health coaches or doctors, the strength of the relationship predicts outcomes.6 Again, actions and comments that support autonomy instead of being dictatorial are helpful.
Any behavior change support intervention that helps patients develop and set goals they believe in for weight loss, nutrition and exercise helps. This can be through additional training for the practitioner or a guided computer program the practitioner uses.
Group support
Behavior change support groups have both advantages and disadvantages.7 In general, groups with social influence can make behavior change seem easier, more fun and interesting, maybe even exciting! On the flip side, they can also be invasive, impact your privacy and might have an impact on relationships! Oof! Pick your groups wisely!!
Competition
Competition provides motivation (can’t let that other group win!) and a sense of accomplishment when you do win. It can also be discouraging if you never win and trivialize the importance of healthy behaviors.
Social Comparison
Social comparison provides subtle peer pressure, but it can also be a little empowering when a person thinks they’re better than their peers. Met more goals this week than your teammates? Hah! Let them live up to your shining example! Comparison can also lead to body shaming and disordered eating/eating disorders, along with less self-esteem. Some people call this the “compare demon.”
Cooperation
What is cooperation? Cooperation is a chance for mutual support, encouragement and reinforcement of the new skills you learned to get you to your goals. Lack of cooperation could also cause unnecessary stress and anxiety if you’re not comfortable with your group or you don’t get the needed support and encouragement.
3. eHealth support
What is eHealth? eHealth is health care provided electronically, over the internet.8 A subset of this is mHealth, or mobile health, delivered via mobile devices. Many of the mHealth apps use gamification, the application of typical elements of game playing (e.g. point scoring, competition with others, rules of play) to other areas of activity, typically as an online marketing technique to encourage engagement with a product or service.
In person virtual support
eHealth and mHealth can be virtual in person support, because you’re accessing a dietitian, a health coach or a doctor. Or it can be group support, such as through a Facebook group or MyFitnessPal. Or it can be a self-monitoring tool.
With variation for the huge variety of behavior change support services available, eHealth offers feedback and monitoring, essential for showing progress.9 Self-monitoring, such as tracking weight, diet, or exercise can be part of the monitoring functions. Tailored feedback with graphs, charts, symbols, dashboards, plus texts (maybe), can reinforce the monitoring and show results in a fast, easy to understand way.
A well-trained behavior change support professional will guide you in setting goals and planning for future endeavors, send reminders, and help with roleplay of “dangerous” situations. Apps can do all but the roleplay, with less immediate feedback. Some health coaching for behavior change takes place via app, so you get live feedback relatively quickly.
Group eCoaching
In group e-coaching situtations, you can find social support from both professionals and peers. This can reinforce and maintain new habits.
Many apps and any service that provides one-on-one care can provide tailored messages personalized for you, such as answers to questions, motivational quotes, coping strategies, and maybe most importantly, reminders that stimulate self-monitoring.
To varying degrees, these services and apps also might provide education on diet, exercise, behavior change techniques, and tracking anything you find helpful. So if you want to change or add to your goals, you’ll find information and ideas on how to do that well.
What are the pros and cons of different types of behavior change support?
Advantages
Working through any sort of structured system helps clarify ideas, track important data and show progress. This can be done solo through goal setting and self-monitoring. It can be done in a group setting or with a health pro, either in person or via app.
Accountability absolutely helps, and you can find that anywhere, although many people find external accountability to be more useful than being accountable to oneself. Having people to compete against and work in collaboration with often provides motivation and a sense of fun to the daily efforts.
Cost of working alone is usually very low. You might purchase a fun tracking journal, for instance. There might be an upfront fee or monthly membership cost for groups, and fees for access to a health professional. Group fees might be the lowest option there.
Disadvantages
It’s possible to ignore goals when there’s no external accountability and you’re working alone. It’s also possible to not truly buy into a program or a group that you’re not enthusiastic about, and some groups and apps require giving up a great deal of privacy.
Family relationships can be strained if all parties aren’t equally committed to supporting the behavior change, maybe even sabotaged. And that compare demon can always rear its ugly head, reducing self-confidence and self-esteem.7
Fees, especially for fancy groups with big name health professionals, can be extremely high.
When might you use the different types of support?
If you’re very self-motivated, you might do all goal-setting, tracking and motivation solo. You need education? Find low-cost information in many places (professional association websites, libraries, experts in your area).
For behavior change support from outside of your head, you can join a group. Most large hospitals and medical groups run group programs year round for support and education on a wide variety of topics.
If you need personalized, one on one attention, find a registered dietitian, health coach, social worker or other mental health professional to help you set goals, track progress and provide resources.
There’s also no reason to think that you can only do one at a time. You can move from one type of support to another or utilize a mix at for any given time or goal.
What kinds of behavior change might you use these strategies for?
Pick one! A little behavior change support can make changing up your life easier.
Options include but are not confined to: exercise, weight loss, other body comp changes, eating patterns, thought patterns, recovery from injury/rehab/prehab, meal planning/shopping/cooking, morning/evening routines, budgeting/finance, family relationships, getting through menopause, shifting from elite sport to being a regular person, organizing your life… Really, the sky’s the limit!
If you need help with goal setting and making progress in sports nutrition, check out Nutrition HeartBeat’s Health Coaching Services.
A discussion of different types of goals is a good place to start if you’d like to set some of your own.
If you want to apply this knowledge to weight loss, check out the related weight loss blogs on pros and cons of weight loss on your athletic performance, athlete weight loss/meal timing, arranging your environment to support your weight loss, and teen weight loss.
References
1 Dictionary.com. https://www.dictionary.com/browse/support. Accessed May 7, 2021.
2 Mata J, Todd PM, Lippke S. When weight management lasts. Lower perceived rule complexity increases adherence. Appetite 2010:54;37–43.
3 Karfopoulou E, et al. The role of social support in weight loss maintenance: results from the MedWeight study. J Behav Med. 2016 Jun;39(3):511-8.
4 Ort A, Fahr A. Using efficacy cues in persuasive health communication is more effective than employing threats – An experimental study of a vaccination intervention against Ebola. Brit J Health Psych 2018:23;665–684.
5 Gorin A, et al. A randomized controlled trial of a theory-based weight loss program for couples. Health Psychol. 2020 February;39(2):137–146.
6 Johnston CA. Predictors of Successful Weight Loss. Am J Lifestyle Med 2013:7;115.
7 Orji R, Oyibo K, Lomotey RK, Orji FA. Socially-driven persuasive health intervention design: Competition, social comparison, and cooperation. Health Informatics J 2019:25(4);1451 –1484.
8 Oxford English Dictionary, oed.com. Accessed May 7, 2021.
9 Asbjørnsen et al, Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review. J Med Internet Res 2019:21(6);e14265.