HEALTH PROMOTION

1.0 Introduction

1.0.1 Health Promotion

            Many individuals around the world suffer different problems that directly or indirectly affect their health statuses. Most people normally have to seek medical attentions or medical interventions in order to manage, treat, or control any given health problem. Doctors on the other hand have to work closely with such people in order to help them achieve their desired goals. Moreover, in many cases, the health professionals notice that the person needs to adopt changes in his or her behavior so that he or she can realize the desired health status. In addition, previous researches have proved that these professionals usually use various models to help their patients either through treatment or intervention procedures. Other studies have also proved that there are several theories or models that the professionals may use to help an individual or a group of people achieve a healthy living. In the world today, such models comprise the reasoned action model, trans-theoretical model regarding the human health behavior change as well as the health belief model. Additionally, the theories may include the most popular theory of planned behavior.

            Therefore, this paper was a discussion of the trans-theoretical model of health behavior change. It investigated how different physicians have successfully used this model to help promote health issues among adult smokers by helping them change their behavior towards smoking. The paper also critically analyzed the Action on Smoking and Health (ASH) campaign, and discussed how the campaign was effective in helping addicted and new smokers with ways of dealing with the vise of smoking (O’donohue & Krasner 1995, p. 9).

1.0.2 Trans-theoretical model of health behavior change

 Prochaska and DiClemente proposed the trans-theoretical model (TTM) of health and behavior change in 1983. The theory’s revision works took place in 1992 as stated by Prochaska et al., and finally refined by Prochaska in 2006. Evidently, it was a model that used cognitive and behavior strategies in helping people achieve desired behavior changes that would also change their health needs (Elsevier 2009, p. 13). Similarly, this model was effective in promoting health benefits because it used the stages of change in incorporating the most powerful principles and procedures of change from outstanding theories of counseling and behavior change. Moreover, the model was founded on principles developed from scientific research, medical intervention development and a variety of pragmatic studies carried out for a period more than 34 years.

The trans-theoretical model of health behavior change applied the results of research funded by over $70 million worth of grants and carried was out by more than 160,000 research participants (Lutzker & Martin 1981, p. 19). Additionally, different professionals around the globe are currently using this model to help their patients in promoting practical behavior changes (Riekert et al. 2009, p. 49). Various health professionals rely on TTM to help patients achieve optimum health statuses by aiding them to change their behavior through cognitive thought process which were used in the model. Studies have revealed that unlike other models of behavior change, which mainly focus on certain magnitudes of change, for example, theories that mainly focus on social or biological impacts, the TTM seeks to incorporate and integrate major paradigms from other theories into an inclusive theory of change that was applicable to a variety of behaviors, demographics, as well as settings. For instance, TTM can be used in areas of treatment, prevention, intervention and policymaking procedure, hence, the origin of the name trans-theoretical model.

Velice and Prochaska (1992, p. 287) stated that TTM assumes that no theory can attempt to fully analyze and effect behavior change, since change in behavior was found out to be gradual and that it occurred over a given period, and that it was important to come up with one comprehensive model that would monitor changes in behavior across other models and theories as well. Therefore, model seeks to use processes change after its proposers found out that people shift through a series of stages when changing or attempting to change their behavior. Whereas the time an individual may take in each stage was different, the tasks required to move from one stage to the next do not vary but remain constant throughout the intervention or medication process (Bergin & Garfield 1971, p. 31).

Various health professionals have used the TTM method in helping old adults and young individuals to change their behavior by repositioning their cognitive abilities in order to achieve a better health. Nonetheless, the stages of TTM include pre-contemplation, contemplation, preparation, action, maintenance and termination phases (Corner et al. 2003, p. 22). Pre-contemplation refers to a phase in which the people involved do not anticipate to take any action in the near future, which was generally projected to be a period of six months. Similarly, lack of proper understanding on the consequences of one’s behavior may lead to demoralization of the individual, hence, failing to make the decision to take actions towards their behavior change needs. This was particularly so with adult smokers who thought that there was nothing wrong with one being a smoker.

On the other hand, the contemplation stage was when the adult smoker starts internalizing the consequences of smoking and how this might affect his or her health, or how the behavior has already affected his or her health. The person may also consider how this vice was affecting the people around him or her and how close associates were reacting towards the same (Prochaska 2006, p. 36). At this point, the individual contemplates on how to go about changing his behavior in order to acquire a better health. In most cases, most young adults would contemplate on effects as well as advantages of changing their behaviors.

The process of weighting the pros and cons of changes in behavior can make the individual either stay for long in the contemplation stage or relapse to the pre-contemplation stage depending on his/her personal convictions.

The preparation phase is mostly used to refer to a given point when young and old adults intend to take immediate actions in the near future. It comes after an individual has given his or her behaviors thorough thought and critically analyzed how the behavior (smoking) negatively impacts his life and the lives of those around him (Prochaska 1997, p. 51). Moreover, at this point, the adult had made a proper decision and was hoping to seek help or intervention in order to change their actions. The people in the preparation stage had a plan of action, for example, they may have decided to join a health education class, consult a counselor, talk to their physician, buy and read a self-help book or else rely on a self-change program in order to change their behavior.

Action refers to the stage in when individuals have made definite and clear changes in their lifestyles in the past six months (Lenio 2006, p. 14). However, according to this theory, action point was just another of the many stages in the model, therefore, all changes in behavior cannot be considered as action in this model. In most professional applications, people have to achieve a criterion that scientists and health professionals approve as sufficient to reduce the hazards of the behavior or disease. For instance, reducing the number of cigarettes or switching to low tar and low nicotine cigarettes were formerly viewed acceptable actions, however, the person realizes that the only best way to abstain from smoking (Whyte 1991, p. 33).

Maintenance on the other hand was the phase when the adult had made specific notable alterations in their lifestyles. They were aiming to prevail over the possibility of reoccurrence of the past behavior. Nonetheless, they did not use processes of change as often as adults in action stage did. Adults in the maintenance stage felt a lesser urge to go back to their old ways of life. Research studies indicated that people could maintain being in this stage from half a year to five years without reverting to their former behaviors. The research further proved that after a year of abstinence, 45 percent of individuals relapsed to smoking (Burg 2005, p. 20). The degenerate cases reduced significantly to 7 percent after five years. 

Termination refers to the point in the trans-theoretical model when the adults were not tempted go back to their initial smoking behaviors. In addition, the people had achieved a hundred percent success in changing their smoking behavior (Shani, Woodman & Pasmore 2011, p. 74). In many cases, such individuals had fully quite smoking and were no longer using cigarettes. Whether they were lonely, depressed, angry, anxious, bored or stressed, people in this stage were certain that they would not revert to their unhealthy practices as a way of dealing with their problems (Martens & Mcmichael 2002, p. 21). It was an indication that their newly acquired behavior had almost become a mechanical routine and hence they could not go back to their former behavior methods.

Many professionals had used the TTM method in helping different individuals especially adults to overcome their smoking habits and to acquire behavior that would help them to stop smoking (Hardinge 1970, p. 18). Consequently, the model allowed the professionals to move in a systematic way and ensure that the individuals had successfully passed a stage before moving on to the next stage. The TTM enabled patients to work or move at their own pace without being pushed by the health care professional to move on to the next stage. Using this model, the caregivers were allowed to assess the patients critically from one stage to the next as they guided them through the different stages.

The advantages of this model were that it made it possible for health professionals to aid their clients in a systematic way. Additionally, it did not stop at actions stage just because an individual had decided to act on their behavior, however, the health professionals who used the TTM as a means of behavior change only stopped after realizing that the patients had fully recovered. The only disadvantage was that the clients could not agree with the duration, as TTM was gradual and did not happen over a short period (Adams 2002, p. 237). The main issue that the professionals had to deal with was aiding patients so that they did not relapse and helping them make a comeback after relapsing.

Stages of Change in Human behavior change
Pre-contemplation	“ I will not” or “I cannot”
Contemplation	Use of reasons either for/against change
Preparation	Want to but…
Action	Doing it
Maintenance/Relapse	Now a habit or risk of lapse

Figure 1.0.3 indicating the different stages of behavior change (Burg 2005, p. 27).

1.1 Health Promotion Campaign

Many organizations had come up with campaigns to help people stop smoking. The Action on Smoking and Health (ASH) refers to a health campaign whose main objective was to inform everybody in the United States and the world on the disadvantages of smoking. Moreover, the activists believed that every cigarette you did not smoke helped in preserving your health and that the vice versa was true. This campaign was inclusive and did not only aim at informing adolescent, youths or adults on the vices of smoking, but was tailor made for every group and age of people. Similarly, the campaign was effective in the sense that it targeted every smoker of every age, it was available both locally and internationally (http://www.ash.org.uk/, 2014). The campaign also seemed to tackle issues such as electronic cigarettes, who have them, their safety, and how effective they were in dealing with smoking issues. The health promotion informed people on all the facts and myths about smoking as well as offering suggestions on where an individual could find help (Eddy 1981, p. 39).

. In addition, it also told people about the negativity of consumption of cigarettes as well as how this act could harm those around the smokers. They also had proposals for rehabilitation centers that an addicted smoker could attend to get the much-needed help. The campaign also provided an access to information and resources that smokers and non-smokers could use to help gather more information about smoking as well as help people who smoked but were afraid to seek help (Markóczy & Goldberg 1998, p. 391). They had a site that was easy to use and invited more people to join them in the campaign to help others quite smoking and live a cigarette free life (http://www.ash.org.uk/, 2014).  

Moreover, the ASH movement also educated smokers on the costs of social care, and how they could participate in activities that would enable them end smoking. In addition, the movement also volunteered to inform and teach people on the impending dangers of smoking in cars and educated them about the new smoking policies put in place. This campaign was also aimed at aiding those struggling with smoking issues to quit and never relapse again (Dubé 2010, p. 16).

Figure 1.0.4 A representation of the behavior change in different individuals (Hardinge 1970, p. 89).

1.3 Conclusion

There are many smokers around the world who are either not aware of the effects of smoking or just do not care about the effects of the vice in regards to their health. There are also various campaigns found in different parts of the world whose mandate is to ensure that people do not smoke (Salmon 1989, p. 44). Health professionals can use a comprehensive model such as the TTM to aid individuals who wish to quit smoking with the aim of changing their behaviors for proper health. The TTM helps both young and old adult smokers in changing their behavior so that they can practice better help. They acquire appropriate behavior change by using this method through the assistance of their health professionals. Many professionals also prefer this model because it was very inclusive, not biased in nature and it was systematic (Elsevier 2009, p. 38). The application of the model enabled the health worker to aid the patients or clients in a systematic process through stages until they achieved the desired health behavior change. 

There are different campaigns that aim at influencing people to stop smoking and the ASH campaign was one of them. The use of campaigns was an effective method because it aims at influencing people from various backgrounds to stop smoking (Velice & Prochaska 1992, p. 67). The campaigns targeted both local and international audience.

 

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