{"id":64,"date":"2019-07-23T21:00:00","date_gmt":"2019-07-23T21:00:00","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-mcc-childdevelopment\/?post_type=chapter&p=64"},"modified":"2019-08-19T13:54:08","modified_gmt":"2019-08-19T13:54:08","slug":"healthy-behavior-and-goals-for-child-health","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-mcc-childdevelopment\/chapter\/healthy-behavior-and-goals-for-child-health\/","title":{"raw":"Healthy Behavior and Goals for Child Health","rendered":"Healthy Behavior and Goals for Child Health"},"content":{"raw":"Early Habit Formation and Health Outcomes<\/strong>\r\n\r\nMuch of our health is determined by daily habits and behaviors. \u00a0These habits have developed over the years, most without thought. Socialization has a great influence on our behaviors and habits. Socialization is the process of learning to behave based on influences in our environment.\u00a0 The earliest significant influences are of those caring for us in infancy and as we grow.\u00a0 We are greatly impacted by the values and attitudes of our caregivers. These influences help determine our behaviors and the habits that we develop.\u00a0 Some are healthy and some are not. Some habits improve our health and some do not. \u00a0Brushing our teeth is a habit that enhances our health. Having a candy bar and soda pop every night before bed is a habit that, over time, would likely be harmful to our health.\r\n

Health Risk Behaviors that Contribute Significantly to Chronic Disease<\/h3>\r\nHealth risk behaviors are unhealthy behaviors you can change. There are many aspects of health that can contribute to overall health and wellness. The Center for Disease Control has identified that most illness, suffering, and death are related to four individual behaviors:<\/strong>\r\n\r\n1) Lack of Physical Activity,<\/strong>\r\n\r\n2) Poor Nutrition,<\/strong>\r\n\r\n3) Excessive Alcohol Consumption,<\/strong>\r\n\r\n4) Tobacco Use. \u00a0<\/strong>\r\n\r\nThe Determinants of Health<\/strong> \u2013 What Contributes to Our Health Status?<\/strong>\r\n\r\nThe range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health fall under several broad categories:\r\n
    \r\n \t
  1. Biology and Genetics <\/strong>(ex: gender, age, family history)<\/li>\r\n \t
  2. Individual Behavior <\/strong>(ex: substance use, unprotected sex, smoking, dietary choices)<\/li>\r\n \t
  3. Health Services\/Medical Care <\/strong>(ex: access to quality healthcare and health insurance status)<\/li>\r\n \t
  4. Environment\/Policymaking <\/strong>(ex: regulations that support or hinder health status)<\/li>\r\n \t
  5. Social Circumstances <\/strong>(ex: discrimination, income, gender, availability of resources)<\/li>\r\n<\/ol>\r\nDetailed examples of Social Factors<\/strong> that can contribute to poor health outcomes include:\r\n
      \r\n \t
    • Availability of resources to meet daily needs (ie. educational, job opportunities, living wages, or healthful foods)<\/li>\r\n \t
    • Social norms and attitudes, such as discrimination<\/li>\r\n \t
    • Exposure to crime, violence, and social disorder, such as the presence of trash<\/li>\r\n \t
    • Social support and social interactions<\/li>\r\n \t
    • Exposure to mass media<\/li>\r\n \t
    • Socioeconomic conditions<\/li>\r\n \t
    • Housing, homes, and neighborhoods<\/li>\r\n \t
    • Exposure to toxic substances, environmental or other physical hazards<\/li>\r\n<\/ul>\r\nIt is the interrelationships among the above factors that determine individual and population health. Therefore, interventions that target multiple determinants of health are most likely to be more effective from a public health standpoint.2\r\n\r\nIndividual Behavior is the Most Significant Contributor in Most Cases<\/strong>\r\n\r\nMany people think that the most influential aspect of our health is biology and genetics, but it is not.\u00a0 Although family history does have play a part in our level of risk, individual behavior<\/strong> outweighs that aspect in most every case, and is the largest contributor to health status.\r\n\r\nIn addition to the individual behavior category, take a look at some of the other categories that individuals may be able to modify. Adding those components together increases the level of control we have.\u00a0 We must keep in mind, however, that children have less control over their decisions than an adult.\u00a0 For example, if a child is living with an adult who is smoking in the house, the child can\u2019t simply choose to move out of the house. Children also have little influence on the household grocery purchases, in many cases. Regardless, the fact that individuals can modify their individual behavior allows it to be a most significant influence on individual health status.\r\n\r\n \r\n\r\n\"Determinants<\/strong><\/span>\r\n\r\n \r\n\r\nAdults as Role Models for Decision Making<\/strong>\r\n\r\nAdults can serve as positive or negative role models.\u00a0 As part of the process of development, children imitate others.\u00a0 Their values, attitudes and behaviors are greatly influenced by those around them, particularly their parents or caregivers.\u00a0 If adults are choosing healthy behaviors, this will have a positive impact on youth.\r\n\r\nAdults can also assist children in making healthy decisions. We can teach them strategies for decision making.\u00a0 First, we want to encourage them to stop and think instead of making snap decisions. We can model this for children at a very young age.\u00a0 Discuss decision making at the grocery store.\u00a0 Describe the process when you are deciding what food to buy. Demonstrate how to consider the pros and cons and discuss potential outcomes.\u00a0 As a child gets older, allow them to help with the decision making process.\r\n\r\nHealth Behavior Theories and Models<\/strong>\r\n\r\nHealth Behavior Theories and Models can help to explain why humans behave in the ways that they do. If we know that certain behaviors are healthy, then why don\u2019t we just do them?\u00a0 Part of the issue is that healthy outcomes of behaviors are usually long term.\u00a0 It is more difficult to be motivated toward behavior when we won\u2019t see the benefits right away.\u00a0 However, the benefits of developing healthy habits early in life will be very beneficial for the lifespan.\r\n\r\nK-A-B: \u00a0(Knowledge, Attitude, and Behavior) <\/strong>\r\n\r\nThe KAB concept is at the foundation of understanding health behavior change. <\/strong>\r\n\r\nWe can have all of the reliable knowledge in the world about health risk (we know that many people have died horrible deaths as a result of smoking cigarettes), but if our attitude (belief that it could happen to us and desire to make change) is not in alignment, we are unlikely to make a healthy behavior change. \u00a0The result is a gap between knowledge and behavior that keeps the individual from changing their behavior. More knowledge can certainly be helpful, but if there is not an attitude or desire for change, it will not happen. \u00a0Both knowledge and attitude are needed in order to move us toward healthy behavior.\u00a0 You will find that this aligns with some of the models in this chapter.\r\n\r\nHealth Behavior Theories and Models<\/strong> attempt to explain why people behave in certain ways. \u00a0Utilizing these theories or models can be helpful with interventions for encouraging positive changes in health behavior.<\/strong>\r\n\r\nExample #1<\/strong>: \u00a0According to the Internal and External Locus of Control (LOC) models<\/strong>, if we feel that something outside of ourselves is responsible for our health (external locus of control), then we are less likely to carry out healthy behaviors. \u00a0For example, with external locus of control, if a person who smokes believes that their smoking behavior will not influence their health, they are not likely to make a change. Their perception that other external<\/em> forces will determine their health and lifespan deters them from healthy behavior. On the opposite end, having an Internal Locus of Control (believing that our actions DO make a difference) <\/em>allows us to be in the driver's seat and take action for positive results. \u00a0If an individual believes that their decision to smoke or not to smoke contributes to their health status, then they are more likely to quit.\r\n\r\nAre you more Internal or External? \u00a0How much of a difference do you believe your behaviors make relative to your health?\r\n\r\nHave you ever said or heard someone say,<\/strong> \u201cWell, it\u2019s in my family, so there\u2019s nothing I can do about it\u201d<\/strong> or \"If I'm going to get sick, I'm going to get sick and there's nothing I can do about it\"? \u00a0Those perceptions would show that a person has an \"External Locus of Control\".<\/strong>\r\n\r\nWhile there is a genetic component for our health status, it is a very small component in comparison with the influence of our individual behaviors.\u00a0 The good news is that our individual behaviors can positively influence our health and we can make positive change through our decisions. An internal locus of control is helpful in moving an individual toward healthy behaviors.<\/strong>\r\n\r\nExample #2: \u00a0The Health Belief Model <\/strong>\u00a0is related to our Locus of Control and <\/strong>contains cr<\/strong>itical components that may explain why people choose certain behaviors. \u00a0The core components of this model are \"perceived susceptibility<\/strong> and perceived severity<\/strong>\". If a person believes (perceives) that they are susceptible (or vulnerable) to negative consequences and that those consequences are severe, they are more likely to carry out a health behavior.\u00a0 If the person truly believes that their smoking behavior will have negative consequences and that those consequences will be severe and it could happen to them, the person is more likely to take action. \u00a0An example would be, in determining whether a sexually active person will utilize a condom, a script may run inside their mind saying, \"I won't catch anything having sex just this one time<\/em><\/strong> without protection\". \u00a0This person perceives that they are not susceptible. \u00a0The script goes on to say, \"If I catch something, I can just go get a prescription for it\". \u00a0These perceptions demonstrate a lack of knowledge and an attitude that the behavior isn't that important. \u00a0Perceived benefits<\/strong> and barriers<\/strong> also come into play when an individual perceives that the barriers are more influential than the benefits. (Trying to get a condom and using it in the moment are very large barriers that may seem larger than the benefits of protection.) The individual may also lack self-efficacy<\/strong> or confidence in their ability to carry out the condom usage and may not receive a cue to action<\/strong>, such as advice or encouragement from a friend to carry out the health behavior. In reality, this one decision could change the person's life.\u00a0 Someone could contract an infection with just one unprotected encounter, and there are many sexually transmitted infections that are not curable.\u00a0 There could also be a life-changing pregnancy.\u00a0 However, if the person does not perceive it as serious or something they are susceptible to, then they are not likely to carry out healthy behavior.\r\n\r\n\"Health\r\n\r\nThe Bad Example(s)<\/strong>\r\n\r\nA \"bad example\" can influence our perceptions and can be applied to the Health Belief Model. \u00a0This can be particularly problematic for youth. When someone you know participates in a risky behavior with no (apparent) negative outcomes it sends a message that nothing bad will happen as a result of the behavior.\u00a0 Ex:\u00a0 Your Grandfather smoked unfiltered cigarettes until he was 90 without ever getting sick. \u00a0Your friend had unprotected sex multiple times without an unintended pregnancy, STI or HIV (that you know of). Your uncle ate only the healthiest foods and dropped dead. \u00a0Can you think of another example like this? \u00a0These are the examples that really throw us for a loop. \u00a0We WANT to believe in these examples because it helps us to justify unhealthy behavior.\u00a0 In reality, there are other factors that make up a person's total health that can influence their health status. \u00a0Maybe your uncle was suffering from stress and mental anguish in his other dimensions, while Grandpa was extremely healthy in those areas.\u00a0 We are happy for Grandpa even if he was a bad example, however, we have to remember that these cases are rare and are not representative of how behavior is likely to impact our quality and length of life.\r\n\r\nE<\/strong>x<\/strong>ample #3: Stages of Change<\/strong>\r\n\r\nThe Stages of Change (Transtheoretical) Model<\/strong> is also commonly referenced when it comes to health behavior. \u00a0This model basically says that if you are not ready to change, you are not going to change. \u00a0Can you relate to this? \u00a0Have you ever had someone on your case to quit smoking, lose weight, exercise, or eat vegetables and all you heard was \"Blah, blah, blah, blah\"? <\/strong>\u00a0If we are in the \"pre-contemplation\" stage, it means that we aren't ready to even think about change. \u00a0Although the people in our lives can be very influential and supportive with our positive behavior changes, sometimes their nagging can be less than effective if we are not ready to hear it. \"Contemplation\" is the stage in which we are thinking about change. \u00a0In the \"preparation\" stage, we are researching and making plans regarding the change. \u00a0\"Action\" is when we actually implement the change, and \"maintenance\" involves continuing the behavior over the long term.\u00a0 Some resources list \"termination\" as the final stage, others keep the last stage as maintenance.\r\n\r\n\"Transtheoretical\r\n\r\nExample #4<\/strong>:\u00a0 Theory of Planned Behavior \u2013 <\/strong>This theory is an adaptation of the theory of reasoned action based on the assumption that humans are usually quite rational and make systematic use of the information available to them. The theory states that people assess certain factors before deciding to engage or not engage in a behavior. According to this theory, intention will help predict future behavior. The difference in intention is composed of three constructs: (a) attitude toward the behavior, (b) subjective norms, and (c) control. A number of studies have found an association with the intention-behavior relationship. It also has been found that intentions have a substantial causal effect on behavior.\r\n\r\nOther Critical Influences on Individual Behavior<\/strong>\r\n\r\nThe Impact of Self-Control and Delayed Gratification<\/strong>\r\n\r\nDelayed gratification<\/strong>, or deferred gratification, is the ability to resist the temptation for an immediate reward and wait for a later reward. On the other hand, human beings are certainly drawn toward behavior involving instant gratification<\/strong>, meaning that we do things that make us feel good right away instead of waiting. Generally, delayed gratification is associated with resisting a smaller but more immediate reward in order to receive a better reward later. We practice it every time we consciously delay immediate rewards to earn the benefits of a more distant goal. Waiting to eat a piece of candy, or choosing to save up our money for something are examples of how we choose delayed gratification and utilize self-control. Studies have shown that delay of gratification is an observable measure of self-control, and that self-control predicts future success better than measures like IQ and standardized test performance. Research shows that students from countries emphasizing the value of delayed gratification did better than students from countries without that emphasis. The benefits are long-lasting, and get stronger over time. These students also had fewer absences and fewer disciplinary problems.\r\n\r\nMore Factors that Can Help Explain Behavior\u00a0 <\/strong>\r\n\r\nPredisposing Factors<\/strong>:\u00a0Individuals will be \"predisposed\" to certain behaviors or be more likely to participate in certain behaviors if they have been exposed to it previously. \u00a0For example, if your parents drink alcohol, smoke cigarettes, or do other drugs, you will be predisposed. \u00a0If you've grown up in a household with depression or unhealthy communication you will be predisposed to those things. \u00a0If a good amount of sleep, healthy nutrition, and exercise weren't part of your routine growing up, this would be a predisposing barrier to health as well. \u00a0On the other hand, if you grew up with healthy influences, you will be predisposed to some healthy behaviors.\r\n\r\nEnabling Factors<\/strong>: \u00a0Enabling factors are skills or physical factors such as accessibility of resources or services that facilitate achievement of motivation to change behavior.\u00a0 If you have a farmer's market right down the road, this would enable you to eat many healthy vegetables and fruits.\u00a0 If you have many sidewalks in your neighborhood, you may be more likely to be physically active. We may have negative enabling factors as well, such as a spouse or peers that behave in unhealthy ways.\r\n\r\nReinforcing Factors<\/strong>: \u00a0Reinforcing factors include factors that reward or reinforce the desired behavior change, including social support, economic rewards, and changing social norms. You could be positively reinforced by having a friend or relative who wants to plan activities that promote physical activity, or a contest that gives a prize to the people who quit smoking. \u00a0There can be negative reinforcements as well, so deliberately choosing to be in places and around people who reinforce healthy behavior is a smart move.\r\n\r\nHelping Youth Reach Goals for Healthy Behavior <\/strong>\r\n\r\nYou would think that taking care of ourselves would be instinctive and always a top priority. \u00a0After all, we only have one body and we are much more productive and happy if our minds and bodies are healthy. \u00a0However, no one is born knowing what behaviors will contribute to a good quality and quantity of life.\u00a0 Adults need to guide children in making healthy decisions.<\/strong>\r\n\r\nFor the sake of our health and wellness and for the sake of the children who will be watching our behavior and likely imitating us, we need to be sure that we are utilizing sound information to inform our choices.\u00a0 We will also need to help them prioritize in order to support their success.\u00a0 In addition to Healthy People goals and CDC recommendations, there are more specific recommendations for children, such as the 5-2-1-0 goals.<\/strong>\r\n\r\n5-2-1-0 Goals<\/strong>\r\n\r\nHave you heard of 5-2-1-0?\u00a0 5-2-1-0 is a nationally recognized program that includes four core goals that promote health and wellness for children.\r\n\r\n5 - Eat at least 5 servings of vegetables and fruits per day.\r\n\r\n2 \u2013 Limit screen time to no more than 2 hours of recreational screen time per day.\r\n\r\n1 \u2013 Be physically active for at least one hour (60 minutes) per day.\r\n\r\n0 \u2013 Consume zero sugary drinks, replace with water.\r\n\r\nSMART Goals<\/strong>\r\n\r\nUsing goals that are specific and measurable will help us to be more accountable and, therefore, more successful.\u00a0 It is recommended that individuals begin with one behavior change goal at a time and then move to another once the first one has become habit.\u00a0 <\/strong>\r\n\r\nS- Specific \u2013 <\/strong>The more specific, the better.\u00a0 What will you do, when and for how long?\u00a0 <\/strong>\r\n\r\nM- Measurable \u2013 <\/strong>You must be able to measure whether or not you are successful.\u00a0 Ex:\u00a0 If I just say \u201cI will eat healthier\u201d, that is not measurable because you must define \u201chealthier\u201d specifically.\u00a0 I will eat three servings of vegetables per day five days per week is measurable.\u00a0 You can determine whether or not you actually did it.\r\n\r\nA-Actionable\/Attainable \u2013 <\/strong>It must be something that you can actually do.\r\n\r\nR- Realistic \u2013 <\/strong>The goal must be realistic for you.\u00a0 If it is not realistic for you to exercise for one hour per day, do not set that as an overall goal.\r\n\r\nT- Time-bound \u2013 <\/strong>Timeframes must be set.\u00a0 If we don\u2019t state when we will do things, they will never happen!\u00a0 Example of overall goal:\u00a0 I will eliminate cigarettes from my life by X date.\u00a0 As noted below, you will also set smaller time bound goals to gradually get you to your goal.\r\n\r\nEXAMPLES of SMART Health Behavior Change Goals: <\/strong>\r\nUse the examples below as models to assist in creating health behavior change goals that support success.\r\n\r\nGood Examples<\/strong>:\r\n\r\n*I will eat five servings of vegetables per day, at least five days per week. \u00a0(Example of outlining smaller steps:\u00a0 I will begin with two servings of vegetables per day for the first two weeks, increase to three servings per day for the next three weeks, etc.)\r\n\r\n*I will take a 60 minute walk every day at 3pm.\r\n\r\n*I will limit my (non-school related) screen time to less than 2 hours per day.\r\n\r\n*I will drink water with meals and snacks.\r\n\r\nIn addition<\/strong>:\u00a0 To make all of the above time bound, add a target date for reaching your goal.\u00a0 It could be \u201cby the end of the year\u201d, \u201cby the end of the semester\u201d, \u201cby the end of next month\u201d or whatever you choose.\u00a0 <\/em>\r\n\r\nPoor Examples \u2013 Do NOT use<\/strong> - Not specific or measurable: I will eat healthier, or I will exercise more. These are too vague and we are less likely to carry out the behavior if goals are not specific and measurable. You need to add more detail such as how many servings of vegetables you will each per day or how many minutes of what type of exercise you will do at what days and times.\r\n\r\nIMPORTANT:\u00a0 Do not use:\u00a0 I will lose weight or I will lose X pounds by X date.\u00a0 Weight loss is not a behavior. <\/strong>If you want to lose weight, then you would want to choose a behavior that will move you toward that outcome (such as increasing intake to X servings of vegetables, increasing activity to X minutes per day, decreasing intake of processed foods to X serving per X, drinking X ounces of water).","rendered":"

      Early Habit Formation and Health Outcomes<\/strong><\/p>\n

      Much of our health is determined by daily habits and behaviors. \u00a0These habits have developed over the years, most without thought. Socialization has a great influence on our behaviors and habits. Socialization is the process of learning to behave based on influences in our environment.\u00a0 The earliest significant influences are of those caring for us in infancy and as we grow.\u00a0 We are greatly impacted by the values and attitudes of our caregivers. These influences help determine our behaviors and the habits that we develop.\u00a0 Some are healthy and some are not. Some habits improve our health and some do not. \u00a0Brushing our teeth is a habit that enhances our health. Having a candy bar and soda pop every night before bed is a habit that, over time, would likely be harmful to our health.<\/p>\n

      Health Risk Behaviors that Contribute Significantly to Chronic Disease<\/h3>\n

      Health risk behaviors are unhealthy behaviors you can change. There are many aspects of health that can contribute to overall health and wellness. The Center for Disease Control has identified that most illness, suffering, and death are related to four individual behaviors:<\/strong><\/p>\n

      1) Lack of Physical Activity,<\/strong><\/p>\n

      2) Poor Nutrition,<\/strong><\/p>\n

      3) Excessive Alcohol Consumption,<\/strong><\/p>\n

      4) Tobacco Use. \u00a0<\/strong><\/p>\n

      The Determinants of Health<\/strong> \u2013 What Contributes to Our Health Status?<\/strong><\/p>\n

      The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health fall under several broad categories:<\/p>\n

        \n
      1. Biology and Genetics <\/strong>(ex: gender, age, family history)<\/li>\n
      2. Individual Behavior <\/strong>(ex: substance use, unprotected sex, smoking, dietary choices)<\/li>\n
      3. Health Services\/Medical Care <\/strong>(ex: access to quality healthcare and health insurance status)<\/li>\n
      4. Environment\/Policymaking <\/strong>(ex: regulations that support or hinder health status)<\/li>\n
      5. Social Circumstances <\/strong>(ex: discrimination, income, gender, availability of resources)<\/li>\n<\/ol>\n

        Detailed examples of Social Factors<\/strong> that can contribute to poor health outcomes include:<\/p>\n