23 March 2011

The month of not setting unachievable goals

This April, I have vowed not to set unachievable goals. I will not plan to work ten hour days. I will expect to take at least an hour to deal with the most pressing of my emails every morning. I will go running three times a week and no more. I will definitely not give up drinking coffee. I will probably not blog.

And this is all in aid of what?

Well, first of all, I'm getting married in May, and am trying to avoid breaking out in hives in the run up to the big day. Secondly, though, as a response to this thought-provoking piece of literature on behavioural norms and why they are nigh-on impossible to change.

Actually it's been something of a chain reaction set off by a conversation in the pub last week (isn't it always?). I was trying to claim - probably rather over-zealously - that it would be as hard for me to give up my 11am coffee as it would for a smoker to give up their 11am fag break.

Then, yesterday, in the process of some research on the subject of public health, I stumbled across the aforementioned literature. It argues, quite sensibly, that in health education, providing all the relevant information about the harm that a particular behaviour may cause "does not necessarily lead to a change in health behaviour". Quite right. Otherwise, we'd be a nation of smoke-free, caffeine-free, tee-totaling, salad scoffers.

(Also, slight extrapolation, but it's the same sort of argument that's used against the one-way, "deficit" model of science communication, which neglects attitudes to scientific issues and focuses only on addressing knowledge gaps. Interesting, if slightly off topic).

The paper also touches on the importance of setting realistic goals for behavioural change. It's referring to nurses changing the behaviour of patients, but as a general principle it's something I think is useful to understand: changing the way people behave is tough. Changing drugs (with exceptions) or physiotherapists or your location in relation to a pub/mobile phone mast/nuclear power station might be simple - in theory, at least, if not in practice. But changing the habits of a lifetime is easier said than done.

Worth remembering, I think, when reading or writing about interventions (or policies) that aim to radically change behaviour.

Anyway, in a vote of solidarity for "setting realistic goals" I will be devoting April to achieving no more and no less than I do every other month.

Ref: Whitehead, D. and Russell, G. (2004). How effective are health education programmes – resistance, reactance, rationality and risk? Recommendations for effective practice. International Journal of Nursing Studies, 41, 163-172. DOI: 10.1016/S0020-7489(03)00117-2