I am the kind of person who...

A discussion in one of my Health Behavior and Health Education classes recently got me thinking. Not that my classes don't always get me thinking, but this one really stuck with me.

We were in my Sticky Health Communications class, and we were talking about why New Years resolutions don't work.

There were a number of ideas thrown around by students, and there isn't really one right answer. But the professor, Dr. Brian Zikmund-Fisher, posed this as an explanation:

If you don't convince yourself that you're the kind of person that does something, you won't stick with it.

I have kept this idea with me for over a week now, and I have spent a little more time considering it than I should probably admit. I first tried to think about it in terms of my own behaviors, and previous attempts or successes in behavior change.

It wasn't hard to see how this idea applied to some things in my own life, like making the transition to not eating meat, the trials of committing to diet and exercise, something as simple as actually flossing every night.

So then I started looking for it to pop up as a theme in TV. Tuesday night it popped up right on The Biggest Loser. Not too surprising that this would be the first place I see it.

Some of the things I think this can be most easily applied to are:

• resisting food temptations, ex. "I am the kind of person who can walk away from the cookies in the break room at work, and know it's not worth it to indulge on low quality cookies"
• adding small amounts of exercise to your day, ex. "I am the kind of person that parks a little farther from the store to add some extra walking in to my day"

These are relatively simple behaviors, but unless you have convinced yourself that they are a part of you, it is sooo easy to say "well I just can't resist."

This by no means make this system flawless. You can end up off track. In my opinion though, every time you get off track and realize you need to work on it harder next time, you make yourself stronger in your convictions. You also learn what you should feel bad about, and what is really just a one-time indulgence that you know doesn't need to lead to other indulgences.

This all comes at a time when I realize I have gotten horribly off track for just over a week, after losing 12 pounds. Time to recommit, and get back on track, stronger than ever.

If anyone out there reads this and has a reflection of something in their life that took changing self-concept to change behavior, I would love to hear about it.

**
Additional note: In my field we talk a lot about self-efficacy as a key predictor of behavior change. Self-efficacy is the belief in oneself to be able to perform a specific behavior, in a specific situation. I don't see the concept discussed above as being the same. I think this is much more self-concept/personal identity based.

My Food Pyramid Results!

For the last week I have been keeping track of how many fruits and veggies I eat during the day. I wanted to see if I was meeting the recommendations of the MyPyramid site. I tried really hard to not change my eating habits this week, because I wanted to find out how I was doing on my own.

Here's a fun little graph a created to show visually how I did. 

Purple represents the fruit recommendation of 2 cups/day. 

Green represents the veggie recommendation of 2.5 cups/day. 

The peaches are how many fruits I actually ate, and the carrots are how many veggies I actually ate.

I love how this gives a visual of what my eating habits were over the week. 

Can you guess which day Matt and I went grocery shopping? Sunday

Can you guess which days I was at school all day and packed my own foods? Monday and Tuesday

Can you guess which days I ate at least one meal out (a whole other issue of it's own)? Thursday, Friday, Saturday, Sunday

So the verdict is clear I think. I NEED to eat more veggies. And, I need to work harder to eat we rounded all week long, not just the days that I spend all day on campus. Oh, and I obviously favor fruit over veggies.

--

Now, for the next week I am going to track how I do trying to even out the recommendations with my actual intake, and find more of a balance between fruits and veggies.

--

Did you know the fruit and veggie recommendations are now measured in cups/day, not "servings?" Did you know that recommended amounts vary based on your age, sex, activity level, and weight goals? To find out your recommended amounts, check out the MyPyramid site for yourself!

Examining MY "food pyramid"

As and MPH student, I spend every day learning about, talking about, and thinking about health. Recently I was using MyPyramid.gov for a work project, to look up the general fruit and vegetable intake recommendations.

Now we've all heard that Americans aren't eating enough fruits and vegetables. In 2005 about 33% of U.S. adults ate fruit two or more times per day, and about 28% ate vegetables three or more times per day.

I am not doubting that we need to eat more fruits and veggies as a country, I mean look at those around you. Very few people have a circle of family and friends in which EVERYONE eats and ideal diet. On the  other hand, I wonder how accurate these statistics are. Especially because there is so much confusion about how many servings of fruits and veggies you should be getting, and what a serving actually is.

As a student of health behavior and health education I am fairly well informed about healthy eating, but I am no expert. I don't have have a background in nutrition or dietetics. While my professional interests separate me from the general population, I was curious how well rounded my own diet is. I try to ensure fruits and veggies in my diet every day, but lately I have been noticing that I eat more fruits than veggies.

So I decided to look at my typical intakes, and see how they compare to the guidelines set forth by MyPyramid.gov. I am using MyPyramid because it is often used to teach students in school, and is known as the simple "go to" source for basic nutrition guidelines.

There is a feature on the MyPyramid site to enter your age, sex, height, weight, and activity level. A personalized recommendation list is then generated based on your current weight, or for losing weight if you are above the "healthy range" for your height and sex. Here are my recommendations based on my current weight.

Some time next week I will post how I measured up for the days that I tracked. I am going to work hard to not do anything different because of this, but to instead just stick to meals that have been typical to me recently.

Stay tuned for the results...I can't wait to find out myself!

On Wellness Literacy

As someone studying Health Behavior and Health Education, I have spent time learning about health literacy. In fact, health literacy is perhaps the area of my field I am most interested in.

Healthy literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decision."

As you can see from this definition, there is no mention of ability to read. Health literacy is about more than being able to read. For instance, have you ever walked out of your doctor's office saying that you have no questions. But really, you're not sure how to take your new prescription, or why it is that you're being referred to a specialist.

Low health literacy can affect people of any race, age, income, or education level. Just because you know how to read, write, and speak a language, does not mean that you understand the issues related to your medical care. Doctors are not trained to speak at the patient's level, and when you are trained to use a certain language to speak about something, it's hard to feel like you are communicating the correct information if you don't use that language you were trained in. Basically, doctors, nurses, and health educators have a hard time letting go of words sometimes.

But outside of the medical realm, there are things that you read, hear, and process every day that affect your overall wellness.

For instance, all of the food you eat has an impact on your health. And virtually everyone knows that to be healthy you need to watch your calorie and fat intake. But does everyone know how to read a food label? Sure you may look at it and see the number of calories, but unless the serving size is the same size as the container, you have to do a little thinking about how much you can eat to take in that number of calories.

I was buying popcorn the other day, and I just started eating kettle corn. I wanted to see how many calories I was getting myself into though. I looked down, and thought, this is outrageous! How can lightly flavored popcorn have this many calories. I started to walk away, but decided to take a second look. I knew I had to be missing something.

As it turns out, I was looking at the number of calories that 1 cup of unpopped corn is. The popped amount was far smaller, and closer to what I expected. That's not to say that it got easy from that point on, figuring out the serving size was beyond what I felt like dealing with.

Now in all fairness, if I stop and think clearly about this popcorn label, it takes me about a minute to figure out what it all means. But what if you read at a 4th grade level? What if you have limited numeracy? Staying well in today's world is not as easy as many doctors and even health educators would have you believe.

Media literacy also impacts everyday health literacy. What I mean by this is, if you don't know how to decipher what is credible and what is bullshit in the media, your functional health literacy will likely decrease. You will likely fall for fad diets, or believe that a miracle pill will help you lose weight, or that a new supplement discovered in the jungle will cure cancer. And even if you wanted to go search for more information for yourself, do you know how to tell if a website it credible. And even if that website is full of credible information, will you feel overwhelmed by how little white space there is on the page or how many technical words are used.

I could go on, but I suppose my main concern stems from how incredibly simple and difficult it is to stay healthy in America. And in the public health field, all the attention going to health literacy is focused on the doctor/patient interaction. There is so much more to health literacy though, and only focusing on the medical side will not reach far enough.

Let's not condemn all who make the wrong choices, let's find ways to better present information so they can understand how to make the right choices. Let's put restrictions on health products and claims not reviewed by credible scientists. And let's integrate functional health literacy in to school curriculums.

If only it were so easy...

Video about Public Health

Still not sure what it is that public health is all about? Videos are always a fun way to learn, check this out!

What I spent my semester doing...

Prior to starting school last fall I posted an overview of the field of public health that I am focusing on, health behavior and health education. Now that I am less than a week away from the end of my first half of grad school, I thought I would share the projects I am working on this semester. They are VERY hands on, and should give a better sense of what my field is all about.

Two courses will be covered, the other three aren't nearly as interesting.

HBHE 641: Materials and Methods

This course is basically about how to evaluate and create effective and appropriate health education materials.

Each group was given a community agency to work with, and my group worked with Allegiance Health, the hospital/health system located in Jackson, MI. Allegiance heads up the Health Improvement Organization of Jackson County, and they were looking for a campaign to promote physical activity, healthy eating, and stress management.

My group decided that we want to focus on promoting local resources and finding ways to make healthy choices that make sense for your life.

We started with the idea of a print campaign. We wanted to take photographs of Jackson residents modeling healthy behaviors. As a tying slogan we had the idea "ReThink" health. For instance, we wanted to promote things like playing in the snow with your kids as a way to get physical activity.

After pitching the idea to our contact at Allegiance, we decided to add a website to the campaign. For each of the three topic areas we provided educational material, as well as links to and information about local resources.

Enough with the words though, here's the result...

Print ads (click each ad for a larger view):

The website we created can be viewed here. This is purely a mock-up, and there is no guarantee it will be used by the organization. As a group we decided what we wanted the website to contain, how we wanted it to look, and wrote all of the educational material. Our professor paid for a web designer (a U of M senior who does this as a hobby), to work with us to create the website. In addition, every group had a budget of $200 to create the project. Ours was spent on hosting a focus group to test our materials, providing a thank-you gift for Jess, and a few dollars spent on printing the ads to present in class. This class was amazing.

My internship this summer will actually be with this organization, and I will be focusing my work on materials creation, so I may get a chance to continue work on this project!

The next course will covered in a different post, I'm sure the suspense is killing you ;)