The health promoting behavior I decided to focus on was exercise.  I chose exercise because it can help combat a multitude of illnesses and diseases, and I am trying to fight off two health issues: high cholesterol and my risk of getting cancer.  Long-term exercise has been shown to decrease high cholesterol levels, (and/or restrain bad cholesterol from getting to high levels) (Wilund et al., 2009, p. 549), and exercise can also help prevent cancer (Kincaid, 2007, p. 615).  I perceived both of these health issues as my primary risk factors because they were/are present on both sides of my family, and these health risks can arise in a person due to genetics.  My genetic predisposition for high cholesterol and cancer puts me at a greater risk of contracting either one of them more than somebody who does not have the genetic vulnerability.  One way I try to combat these health risks is via exercising.

 

          After reviewing my tracking sheet, one can probably tell that I did not just start exercising when I started tracking my behavior.  I started exercising when I was in middle school; I went through a time in my life where I was unhappy with the way I looked, my friends treated me terribly, and I had very low self-esteem and confidence as a result.  Because I was feeling so down about myself, one day I decided I wanted to make a change in my life, start eating healthier and exercising, and since then, I never looked back on my road to a healthier being.

 

          It was very interesting for me to read in our Health Psychology book that middle school is a crucial time for health behaviors.  In middle school, students are in a “window of vulnerability” (Taylor, 2012, 49); at this point in their lives, the students are starting to socially shift their focus from their family to their peers, which can lead them to possibly partaking in certain risky behaviors due to social pressures, the extreme examples are engaging in drugs and alcohol.  Middle school is an important time for the development of health-related habits, like choice in snacking, dieting, and food choices, because these health-related behaviors begin to crystalize at this point in an individual’s life (Taylor, 2012, p. 49).  That is why it was so important that I made a change in my exercise behaviors before my fairly, sedentary lifestyle was crystalized.

 

          I have been exercising for over seven years now, which puts me in the maintenance stage of the Transtheoretical Model of Behavior Change.  In this stage, people work to “prevent relapse and to consolidate the gains they have made” (Taylor, 2012, p. 68).  I am trying to prevent relapse of barely exercising; moreover, before modifying my behavior, I would not push my body hard enough to actually produce perspiration when I worked out.  I also want to maintain the endurance level I have reached; prior to changing my exercise habits, I could barely run one mile, and now I can run over three-and-a-half miles.  Therefore, in order to prevent relapse and keep my endurance level up, I have to continue exercising. 

 

          This maintenance stage may be the hardest step, for many people return to their old ways after loosing weight, or reaching the goal in which they wanted to reach.  For example, say a person was training to run in a marathon, trained all year for it, ran the marathon, and then stopped exercising after the race because they had reached their goal; in other words, people may “take action, attempt maintenance, relapse, return to the precontemplation phase, [and] cycle through…the stages [again]…” (Taylor, 2012, p. 69).  It is so important for people to keep up the behavior change they have started once they enter the maintenance stage because they have already worked so hard to get to that last stage of the stages of change model.  People need to keep up their willpower, stay in the maintenance stage and work to prevent relapse.  That is why it is important to employ different models and techniques to keep a behavior modification stimulating and not dull.  Relapse prevention is effective when people think of their behavior change as a long-term goal, use coping techniques in high-risk situations, and when they integrate their behavior change into their lifestyle (Taylor, 2012, p. 67).  I have prevented relapse by integrating my behavior change into my lifestyle; every morning or afternoon, about an hour after I eat breakfast, I workout; this routine helps me maintain my exercise regime.  I also think of exercise as a life-long habit in order to stay healthy, which also helps sustain my exercise routines.

 

          A model that is very influential to maintain my behavior modification is the health belief model.  The two factors that determine if a person will perform a health behavior are: 1) whether a person perceives a personal health threat, and 2) whether a person believes a particular health practice will be effective in reducing that threat (Taylor, 2012, p. 54).  Because I believe high cholesterol and the possibility of obtaining cancer are two health risk factors for me, I exercise to try and reduce those threats.  This intrapersonal model incorporates four main components, which are: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers (Taylor, 2012, p. 54 & 55).  Individuals assess these four components based on their specific health risks/problems.  For example, I realize that I am susceptible to having high cholesterol and/or cancer because of my genetic vulnerability, and I realize that these health conditions can be severe and detrimental to my health.  However, I know that if I exercise, I will/can decrease my risk of these health issues.  With any behavior modification, there may be some barriers I encounter in life that may hinder my ability to exercise, but I will overcome such barriers.  For example, say I was planning to run on the treadmill, but we lost power due to a storm.  Instead of running on the treadmill, I could run up and down the stairs to still get in my cardio workout.  Another barrier I could encounter may be a social barrier.  Say my friends are all going to the shore for a weekend and invited me to go with them.  There is no gym around the residence in which we stay at the shore, so I would have to find other ways to be active, like walking and/or riding bikes to the beach or boardwalk.  Evidently, one has to have a creative mind in order to overcome barriers they encounter with his/her behavior modification.  Overall, the health belief model has been successful in modifying and maintaining my health promoting behavior of exercising.

 

          The health belief model is not the only health intervention/model that applies to my health behavior modification.  Because we are tracking our health behaviors, the cognitive behavioral approach is also in use.  Cognitive behavior therapy (CBT) focuses on the behavior itself and having the client serve as a “co-therapist” by tracking his/her behaviors.  This successful technique used in CBT is self-monitoring or tracking a behavior (Taylor, 2012, p. 58); just by charting or tracking one’s behavior can be sufficient to spur a behavior change. 

 

          Monitoring behavior can produce the Hawthorne effect, which states that a person is likely to change a behavior if he/she knows they are being monitored (Mangione-Smith et al., 2002).  I can relate to Hawthorn effect when I first started to change the way I was eating and exercising in middle school; I went to Weight Watchers and lost about thirty pounds after changing my health behaviors.  The most impactful thing I did, which Weight Watchers requires, is write out everything I ate on a tracking sheet.  I was shocked the first day I reviewed everything I had recorded consuming.  This alone made me want to change the unhealthy foods I had consumed into healthy foods.  Just recording what I had eaten made me want to change my behaviors; moreover, the Hawthorne effect influenced my behavior modification regarding my eating habits.  Now, tracking my health promoting behavior of exercise motivates me to exercise so I actually have something to record.  Cognitive-behavior therapy can help stimulate change in a person, and something as simple as tracking one’s behavior, can be very influential and help make/sustain a behavior modification.

 

          Another technique I use to help maintain my exercise is by switching up the exercises I do, and I do this by occasionally watching exercise tapes/videos; here, I employ the modeling technique.  Modeling is learning that occurs when one sees another person perform a behavior (Taylor, 2012, p. 61), which is what people do when they watch exercise videos.  For example, I will pick from a variety of DVDs I have, or go to “On Demand” and pick an exercise video that appeals to me that day.  Then, I watch the person on the tape and try to mimic what they do.  However, I consciously choose videos that are within my abilities and skill level, so I can relate to the instructor or trainer, and perform the exercises he or she is doing.  If I pick, for example, a beginner yoga video, it would be hard for me to relate to the instructor; I would most likely be bored, and not do the poses shown out of ennui because I am at a more advanced level in yoga.  This is why it is so important to make sure that a relation can be made between the “model” and person trying to change their behavior (Taylor, 2012, p. 61), because if no connection can be made, then it is unlikely the behavior modification will take place.

 

          Psychological techniques can also help a person through a behavior modification; some techniques that help me stay in the maintenance stage of exercising are by using self-control and mindfulness.  I have to act as my own personal trainer and motivate myself to exercise.  Some days, I have to force myself to exercise because I feel tired, but making exercise a mandatory behavior actually energizes me after performing the exercise and enhances my mood and self-esteem.  So, having good self-control makes it easy for me to follow my behavior modification and stick to my exercise plan.

 

          Another useful technique I use quite often is mindfulness.  When I first started exercising, I would run three miles every day and do a very intense circuit workout after each run; I did not give myself even a day of recovery.  My menstruation cycle had ceased to exist and I was doing more harm than good for my body; moreover, I was pushing my body too hard and certain body systems, like the reproductive system, shut down.  Then, when I started to pay attention to my body, I realized that I was over-exercising and needed to make a change.  My body was telling me I was pushing my body too hard by having my menstruation cycle stop.  Therefore, I scaled back my workouts and now only run 3 miles a few times a week, rather than every single day. 

Something that has helped me be mindful is yoga.  Yoga has helped me be in tune to my body and really listen to the bodily sensations I am feeling; it allows me to attend to muscles and body systems that need to be tended to via meditation and through the various poses that we flow through.  After realizing how important it is to be mindful and listen to one’s body, I always stretch before and after I exercise, which is a good time for me to do a quick check on how my body is feeling.  For example, after running I stretch and pay attention to what muscles feel tight.  If I feel like my hips are tight, I will do more hip opening stretches, and if I feel my neck is tight I will do more neck stretches.  Being mindful helps keep my body in check of making sure I care for it properly. 

 

          I will continue to use the mindfulness technique to pay attention to my body and make sure I am not pushing myself too hard with exercising; with that being said, I will run about three-and-a-half miles a few days a week, and make sure I am eating enough to compensate for the calories I burn.  Since I have conditioned my body to be in an exercise routine, I will continue to exercise in the morning to help kick-start my days, or find another time in the day that is convenient for me to perform my health promoting activity.  I will also continue to switch up my workouts by employing the modeling technique when I watch exercise videos; these videos help keep exercise interesting and exciting, which prevent me from becoming bored with my exercises.  These techniques will help me stay in the maintenance stage of the Transtheoretical Model of Behavior Change, (also known as the stages of change model), and reduce my health risks of high cholesterol and my risk of cancer.

           

          Reviewing my behavior modification, I have used multiple techniques to help maintain my behavior modification of exercising.  One technique I used was called mindfulness.  This technique helped me stay in tuned to my bodily sensations, and really listen to what my body was telling me.  For example, if I noticed my legs felt tight after running, I would stretch my legs until the tight-feeling was released; additionally, doing these leg stretched helped blood flow to such areas, reduced the risk of exercise induced injury, and improved flexibility, which in turn enhances one’s performance (Mayo Clinic staff, 2011).  I noticed that on days I was not mindful, and rushed through stretching, I did not feel as good as when I was mindful.  For example, I was running late to meet my friend for lunch after I had just ran 3 miles, and I rushed through stretching at the end of my run because I wanted to fit in a quick circuit before I had to go.  Immediately after exercising, my muscles felt extremely tight and ached.  I realized that I had not stretched sufficiently, and my body was informing me.  When one does not listen to his/her body, consequences result, like having tight and/or aching muscles.  That is why it is so important to listen to bodily sensations because every sensation is trying to tell you something, good or bad.  For example, if one feels that their muscles feel tight, his/her body is trying to tell him/her that they need to stretch to relieve the tight feeling in their muscle.  Being mindful helped keep me in tune to my bodily sensations.

           

          The mindfulness technique also helped ensure that I was not over-exerting my body.  Especially if my muscles felt tight after running over 3 miles one day, I would listen to my body and not push it too hard the next day.  Additionally, I only allowed myself to run 3 miles or more a few times a week, rather than every day.  Prior to being mindful, I was pushing my body too hard and running three miles or more every day, not giving my body even a day to rejuvenate.  Listening to my body helped me cut back my exercise, while still doing some form of exercise daily without over-exerting my body.  In other words, I want to exercise to be healthy, not to harm my health status by pushing my body too hard; furthermore, the mindfulness technique has helped me achieve an optimal level of exercise.  Additionally, being mindful ensures that I am eating enough calories to account for the calories I am burning during exercise.  I make sure I eat enough so I have enough “fuel” to exercise and sustain enough energy for the rest of the day.

           

          Modeling was another technique that helped me maintain my exercise regime.  I employed this technique when I watched exercise videos; moreover, I would watch the trainers on the videos, and try to mimic the moves they were doing.  Mimicking their moves helped me try a variety of exercises that were novel to me, which helped keep my exercise routine exciting and new.  For example, if a person does the same routine every day, he/she may feel as though their routine is monotonous after partaking in it every day, which is why changing up my exercises helped me stay in my exercise plan by keeping it exciting.  The videos helped work all different muscles, and every week I tried to work as many different muscles as I could; the more muscles one exercises, the healthier they will be (2009).  In other words, the modeling technique made me want to try new moves and work different muscles.  Working a variety of muscles is beneficial for a person’s health because if one works the same muscles over and over again, they are ignoring the numerous, other muscles in the body; furthermore, those muscles may be overworked, and the lack of attention being given to other muscles, can cause a person to feel imbalanced within themselves (Clausen, 2013).  For example, if a person just worked on their leg muscles, they may feel as though they have no upper-body strength; additionally, they may look abnormal because they have big leg muscles, yet little or no arm, shoulder, and abdominal muscles.  This is one reason why it is important to try novel exercises and work different muscles that have not been worked.  New exercises help maintain homeostasis and balance within a person, and the modeling technique can help one learn/perform new exercises to work a myriad of muscles.

 

            In addition to these techniques, I continued to exercise the majority of my days in the morning.  Research has shown that exercising in the morning can be beneficial, because it helps a person achieve a better night’s sleep; furthermore, morning exercise affects the body’s circadian rhythm so one can receive better quality sleep (Davis, p. 1).  Morning exercise also ensures that people will not cancel their workout plans if it is integrated in their daily life and becomes a part of their regular routine (Davis, p. 1).  For example, exercising in the morning is a good time of day to workout because it helps kick-start the day with energy before one gets tied up in running errands, or in his/her schoolwork or job.  It also helps to think about exercise as a “business appointment–one can’t easily cancel” (Davis, p. 1); in other words, making exercise a mandatory activity can help a person stay on track with his/her plan.  In conclusion, I mainly exercised in the morning to not only rev my energy immediately at the start of my day, but also to ensure I exercised before I got caught up in my day, and to receive the additional benefit of achieving a better night’s sleep.

 

            All of these techniques and working out in the morning helps me stay in the maintenance stage of the Transtheoretical Model of Behavior Change.  Continuing to exercise will reduce my risk of mortality and morbidity for all illnesses since I am engaging in a health promoting activity.  Exercise will especially help reduce my risk of obtaining high cholesterol and my risk for obtaining cancer.  As previously stated, exercise helps reduce the risk of contracting cancer, as well as reducing the risk of high cholesterol by preventing plaque buildup in one’s arteries.  However, exercise will also benefit other regions of my body, like my mind,  as it promotes and maintains brain health and plasticity (Cotman & Berchtold, 2002, p. 299); in other words, exercise helps maintain memory, which typically declines as age increases.  Therefore, exercise benefits many different areas in the body, as well as the mind.

 

            In conclusion, I will continue to maintain my health promoting behavior of exercise, for it will reduce my risk of mortality and morbidity for all health risk factors.