In the past week, I’ve spoken to two cardiologists about the challenges of behaviour change.
We all know most cardiovascular events are preventable – yet heart disease remains the number one killer in many countries.
Why? In some communities and socio-economic groups, there is a serious need for more education and resources. But, in many cases, the problem isn’t lack of knowledge – it’s resistance to change.
People don’t modify their risk factors. People don’t adhere to their treatment programs.
Successful behaviour change requires desire, knowledge and skills.
As health writers, we emphasise knowledge.
We write ‘how to’ articles about eating better, exercising more, breaking bad habits, making healthy choices and reducing risk factors.
We offer knowledge – but, we rarely sell the desire to change.
There’s tons of health information freely available online, and we know more about disease and risk factors than ever. So, why aren’t our communities getting healthier?
Could it be people are just not motivated enough to want to change?
I believe you have to really, honestly want to do what’s needed to make a healthy lifestyle change a success in the long-term. (And I write this as someone who gave up alcohol for one year and counting.)
Some people – most, even – probably want to be healthy. But, they don’t necessarily want to do what’s needed to get there.
Quit smoking, cut back on drinking, eat less junk, eat more healthy food, exercise more. People just don’t want to make those changes.
That’s why our society loves a quick fix – a super tablet that fixes your ailments, a magic cream to make you look younger, a diet pill that counters the need to exercise and eat healthy food.
Perhaps if we stimulate the desire for change, we can help more people want to change their unhealthy behaviours.
So, how can we, as writers and public health advocates, encourage our readers to want to make healthy changes?
Understanding the unmotivated mindset
In 2015, a group of psychology researchers writing in the journal Frontiers in Psychology asked the questions: how can we motivate the unmotivated, and how can health behaviour be changed in those unwilling to change?
The research group argue that ‘self-determination theory’ offers an insight into the unmotivated mindset, calling the state in which someone lacks the intention to act ‘amotivation’.
People who are amotivated towards health behaviours are:
- unable to identify the reasons why they act, and
- tend to have low intentions and poor uptake and adherence to health behaviours.
Then there are people in a ‘pre-contemplation’ stage. Pre-contemplators have no apparent interest in engaging in health behaviour. They don’t feel a need to change, and they’re also resistant to suggestions of change.
Researchers argue that motivating unmotivated people to change their health behaviours starts with an analysis of the underlying reasons for being in an amotivated or pre-contemplative state.
Influencing the quality of motivation
Amotivation may stem from:
- low levels of self-efficacy – when people feel like they don’t have the capacity or resources to take an action
- outcome expectancies – amotivated people think costs outweigh benefits
- effort beliefs – it’s all ‘too hard’
- value beliefs – amotivated people put up barriers, such as fear of embarrassment, lack of knowledge, unwillingness to invest the time needed
- low-value beliefs – people don’t attach enough value to a particular behaviour, and therefore don’t feel it’s worthwhile pursuing.
It’s not surprising that motivation-enhancing approaches are associated with greater participation in treatment and positive treatment outcomes.
Enhancing motivation starts with reducing amotivation – countering those beliefs that fuel amotivation.
So how can we, as health writers, preempt and counter amotivation?
- Build reader confidence by showing how and why change is easy, simple and straightforward
- Address the belief that costs outweigh benefits by focusing on the benefits that come with healthy change, not only how-tos – a popular, effective copywriting strategy
- Challenge those value beliefs by asking readers to ponder their intrinsic and extrinsic motivators
- Look at motivational interviewing – an evidence-based technique used by health professionals to help patients adhere to their treatments.
Next time you’re writing a how-to piece, try adding some copy that stimulates the desire to change.