Modifiable behaviors, such as smoking, obesity, alcohol and lack of exercise are responsible for nearly half of the leading causes of American deaths, according to the review, published in the April issue of the American Journal of Preventive Medicine.
“Increasing awareness that one has some personal risk of harm, or has already caused physical harm through unhealthy habits, may increase motivation for health behavior change,” says author Jennifer B. McClure, Ph.D., of the Center for Health Studies of the Group Health Cooperative in Seattle.
Studies that assess the use of biological indicators of health status, referred to as biomarkers, to motivate people to take better care of themselves have produced mixed results, but when analyzed together a pattern emerges, McClure says
In her analysis of eight randomized studies, those studies that did not show a significant effect on motivation or behavior change used a single health indicator, tested on one occasion. In contrast, studies that showed positive results used a single indicator assessed at multiple visits or multiple indicators assessed at a single visit.
For example, in one study, patients informed of their carbon monoxide levels (resulting from smoking) and genetic susceptibility for lung cancer were twice as likely to attempt to quit smoking compared with similar subjects who were not provided feedback on their personal disease risk.
The health indicators reviewed include cholesterol level, carbon monoxide level, lung cancer susceptibility genes, depressed breathing function and other pulmonary symptoms and physical fitness.
The studies explored the effects of health indicators on tobacco use, dietary change and physical activity. The number of participants in each study varied from 90 to more than 2,000.
“The prevalence of behavior-related disease in our society makes it critical that we continue to improve our ability to promote more healthful behavior. To be effective, this work should be based on empirically validated techniques,” says McClure.
Although the results of this work suggest that health indicators that convey quantitative information about harm exposure, disease risk or impaired physical functioning may increase motivation to engage in more healthful behaviors, appropriate treatment may be necessary for lasting behavior change.
However, conclusions are limited by the dearth of randomized studies on this subject. This field of research has also so far not explored the potential psychological damage that could result from telling people they have done harm to themselves, she says.
Funding for this review was provided by the Robert Wood Johnson Foundation and the National Cancer Institute.
The American Journal of Preventive Medicine, sponsored by the Association of Teachers of Preventive Medicine and the American College of Preventive Medicine, is published eight times a year by Elsevier Science. The Journal is a forum for the communication of information, knowledge and wisdom in prevention science, education, practice and policy. For more information about the Journal, contact the editorial office at (619) 594-7344.
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American Journal of Preventive Medicine