Marie-Josée (MJ) Salvas Shaar, MAPP '07, CPT, has studied, tested, coached, and taught smart health habits for over 13 years. Combining positive psychology with fitness and nutrition, she created a coaching method that builds better sleep, food, mood, and exercise habits, as described in her book, Smarts and Stamina: The Busy Person's Guide to Optimal Health and Performance, which includes 50 practical health-building activities. Today MJ gives keynotes for corporate wellness programs and offers continuing education for wellness professionals, who can license her Smarts and Stamina Online program. Full bio. MJ's articles are here.
Many sources in the wellness industry erroneously treat the concepts of disease prevention and health promotion as if they were one and the same. Similarly, a lot of people think of health as the absence of illness, something to be detected via health risk assessments, instead of the high energy, clear focus, and joyful mood that come with good habits. That’s a big mistake, and not recognizing the inherent distinction between the two undoubtedly reduces our ability to implement our health intentions. Here’s why.
Disease prevention aims at reducing the occurrence of illness. It involves running away from something undesirable or trying not to fall below zero on a virtual health scale. The messages for disease prevention sound like this: “Avoid diabetes,” “Keep off excess weight,” and “Prevent heart disease.” It is deficit-based and appeals to fear. Disease prevention is the logical next step after we’ve received bad news about health.
Health promotion aims at building stronger health. It involves running towards something desirable or trying to make progress above zero on our virtual health scale. The messages for health promotion sound like this: “Increase your energy,” “Improve your productivity,” “Accomplish your goals,” “Feel sexy doing it.” It is abundance-based and appeals to a broader base of emotions including hope, curiosity, interest, and aspirations for the future. Health promotion connects us to our best possible selves, to the purposes of our lives, to the desire to make a positive difference in the world.
What it Means for Your Health Motivation
Confusing the two is a huge mistake when it comes to reaching for healthy habits. But before I go further, let me relate one of the messages Victor Strecher, PhD, shared in his keynote address at the Art & Science of Health Promotion Conference 2 weeks ago.Research by by Yann Cornil and Pierre Chandon shows that sports fans are influenced by their favorite team’s results in deeper ways than their immediate after-game mood swings. They found that sports fans tend to reduce their sugar and fat consumption by an average of 9% when their favorite team wins. The reverse is also true. For fans that see their team lose a game, sugar and fat consumption increases on average by 16%, probably as a result of trying to overcome the identity threat they feel following the loss. But if you ask viewers to write about what’s most important to them in life, or affirm their core values after the game, the differences disappear between sports fans whose teams won and those whose teams lost.
The application for us is that if we connect with our core values and with what gives meaning to our lives more often, we are more likely to make healthy choices. This is very different from the typical fear-based messaging associated with a disease prevention focus.
When to Use EachAny business leader knows that a driving vision must be a compelling dream, something everyone can aspire to and be motivated by. Why should we be driven differently when it comes to health? When we think we are doing OK, being told that we can reduce the likelihood of the future occurrence of a disease sets the bar too low. It’s not exciting enough, because we’ve turned health into an avoidance goal and not a certain one at that. We know that avoidance goals are weaker than approach goals, never mind avoiding something that is a future possibility instead of a current reality! The vision is not compelling enough for anyone to be moved to action. In addition, the optimistic bias described by William Klein kicks in. We tend to think that the diseases won’t happen to us and the status quo can be peacefully maintained.
That being said, we shouldn’t throw away the disease prevention model altogether. When you’ve just been served a harsh wake-up call by your doctor, when you realize that without change, your quality of life will imminently be seriously diminished or shortened, the reluctance to make changes often gives way to a sense of urgency. In that case, higher energy and joyful moods sound nice to have in the future, but only after implementing the treatment needed to prevent or diminish a very real and compelling ailment.
In other words, if you have been diagnosed or pre-diagnosed with a disease, the consequences of which are harder to live with than the health behaviors needed to alleviate the condition, you will be motivated by the urgency and reality of disease prevention language. For everyone else, health promotion is a more highly motivating concept.
So what are your health goals, and are you using the appropriate strategy to motivate yourself?
Author’s note: If you have been diagnosed or pre-diagnosed with a chronic disease, consider Barclay Schraff’s upcoming online class, Safeguarding Your Health: Disease Prevention through Sleep, Food, Mood and Exercise starting on April 24. In this 6-week online program, Barclay uses the Smarts and Stamina health promotion model to help participants replace bad habits with sustainable, health-promoting behaviors that will strengthen their bodies and minds against chronic disease.
If you are looking for health promotion tips, check out Smarts and Stamina: The Busy Person’s Guide to Optimal Health and Performance. In it, you will find health-building activities activities that you can approach with gusto.
American Academy of Family Physicians (no date). Health Promotion and Disease Prevention: Recommended Curriculum Guidelines for Family Medicine Residents. AAFP Reprint No. 267
American Psychological Association (2013). For Disappointed Sports Fans, Defeats Increase Consumption of Fat and Sugar. Press Release.
Cornil, Y. & Chandon, P. (2013). From Fan to Fat? Vicarious Losing Increases Unhealthy Eating, but Self-Affirmation Is an Effective Remedy. Psychological Science.
Klein, W. M. P. (no date). The optimistic bias. National Cancer Institute, Health Behavior Constructs, Theory, Measurement, & Research. Includes a scale for measuring optimistic bias.
Elliott, A. (1999). Approach and avoidance motivation and achievement goals. Educational Psychologist, 34(3), 169-189.
HealthyCulture.com (2013). Personal Wellness StrengthsBuilder.
Miller, C. A. & Frisch, M. B. (2009), Creating Your Best Life: The Ultimate Life List Guide. New York: Sterling. Includes a discussion of approach versus avoidance goals.
Shaar, M.-J. (2014). Five thinking errors that hurt your health. Positive Psychology News.
Shaar, M.-J. & Britton, K. (2011). Smarts and Stamina: The Busy Person’s Guide to Optimal Health and Performance. Philadelphia, PA: Positive Psychology Press.
Strecher, V. J. (2013). On Purpose: Lessons in Life and Health From the Frog, Dung Beetle, and Julia. Dung Beetle Press.
Tengland, P. A. (2010). Health promotion and disease prevention: Logically different conceptions? Health Care Analytics, 18(4): 323-41. doi: 10.1007/s10728-009-0125-0. Abstract.
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