European Stars And Stripes (Newspaper) - May 23, 1987, Darmstadt, Hesse                                Making behavioural changes stick by Janee. Brody new York times Eer pressure group support external rewards and a nagging spouse May prompt people to change their bad health habits. But these popular incentives alien backfire in the Lona run Accord Iarj of a is Oflinn specialist in health pro Niolion. If people make behavioural changes without changing their internal values beliefs and attitudes the new Behaviours Are less Likely to stick when the external supports  the specialist. Or. Lawrence w. Green said in an interview. Green is director of the Center Lor health promotion research and development at the University of Texas health science Center in Houston. He said an analysis of his own research and other recent studies suggests that health promotion efforts have relied too much on peer groups social pressures and even financial incentives to influence behaviour. I m developing a growing concern about the gimmickry used in a Tor of programs. A3 soon As the poem group disappears or is no longer forced to behave in a certain Way the pressure is or the individual and tie reverts Back to his bad  Green says this is Why people who participate in weight loss or Slop smoking groups so often relapse after the Iwig the group. As he explained usually there is an informal Short term attachment to an a i facial temporary group of people brought together without any relationship to each other except for their shared health problem. When Tiro group ends each participant goes Back to his own environment without those Strong social  one of the Tew groups with a High degree of lasting Success is alcoholics Anonymous. A is unique because if is not a transitory group Green said. Individuals Mako a deep lifelong commitment not the try this for awhile and see if it works " even those who leave a often join some other organization that supports Ihetu continued sobriety. Though Green s observations May Soi d like common sense he said that in the decades since the theories of . Skinner gained dominance in behavioural psychology values attitudes and beliefs have been neglected As factors Hal Are important in changing behaviour. But when a person is left to his own devices that s what he must tall Back on he said. Green conceded that groups can be very supportive for people who have already undergone a conversion of values beliefs and attitudes. But he added if you re using the group in order to instigate conversion it becomes coercive process. You re not following uie dictates of your own conscience so much As you Are conforming to the  the same is True in the Case of a significant other who instigates the behavioural change. A significant other can be a powerful stimulus for behavioural  Green said. But if you Are taking action merely because someone else wanted you to you re not Dang in because you wanted to and you Are much less Likely to persist in that  he cited a study of 400 patients suffering from High Erma Bombeck fhe i Hill Jupi a tote of foot turn Grote support program wish � High Dogma of letting dec a it alcoholic Anonymous. Blood pressure. The purpose of the study conducted at Johns Hopkins University was to determine what Best prompted patients to comply with the prescribed treatment. One group attended explanatory sessions with a health Counselor another attended voluntary group meetings and for the third a Counselor made a Home visit with a family member who had influence on the patient. In the Short run the Home visit was most effective Green said. After two years these patients compiled Best with the medical regimen and prescribe diet kept More of their follow up appointments and achieved the Best blood pressure control but in the Long run five years later. Those in this group had the worst medical record a said. In another study of women attending a family planning clinic in Pakistan those who came at the urging of a personal Friend or family member we a less Likely to return than those who came on their own in response to an advertisement for the clinic. When you bypass the patient himself As the target of the education you set the person up for Long term failure because there is no underlying change in the person s belief system Green said. He explained that people typically influence each other through two pathways of personal identification. In one. The reciprocal relationship you do what another person wants you to do because you want to maintain the relationship i do this for you because you do something else for  in the second you mimic the behaviour of someone you Admire. This occurs for example among teen agers who mimic idols or children who copy their parents behaviour. It is also the principle underlying the effectiveness of Many advertisements such As for Virginia slims or Marlboro cigarettes. Bui when trying to use the influence of personal identification to change bad health habits the gimmick can backfire Green said. The individual May get angry or disillusioned with the role Model or. As soon As thai Model is out of sight substitute  i m afraid that the More we depend on such expedient methods Lor achieving Behaviours changes the More we May be undermining Long term Success. As for the nagging spouse Green said thai this approach can sometimes galvanize resistance to behavioural change. The person under pressure to change May think of reasons that the desired action is not possible and with each subsequent urging the person reinforces his belief thai change is impossible. The internal conversion that is most Likely to result in lasting changes in health damaging behaviour starts with a belief in susceptibility Green said. The person has to gel beyond Anonymous statistics to realize that this could happen to him he said. Next comes a belief in the severity of the problem that in is something Worth worrying about. Finally comes the belief thai what you do about the problem will accomplish the desired health preserving Elf eel. For most people Green noted health n not a terminal value an end in  rather he said people Are concerned about health in order to be More attractive More effective More competitive and less dependent. Health has to be attached to values that Are already important to the individual holy Robin Leach can you believe the Flap Over Raisa Gorbachev dropping a Lew Bucks on jewelry during a recent visit to London critics who viewed Russia s first lady on an underground video yet As she signed her american express card accused her of being extravagant vain and caught up in the decadence of the Western world. I Hale to say in but in the shopper s race the soviet Union is a Good 200 years behind the Resl of Iho world while they were sitting Over there stockpiling missiles and connecting dots on All those Horal print dresses the rest of the world was turning its technology toward shopping emporiums London launched harrods. Japan positioned issey Minahe Hong Kong perfected a fabulous silk factory called Kaise estates phase i. And frankly if i saw Page 16 the stars and stripes Bloomingdale s and Bergdorf Goodman aimed toward me from the United states. I would t sleep Well in the soviet Union tonight. In All the years the world s ton most famous shoppers has been circulated not once has a russian woman made the Tisl. Most of them Are first ladies and powerful women like Tammy Faye Bakker who recently launched he secret weapon Lor dealing with Lite s problems. When i m shopping. I Don l think about the Bills at pal. There s limes i just have to quit thinking and the Only Way i can quit thinking is by  if mrs. Gorbachev is really serious about making Russia a super shopping Power she should learn the first Rule about shopping never sneak around and do it alone. Alert the press corps and make every 6 and 10 o clock newscast in the world. Before Ferdinand Marcos oven made airline resort hons to return to the saturday Way 23.19s7 Philippines in a takeover the first thing he did was to gel Imelda shopping at the banana Republic for takeover clothes. Don t be too embarrassed or too proud to study and to follow the Lead of shoppers with Moe experience. Wherever there is a Summit meeting ask yourself Why in t Nancy Reagan going to Reykjavik and then answer i Ourse Why would you want o go anyplace where they Haven t heard of Adolfo i would say Raisa has her work Cut out Lor her. The wives of soviet leaders weren t even visible until her husband came to leadership. If they did appear in Public they were airbrushed out of the photographs. On the other hand if she s airbrushed out of the next state photo Well know the russians Aren t up to decadence