Changing behavior

Last week I gave a presentation to an auditorium filled with high school students and their parents who are apart of a college prep program at the school.

The topic? Nutrition. I titled my presentation, “Fueling for Success,” and did my best to connect the dots between what we put in our mouths and how we feel and perform. Come to think of it, I don’t think I even used the word “health” all that much.


Well, long-term health or preventing diet-related chronic disease are both pretty abstract concepts for a teenager to wrap their heads around. There’s a huge time disconnect. These things require considerable foresight. We are doing things now to influence an outcome that’s years down the road.

This isn’t how any teen thinks. Their concerns are more immediate. (Though, yes, chronic diseases, such as type 2 diabetes or signs of heart disease, aren’t all that far down the road as what they used to be.)

So, I tried to frame my entire talk in terms of what teens can relate to – how they feel on a day-to-day basis, and how food choices can influence mental performance (this was a college prep group after all).

But, despite my best efforts, I left the event wondering if I made any difference. My questioning soon took a higher-level view, one of public health in general.

I’ve written before about success in public health. As a health coach and public health professional, what’s my role?

In community-based public health work we talk a lot about behavior change. It’s really the foundation of public health. We try to do things – whether enact policies, create programs, or communicate information – that will consciously or unconsciously enable people to behave in a way that’s best for their health.

But at the end of the day, whose the one responsible for changing behavior? I can stand in front of a room of students and parents and deliver the best content in the world, creatively meshing science and research with marketing and PR.

That’s where my responsibility stops, though. It’s a hard realization to come to, and an even harder one to accept. The success of what I do (improve public health) is entirely dependent on choices and actions that I, myself, ultimately have no control over.

In public health, we hold ourselves accountable for changing behavior. Ask any public health evaluation or researcher about measuring success and they’ll go straight to outcome-based behavior change. But, there’s a big assumption in all of this – that people act.

Every individual has the final say. It’s ultimately up to them, however much I want someone to change their behavior.

Though I may know more about the technical side of health and nutrition, that doesn’t give me a free license. My rationale for why you should change your lifestyle can’t be “because I know better or more than you do.”

Sounds pretty paternalistic doesn’t it? It’s also neither effective nor sustainable. If someone doesn’t internally want to change their behavior, it’s not going to happen.

And then I have to accept it.

You can’t force change.


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