Stealth Interventions for Obesity Prevention and Control

Publisher Summary Stealth interventions can take multiple forms. As demonstrated in interventions to reduce children's screen time, emphasis is placed on incentives for the process of behavior change rather than outcomes, by using frames to enhance intrinsic motivation such as perceived choice and control, individualization, fantasy and contextualization, challenge, curiosity, and cooperation and competition. These design features make the process of behavior change rewarding, easy, and desirable rather than a sacrifice or burden, as “diets” and “exercise” are often perceived to be. These same approaches can be applied to the design of other nutrition and physical activity interventions to raise the incentive value of participation, rather than trying to persuade participants to change through reason and logical arguments. Taking stealth interventions to the next level is to identify or structure health-promoting environments and activities that are motivating in themselves. As shown, after-school ethnic dance classes for girls can redefine sustained moderate to vigorous exercise (with its perspiration, fatigue, and soreness) as a highly rewarding and fun, cultural, social, artistic, and political activity. These interventions are designed such that, from the perspective of the participants, physical activity, diet, and weight changes are positive side effects of their participation, rather than the primary motivators. Finally, the next logical step for the stealth intervention approach is to harness the motivational appeal of existing and emerging social and ideological movements, to achieve greater and more sustained effects on behavior.