A chaotic view of behavior change: a quantum leap for health promotion

BackgroundThe study of health behavior change, including nutrition and physical activity behaviors, has been rooted in a cognitive-rational paradigm. Change is conceptualized as a linear, deterministic process where individuals weigh pros and cons, and at the point at which the benefits outweigh the cost change occurs. Consistent with this paradigm, the associated statistical models have almost exclusively assumed a linear relationship between psychosocial predictors and behavior. Such a perspective however, fails to account for non-linear, quantum influences on human thought and action. Consider why after years of false starts and failed attempts, a person succeeds at increasing their physical activity, eating healthier or losing weight. Or, why after years of success a person relapses. This paper discusses a competing view of health behavior change that was presented at the 2006 annual ISBNPA meeting in Boston.DiscussionRather than viewing behavior change from a linear perspective it can be viewed as a quantum event that can be understood through the lens of Chaos Theory and Complex Dynamic Systems. Key principles of Chaos Theory and Complex Dynamic Systems relevant to understanding health behavior change include: 1) Chaotic systems can be mathematically modeled but are nearly impossible to predict; 2) Chaotic systems are sensitive to initial conditions; 3) Complex Systems involve multiple component parts that interact in a nonlinear fashion; and 4) The results of Complex Systems are often greater than the sum of their parts. Accordingly, small changes in knowledge, attitude, efficacy, etc may dramatically alter motivation and behavioral outcomes. And the interaction of such variables can yield almost infinite potential patterns of motivation and behavior change. In the linear paradigm unaccounted for variance is generally relegated to the catch all "error" term, when in fact such "error" may represent the chaotic component of the process. The linear and chaotic paradigms are however, not mutually exclusive, as behavior change may include both chaotic and cognitive processes. Studies of addiction suggest that many decisions to change are quantum rather than planned events; motivation arrives as opposed to being planned. Moreover, changes made through quantum processes appear more enduring than those that involve more rational, planned processes. How such processes may apply to nutrition and physical activity behavior and related interventions merits examination.

[1]  N. P. Landsman,et al.  A random walk down Wall Street , 2008 .

[2]  L C Larabie,et al.  To what extent do smokers plan quit attempts? , 2005, Tobacco Control.

[3]  R. Kushner Low-carbohydrate diets, con: the mythical phoenix or credible science? , 2005, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[4]  Kelli A Komro,et al.  Applying Theory of Planned Behavior to Fruit and Vegetable Consumption of Young Adolescents , 2002, American journal of health promotion : AJHP.

[5]  K. Glanz,et al.  Health Behavior and Health Education , 1990 .

[6]  W. Miller,et al.  Motivational interviewing: preparing people for change. , 2002 .

[7]  J. Brug,et al.  Web-based tailored nutrition education: results of a randomized controlled trial. , 2001, Health education research.

[8]  Carrie D. Heitzler,et al.  Physical activity levels among children aged 9-13 years— United States, 2002. (Report from the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, MMWR. 2003;52:785-788) , 2003 .

[9]  J. Brug,et al.  Differences in use and impact of computer-tailored dietary fat-feedback according to stage of change and education , 2000, Appetite.

[10]  A. Åstrøm Validity of cognitive predictors of adolescent sugar snack consumption. , 2004, American journal of health behavior.

[11]  James Gleick Chaos: Making a New Science , 1987 .

[12]  M. J. van der Laan,et al.  Nonlinearity in demographic and behavioral determinants of morbidity. , 2003, Health services research.

[13]  M. Farrell Motivational interviewing preparing people for change (2nd edition) , 2006 .

[14]  David W. Wetter,et al.  Theory as Mediating Variables: Why Aren't Community Interventions Working as Desired? , 1997 .

[15]  Denise Ernst,et al.  Motivational interviewing in health promotion: it sounds like something is changing. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[16]  A. Grossman,et al.  Attitudinal, social, and practical correlates to fitness behavior: a test of the theory of planned behavior. , 1999, Perceptual and motor skills.

[17]  M. Becker,et al.  The Health Belief Model: A Decade Later , 1984, Health education quarterly.

[18]  Applying the Theory of Planned Behavior to Fruit and Vegetable Consumption by Older Adults , 2004, Journal of nutrition for the elderly.

[19]  Tom Baranowski,et al.  Are current health behavioral change models helpful in guiding prevention of weight gain efforts? , 2003, Obesity research.

[20]  D. Rader,et al.  A randomized trial of a low-carbohydrate diet for obesity. , 2003, The New England journal of medicine.

[21]  W. Polonsky,et al.  The Tipping Point , 2007, The Diabetes educator.

[22]  Vicki S Conn,et al.  Older women and exercise: explanatory concepts. , 2003, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[23]  Ken Resnicow,et al.  Motivational Interviewing in Medical and Public Health Settings , 2002 .

[24]  Robert West,et al.  “Catastrophic” pathways to smoking cessation: findings from national survey , 2006, BMJ : British Medical Journal.

[25]  W. Miller,et al.  The phenomenon of quantum change. , 2004, Journal of clinical psychology.

[26]  C. Husten,et al.  Cigarette smoking among adults--United States, 2006. , 2007, MMWR. Morbidity and mortality weekly report.

[27]  Johannes Brug,et al.  Past, present, and future of computer-tailored nutrition education. , 2003, The American journal of clinical nutrition.

[28]  G. Kok,et al.  The Theory of Planned Behavior: A Review of its Applications to Health-Related Behaviors , 1996, American journal of health promotion : AJHP.

[29]  Ralf Schweizer Does God Play Dice? The Mathematics of Chaos, Ian Stewart. 1989. Basil Blackwell, Cambrdige, MA. 317 pages. ISBN: 0-631-16847-8. $19.95 , 1991 .

[30]  Gustav Feichtinger,et al.  A model of chaotic drug markets and their control. , 2004, Nonlinear dynamics, psychology, and life sciences.

[31]  Matthew W Kreuter,et al.  Tailored and targeted health communication: strategies for enhancing information relevance. , 2003, American journal of health behavior.

[32]  Keith Warren,et al.  Substance abuse as a dynamical disease: evidence and clinical implications of nonlinearity in a time series of daily alcohol consumption. , 2003, Addictive behaviors.

[33]  M. Livingstone,et al.  Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials” , 2006, BMJ : British Medical Journal.

[34]  M. Conner,et al.  The theory of planned behavior and healthy eating. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[35]  C. Husten,et al.  Cigarette Smoking Among Adults, United States , 2006 .

[36]  Z. Sloboda CHANGING PATTERNS OF “DRUG ABUSE” IN THE UNITED STATES: CONNECTING FINDINGS FROM MACRO- AND MICROEPIDEMIOLOGIC STUDIES , 2002, Substance use & misuse.

[37]  J C Sprott,et al.  Dynamical models of happiness. , 2005, Nonlinear dynamics, psychology, and life sciences.

[38]  V. Strecher Computer-tailored smoking cessation materials: a review and discussion. , 1999, Patient education and counseling.

[39]  C. Weisner,et al.  Reasons for drinking less and their relationship to sustained remission from problem drinking. , 2005, Addiction.

[40]  A. Åstrøm,et al.  The use of the theory of planned behavior to explore beliefs about sugar restriction. , 2003, American Journal of Health Behavior.

[41]  S. Trost,et al.  Psychosocial correlates of physical activity in white and African-American girls. , 2002, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[42]  I. Rosenstock,et al.  Social Learning Theory and the Health Belief Model , 1988, Health education quarterly.