Episode 23: Will you be one of the 8% who keep their New Year's resolutions? Understanding behavior change.
Release Date: 12/16/2016
Guest:Rose Marie Ward
Dr. Rose Marie Ward is a professor in Miami University's Department of Kinesiology & Health. She studies college student health, with a focus on both addictive/harmful behaviors (alcohol use, disordered eating, unsafe and unwanted sexual behavior) and prosocial activities (women’s leadership, life satisfaction, scholastic achievement, exercise, and athleticism).
Rosemary Pennington: We’re in the tail-end of 2016 and as many count down the days until the year’s end, others are counting up to the start of their New Year’s resolutions. About 45% of Americans say they make resolutions each year which might include hitting the gym more frequently or carving out more time for self-care, but only 8% say they stick to their resolution all twelve months. Typically people begin to work toward those goals with vim and vigor, most losing steam about two weeks in, often leaving the resolution breakers feeling guilty and frustrated. What they have unknowingly encountered is something researchers have been struggling with for years, the difficulty of changing human behavior. That’s the focus of this episode of Stats and Stories, a program where we look at the statistics behind the stories and the stories behind the statistics. I’m Rosemary Pennington; joining me on Stats and Stories are our panelists, Miami University Statistics Department Chair John Bailer and Media, Journalism, and Film Department Chair Richard Campbell. Our guest today is Rose Marie Ward. Rose Marie is a professor of kinesiology and health at Miami University; she conducts research on human behavior. The classes she teaches at Miami are often focused on research methods and behavioral statistics. Rose Marie, thank you for being here. As I was doing research on resolutions and looking for statistics on how well people keep their resolutions, what I kept coming across over and over again were stories about how they don’t. People might keep it for a week and they flame out really hard. So what is someone who is thinking about making a change going into 2017, whether it’s small or large, what are they supposed to do with this information as they’re figuring out the step they want to make to make that change?
Rose Marie Ward: That’s an excellent question and it really depends on what stage they’re interested in in changing their behavior. So in behavior change theory we think that there are five stages of change and so that first one is precontemplation. And there’s actually people who, with the New Year, aren’t even thinking about changing their behavior. Whether it’s testing their house for radon, whether it’s stopping eating that fried chicken, all those kind of things. Some people aren’t even thinking about changing it at all. And when you’re working with someone like that, we tend to give them a lot of information, remind them that behavioral change happens when they have a peer keeping them in check. So having that social support really helps. If somebody, instead, is thinking about it, they’re in contemplation. And there are actually a lot of people out there that are chronic contemplators that are always thinking about exercising, always thinking about changing their behaviors. Maybe you know a couple people, I tend to know a lot of faculty like that. And so when they want to change their behavior, a chronic contemplator or somebody in contemplation, it’s good to have those situational cues. So putting their shoes by the door if they want to work out or having their gym bag in their car when they want to work out, but then also having somebody at the gym that’s going to meet them there. So it’s that combination of situations that cues, that reminds them, it’s known as stimulus control and the people that can help them keep in check. If somebody’s in preparation, so they said they’re going to do it and it’s going to be in the near future. So this is the period where we see a lot of people preparing to change their behaviors because New Year’s is right around the corner. Those are the people that really could benefit from a lot more information but also, interestingly enough, some policy changes. So if Miami wanted to make some kind of benefit for us with our change of our insurance that happens with the New Year, that could help more people be working out or quit smoking or other things. So that policy is called social liberation could help us change, in addition to social support of having their peers. But at this point, when somebody is in preparation, they’re really aware of all those positive things to change their behavior and so it’s also reminding them there are some negative things to changing your behavior and how can you work on that when those situations arrive? The next group of people that will change before the New Year even starts and they’re called action. And they are really gung-ho about it but those are the people that you were talking about that were flaming out. So when somebody’s in action, once again, it’s thinking of all those behavior strategies I gave for the other stages, but how can we get them to the next stage of maintenance by using those? By building from their relationships with other people, by changing their environment, by changing how they talk and think about things can help people sustain their behavior into that maintenance stage, which is maintaining it for six months or more.
John Bailer: So as you think about this, this is a very general framework. And thanks for the quick review of that, that’s really nice, a foundation to think about this. When you work in this arena, you don’t work generally, you work in particular types of behavior change so what are the things that you have studied?
Ward: So I’ve looked at eating disorders, alcohol, and sexual assault primarily, all with college students. And so with alcohol, what’s really interesting is a vast majority of students are binge drinking with no intentions of stopping. And so when we think about that population and that behavior change, we have to use different strategies. And so some of the things I talked generally aren’t going to apply. I could say, “Have a buddy that’s going to help you not drink.” Well most of them aren’t even thinking about stopping drinking because they think to have a buddy they have to drink. Our social situation has set up some reinforcing of the negative behavior and so for us to change that alcohol, we would have to change the social situation and put in policies to show that they could have a social situation without it.
Bailer: That sounds like it’s pretty much outside of that framework.
Ward: Well it’s still within the framework. So with each behavior, when we look at the stages, different things get targeted or we see are more effective with the stages. I pretty much gave you a general addiction model when I was giving the overview. But when we look at exercise, for example, and maintaining that, going from action to maintenance, those people are always tempted to stop. I’ll speak for myself, every morning I get up at 5:30 and I run and every morning my sheets and my warm bed just scream out, “Stay in bed!” So when you’re thinking about maintaining exercise, you have to work on those temptations the whole time, even when they’ve been doing the behavior for a long time. When we’re talking not just exercise, when we talk about smoking, we actually see the temptations actually decrease over time. So they don’t have to think every day, “Oh I’m going to quit smoking.” They may for a period of time but we actually see past that six month mark, smokers have a much higher likelihood of staying in that maintenance stage than our exercisers. You bring up a good point, depending on what behavior we’re talking about, different strategies are going to be more effective.
Richard Campbell: You’ve come to my University 101 class and talked about drinking. One of the things that surprised me, and this is two years in a row, is the number of students who say they don’t drink. So first, I think it’s around 30%, and is that kind of a national figure, do you know? And do you believe that number? We’ve talked a lot around this recent election about whether people can trust what pollsters soliciting in terms of answers and whether people are truthful.
Ward: I think people are truthful, first of all, on my surveys. So I’m going to say I trust my numbers, do I trust the polls, that’s a whole other question. But the data I collect here at Miami, I’m always surprised how open and honest the students will be because not only are they honest on the anonymous, online surveys, but when I go uptown and we’re breathalyzing students, they want to talk to me about their alcohol. They want to talk to me about their eating disorders. They see it as normal, normal-speak, so it’s no big deal. And also it’s interesting there is a number of studies out there talking about, “How accurate are they?” Well they’re not really good at knowing how much they’re drinking, but they’re good at knowing they’re drinking a lot. So in terms of the not drinking, I do trust that about 30%. The reason why most people don’t here at Miami is because all you see are the drinkers. The non-drinkers are not the ones getting in trouble. They’re not the ones out socializing uptown. They’re not the ones that are vandalizing or causing problems in the classroom.
Campbell: You said earlier that you were concerned because some of the students who categorize themselves as binge drinkers have no intention in changing. So one of the things, when you present numbers and data on this, do you do follow-up and study, does that have any change when somebody actually know the data, know the numbers, know the risks?
Ward: That’s interesting, you’re bringing up a social norming campaign. We’ve done a little bit of that here, we have not done that broad here at Miami. What I have noticed, that anecdotally, working with my students, when they see that and they see the numbers, my students do change their drinking behaviors. I will recruit heavy drinkers into my research lab on purpose because who else is going to tell me about college student drinking other than the drinkers, and I get non-drinkers, but they change their behaviors across the time in the lab, which is really amazing.
Pennington: You’re listening to Stats and Stories where we discuss the statistics behind the stories and the stories behind the statistics. Our topic is the difficulty in getting people to change their behaviors. I’m Rosemary Pennington; joining me are panelists Miami University Statistics Department Chair John Bailer and Media, Journal, and Film Department Chair Richard Campbell. Our guest is Miami University Kinesiology and Health Professor Rose Marie Ward. Rose Marie, I want to go back to something, when you were talking about the cigarette smokers and the six months it takes to get them through the rough part. If we’re translating that into other kinds of behavior change, what sort of policies or practices can support networks, whether it’s the university or families or friends put in place to help these people who are trying to make that change? Whether it’s to quit binge drinking or quit smoking.
Ward: That’s an excellent question. It’s interesting because we tend to think of people’s behavior as individuals and in actuality, we could probably talk right now and spend plenty of hours talking about how Richard’s behavior or John’s behavior is not dictated by their own decisions. It’s by what opportunities we have around them and the people we have around them. And we see that with smoking and exercise and eating disorders and alcohol, that if we look at your network, not only do your friends impact your behavior, your friends’ friends impact your behavior, and your friends’ friends’ friends. We make the joke about how if I’ve dated someone, I’m sorry, Richard, you can’t date them. But the same thing is there’s those degrees of separation and in social network analysis we know that not only do you influence one, two, and three out, 11% of that third degree out, you still impact their behavior with your choices. So with respect to addiction stuff like smoking or alcohol, we need to work with those key, very centralized people, change their behaviors, but also realize we’re going to have to get all the people around them as well, to be involved. It’s a system that we need to kind of break down. And there’s this great study by Nicholas Christakis that shows that when we look at obesity and smoking, if we can change those key players, the smokers who used to be central to the network actually go to the fringes. And so the network as a whole becomes more healthy because all those degrees of separation. I mean we could make jokes about Kevin Bacon if we wanted to, do we need to put other buzz names in here?
Bailer: One thing that it seems like there’s a real challenge, in some of the research area, you’re looking at people and studying movements and change where people don’t necessarily want to change. One aspect of resolutions are these are things people think, “I want to do this. I’m going to make this positive change in my life. This is for my health.” It could be financial health, it could be personal fitness, there’s a different component to this. The question that I had was when I think about the behavior change and the stages here, there’s some really interesting questions if you’re trying to study that may draw conclusions, is how do you measure this? Because you’re talking about measuring behavior, I mean you can measure cigarettes by how much you smoke or exercise by how often or minutes you exercise, although maybe that’s not adequate in terms of measuring some of this. But measuring where you are in terms of this scale from precontemplation to this maintenance component, what are some of the things that are required for trying to develop such a scale?
Ward: That’s a good question, as well. For scale development here, we develop something called an algorithm and we measure that based on their thoughts about changing. So do you intend to change your behavior in the next six months? Any behavior there, so do you intend to stop binge drinking in the next six months? And we define binge drinking for people and so depending on whether they say yes or no and then we say, do you intend to change your behavior in the next 30 days? And so six months gives us whether or not they’re at the action/maintenance criteria, 30 days gives us if they’re in preparation and if they’re not even thinking about it we know they’re down in the precontemplation. So we actually have a one-item staging algorithm for most of the behaviors and based on the response option, we can put them into the stage.
Campbell: So based on what you just said, in terms of getting change, is part of the reason why you have this response that a lot of binge drinkers don’t really plan on changing is because they dramatically would have to change their social networks to do that, right? One of the things they do in alcohol treatment centers is when they send you out of there, you have to find new friends. That’s a real challenge here. So how can we change this culture? This is of course a national problem, not just a Miami problem.
Ward: It’s definitely a national problem. What plays into that a lot is when you ask a student about this, the first thing they say is “Well, there’s nothing else to do here.” No matter whether you’re at Miami, Penn State, OSU, no matter what school you’re at, they always say, there’s nothing else to do here but drink. And I always follow that up with, “Then me and my family better leave because my 13-year-old, 10-year-old, and 2-year-old are going to be alcoholics before we know it.” Because it’s that idea that you make the choice. And so it’s teaching them to make the choice, but also making those environmental changes so that they can make better choices. If all they see is the choice to drink and to play beer pong and to do vodka eyeballers and all these things, they aren’t seeing the other choices. And so some of it is in University 101 and other situations with students is showing them the choices that they can make. There are other options. Playing Monopoly is a perfectly fine activity on a Saturday night.
Pennington: You mentioned not seeing other options, so I’m going to bring in the media into this conversation, now. How do you think the media plays into this perpetuation of the idea of what a college culture is supposed to be? It’s supposed to be binge drinking and beer pong, not Monopoly.
Ward: Not only not Monopoly, even when you look at little kid movies like Monsters University, one of the opening sequences as they’re walking onto the college campus is kids playing, it doesn’t say beer pong, but some derivative of beer pong. We’re telling our little kids that this is a party culture. So whether we’re talking about the Hangover, the Hangover II movies, we’ve not only glorified in the media and the movies and popular culture doing this glorified blacking out. Which is so scary to think we’re saying, “Go get blackout drunk. Don’t even know what you’re doing in that incidence. Have an alcohol-induced amnesia experience so that you’re doing things and have no memory of them.” Which to me should be the scariest thing you could experience, but we say that’s great and so they’ve celebrated this culture and the media talks about it, there’s books, we could go online and find blogs where they talk about now the college students come together after a blackout experience and part of their bonding as students is to recreate it. I don’t remember what Rosemary did, but I remember what you did, Richard. And so they kind of piece together the night because they each have little bits of the memory.
Campbell: So let me follow up on that, too, with, you have a good reputation here of talking to student journalists and one of the things that we know is that a lot of people find out about this kind of data through journalists, they have to tell stories about this. Do you have tips, not only for student journalists who have to cover stories with the kind of data that you present? And talk too, about some of the mistakes that you see made, not just by student journalists, but by journalists in general when they discuss these kinds of issues.
Ward: So whether it’s a student journalist or a journalist like the Dayton Daily News that I’ve been interviewed by, what’s always interesting to me is when they come in and are so sold on how the story is going to be told and they try to twist my words right from the get go or “Give me data to support this,” and that’s a little bit frustrating. Instead of letting us have a conversation and see how the story unfolds, they are so convinced it’s going to go this way and even when I tell them, “That’s not how my data plays out.” They’re like, “Well, then who else can I talk to on campus?” One tip would be to come open. Come open to the experience that it’s going to change, just like this conversation has gone many different ways than I had expected. Just be willing to take the conversation, and it’s great for them to come prepared with questions, but also that ability to follow up with a question instead of just being what’s on their paper would be my second tip. A lot of them just feel so, it’s got to be, “I have to have it down, I’m done now,” instead of “Let’s have a conversation, let’s let it unfold.” I mean I know you’re recording this so you’re going to listen to it later, but let’s talk it though and I think that works better.
Bailer: Now I want to get back to the idea of, so I’m thinking about what resolutions I should be making for next year. And I’m trying to decide, if I know where I am in this, clearly I’m beyond precontemplation if I’m thinking about this. And by the way, I’m not sure that I am thinking about it. But for the sake of argument, if I want to do this, I heard you say some things about this. How does knowledge that there is a process by which behavior evolves and changes help me in making a resolution and sticking to successfully? How does this theory help inform that?
Ward: That’s great because so much of the time when we think we’re changing our behavior, we think we have to make the change, whereas some of the change is changing your thoughts. Realizing that it comes in little increments and sometimes it’s thinking and preparing to do it in the future, even though you’re not doing it today. Change doesn’t happen like today I do it and therefore it’s going to be the rest of my life, it’s actually the preparation process. And knowing that you’re going to regress through the stages as well. Sometimes you go and you start at the behavior and for whatever reason, tenure stress or final exams or my goodness, that Chair gave me something else to do, and therefore you don’t have time to exercise anymore and you kind of go back to a different stage. So it’s knowing it’s a process but as long as you’re always trying to move forward in your thoughts, then your actions will follow.
Pennington: You’re listening to Stats and Stories. Our discussion today focuses on New Year’s resolutions and getting people to change their behaviors. Our guest is Miami University Kinesiology and Health Professor Rose Marie Ward, whose research focuses on addictive and harmful behaviors, often amongst college-aged adults. I’m Rosemary Pennington along with our regular panelists Miami University Media, Journalism, and Film Chair Richard Campbell and Statistics Department Chair John Bailer. Rose Marie, you reminded me of a good friend I had in college who every year would come back, and she would create these large paintings and pictures of leaves saying that she was turning over a new leaf. It’s January and she’s turning over a new leaf and it would last for about a week and then it would sort of disintegrate. Are there things that you’ve seen in your research that people can do that can serve as sort of totems or things to help get them through those rough parts? She would look at the leaf and feel guilty until eventually the leaves came down because she just knew she wasn’t going to be able to power through it. Are there things people can do to help them through that hump?
Ward: Sure, the leaf is brilliant, I wish that would have worked for her, but having those little reminders, I love calendar reminders, people do that a lot. But it’s the friends. We forget how social our behaviors are and when your friends are doing something, I’m 41 and even at 41 that peer pressure still exists for certain things. And so when you find a peer group or you find someone that can support you in making those decisions, we feel guilty when we’re not meeting someone for the gym or we feel guilty when we’ve said publicly, “I’m working on how I’m eating.” Other people know it and so that it’s not just the guilt, but it’s the goal setting, the time commitments, and having that kind of reinforcement from others.
Bailer: How did you get into this? What’s your background? You’re a psychometrician by training; that’s you’re degree. What does psychometrics mean? And how does someone prepare for a career like this?
Ward: Well I kind of fell into this. To be quite honest, I applied for graduate school thinking I was going to be a cognitive psychologist. My interview process didn’t go so well and as backup I went to a different school. When I got there, one of my first stats classes, I remember sitting there going, “Wow, this is so easy. I don’t remember it being so easy. This is fun.” And then I started realizing people kept asking me for help. And it was like, “Me? Who am I? Why are you asking me for help?” And it was at that point that I was like, “I’m going to keep doing this, and I’m going to charge people for what I know. This is awesome.” And I tell my stats classes, right now I tell them, I not only charged people because they were afraid of it, but I paid for an entire wedding with stat consulting money. This is what you do, guys. This is how you get ahead. You can charge people for what they fear. For me, psychometrics is something that gave insight in how to ask questions. That there are numbers that you can assign to see patterns in how people respond and those patterns can let you see underlying themes. And without knowing those underlying themes, it’s really hard to intervene with people with health behaviors. A poorly written question does us no service. A well written question with good numbers to back it up can change the entire frame of how a picture looks. Finding that field and getting a Master’s degree in stats or taking a minor in stats, I’m so promoting that department right now, but doing that is amazing. And if they didn’t know already, my undergraduate degree was also in communications, totally promo that department as well.
Campbell: I appreciate that. And also to follow up on that, we have a lot of students in the journalism program, in our major, essentially, who are scared to death of taking stats. You talked about it as something that you were, that you did not fear. And I think it’s important for all of our students to take statistics and understand them, but particularly our journalism students who I want to be better at telling stories about data and numbers. Is there any tips that you have about how to alleviate the fear that students have of numbers classes and statistics?
Ward: Most definitely. Every time I start a stats class, I remind them that stats is just another language and just like you would think if you were taking French or Spanish or any other language that you might struggle with the syntax or you might struggle with knowing past tense or present tense, you’re going to have to mess up a couple times. You’re going to have to practice, but once you learn the different concepts and how they flow together, it’s not math. It is really an understanding about how to assign numbers to meaning and there are a lot of choices in that field that if you get to understand numbers and how to interpret them, you’re just going to be a better citizen. I also then tell them the story about how to make money to pay for a wedding.
Campbell: Well we do know that journalism students who know statistics and can tell stories well find work and there’s a lot of opportunities out there for them.
Bailer: I’d say I really like the way this conversation has been going.
Campbell: You should, John.
Pennington: What pointers might you have for people who are working in the field who are trying to translate stats? They’re not a student who can find a love of stats, but they’re someone who is a journalist who can probably, I was very terrified of statistics until I went to grad school actually, but how do you suggest journalists who are trying to write about things that are studies like what you do or someone else? How do they get through that, to be able to understand what’s important in the stats and what’s not? A lot of times it feels like sometimes the journalism doesn’t really focus on the most important part of a study, and maybe we’ll find this is not your impression, find the flashiest piece but missed the bigger picture.
Ward: That’s interesting that you bring that up because that happened with a drunkorexia study this summer. I’ve studied drunkorexia which is this idea of not eating before you go out drinking, compensating for the calories that you think you’re going to consume during alcohol consumption. And we had a journalist at our talk and they took one number out of the entire two and a half hours and really ran with it all throughout the media. And I was like, “You really kind of missed that that was not the take home message there.” So my idea is to sit with the numbers. You have to really sit, we don’t give ourselves enough time in society to kind of sit and think about things. I know in journalism it’s all about the deadline, I get that, but that time to think is so crucial to be able to have another experience after you’ve been exposed to the number to see how it might connect to another part of your life and then that interpretation comes a little bit more easily. But until it’s easy for you to interpret the numbers, we need time. The rush to rush through numbers and find that quick buzzword I think is sometimes our problem.
Bailer: To add on a little bit to that, I think for students, or anyone that is a little bit reluctant to engage in statistics, I think of it as teaching a data self-defense class. I think part of this is I assume that journalists want to be correct. They want to be correct and they don’t want to be fooled. And part of this is making sure that you’re equipping yourself to encounter an argument that might not be well-formed and well-founded in terms of numerical reasoning. The other part is that there are insights that might be gleaned with deeper understanding. I think that’s part also of the story and the value in this.
Ward: I agree.
Campbell: I think the challenge for journalists a lot of times, Rose Marie spoke to this a little bit, is that journalists are looking for the story, right? Who are the characters? What’s the conflict? So this is hard to do with number stories. And I think the trick is always, can you find an example that will allow you then to tell a story about someone, for instance who is thinking about New Year’s resolutions? And then as part of that story end up talking about the data and the studies, but the hook is, I’ve got to find a character, I’ve got to find somebody who might illustrate something that we found in the numbers. And I think that journalists have a lot of trouble making that leap from just telling the story about an individual example to what the larger data might say.
Bailer: I think that also one thing that’s good for the stat folks and the quantitative people is to have the journalist’s world view, too. The idea of what’s the narrative that makes this more easily communicated, I think that’s a big part of telling the story.
Ward: It is definitely a big part and I think it’s part of the teaching whether it’s through journalism or through a class is that you’re teaching about the numbers, you’re teaching about the situation.
Pennington: Well thank you, Rose Marie, for being here. It was a really interesting conversation. That’s all the time we have for this episode of Stats and Stories. If you’d like to share your thoughts on our program, send your email to StatsandStories@MiamiOH.edu and be sure to listen for future editions of Stats and Stories, where we discuss the statistics behind the stories and the stories behind the statistics.
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