Many experts blame this behavior on peoples attitudes toward foods. People are drawn to unhealthy, fatty foods and tend to avoid healthy foods such as vitamin rich items and complex carbohydrates. "Carbohydrate foods are often thought of as fattening and uninteresting, or merely vehicles in which to transport other foods to the mouth. They have not had the allure, either in the marketplace or on the dinner table that meats have had." (Hodges, 1994, p.l78) It is true, fats are often the most tempting foods and sometimes very deceptive as well. When selecting foods, fatty items often appear less harmful than carbohydrates and therefore are often selected over them.
A second contributing factor is todays fast pace lifestyle. With increased work hours, single parenting, dual income homes, and the death of the family meal, fast food has emerged a big winner in the last twenty years. With over 100,000 fast food restaurants surrounding us it is easy to see how one can fall into this unhealthy eating trend. "Fast food items tend to have high levels of kilocalories, sodium, and fat, problem areas in the American diet. Some fast food meals derive as much as 51% of their kilocalories from fat." (Escleman, 1989, p.196)
It is still unclear as to the central reason fat intake is at such a high level. Ignorance, convenience, and lack of personal concern can all be considered. However this much is clear; high fat diets are a severe health detriment. "The consumption of saturated fats must be less than 10% of energy intake, that of cholesterol to an average of under 300 mg. per day and obesity must be avoided." (Smith, 1988, p.17) Regrettably this is not the case. Healthy eating habits have become the exception rather than the rule. This is a large contributing factor to the increase in the cost of national health care. We currently spend 751.8 billion dollars keeping ourselves healthy. The cost just ten years ago was only 422.6 billion dollars. Although heart disease has actually declined 27% in the last ten years, it is still at a very high level, and a leading national medical expense. One must consider that many other causes of heart disease have been on the decline, such as smoking and inactivity. This largely contributes to the downward slope of heart disease. Poor diet remains just as prevalent as ever. if people would adhere to healthy eating habits, the amount of heart disease would decline at an even greater rate.
For most of us, the budgeting of our time and money tends to dictate our eating patterns. These restraints should not be allowed to detract from the importance of eating a healthy enjoyable meal, but the growth rate of McDonalds alone should be enough to medicate that it is. What is to be done? Should we sink into a pit of illness, poor physique, low energy levels, and even premature death? Of course not you say, but the statistics indicate most of you don't live by your words. This is the underlying principle in the problem of promoting good eating habits. Although ignorance of healthy eating is a problem with many Americans, there is a second problem of equal or greater magnitude. It is very difficult to get people to act on their knowledge of right, if it is inconvenient or if they don't associate a great deal of personal relevance. "In general, it may be only when individuals explicitly define their attitudes as relevant and appropriate guides to action, that they can be expected to turn to their general attiudinal orientations for guidance in making their behavior choices." (Snyder, 1982, p.114)
Bearing all this in mind, one can see how influencing people to adopt good eating habits can be very difficult. However, difficult should never be interpreted to mean impossible. If a problem is too complex to be solved by merely pointing it out and telling people to behave differently, a strategy of persuasion must be established.
My persuadee is my fiancee Shannon. I met her about a year ago in Tempe, Arizona. She is both intelligent and attractive. She certainly did not strike me as someone who was a victim of poor health due to diet. After knowing her for a few months, I realized she did need to improve the way she ate. Shannon is young and exercises regularly, so the physical effects of poor diet are not readily detectable. However, she often complains of low energy and the difficulty she experiences maintaining her shape. Perhaps most disturbing is that she suffers form high blood pressure. At present it is manageable, but as she gets older and her poor diet continues, the risl,, of heart disease will be a serious problem. I who plan to be with her for many years am very eager to steer her away from danger.
Shannon is largely a product of her environment. She is a college student on a fixed income. These circumstances often lead on to unhealthy cuisine. She claims she doesn't have the time or money to make a change. She also feels her eating practices "aren't that bad."
Through spending time with her I am able to deduce her actual attitudes towards her behavior. This allows me to avoid the preliminary step of measuring her attitudes through attitude measurement tests. I know she realizes a change is needed, she simply requires motivation and direction. When directly confronted, her immediate reaction is to deny that a real problem exists. Being aware of her pro-health attitude leads me to believe that she is using a defense mechanism against the unpleasantness and inconvenience of lifestyle change. This defensive posture is an obstacle that I must overcome. Her resistance to and refutation of persuasive statements is a common occurrence in the field of persuasion. It has been examined and analyzed. "Direct refutation may be subdivided into four areas; 1) refute the argument by negating its content validity 2) refute the argument by showing it to be irrelevant to the persuades or the concept at issue 3) refute the argument by pointing out a covert strategy 4) refute the argument by pointing out long-term dysfunctional effects." (Duryea, Ranson, & English, 1990). The fact that her fiancee is the persuader virtually rules out reason number 3. She is too intelligent and well educated for number 1or number 4 to factor into her rationale. Therefore number 2 seems to be her line of defense. She has attempted to detach herself from the problem. This in turn will render all persuasive arguments as irrelevant to her, as the problem itself.
For Shannon, I chose a more central route of persuasion. There are two main factors to consider when deciding whether or not to use central route; motivation and ability. Although Shannon has done nothing substantial to change her behavior, the grounds for strong motivation exist. Foremost is her personal involvement with the issue. This is her life and her appearance, she has a predisposed vested interest in it. A second factor is the presence of multiple influences presenting multiple arguments. Friends, parents, experts, and the media all have many good reasons to adopt a healthy eating policy. And finally Shannon is highly intelligent and enjoys using her mind. She only feels comfortable with a decision after she has thought it through. She does not enjoy, and is almost fearful of, rash decisions with no basis on fact.
Although the central route does seem the obvious choice for my persuadee, peripheral methods may not be completely useless. Shannon likes me. The Liking heuristic states that persuasion will be more likely if the persuadee likes the communicator. Although I have no need to use this to distract her form the facts, this can be useful in breaking down anti-persuasion attitude. She will be more likely to actually listen to my arguments and consider them fairly.
The question of self monitoring should be addressed early in the intervention. Self monitoring refers to the amount one allows their behavior to be altered or dictated by outside cues. High self monitors are very concerned with cues and situational appropriateness, where low self monitors base their behavior on internal states and personal belief. It is important to assess the level of self monitoring in a persuadee in order to best design the persuasion program. Outside influences will be very crucial in both persuasion and dissuasion with high self monitors. They can be used as persuasive tools, however if one is not mindful they can act as serious distractions and deterrents. I considered Shannon carefully and at first she appeared to be a rather high self monitor. She was very aware of the actions and opinions of the people around her. However, I ultimately decided she was a low self monitor. Although she has a high awareness of external factors, she rarely, if ever, bases important decisions about her life on them. She is much more likely to consider the facts and do what she feels is best for her.
Now we are ready to put theory into practice. The desired attitude has been achieved and stored, and we can now facilitate behavioral change. In order for Shannon to act on her belief, two key el-ements must be present; information and opportunity. information on what healthy food is and how to prepare it are essential. Fat percentages, sodium levels, and cholesterol levels should be discussed. Practacle information such as where to purchase these items and how to make them fit into a budget are also important. Information on how to identify misleading advertising ( such as fast foods that claim to be "light" but in actuality are only slightly less fattening than their normal items) should also be addressed. There are some healthy fast foods (Taco Bell Border Lights, Hardees Grilled Chicken) that should be brought to Shannon's attention. Finally preparation methods including butter, salt, and oil reduction, and defatting meats should be discussed.
Opportunity to exercise this new knowledge is the next step. Opportunity literally means "a good chance." In order to give Shannon a good chance at healthy eating, it is important to make this process as easy as possible. In order to do this I have devised a healthy eating program to issue her. It lists healthy foods and their approximate price to help her make a shopping list. It also has a breakdown of the healthier fast foods. There are healthy cooking techniques outlined as well. Basically, all of the information I have discussed with her has been presented in an easy-to-use packet to ease the process of healthy eating. Another step is to take her to the grocery store and show her how to plan meals for the week and purchase the necessary food. Finally, some basic cooking classes and hands-on lessons on food preparation are administered. At this point she knows what to do and how to do it. She also will become aware that a delicious, healthy meal is well within her financial and time budget.
After the plan has been implemented, it is important to follow up with mild pressure for her to continue on the program. In order for the plan to work, she must follow it for an amount of time that will cause it to become habit or lifestyle. If my intervention ends before this occurs, she may be a risk of losing interest or softening her position. In most cases, when noticeable positive results are achieved (increased energy and better physique) the persuadee will follow the plan without further outside intervention.
Information on how to change was provided to rule out the risk of lack of action due to ignorance. Dr. Neil Weinstein conducted a study where students attempted to persuade fellow students to adopt a health precaution. He compared intervention success on the basis of conversation content and concluded, "Even for behaviors that health professionals may feel are too simple to require detailed direction - in making changes in one's daily behavior patterns - constitute major barriers to precaution adoption. It appears that practitioners need to focus more attention on these barriers to action, barriers that face even people who are already convinced that action would be worthwhile." (Weinstein, 1993, p350).
However information alone is not enough. Opportunity or hands-on help in facilitating change is also needed. Referring to a study done on school children's increased knowledge of healthy eating and their behavior. the Minnesota Heart Health Program had this to say, "The data suggests that changes in knowledge cannot be interpreted as accompanying changes in food choice behavior. Considering the weak association documented, nutrition interventions should focus more on directly influencing dietary behaviors, as compared to strategies designed to influence knowledge alone." (Kelder, Perry, Lytle, & Klepp, 1995, p. l27). These scientists do admit that there were validity problems with their experiment and do caution people on the interpretation of their results. However, as information-action strategy does seem to be the most effective method of intervention. This was the rationale behind the hands-on work I did with Shannon, introducing her to the practices of healthy eating. Rather than just tell her how to change, I actually cooked and shopped with her to put her in a healthy eating situation. This was then followed by mild but constant pressure to continue this lifestyle.
Bearing all this in mind, I set three behavior based criteria to measure my programs success. The first was the average fat content per serving of food items she purchased. Thesecond criteria was the number of healthy "home-cooked" meals, compared to fast-food meals consumes. The final criteria was the amount of fat grams consumed in a day.
Two weeks later (with little additional persuasion) a third assessment was taken. This week, a negative trend towards baseline was prevalent in all 3 criteria. 8-11% average daily fat content per serving on purchased food items. Fast food meals were up to 9 out of 16 meals and fat gram intake had increased to 60-70 (gpd).
One week after this "locus of attribution" intervention, another reading was taken for each criterion. The results were very encouraging 5-6% average daily fat content per serving of purchased foods. 2 out of 17 meals were fast-food and 50-60 (gpd) of fat in her diet.
Two weeks after the last measurement a final measurement was taken. The results were as follows: 4-5% average daily fat content per serving of purchased foods, 4 out of the 16 meals were fast food, and 45-55 (gpd) of fat in her diet.
The second intervention caused two important results. First it gave positive feedback for her efforts and secondly it gave her internal attribution -for these results. Her new mindset was "'this is a posit-live action that produces positive results (praise, eventual health increase)." Furthermore it is something that I control and am responsible for maintaining. With this new attitude, further outside intervention was no longer needed. She now took responsibility for continuing to eat healthy foods on her own. As she continues to conciously make the effort to eat correctly it will start to become habit. Eventually she will no longer have to "force" herself to follow this behavior for it will become routine in her daily life.
Derby, G., Drovin, P., and Stoltz, J.F. (1981). HyperLipoproteinenia, Atherosclerosis, and Nutrition. XII International Congress of Nutrition, 811-820.
Eschleman, Marian M. (1989) Introductory Nutrition and Diet Therapy lst edition. J.B. Lippencot Co. Philadelphia.
Eschleman, Marian M. (1991) Introductory Nutrition and Diet Therapy 2nd edition. J.B. Lippencot Co. Philadelphia.
Duryac, Elias J., Ransom, Mary V., and English, Gary (1990) Psychological immunization: Theory, Research, and Current Health Behavior Applications. Health Education Quarterly, 17, 169-180
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Weinstein, Neil J. (1993) Health and Safety Precautions. Health Education Quarterly, 20, 347-360.
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Used with permission of the author for the Comm 221 course