Stealth Interven,ons to Promote Physical Ac,vity and Health Thomas N. Robinson, MD, MPH Solu,ons Science Lab Center for Healthy Weight Division of General Pediatrics Stanford Preven,on Research Center Strategies for Preven,on & Control Environmental Policy -- regulatory, social, economic Interpersonal Individual (self-regulatory) Changing Behavior 1 Social Cognitive Theory key learning processes Attention Retention Production Motivation Motivation To adopt the new behavior (the outcome) To participate in the intervention itself (the process) 2 Mo,va,on Obesity Diabetes High Blood Pressure Heart Disease Cancer Choice & Control Curiosity, Goals, Challenge Fantasy, Contextualiza,on Individualiza,on Coopera,on & Compe,,on Social interac,on Feedback on performance Pride, sense of accomplishment Peer/parent approval Does a health behavior change interven,on need to look, feel, sound, smell or taste like health educa,on? Stealth Interventions Where physical activity/reduced inactivity or diet changes are “side effects” of the intervention target behaviors that are motivating in themselves 3 Less screen ,me Less weight gain Less aggression Less consumerism Improved test scores Lower Cholesterol Less Pre-‐Diabetes Greater Cultural Iden,ty Less Depression Photos: Jason Chuang 4 Social & Ideological Movements •  •  •  •  •  •  •  •  •  •  •  •  •  •  Environmental Sustainability/Climate Change Food Justice/Urban Agriculture Food Safety Antibiotic Resistance Community Safety, Beautification, Traffic Reduction Human Rights/Social Justice Anti-Globalization/Nationalism Animal Protection Political Action Anti-Consumerism Violence and Crime Prevention Cause-Related Fundraising Energy Independence National Security/Anti-Terrorism Robinson TN. Obesity, 2010;18(suppl 1):S17-‐S22 Iden,ty, Values, Beliefs, Emo,ons Social Interac,on, Membership Models, Social Support, Perceived Social Belonging, Collec,ve eﬃcacy Less risk of failure Changing norms and policies 5 Stealth Interventions A health behavior change interven,on does NOT need to look, feel, sound, smell or taste like health educa,on Physical ac,vity/inac,vity or diet changes are intended “side eﬀects” Iden,fy target behaviors that are mo,va,ng in themselves Theory-‐based (process mo,va,on) Knowledge of “cause” of problem is not necessary or suﬃcient. Applies to individual-‐, community-‐, social-‐ and physical environment-‐ level interven,ons Opportuni,es for new allies and synergies Robinson TN. Stealth interventions for obesity prevention and control: motivating behavior change. In: Dube L, et al (Eds.) Obesity Prevention: The Role of Brain and Society on Individual Behavior. New York: Elsevier, Inc., 2010, pp. 319-327. Robinson TN. Save the world, prevent obesity: piggybacking on existing social and ideological movements. Obesity, 2010;18(suppl 1):S17-S22. 6