New Publication: Salutogenic Wellness Promotion Scale for Older Adults

The American Journal of Health Education published the article colleagues and I wrote about the new Older Adult version of the Salutogenic Wellness Promotion Scale (SWPS-OA). Using the salutogenic framework, this scale as the young adult, adult and Arabic validated SWPS versions have done, focuses on health creation or potential measurement. These scales have  shown to be effective for assessment, guidance, evaluation and promotion of health for participants and professionals. Here is the abstract. A link to the article is below the abstract:

The Salutogenic Wellness Promotion Scale for Older Adults

Abstract: Background: From 1990 to 2050, the population aged 60 years and older will rise from 9% to 21%. Healthy aging initiatives are vital to promote individual, community, and global well- being during this transformation. Accurate health measurement tools are needed to successfully guide strategies and plot progress. The validated multi-dimensional Salutogenic Wellness Promotion Scale (SWPS) measures health and has demonstrated that increased engagement in measured health-promoting behaviors relates to improved health, higher life satisfaction, and fewer problems. Methods: To extend existing work to the growing older adult population, an older adult version of the SWPS(-OA), a perceived health assessment, satisfaction with life survey (SWLS), and a depression scale (Center for Epidemiological Studies–Depression, CES-D) were pilot tested with 6 groups (N 1⁄4 218) of older adults. Results: Data produced a Cronbach’s alpha of 0.933, significant positive correlations between the SWPS-OA and health (r 1⁄4 0.955, n 1⁄4 218, P , 000) and with life satisfaction (r 1⁄4 0.715, n 1⁄4 218, P , 000) and a significant negative correlation between SWPS-OA and depression (r 1⁄4 20.867, n 1⁄4 218, P , 000). Discussion: This pilot test suggests that the SWPS-OA holds promise as a psychometrically sound tool to assess, evaluate, and promote older adults’ health. Translation to Health Education Practice: Using the SWPS-OA to assess and evaluate lifestyles of older adults can help health professionals develop a plan to improve health and quality of life of older adults which research has shown also helps prevent and avoid problems such as chronic diseases.

Enjoy.

Expectationism Over Engineering-Education-Enforcement

In an interesting and  well supported proposal, Gerald Wilde suggests creating higher levels of future hope is a more powerful way to alter behaviors toward health and safety than engineering, education and enforcement efforts. Dr. Wilde’s major outcome has been Risk Homeostasis Theory  which is a general human theory of behavioral compensations in response to changes introduced in intrinsic risk. In other words, his data demonstrate that people maintain their perceived risk, what he calls their Target Risk Level (TRL), by using behavioral compensations. To support this theory he uses powerful data supported examples that demonstrate the compensations people make when people are in safer cars. For example when cars have anti-lock breaks, air bags or because drivers have additional drive training, their general response is to  drive more recklessly, possibly because of overconfidence, and these behavioral compensation maintain them at their static target risk level.

This theory therefore suggests that little can be done to improve heath and safety because when one area is made safer, for example through engineering with more lights on the road or through education with more training, people drive faster. Researched examples with enforcement such as more police doing DUI checks leads to people making behavioral compensations such as taking different routes or causing other difficulties. In other areas outside of automobile safety, there are similar behavior compensation responses. For example, when cigarettes lowered tar or nicotine, people smoked more or “harder” thus maintaining the same risk through behavior compensations. The example all of us know are the people who exercise more or harder so they can have their desert or eat more thus nullifying or compensating for any real “gains” in well-being. In other words, Risk Homeostasis Theory is a theory that provides a good prediction of future behavior compensations and expected outcomes. Remember a theory at its roots is just a prediction.

You can see Dr. Wilde’s writings and articles at Risk Compensation Resource Center  where  you can get a copy of his newest book, Target 3: Risk Homeostasis in Everyday Life. In his book he explains that Engineering changes such as safer products or roads, Education or improved knowledge of how to drive or behave and Enforcement of laws and regulations that limit risk behaviors will ineffectively limit or diminish problems because people make behavior compensations such as those previously described.

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According to  Risk Homeostasis Theory outcome changes are only possible if the perceived Target Risk Level (TRL) is altered. An Increase in Target Risk Level (TRL) can happen if:

  1. Their is a perceived increase in the expected benefits from risky behavior or
  2. Expected costs of cautious or safe behavior is increased

In other words, if it is perceived to be easier and less costly to engage in more risk, it is more likely to happen. Makes sense!

A Decrease in Target Risk Level (TRL) can happen if:

  1. Expected benefits from  safe or cautious behavior is perceived to have increased
  2. Expected costs of risky behavior is perceived to have increased

In other words, if it is perceived that engaging in safer behavior is more beneficial and the risky behavior is more costly, they will not behave as risky. Again, this is common sense.

Although all this seems like common sense, the data he provides and information presented documents that traditional approaches to make the world better or safer through engineering, education, and enforcement, E³, are ineffective because of behavioral compensations.

What helps? Dr. Wilde documents that a belief and desire for a better tomorrow. In other words having something desirable to look forward to. This is something I continually have written about and I emphasize that a better tomorrow won’t just happen, we must help make it happen. As the Second Law of Thermodynamics explains, an open system left to itself will move toward chaos so if we want it to be a predicable and better tomorrow, we must make it happen.

To create a desire to engage in helpful behaviors, he calls for “Expectationism” and the desire to live for something good and better in the future. This also relates to my first step to practice Paneugenesis which is “Operationalize an Idealized Outcome”. Having an exciting and desirable outcome to move toward or look forward to would in itself create expectationism which he demonstrates leads to behavior compensations that make it more likely they will get to experience a desirable future. Data demonstrates people who have an optimistic or desirable view of the future take care of themselves and the world better today because they are looking forward to tomorrow. This also means these people practice environmentalism or are green because they are good stewards.

In other words, Risk Homeostasis Theory provides another solid reason to want to generate comprehensive improvements by creating interactions so everyone and everything benefits thus helping us all have a better tomorrow. I look forward to working with you to make tomorrow even better than today.

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Is a Problem Needed for Change?

In Dear Abby this morning (8/19/2015) (yes I read Abby) a wife wrote about her husbands lack of interest in sex and her desire for more intimacy and better sex  (see letter and response here).

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Abby started her response to the concerned wife by saying:

“Your husband has a problem, but in order for there to be any changes in your marriage, he will have to admit to himself —and to you—that he has one…”

Is this the best way to a better outcome? Is she saying there has to be a problem to want improvement? Of course we can call anything a problem. Shakespeare summarized this idea well in Scene 2 Act 2 when Hamlet remarked:

…for there is nothing either good or bad, but thinking makes it so.

Isn’t reality, reality? It is what it is. If it is unsatisfying, we must work to make it better (toward improvement)!

As noted in previous posts, starting with a problem is difficult and starting with a person’s problem means you have to knock them down before you can help. Starting with a problem then makes it more difficult to create interactions so everyone and everything benefits that can generate comprehensive improvements (in their relationship and sex life using this example). Focusing on a problem makes the first discussions, steps, actions or anything more difficult.

To start an improvement process, you must start and the activation energy required to start, as Shawn Achor called it, must be low. If it takes to much effort to even start the improvement process, improvements won’t happen. (Shawn Achor’s great presentation is at the bottom of this post)

As Wayne Gretzky said,

You miss 100% shots you never take.

The shot I suggest they take, as described in many posts, focuses on the idea of paneugenesis or creating all good. My suggestion would be to focus on what they want by Operationalizing an Idealized Outcome. Operationalize means to makes sure all parties see the outcome the same way so all will work toward the same goal. To Operationalize takes work and is the first step – you must clarify what it is you want to create and it is important to insure that involved parties have the same vision – that is what I mean to operationalize. Idealized is what could be but isn’t now.

The concept of Operationalize was learned from W. Edwards Deming who did amazing work and led the quality management movement. If you want to learn more about Deming and his work, you can access the institute and related works done in his name (he died in 1993) here.

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My recommendation

  1. Operationalize an Idealized Outcome: determine what could be an idealized outcome they both want. Being married, it seems this would be easier than trying to get my spouse to admit to having a problem. Besides, who wants to be married to a problematic spouse.
  2. Discover Precursors: Figure out what has to be true or what factors must exist for that idealized outcome to be realized.
  3. Optimize the Process: Determine what must be done, skills developed, and environment to create, for agreed upon necessary precursors to exist and be in place.
  4. Plot the Progress: A way needs to be developed or decided upon to measure and communicate or plot progress toward their idealized outcome. Progress after all is the most important contributor to improved well-being. Documenting progress toward their Idealized Outcomes will be fulfilling, exciting, motivating, and fun.

That of course, for those of you who have followed me is how to Practice Paneugenesis: to generate comprehensive improvements by creating interactions so everyone and everything benefits. Do you think this might help that couple that wrote to Abby? How can you apply this to your life or work? I look forward to hearing how you Practice Paneugenesis and about the improvements you generate.

Shawn Achor does a great and entertaining TED Presentation you can access here:

Be Well’r,
Craig Becker

Be selfish, selfless, & synergistic so everyone and everything benefits!

Fixing Problems is Inefficient, Ineffective & Insufficient

Don’t fix problems, it cannot get us to where we want or need to be. Our focus must be on Better. This concept was ringing in my head as I watched a 60 minutes episode. As I watched it also suggested to me why many things that seem necessary are not being funded. Below is Preview of that 60 Minutes episode from November 23, 2014:

In this episode Steve Kroft reported about problems with our roads, bridges, airports and rail. He explained that they are outdated and need to be fixed. Throughout the segment everyone he talked with agreed that they were falling apart and were in immediate need of repair. Even so, nobody seemed to have the motivation to fix the problems with these necessary and vital conduits to transportation. Below is a discussion about the issue. Link to whole 60 Minutes episode here.

Although I saw the need to do something and was concerned and disgusted that these problems were not being fixed, I realized the emotions generated by the story did not motivate me. In the story they acknowledged that we are way behind in rail transit and one of the only first world nations without High Speed Rail. I realized, I was not motivated to move or do something because even if it was fixed, we would be left with our currently outdated structures. How can anybody get excited or motivated to raise money to rebuild something that they admitted is already outdated?

If we are going to spend money, wouldn’t people be more motivated to create something better, not just less bad? To me this means the focus needs to be on how to Operationalize an Idealized Outcome. The Idealized Outcome discussion needs to be about what could and should America have to THRIVE, not just survive. This should have been an exciting story about what could be created and how this new vision would enable so much more.

Of course those of you who have followed me and my work with paneugenesis understand that better is my focus. I work to Generate Comprehensive Improvements by Creating Interactions so Everyone & Everything Benefits! This links to a previous discussion  “Prevention Can’t Work & Problems are Irrelevant”  which explains how to take this approach and how to switch to  a better focus. A result of a better focus is it also remedies or makes problems irrelevant. Focusing on problems is insufficient, ineffective and inefficient. We must focus on what could be and how to make it happen.

The 60 Minutes Falling Apart Story provides another example of how and why our focus needs to be on better or the end to Practice Paneugenesis so everyone and everything could benefit. I look forward to hearing your thoughts.
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Do Whatever You Want – You will be Ok, is that desired???

Do Whatever You Want and you guess what, you will probably be Ok. Ok, yes, Great?, unlikely. Much of this post came to me after reading about Risk Homeostasis Theory and thinking about my life. As many of you know, I was the victim of a near fatal car accident where the driver and 2 other passengers in the car I was riding were killed. I suffered a severe brain trauma, lapsed into a coma, was paralyzed and lost all I had ever known. Still today, as a published professor, writer and speaker, it seems I am still able to function at a high level.

Does recovery’s such as mine lead us to believe we can do what we want with impunity? I was fixed pretty much, why should we be careful? Aren’t we encouraged to get all we can now? Situations seem to suggest we can do what we want and still be ok. Yet as I learned, it is true we can do anything we want if we  just want to be ok. I however wanted to be better than ok. To be better than ok or just not bad, I had to work to be able to function at a higher level through specific actions. I like must people want to have a life of meaning and do what Steve Jobs referred to as making a dent in the universe.

Isn’t great what we are after? Are any of us striving and working to be average? How many want or think their kids are average? Statistics impossibly document that over 50% of us consider ourselves better than average – at least we want to believe that. If most of us want to be better than average, what should we do? How can we make it happen? What do you want out of your life? Not bad or Really good? To me being better is a simple choice, work to be better, or don’t.

Of course that simple idea is challenged by Gerald Wilde’s Risk Homeostasis Theory (RHT) (linked to article). Dr. Wilde’s focus is traffic safety. He however proposes that RHT can be a theory to predict all human behaviors related to health and safety. He explains that homeostasis is an active, not static process because preserving equilibrium is about ongoing change. He compares risk homeostasis to processes like body temperature, heart rate and sugar level that constantly work to keep levels within a range through process adjustments. Homeostasis, therefore is a process of continual adjustments to short-term fluctuations to maintain long-term steadiness.

In my recent read of Target 2: A New Psychology of Safety & Health; what works, what doesn’t and why I feel like I was educated and enlightened. The data provided and his explanations seem to justify logic but do not flow with traditional understanding of how to make things better. Risk Homeostasis Theory is explained by what he calls the Delta Fallacy. He explains the Delta Fallacy as: if there are 3 delta’s through which water flows to go to the ocean, blocking 2 delta’s does not mean that only 1/3 of the water gets to the ocean. As happens, the water still gets to the ocean even though 2 deltas are blocked, however now instead of through the 3 deltas, more flows through the one open delta or new channels are developed to disburse the water. In other words, simply blocking the flow does not change the output of water into the ocean, it just changes its path to get to the ocean.

Wilde uses this as an analogy for risky behaviors. He explains, if we block one risky behavior, it will come out in other ways. He supports this contention with mountains of data. Some simple examples he provides with research include when anti-lock breaks are on cars, people then adjust their behaviors by driving more recklessly relying on the ABS system and death rates overall remain constant. He explains this as an unconscious adaptation that takes place to maintain, or to keep our risk level constant or homeostatic. He supports this contention with many more data supported examples that show no change in overall deaths despite engineering, education and enforcement safety actions such as seat belts, air bags, road improvements, and driver education and the outcome of traffic death rates.

The reading that really caught my attention was when he ventured over to health behaviors citing examples such as cigarette smoking by documenting that when tar and nicotine were reduced, deaths remained constant because people changed how they smoked. Studies document “Harder” Smoking. Article: Smoke Harder? As many of us can readily recall, we know the people who exercise longer or harder so they can eat more unhealthy foods, nullifying gains produced by exercise.

In other words, what he is saying is that focusing on risks and decreasing risks does not and cannot create better outcomes, it just changes how it happens – the Delta Fallacy. What is most interesting is how he documents that people and society per se have a target level of risk that they are willing to accept or have and one that they work to maintain. With well supported documentation for this contention, he shows that when we take action to decrease risk in one way, we will increase our risk in another way so our risk level remains constant or homeostatic.

Wilde proposes this closed loop Homeostatic Mechanism Model. It is considered closed loop because as environment or behaviors decrease risk, behaviors adapt accordingly to keep risk levels and related outcomes constant. I found it interesting to do a thought experiment using these homeostatic mechanisms, which I will follow up with research, about how this applies to our life and that of our culture.

Homeostatic Mechanisms

Overall, in well supported ways he documents that traditional methods we use to make us better are ineffective because all these actions do is switch the risk based behaviors. These actions end up just switching the risks we are currently engaged in based on political direction of the day to other risky actions that are we are not dissuaded from doing.

So how can we be better? In his book he proposes ways we can use to adjust the target risk level people are willing to accept and have. I will address specific ideas related to his recommendations in coming posts related to his ideas that seem to correspond with my work. Examples I will use focus on creating a desirable future expectation or what he calls expectationism for a better tomorrow. The other related idea I will address focuses on ways to overcome difficulties enmeshed with behavior change related to todays desire to maximize personal benefit over social benefit or what I call the greater good. In other words, this idea addresses concerns related to why and how we would choose to engage in actions to generate comprehensive improvements by creating interactions so everyone and everything benefits.

Thank you for reading this, making these posts helps me learn. Please, share your thoughts, questions or assertions – I look forward to a lively discussion.

I was unable to find any presentations by Dr. Wilde.

Here is a brief overview of the theory: Wilde – Risk Homeostasis Theory an Overview and here is a link to the Risk Homeostasis Resource Center. At this site is a copy of Target 3, which appears to be an update of the book I just read Target 2.

This is  a link to a radio show about Risk Homeostasis Theory available at the resource center site.

Be Well’r,
Craig Becker

Be selfish, selfless, & synergistic so everyone and everything benefits!

Post 2 – Presentations from Fantastic Energy Summit

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My previous post described the fantastic energy summit at UNC’s Appalachian State University. As noted, I am making the presentations by the speakers available. The 2015 Appalachian Energy Summit was amazing, educational, inspiring and scary. Not only was it highly educational, it practiced what it preached by being a zero waste event while making it a higher quality event than most. At the summit Amory Lovins of Rocky Mountain Institute, environmental activist Robert Kennedy, Jr. of RiverKeeper and other organizations, and author and presenter David Orr of Oberlin College provided stunning and valuable information.

This links the speaker page and below are links to their summit presentations.  I encourage you to listen their presentations:

Robert Kennedy Jr.: Keynote Address, Armchair Discussion

David Orr: Address

Amory Lovins: Armchair Discussion, Panel Discussion

After listening, please post your thoughts as you work to Generate Comprehensive Improvements by Creating Interactions so Everyone & Everything Benefits.

Be Well’r,
Craig Becker

Be selfish, selfless, & synergistic so everyone and everything benefits!

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