Behavior Change Argument Analysis

Tengland (2016) outlines two distinct approaches to health promotion which are behavior change and empowerment. Behavior change as a means for health promotion may include such things as healthy eating or increased physical activity. These are considered lifestyle changes. In the example of physical activity we know that exercise can help improve health by increasing circulation, reducing insulin resistance, and contributing to achievement of a healthy weight. According to Tengland (2016) these are considered indirect and instrumental goals. By this he means that the acts themselves do not improve health directly, but rather are intended to reduce future risk of disease. While his point is appreciated and in a general public health arena may make sense, I respectfully disagree with his concept as it relates to diabetes. Exercising has both a direct and indirect impact on health. To Tengland’s point, it does have an indirect impact on health as noted previously. However,

Determining what a person “should do” to promote health does not take the person, their priorities, values, concerns, or desires into account. In many instances, such broad goals also neglect to take into account cultural and generational differences. Food choices for many stem from cultural preferences. Broad spectrum goals that do not take these differences or preferences into account surely will not succeed, may run the risk of alienating people, and ultimately could result in blame for their health being placed on them. He also addresses the fact that goals that are prescribed have little meaning or value, and goals a person identifies are preferred. This is very much in line with a patient centered approach as described by Miller and Rollnick (2013), Inzucchi and colleagues (2012), and Anderson and Funnell (2010). Tengland’s points on these matters are well