Health behavior change and relationships – can we support our partner?

Our relationships hinder or support behavior change.

Not Feeling Healthy and Fit?

Look @ Your Partner –

There is a Strong and Consistent Link Between

Marriage & Physical Health

In marriage (or long-term relationship for that matter) health and health behavior can be positively influenced in two ways:

promote health-enhancing behaviors & inhibit health-compromising behaviors

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Spouses affect health behaviors either via:

social support (help spouse achieve or maintain health by offering emotional and instrumental support)

or

social control (deliberately influence partner’s health behavior)

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Presence & Quality of Social Support are Significant Predictors of Well-being

Support Matters & Makes a Difference:

122 different studies were reviewed as part of a meta-analysis [1]. Researchers tried to understand whether social support would increase patients‘ adherence to medical regimens prescribed by physicians following an illness.

Studies have found, compared to patients not receiving any support, odds of adherence are

• 2.35 times higher among patients with greater levels of social support
• 3.6 times higher for patients receiving practical support (e.g., assistance, reminders, and support for a specific behavior)
• 1.83 times higher for patients receiving emotional support (e.g., nurturance)

–> Among other studies with similar finding spouses play a significant role in positively influencing health behavior

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Some Tactics To Encourage Health Behavior Change Are Better Than Other Tactics

Researchers [2] have identified 6 different sub-types of social control tactics:

1. Positive tactics: persuasion, logic, modeling, and positive reinforcement
2. Negative tactics: expression of or attempts to induce negative emotions (e.g., disapproval and guilt)
3. Direct tactics: addressing the issue candidly and openly (e.g., discussion)
4. Indirect tactics: roundabout attempts (e.g., dropping hints)
5. Bilateral tactics: give and take between spouses (e.g., bargaining)
6. Unilateral tactics: one-sided attempts to get their spouses to change (e.g., withdrawing affection)

I don’t think I need to highlight that experiencing negative social control increases likelihood of engaging in health-compromising behaviors while experiencing positive social control increases likelihood of engaging in the desired behavior, or?

However, Which (Positive) Control Tactic Leads to Desired Behavior Change?

It depends partially on who is encouraging the change. It seems wives are more likely to positively influence a health behavior change in their husbands.

Researchers conclude [2]:

–> Wives‘ use of positive, bilateral, unilateral, and direct social control tactics is positively associated with husbands‘ behavior change.

–> No associations were found between husbands‘ social control tactics and wives‘ behavior change.

„Wives may be more effective agents of social control
when it comes to changing health behaviors, compared to husbands“ [2]

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But, it isn’t black nor white. How the partner feels about a social control attempt is at least partly responsible for how s/he responds behaviorally.

Meaning, Affective Response plays a significant role. I’m sure you can relate: at times your partner’s comments feel encouraging and motivating. At other times, the exact same comments can feel belittling, harsh, and bullying.

Additionally, Type of Health Behavior Matters

For example „smoking“: Increased wive’s support is associated with reduced smoking in men. Yet, increased husband’s support is associated with smaller reduction in smoking for women (compared to women with little partner influence).

But also personality! Don’t miss this article to understand how personality influences your eating style.

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How Ready Are You to Change?

Readiness to Change Should Influence How & When You Support Your Partner

 

Let’s take a step back and review the 5 stages of change (using Transtheoretical Model of Change, Prochaska & DiClemente [3], click pic to enlarge):

1. precontemplation (not currently considering change)
2. contemplation (considering the pros and cons of making the change)
3. preparation (planning and committing to change)
4. action (the change is made)
5. maintenance (sustaining long-term change)

 

–> It’s quite clear a spouse’s attempt to promote or support health behavior change will be more effective if the approach or tactic used is appropriate for the partner’s current stage of change.

 

For exp:

You want your partner to quit smoking and buy them Nicotine patch or Nicorette gum. Yet, your partner currently still smokes and enjoys cigarettes (hence: precontemplation stage). Thus, your attempt might be seen as controlling or pushing.

If, however, your partner is already in the preparation stage, has already contemplated about the pros and cons of smoking and decided and is committed to take the first step to quit, your tactic might be viewed as support and thus promote behavior change.

 

Spouses Agree On The Existence Of a Health Behavior Problem

The initiation of a health behavior change, the desire to lose weight, start exercising (more), or reduce certain ailments or medications not always comes from the partner in need of change.

Sometimes, our significant other is the one encouraging the change. Not because they want to nag but rather because they either observe and feel our pain (or discomfort or struggle) or they love us and want the best for us. Most often, it’s a combination of both. More often than not, they might too be burdened by the same problem. Just, perhaps, to a lesser extend.

A study [4] concluded 44% of husbands & 56% of wives would like for their partner to make a health behavior change. Perhaps not surprising, most partners agree they desire to change.

 

Honey, I Love You But Hate You Feeling

Uncomfortable In Your Skin & Clothes.

Intentions are great and research has concluded that we respond positively to our partner’s concerns and suggestions for health behavior change.

Husbands report they would like for their wives to make a health behavior change [4]:

• 73% of wives agreed when the desired change was healthier eating habits
• 90% of wives agreed when the desired change was weight loss
• 59% of wives agreed when the desired change was to increase her level of exercise

Wives report they would like their husbands to make a health behavior change:

• 79% of husbands agreed when the desired change was healthier eating
  habits
• 88% of husbands agreed when the desired change was weight loss
• 85% of husbands agreed when the desired change was to increase his level of exercise

Honey, Me Too.

Same study as above (59 couples, mean age under 40, [4]):

• 29% of couples reported a shared problem with eating habits
• 25% of couples reported a shared problem with weight
• 17% reported a shared problem with lack of exercise

Additionally, research has concluded that we often underestimate our partner’s readiness to change. Hence, by encouraging a change and supporting them, many are actually ready to take the next step.

Honey, I Know You Better Than You Know Yourself

Husbands are most accurate at identifying their wives‘ self-reported readiness to eat in a more healthy way

Wives are most accurate at identifying their husbands‘ self-reported readiness to exercise more frequently

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While many of us might like to have a partner who supports us in starting and maintaining our goal health behavior, many people lack this support. For a variety of reasons.

Honey, I Love You & Hate to See You Struggle

BUT

I’m Not Ready to Be The Example

You Need Me to Be.

Although many women would like for their husband to change or believe a change would do him good (perhaps he even desires to change), some wives choose not to speak up.

 

Having a shared behavioral problem may (negatively) influences spousal support.

Why?

They aren’t ready to make the change themselves.

Think about these scenarios:

Your husband has put on some weight. You, too, have put on some weight but less so than him. Are you really in a position to suggest weight loss?

• Perhaps not if you aren’t willling to change: as both of you have put on weight you could suggest a behavior change (to lose weight) for the two of you to engage in together………

–> The problem: you aren’t ready to lose the few kgs you have gained. Your unwillingness or non-readiness influences your desire to help your husband

 

Your partner always complains about back pain. You know they could benefit from exercising regularly, from strengthening their back and core muscles, from moving more. You yourself love being a couch potato. You hate working out. You are just too tired after work. Are you really in a position to suggest or encourage your partner to work out?

• Yes & no. You can encourage and highlight the benefits from working out but health behavior change is much more likely if we have our partner’s support. Unless you are ready to do something as well, the chance that your partner will stick with it is rather low.

 

Honey, I Love You & Know We Both Could Benefit

From Engaging In a New Health Behavior.

Let’s Work Together.

Sharing is Caring: Let’s Share Our Problem(s):

Same scenario as above:

Your husband has put on some weight. You, too, have put on some weight but less so than him. Are you really in a position to suggest weight loss?

• Yes.  This is your opportunity to, too, start the new behavior. You could be each other’s accountability buddy. You can go together through the ups and down and support each other.

This is actually perfect. Your partner won’t be the one buying chips and ice cream. He won’t be the one suggestion lunches at the buffet. He won’t be a bad influence, won’t tempt you, won’t make you feel like you are missing out.

You Two Are In This Together. Interdependence Can Be a Strong Bond.

 

It can also backfire, however. If you aren’t motivated and if you can easily sway him, you both get off track. Same goes vice versa.

 

Take-Away: How This Matters To You:

• Understand how your partner feels about it.
• What is their motivation? How do they feel about the behavior?
• What stage of change are they in? What tactic supports them right now?
• If they aren’t ready to change, wait. Be patient, and re-approach when time is right.
• How do you feel about the behavior change? (Opportunity or threat)?
• Which tactic works for your partner and why? Can you partially provide a solution? Inquire what he needs.
• Goal is to be helpful and supportive, not pushy.
• Have a conversation.

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Thank you for reading and feel free to comment, like, and share.

 

Sources:

[1] DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology; 23(2): 207-218.

[2] Lewis, M. A., & Butterfield, R. M. (2007). Social control in marital relationships: Effect of one’s partner on health behaviors. Journal of Applied Social Psychologt, 37: 298-318. AND
Lewis, M.A., Butterfield, R. M., Darbes, L.A., &Johnston-Brooks, C. (2004). The conceptualization and assessment of health related control. Journal of Social and Personal Relationships, 21{5): 669-687.

[3] Prochaska, J. 0., & DiClemente, C. C. (2005). The transtheoretical approach. In J. C. Norcross & M. R. Goldfried, Handbook of psychotherapy integration, 2nd edition (pp. 147-171). New York: Oxford University Press.

[4] Sullivan, K.T., Pasch, L.A., Bejanyan, K. & Hanson, K. (2010). Social support, social control and health behavior change in spouses. In K.T. Sullivan & J. Davila (Eds) Support Processes in Intimate Relationships (pp. 219-239). New York: Oxford Press.

 

Other articles of interest:

Family or friends “sabotaging” your health, fitness, and weight loss journey? – Tips how you’ll stay focused & win the fight

Break Unhealthy Behaviors Supported by Society – Wake Up, Choose You, Your Health

Successful behavior change: 1 trick to succeed