We are in the belief-changing business.
Think about it for a couple of minutes. We tell people to wear seatbelts, get a flu shot, wash their hands, wear a condom, drink water….because we have evidence that these things promote health and wellness. But people choose to follow our evidence-based advice because it fits in with their beliefs about life, health, science, God, risks, etc. If people only made health and behavior choices based on facts and rational thinking, many of us would be out of a job. Anyone familiar with humans knows this is a ridiculous idea. So, let’s take a moment to think about belief’s role in public health. We might get a bit philosophical for a moment or two.
In order to know something we have to believe it. And in order to act on something, we have to know and believe it.
We can tell people to get a flu shot a million times, but if they don’t believe that flu shots are safe or necessary, they aren’t going to get one, even if it’s free. So how do we help them believe that flu shots are important, safe, and necessary? By appealing to their values and beliefs. We point out that by getting a flu shot they not only help themselves, but all the people they live, work and play with. There are people for whom the flu is deadly and dangerous: little kids, older people, and people with compromised immune systems. We can appeal to the values of community, fairness, and protecting the most vulnerable.
Another example is condom use. Condoms work very well to prevent the transmission of STIs and pregnancy- when used correctly and consistently. We often forget to mention that last part when we tell people to practice safer sex (but that’s a topic for another day). We also tend to ignore the fact that most people don’t like condoms and will find reasons not to use them (and that’s not hard to do). So what’s the value-based solution? Respect: for self and your partner. Respecting your partner (and yourself) enough to protect him/her and honor their health and well-being. For long-term (committed) couples, you could use love as a value too: loving yourself and your partner enough to be honest, responsible and protective. For women, the values of self-sufficiency and independence can be quite effective. An empowered woman carries condoms and can talk to her partner about using them.
Just talking about the positive effects of a particular behavior can change the beliefs about it. So often we focus on the negative: if you don’t do X, then that horrible thing Y is going to happen to you. We should frame messages in the benefits of healthy lifestyles and preventative measures. Values help us do that.
Values + positive effects = behavior/belief change
In my next post, I’ll share some things I have learned about how to confront those pernicious myths and beliefs that impede our progress to public health utopia. Dr. Paul Offit (one of my heroes) gets the lion’s share of credit for my beliefs about belief (how meta!). More on that badass public health hero next time.