Category: Interpersonal Communication

Wellness Wednesdays: What is Health Behavior?

Defining ‘Health Behavior’

Today, we are going to begin exploring the simplified model of health behavior I introduced in last week’s post. However, I would like to start by clarifying just what ‘health behaviors’ are. Over the years, I have found David Gochman’s definition to be one of the most comprehensive. Gochman (1997) defined health behavior as ‘those personal attributes such as beliefs, expectations, motives, values, perceptions, and other cognitive elements; personality characteristics, including affective and emotional states and traits; and overt behavioral patterns, actions and habits that related to health maintenance, to health restoration, and to health improvement.’


Knowledge: Not Just Facts

‘Knowledge’ is the first component of our Simplified Theory (as a reminder, the other three components are ‘tools’, ‘skills’, and ‘materials’). We will break knowledge into two basic elements: factual information and attitudes/beliefs. Without drifting into a lengthy discussion of metaphysics, there are many academics who have proposed that there is not one reality, but many (I know, I know…it sounds pretty ‘out there’ – just bear with me). In some ways, they are right.


Is Perception Reality?

Individuals dictate their reality in a very concrete way, based on they perceive the world. This ‘subjective’ reality appears objective to the individual, and also has external consequences – but does that make it more ‘real’? To be clear, there is only one reality – my point is that there are infinite ways to perceive that reality, and how a given individual will carry out that perceptual process is determined by the innumerable experiences that person has had.


Necessary, but Not Sufficient

We live in the ‘Information Age’ – enjoying unprecedented access to factual information than ever before in human history. However, this access doesn’t seem to have translated to better health. In fact, health in the United States has been declining for decades, and now, for the first time ever, children born today may actually live shorter lives than their parents. This is unacceptable. But how do we fix it?


Changing Attitudes

Providing information is only the first step to promoting behavioral change. The bigger challenge is changing the attitudes and beliefs that prevent that information from being used to influence behavior and affect health. Next week, we’ll talk about some strategies by which that can be accomplished, on both the individual and organizational level.


Can you think of an example in your life where there is a disconnect between ‘information’ and ‘attitudes’? Have your beliefs about a behavior ever prevented you from trying it, even though you ‘knew’ it would be good for you? Please help to continue this conversation by adding your comments below!

Words may break more than bones

Courtesy of

Courtesy of

We’ve all heard it:

Sticks and stones may break my bones, 

But words will never hurt me.

However, a new paper from an international group of researchers suggests that this may not be the case. Their study, published last month in the journal Bipolar Disorder, found that verbal abuse during childhood may lead to an earlier age of onset of bipolar disorder and more severe occurrences.

Bipolar disorder, sometimes called manic depression, is characterized by mood swings between unrealistic and unsustainable highs (mania) and irrational and often unbearable depths (depression).  The researchers found that verbal abuse in childhood was related to the co-occurrence of anxiety and substance abuse, rapid cycling between the two mood extremes, and a worse prognosis generally.

More than 600 outpatients with bipolar disorder were surveyed about their childhood experiences; in the United States, 59 percent of them reported childhood verbal abuse.  The researchers recommended family-focused prevention programs and psychotherapy for those suffering after the fact.

Perhaps it’s time to replace that old nursery rhyme with a saying from the Dalai Lama:

Be kind whenever possible.

It is always possible.


Safe app for mental health sharing

A shot of NAMI's new AIR app-- anonymous, inspiring, relatable. Courtesy of

A shot of NAMI’s new AIR app– anonymous, inspiring, relatable. Courtesy of

We live on social media these days, but people with mental illnesses are often wary of sharing their experiences in those forums. Stigma and ignorance can make those kinds of disclosures hazardous.

However, studies have shown that sharing the daily experience of mental disorders can help people to overcome them. Now, just in time for Mental Health Month (May) the National Alliance on Mental Illness (NAMI) is unveiling a free mobile app that will provide a safe forum for this kind of sharing. The app is called AIR, for “Anonymous. Inspiring. Relatable.”

It’s available from the Google Play store and the Apple App Store. You provide an email address (not visible to other users) and choose a group—either “individual living with a mental health condition” or “family member or caregiver.” You can toggle between groups.

Once you’re in a group, you can join a conversation or just put your thoughts or condition out there. In NAMI’s words, “users are anonymous but not alone.” And you can respond to posts with “Like,” “Hug,” or “Me Too” buttons.

The app will also allow you to access local and national help resources, such as NAMI’s HelpLine and the National Suicide Prevention Hotline. It’s not a substitute for a doctor visit, but the fellowship of shared experience might provide the boost someone needs to get out the door to the doctor.

Click here for more information about NAMI AIR.

Everyone’s a Health Expert

These days, it’s not uncommon for people to connect via a variety of media and communication channels – websites, blogs, Facebook, Tumblr, Google+, Instagram – tools that allow people to not only network with each other, but spread ideas and exchange information. This system of “user-generated content” is a progressive way for people to make connections and learn – but what happens when the content is all a sham?


Vani Hari, the Food Babe blogger (photo from

Recently, two “wellness gurus” have come under scrutiny: Vani Hari, the Food Babe blogger, and Belle Gibson, the blogger who claimed to have cured her terminal brain cancer through diet changes and other controversial alternative therapies (but later admitted she never had cancer). Both young, beautiful health advocates have hundreds of thousands of followers on social media, as well as cookbooks and iPhone apps. Another characteristic the two have in common: neither has any form of education nor formal training in nutrition, health, or science; however, they’re more than willing to share their firm opinions and recommendations on food and health as if founded in evidence.

At what point did it become acceptable to act as an expert in a field you’re completely unqualified for? Similarly, at what point did it become acceptable for the general public to trust and follow these “advocates” as if they are equally knowledgeable as credentialed medical and nutrition professionals? Not only do these “celebrities” of health lessen the work of true professionals, but it also makes it far more challenging for the public to trust any source of information or respect the true relationships between diet and disease, which is still being rigorously researched.

While it is essential to have the right to communicate one’s opinions and ideas, I urge everyone to observe the credentials (or lack thereof) from those touting the next best magic-bullet cure or diet. Those of us working hard towards (or with) degrees from reputable institutions deserve respect for what we attempt to do, and the public deserves access to honest and reliable information without having to wade through the chaos of fraudulent or exaggerated claims.


Photo sources:

Featured image from the upcoming Australian Women’s Weekly article featuring Belle Gibson, via The Washington Post

Vani Hari on The Food Babe

Fess Up Friday: mental health stigma = icky

antistigmaAbout that mental health stigma thing…

I’ve realized the hard way that it’s pretty icky. Let me explain:

UNC-Chapel Hill’s Counseling and Psychological Services (CAPS) student health unit was looking for people to write or video testimonials about their services. CAPS had really helped me when I had a moment of extreme academic stress, so when I saw the call for testimonials, I thought, “I can do this. I should do this. I will do this,” and fired off the email saying I was available. So far, so good.

I showed up for the video appointment, looked into the camera, and thought: “Who’s going to see this?” And froze.

I was supposed to give my first name, year and school. I did it, but even now I’m having second thoughts about the wisdom of that. I’ve told tons of people about my research interests (mental health in the African American community), and I’ve been candid with a number of classmates about my moment of academic stress. But now my face is on the Internet (I don’t have the link yet, or I’d feel obliged to post it here), advocating for UNC students “like me” to access mental health services.

I’m on the Internet telling the world I’ve accessed mental health services, which is the same as telling the world I had a mental health problem.

Even though I understand that no shame should attach to this, it was one thing to go down to CAPS when I needed help; it’s something else to trumpet to the world that I needed help and got it.

The mental health stigma thing… it’s pretty icky.

Mental health Monday: tackling the topic in the black community

The diva herself, Jenifer Lewis. Image courtesy of

The diva herself, Jenifer Lewis. Image courtesy of

She’s a real live diva. She’s done TV, live action and animated movies, cabaret and big stage work. You know her voice from Cars (“Flo”) and her face on Black-ish (“Ruby Johnson”). She’s played so many mothers and grandmothers that she’s called “the black mother of Hollywood.” And she has bipolar disorder. Be introduced to Jenifer Lewis.

Stephanie Stephens writes about Ms. Lewis in the lead feature of the Spring 2015 issue of bp magazine. The article caught my eye because of one of the pull quotes: “Nobody talks about this [in the black community]… not even the people who may have the disorder.”

Ms. Lewis is absolutely right. We—African Americans—don’t talk about this. In research interviews on this topic, I talked to many black women who’d said and been told: “What happens in this house, stays in this house.” Or even more explicitly, “That [mental illness] is a white people’s problem. We’re tough.”

Nobody’s arguing that black people are tough; we’ve had to be to survive. But we have mental health and wellness concerns just as often as other folks, and we’re not seeking help. That’s got to stop. As Ms. Stephens quotes Ms. Lewis: “Just do the work…There’s simply no other answer to this.”

The American Psychiatric Association has a 20-minute video you can view online if you want information on culturally sensitive ways to address this issue.

In the meantime, check out for warning signs of mental health issues and resources that can help anyone address them.  If the signs are there, start the work. Because as Ms. Lewis is quoted on IMDb: “You never know when you start a project just how good it can be.”

Pro-sanity Sundays: Why the Germanwings tragedy matters to you

img-handsNew events have pushed the deliberate downing of the Germanwings flight off the front pages.  Maybe now you’re wrapped up in the Iranian nuclear negotiations, or engaged in the whittling of the Final Four to the Victorious One. That’s normal. But before you shake your head one last time over the actions of co-pilot Andreas Lubitz, consider this:

Suicide is the tenth leading cause of death in the United States.  For young people ages 15 to 34, it is the second leading cause of death.  According to the Director of the National Institutes of Mental Health, Thomas Insel, M.D., mental illness is not the only cause of suicide. “There are many types of individuals at risk for suicide,” he wrote in a recent blog post. You might know one. You might be one.

There is help.  The National Suicide Prevention Lifeline—1-800-273-TALK—can connect you to local resources, whether you are suicidal or just worried about someone else. There will be a caring individual on the other end of the line, 24 hours a day, 7 days a week.

Don’t suffer alone or allow a friend to do so. Connect, and live.

Type One Tuesdays: Conferences, Bonding and Life Long Friends…Priceless!



As Spring Break approaches and, hopefully, with the snow days behind us, we eagerly look forward to and begin to make plans for summer.  Do you have a favorite place to visit during the summer or a conference to attend?  Over the summer, there are many interesting and fun diabetes camps and conferences.  Two major national conferences that occur over the summer are Students With Diabetes (SWD)’s National Conference and Children With Diabetes (CWD) Friends for Life Conference.

Conferences provided invaluable information, networking opportunities and lifelong friends for people with Type 1 diabetes (T1D).  There are informative sessions that provide information on the latest technology, inspirational and encouraging presentations by successful T1Ds and social activities that provide time to meet and bond with fellow T1Ds.  The relationships made at the conferences provide a great resource for support on the other 364 days of the year when you are not with people who understand your disease.  I met one of my closest friends at the SWD conference several years ago.  Attendees at the conferences relate to each other in a way that is rarely experience in any other setting.  The commonalities between attendees and conference events create an atmosphere for bonding over just a few days.  Even if you don’t keep in touch regularly, some of these people will cross paths with you at other conferences or through other aspects of your life.  Recently, I reconnected with a person, who I had met at a Friends for Life Conference many years ago, when we both participated in a national group project.  It was so great to have a familiar person in the group!  Additionally, when you go back the next year, it is like a family or high school reunion, with the opportunity to also meet new attendees or create stronger bonds with people from previous years.  The experience is priceless.  Are you going to any conferences or camps this summer?  What is your favorite memory?  Don’t let your summer go by without a conference or two to make life-long friends!  Hurry and sign up before registration closes!

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Type 1 Tuesdays: Friends, Laughter and Entertainment — Oh My!

 As  you may have heard the proverb, “laughter is the best medicine,” and you may also know the benefits of spending time with family and friends.  However, have you thought of combining these two behaviors?  Laughter actually results in chemical changes in your body which has a positive influence on blood flow, immune response, blood sugar levels (diabetes alert!), relaxation and sleep.  Did you know that 10-15 minutes of laughter actually burns 50 calories?  Are you trying to lose holiday pounds?  Could laughter be the solution to your diet woes?  In addition, the health benefits of social support from family and friends include having a sense of belonging, increased sense of self-worth and feelings of security.  Therefore, spending time laughing and having fun with family and friends can double the positive impact on your health status while improving your mood as well.

This past weekend, I went to Tampa, Florida for Valentine’s Day weekend, where the Straz Center for the Performing Arts Center is producing the musical “First Date.”  It is a 96 minute show full of laughter that was especially enjoyable since it was also a great opportunity to share the evening with family and friends.  We laughed throughout the show and even after as we discussed the funniest parts of the show.  At the end of the evening, there was a sense of well-being and contentment.    Laughter and socialization truly are the best medicine, particularly for those of us with chronic illnesses.  Do you think you can add a bit of laughter and socialization into your routine?  I assure you that you will be glad you did!

iPhone: Is it also a Medical Alert Bracelet?

Did you get a new iPhone over the holidays, already have an iPhone or are considering getting one?  Whether you are a new or old Apple user, there is a great feature that could apply to you! Have you noticed the “emergency” button on the screen where you enter your 4 number passcode?  This is a cool feature, especially for those who have health problems, such as Type 1 diabetes.  In this area, you can enter your name, medical conditions, allergies, and an emergency contact information.

What does this mean to you?  If you are unconscious or having a medical emergency wherein you cannot communicate, your phone could literally save your life.

This feature is fairly easy to set up.  To set up your information, follow these easy steps:


  • Step 1: Go to the “Health application” on your phone.


  • Step 2: There should be a button on the bottom that says “Medical ID” and looks like a *. If you click on that logo, you come to a page where you can enter the information you wish to fill out.


  • Step 3: Enter the information you want entered. Make sure the “Show When Locked” is selected!


  • Step 4: Click “Done” when you are finished putting in your information.

Follow these easy steps to retrieve your “Medical ID” information:


  • Step 1: Now, when you are on the locked screen, if you select “Emergency,” a logo on the bottom will appear that says “Medical ID” below the keypad.


  • Step 2: If you click on “Medical ID,” the information you entered will be present on the screen.

In the past, people with medical conditions wore “medical alert” bracelets, which were institutional looking bracelets (sometimes made cuter with beads and other decor) or, more recently, they actually got medical alert tattoos (on one’s arm or wrist).  Are cell phones the future of medical identification?  Would you consider using this feature on an iPhone to allow people to have vital emergency information about you?


Photo Credit: Main Image by: Kimberly Hislop. All other photos by: Amanda Mezer