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A journey to a heart-healthy lifestyle


Karen Evans, R.N.

“A journey of a thousand miles begins with a single step.” - Confucius

Confucius must have been referring to something greater than just walking when he said this.  His statement has a lot of wisdom when it comes to humans and change. Most find change difficult and are slow to make it happen, and habits are hard to break. For these reasons, it is difficult for some to make the necessary changes for a healthy lifestyle.

Almost 20 years ago, two well-known alcoholism researchers, Carlo C. DiClemente and J. O. Prochaska, introduced a six-stage model of change to help professionals understand their clients with addiction problems and motivate them to change. Their model is based on their personal observations of how people went about modifying problem behaviors such as smoking, overeating and problem drinking.

Understanding one’s readiness to change by being familiar with the six-stage model of change can help determine the best path on the journey to change. Most people experience these six stages when they need to make a change:

• Precontemplation - This means that a person does not know when a change is needed. It may be because he or she is simply not aware yet, or because of denial. Loved ones may be worried, but the individual needing change is not yet concerned.
• Contemplation - In this stage, the person is aware of the problem but has not made a clear plan to deal with it. This is characterized by the “I should” – I should workout more, I should stop smoking, I should eat less, I should stay away from fast foods, etc.
• Commitment - In this stage “I should” is replaced by “I will.” The thought of living in the current situation is unbearable and the person then commits to change.
• Preparation - It is here the person formulates a plan. This can be very creative and can involve some brainstorming. In order to do this, one has to realize what causes eating too much, smoking or not exercising. It can often take several tries to arrive at a realistic plan with reachable goals.
• Action - This is the “I am” stage. I am exercising three times a week. I am eating five fruits and vegetables a day. I am reducing my cigarette intake. The action stage requires readiness of mind, spirit and emotion. However, it may also involve some lapses. One may need to repeat the whole change-process several times before succeeding. Having a friend or family member share in the journey is helpful during this stage. They can motivate and inspire during challenging times, and help the individual get back on-track if there is a lapse. 
• Maintenance - This powerful stage occurs when one reaches the goal and vows not to return to old unhealthy habits. This stage can take months, years or a lifetime. It takes a lot of commitment to keep from returning to old behaviors and to make all of the positive changes permanent.

For many of us, the journey of a thousand miles will begin with these six stages. Keep in mind – many may need to take those beginning steps several times before reaching the goal. The most important thing is that you try and you start. Nobody ever succeeds at anything without trying. You can live a stronger, healthier and happier life if you prepare your mind and body for the journey ahead and simply make the effort.

Karen Evans, R.N., is a nurse in Flagstaff Medical Center’s Cardiac Rehabilitation department.



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