McDowell I
Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada.
Am J Prev Med. 1988 May-Jun;4(3):172-7.
Most approaches to preventing chronic disease involve changing personal behavior. Appeals to change are often made on the grounds that certain behavior incurs a risk to health, but evaluative studies of health education suggest that this may not be a persuasive argument. Humans have always lived with risks and do not necessarily equate risk with personal danger. Many forces, both social and psychological, underlie the willingness to tolerate risks, and altering familiar behaviors may seem to the individual to be more of a loss than a benefit. If we seek to change health behavior, we must acknowledge this and recognize that factual information on risks will not encourage change unless the change forms part of a broader reappraisal of the person's values. Individual appeals for change will have little impact as long as broader social forces continue to encourage health risk behavior.
大多数预防慢性病的方法都涉及改变个人行为。人们常常以某些行为会对健康造成风险为由呼吁改变,但健康教育的评估研究表明,这可能并不是一个有说服力的论据。人类一直与风险共存,并不一定会将风险等同于个人危险。许多社会和心理力量构成了人们愿意容忍风险的基础,改变熟悉的行为对个人来说可能看起来更多的是一种损失而非益处。如果我们试图改变健康行为,就必须承认这一点,并认识到除非这种改变成为对个人价值观更广泛重新评估的一部分,否则关于风险的事实信息不会促使改变。只要更广泛的社会力量继续鼓励健康风险行为,针对个人的改变呼吁就不会有太大影响。