What changes can health promotion achieve and how long do these changes last? The trade-offs between expediency and durability

Abstract

This article examines the logic and evidence by which health education together with related organizational, economic, and environmental supports or interventions can result in more than superficial or transitory adjustments of behavior conducive to health. Most signs point to continuing development of the health promotion movement, as indicated by its grass roots origins, the long-range convergence of changes in health-related behaviors (e.g., smoking, diet, exercise, alcohol consumption, safety practices), public and private sector investment, and the growing interest of hospitals and medical practitioners in health promotion. To assess the durability of behavior changes accomplished through health promotion activities, the apparent discrepancy between improvements observed on the social level and high relapse rates reported in most experimental studies on individuals is analyzed, leading to the conclusion that the experimental studies have overstated the problem of relapse. There is a trade-off between expedient interventions that achieve short-term behavior changes and more difficult, slower-acting educational and lifestyle interventions that assure a greater congruence between the behavior and the values, beliefs, and circumstances of the individual.