How Can Health Care Providers Help Patients Keep New Year's Resolutions?

Setting—and keeping—long-term goals is always a matter of discussion in January as people choose New Year's resolutions and hope to improve their lives.

Generally speaking, a typical New Year’s resolution will eventually lead to a reward. For example, it takes a while to save enough money to pay off the debt or to moderate diet and exercise enough to lose a significant amount of weight. Because there is a delay before rewards are actualized, many people are unable to reach those New Year’s resolutions. Some experts indicate that by January 23, most have abandoned their resolutions.

Researchers from an unlikely source—the Booth School of Business at the University of Chicago–have conducted a series of studies indicating that immediate rewards increase the likelihood that people will stick with those resolutions for the long-term. Published in thePersonality and Social Psychology Bulletin, this review has some tips that health care providers can use to help patients improve their quality of life.

The basic concept explored here is that all people are different. Some people are intrinsically motivated to exercise, to continue exercising, and to stay at a healthy weight. For these people, the exercise itself is a reward.

In general, however, people who are not intrinsically motivated need immediate rewards to persist in their goal-related activities. When any activity is replete with immediate reward, it becomes a positive experience. The authors reported that immediate rewards increase the likelihood that the individual will continue with the behavior, and also increase the likelihood that they will engage in the activity for longer periods of time.

Retail health care clinicians should note that more than half of New Year’s resolutions are health-related.

The researchers conducted studies that looked at 4 different types of activities requiring persistence: adherence to New Year's resolution at 2 months, persistence when studying in the library, valuation of immediate and delayed rewards as predictors of time spent exercising, and commitment to increase consumption of green vegetables over a week and exercise over 3 months. They conducted an additional study that looked at the timing of reward measurement and its influence on results.

In the New Year's resolution study, participants who reported immediate rewards like enjoyment or interest in what they were doing were much more likely to continue with their resolutions. They found similar results in the library study group and the workout persistence group. In the group of individuals who were improving their diet, if they enjoyed what they were eating and were able to appreciate the taste of healthy food, they were much more likely to persist.

The clinical implications of these findings are that it’s critical to help patients find behavior modifications that they find enjoyable and immediately rewarding. They pointed out that much of the research advises us to have our patients focus on delayed rewards to overcome temptation. Conversely, health care providers need to help patients focus on immediate rewards.

Positive experiences when pursuing a goal lead to persistence. Adding simultaneous activities to a distasteful activity can provide a more positive experience. For example, exercising while watching television or listening to a book creates a reason to exercise. In this age of remarkable technology, patients should be able to listen to podcasts, audiobooks, or news broadcasts while they exercise. Alternatively, making a pact with a buddy can often increase adherence to resolutions.

Advising patients to take steps to make activities more fun and enjoyable will keep them focused on those long-term goals. Eventually, they'll see the desired results—better health, weight loss, improved A1c–and the achievement itself will motivate them to continue.

Reference

Woolley K, Fishbach A. Immediate rewards predict adherence to long-term goals.Pers Soc Psychol Bull.2017;43(2):151-162.