Knowing vs. Doing

Last week in class we watched a video of Malcolm Gladwell discussing the difference between Awareness and Doing. Here is the video:

http://www.tvo.org/TVO/WebObjects/TVO.woa?videoid?24640858001

At about 8 minutes and 45 seconds he talks about how the Unites States had a HUGE campaign trying to make people aware of the dangers of not wearing a seatbelt. There were advertisements and policies put in place, but yet NO ONE started wearing their seatbelt more. This is because the campaign was framed all wrong. When no change occurred, they reframed the campaign to say that if you have a kid under five, they MUST be in a seatbelt. And this amazingly enough had the biggest influence on change. Why you ask? Because these kids grew up and became advocates for seatbelts. The kids would say, “hey mom, I’m wearing a seatbelt, why aren’t you?” When the issue was reframed into an issue of family responsibility, seatbelt numbers increased.

Awareness is not effective. Telling people the facts does not make them change. It is hard to actually come up with a solution and cause a change, which is why we are seeing a gap between the knowing and the doing. The reason the seatbelt campaign worked in the end was because it changed from making people aware of the dangers of not wearing a seatbelt…to insisting that children wear a seatbelt, it changed to the doing. This video really opened up my eyes. To be honest, I had never really thought of “awareness” from this perspective. Malcolm repeatedly calls awareness “just a form of advertising,” and the more I think about it, the more I think he’s right.

Just recently BELL Canada launched a mental illness campaign, which encouraged Canadians to talk about mental illness:

The goal of the campaign is to overcome the stigma associated with mental illness, and to get people talking about it. The hope is that if people talk about it, they wont be afraid to seek out the help and treatment that they need. But is this ad going to help make a change? Or is it just making people more aware of mental illness without giving them an action plan of what to do about it?

Here is another advertisement from BELL Canada that I found, but that I haven’t seen on TV:

What I like about this one is that BELL is not only making Canadians more aware of mental illness, but is also explaining ways in which they will be helping the initiative - BELL will be investing in 4 mental health pillars, one being enhancing access to care. Enhancing access to healthcare is the goal, and now this campaign is making people aware of this…which could help make a difference.

What are your thoughts on BELL's campaign? Do you think awareness is a bad thing? 

Helping the Community

In class this week we had two guest speakers from Access Alliance, a multicultural health and community service organization, come and tell us a little bit about what it means to be a dietitian in the community. The overall goal of the program is “to promote health and wellbeing and improve access to services for immigrants and refugees in Toronto by addressing medical, social, economic and environmental issues.” It was extremely interesting to learn about a dietitian’s role and responsibility within the community, and it became fairly obvious that there is a lot of variation from day to day. The interesting thing about community nutrition is that you can perform clinical one-on-one counseling as well as community work, allowing for so much diversity. I think that community nutrition is sometimes overlooked in our Food and Nutrition program even though there are so many opportunities, and I am extremely happy that I got to hear about it from people who experience it first-hand.

An interesting point that the guest speakers made was that even though clients will be refereed to them for nutrition, it is not always about nutrition management. The program is enriched in the determinants of health, and it is important to always remember the client’s experiences, priorities and changes they will be willing/able to make. If someone is referred to the program because they are hypertensive, but they come in for one-on-one counseling and start talking about how they are depressed, you cannot ignore them. And sometimes it may happen that “food” doesn’t even make it into the conversation.

It got me thinking about all the classes I’ve had to take at Ryerson, and it started to put them into perspective for me. As a transfer student, I often wondered why I had to “waste” my time taking courses on communication techniques, the determinants of health and family dynamics, as I wanted to practice as a clinical dietitian. But as my graduation approaches and I reflect on the program, I realize how important all these classes are and how they all interconnect and make up the term “nutrition professional.” Being a dietitian is not only about food, as it is equally as important to be personable, compassionate and an active listener. A dietitian is far more than an expert in food and nutrition, but a health professional dedicated to understanding the complex interconnections between individuals and food, and it is this relationship that now forms my comprehensive knowledge of nutrition and health.

Usually when people learn that I am studying to be a dietitian the first thing they say is, “I need you to put me on a diet,” or “Can you help me lose weight?’ Programs like the NCT at Access Alliance remind me of why I wanted to go into dietetics, and it wasn’t just to help my friends lose weight. I want to help people understand the connection between food and health, and help teach people to eat well in order to prevent and manage disease.

You can look on the Access Alliance website to learn more about the NCT (Newcomers Cooking Together).

http://accessalliance.ca/services/nutritionprograms

I think it’s such an amazing program, and I definitely want to try and get involved. Is anyone else interested?

Public Policy: A Ban on Smoking

“Patients and their families play an important part in their health care. What do you think Canadians responsibilities are, now and in the future, regarding their health?”

This question was brought up in seminar as part of our discussion on the future of the health care system. The government has been desperately trying to reduce the burden on the health system; however, the majority of funding is still allocated to “downstream” strategies. This means that people believe treatment is the most important aspect of health care. I believe funds need to be better allocated to target promotion and prevention of disease in order to improve health care in the future, but it can’t just stop there. We need to enable each other to take control of our own health, and think about how our actions can affect other people.

An example of an “upstream” approach to health would be tobacco control in Canada. In 2006, smokers in Ontario and Quebec were forced to smoke outside as laws in both provinces banned smoking inside any public place. As a non-smoker, I can vividly remember the smell on my clothes and hair after a night out in Montreal in first year-university (before the law took effect). It was disgusting! Friends of mine would insist on showering at 3 am because they couldn’t imagine getting into their clean sheets smelling like smoke. Even when I could get over the terrible odor that stained my clothes, I could not rationalize all the second-hand smoke that I was exposed to every weekend. The problem was that I didn’t have a choice. If I wanted to go out with my friends on the weekend and socialize at a bar or club, I was going to be surrounded by smokers.

I think that Canadians need to take care of each other. The concept of collectivism implies that people belong to extended families or ingroups, and that one should take care of others before him/herself. It’s a “we” or group orientation. When people smoke inside, they are not thinking of other people; about other people’s values, beliefs and concerns about health. We need to start thinking about our role in society. When the “no smoking” law took effect, people were outraged and concerned about how the change would affect them. To name a specific example, two bar owners in Montreal tried to launch a legal battle. They were concerned that the law would cause job losses because more people would stay at home, costing their business money. This is an individualistic view. Is this the view people should be taking? In my opinion, the smoking regulations positively impacted both smokers and non-smokers through reduction of exposure to second hand smoke. Never mind the fact that it reduced the amount of laundry and showers that needed to be taken after a night out on the town! We all need to start looking at the bigger picture. We need to start thinking about our future and the responsibility we have to each other to make it as healthy as possible.

What else can Canadians do individually to improve the country’s health as a whole?

Sources:

http://www.cbc.ca/canada/story/2005/09/14/smoking_challenge_20050914.html#ixzz1CfZTKM1B

http://www.ctv.ca/CTVNews/TopStories/20060530/ontario_quebec_060530/