UW-Green Bay Health Psychologists

Dr. Regan A.R. Gurung

Dr. Gurung’s work investigates cultural differences in coping with stressors like HIV infection, pregnancy, and smoking cessation. He currently investigates ways to diffuse objectification and sexism, increase health, and fitness, and increase learning. He maintains an active research lab with student research assistants and I also support independent and honor studies.

• Contact him at: gurungr@uwgb.edu
• Visit his Website

What is an intervention?

Interventions are specific programs designed to assess levels of behavior, introduce ways to change them, measure whether a change has occurred, and assess the impact of the change. Health psychologists use interventions for two main purposes: to change a person’s attitudes to change his or her behavior, or to attempt to change his or her beliefs or intentions.

There are ten factors necessary to have a successful intervention:

• Interventions should be based on theory: A theory helps focus attention on the most important factors at hand. Possible theories include Social Cognitive Theory, Transtheoretical Model/Stages of Change, the Health Belief Model, and the Theory of Planned Behavior. Interventions based on theory have a better chance of being useful in the long run.

• Intervene at the appropriate level: Do you want to intervene at a city level? State level? Neighborhood? Families? Individuals? The level you choose to intervene at should be appropriate to the apparent problem. Perhaps this problem only affects at-risk teens. Maybe the problem affects only people who live in a certain area. Whatever it is, target the right market.

• Size matters: Size can refer to the duration of the intervention and to the intensity of the intervention. Longer interventions are more likely to lead to long-term behavior change. In many studies, rates of high-risk behavior increase when interventions are ended. The size of the intervention is related to the extent of change made.

• Interventions should target people at risk: When the intervention is not made at the appropriate level, time and money are wasted. It is worth the time to make an attempt to find the correct target for the intervention. The more an intervention is tailored to the individuals at risk, the more likely it will work.

• Interventions should be appropriate for the risk group/risk factor: Interventions should be designed to speak to the at-risk group. For example, if you are targeting a certain age or sex or ethnic group, it would not make sense to speak in a language they would not understand. For example, if you want to target the level of inactivity in sixth-grade gamer boys, it would not make sense to talk to them at the level of a college graduate. To appeal to a group, an intervention must use terminology, images, or styles familiar to the group.

• Be sure your intervention does only what you want it to do: Sometimes an intervention can have unintended effects. One example of this was a study of norming health behaviors. An intervention aimed at moving people toward the norm had a negative effect on those whose behaviors were healthier than the norm (Schultz, Nolan, Cialdini, Goldstein, & Griskevicius, 2007).

• Preventing dropouts should be a priority: There are two big reasons that dropouts are an issue. First, the participant is not getting the entire treatment. Second, dropouts do not let us completely assess the intervention.

• Be ethical: Researchers must respect participants’ rights and refrain from using deception or making false claims about the unhealthy or healthy behavior.

• Be culturally sensitive: Researchers must pay attention to the symbols and language used in interventions. What may be perfectly fine in one culture might be very inappropriate in another. For example, the swastika is a symbol of good luck for Hindus but may offend the Jews.

• Prevent relapse:  One of the biggest problems in health behavior change is maintaining the new behavior. Interventions should provide participants with the cognitive and behavioral skills to maintain the behavior change.

Schultz, P., Nolan, J.M., Cialdini, R. B., Goldstein, N.  J., & Griskevicius, V. (2007). The constructive, destructive, and reconstructive power of social norms. Psychological Science, 18 (5), 429-434.doi:10.1111/j.14679280.2007.0917.x

Gurung, R. A. R. (2014). Health Psychology: A Cultural Approach, Third Edition. Belmont, CA: Wadsworth.

“There is nothing either good or bad, but thinking makes it so.” – William Shakespeare

What is stress, really? We often say we feel stressed or overwhelmed. The simplest way to describe stress is the upsetting of homeostasis or the upsetting of what we consider normal. Stress is an individualized experience. What stresses one person out may be considered boring to another. Why do these differences exist? Richard Lazarus and Susan Folkman (1984) suggest that way we think about stressors influence our responses.

Lazurus and Folkman (1984) created the Cognitive Appraisal Model to explain the mental processes that influence how we cope with stressors. According to this model, we initially react to a stressor with our primary appraisal. Do we see it as a harm that will do us immediate damage, a threat that will cause us future damage, or a challenge that can be overcome? We create this label based on the resources we think we have to deal with the stressor. Assessing our resources is part of the secondary appraisal. You subconsciously ask yourself, are my resources sufficient? Can I use them well/will they work? You experience distress when you perceive that your coping ability is not enough to deal with the threat.

But how do you become a better cope-r? Like Shakespeare said, thinking really does make a difference. Viewing the stressor as a challenge that can be overcome using your available resources lessens the feeling of negative stress. Your locus of control is closely tied to this. People with an internal locus of control (the belief that you have power over the outcome) tend to cope better. You can also replace stress-provoking thoughts with realistic, unthreatening thoughts. This gives you a sense of control over the appraisal of the stressor.

If you are stressed, take some time off. Reduce your cognitive load and let your chemical levels settle. Talking to someone about your stressors can also be a good way to cope. And of course, the classic, R-E-L-A-X. Focus on breathing slowly and relaxing muscles. Try meditation or guided imagery, like the video below.

Gurung, R. A. R. (2014). Health Psychology: A Cultural Approach, Third Edition. Belmont, CA: Wadsworth.

The Alameda study gave us seven habits of healthy people

1. Avoiding snacks
2. Eating breakfast regularly
3. Exercising
4. Maintaining desirable weight for height
5. Not smoking
6. Drinking less than five drinks in one sitting
7. Sleeping 7-8 hours a night

These seven habits can be divided into three major categories: Eat well, Be Active and Smoke-Free, and Minimize Drinking.

Eat Well:

Our bodies require 46 nutrients to remain healthy. Water is essential to transport nutrients through the bloodstream, remove wastes, and regulate the body’s temperature. Although need varies by individual, most people stay well hydrated with eight 8-oz glasses of water a day. You will know you are drinking enough if you need to pee every two to four hours and the urine is a light color. The other nutrients are divided into five categories: proteins, fats, carbohydrates, minerals, and vitamins.

The U.S. Department of Agriculture suggests dividing your plate into five food groups with approximately 30% vegetables, 30% grains, 20% fruits, 20% protein, and a small circle of dairy. What you eat is just as important as what you don’t eat. Try to buy and eat foods that are minimally processed. The best way to do this is to shop the outskirts of the grocery store. You’ll notice that the outskirts tend to be the fresher, less processed foods.

Here are some power foods that are loaded with nutrients:

• Low-fat Yogurt
• Eggs
• Nuts
• Kiwi
• Quinoa
• Beans
• Salmon
• Broccoli
• Berries

If you want to read more about recommended diets, check out:

https://www.choosemyplate.gov/

Be Active and Smoke-Free

Adults should engage in 150 minutes of moderate intensity or 75 minutes of high-intensity activity per week. This activity can be a combination of 10-minute episodes spread through the week. The guidelines also suggest muscle-strengthening activities for all muscle groups at least twice a week. You have 10 minutes a day to dedicate to your health, right? Physical activity not only reduces mortality from different diseases but also increases life expectancy, improves cardiovascular recovery from stress. Psychologically, physical activity has been correlated with reduced symptoms of depression, less anxiety, and increased self-esteem.

Cigarette smoking is the most preventable cause of illness, disability, and premature death in the United States. A lit cigarette releases 4000 different chemicals into the body. Smoking is also a cause of cancer, causes an increased risk of dementia, and can contribute to the development of cardiovascular disease. Even secondhand smoke isn’t safe.Exposure to secondhand smoke is correlated with an increased chance of developing lung cancer, chronic illness, and sickness-related work absences. It’s easy to say, best to stay away.

Minimize Drinking

Moderate alcohol consumption has been shown to reduce the risk for coronary heart disease by raising the drinker’s levels of high-density lipoprotein (HDL) cholesterol. Higher levels of HDL cholesterol help to keep the arteries free of blockage. Moderate alcohol consumption is defined as a 12-ounce serving of beer, a 5-ounce glass of wine, or a 1.5-ounce gin, vodka, rum, or scotch. However, chronic alcohol abuse weakens the immune system, promotes the formation of fat deposits on the heart muscle, impairs judgment, and makes it harder for drinkers to focus on multiple stimuli.

These three big categories will help you establish a healthy lifestyle. Keep in mind that these are all physical changes you can make. However, you can also make mental changes to increase your well-being. Here are 10 other little habits to get into:

1. Be physically active
2. Be spiritual
3. Nurture relationships
4. Find meaning
5. Be mindful
6. Commit to your goals
7. Go with the flow
8. Be thankful
9. Practice kindness
10. Savor joys

Straub, R. O. (2017). Health psychology: A biopsychosocial approach. New York: Worth, Macmillan Learning.

Dr. Frank Speizer, with funding from the National Institutes of Health, took on the challenge of investigating potential long-term consequences of oral contraceptives. However, the Nurses’ Health Study became much more than that.

Dr. Speizer used nurses as the study population because of their knowledge about health and their ability to provide complete and accurate information regarding various diseases due to their nursing education. Nurses are also relatively easy to follow over time and motivated to participate in a long-term study. Participants were limited to married women due to the sensitivity of questions about contraceptive use at the time. The original population of the study was 121,700 registered women nurses between the ages of 30-55.

While the original focus of the study was on contraceptive methods, it has expanded over time to include research on other lifestyle factors, behaviors, personal characteristics, and diseases. Every two years, participants receive a follow-up questionnaire with questions about diseases and health-related topics, including smoking, hormone use, and menopausal status. A food frequency questionnaire was added in 1980 and is now mailed out every four years. A quality-of-life questionnaire was added in 1992.

In 1989, Dr. Walter Willett and colleagues started the Nurses’ Health Study II. This was created because the younger generation of nurses started using oral contraceptives during their adolescence and therefore exposed during their early reproductive life. Case studies had suggested that such young exposure might be associated with increases in breast cancer risk. NHS II also gathered information on physical activity and diet in early adult life.

In 2010, Dr. Jorge Chavarro and colleagues launched the Nurses’ Health Study 3. It is entirely web-based and includes different types of health workers, as well as men and women. NHS 3 attempts to include nurses from more diverse ethnic backgrounds. This study examines how dietary patterns, lifestyle, environment, and nursing occupational exposures impact men’s and women’s health.

This study has made many contributions to our understanding of health. Not only have they validated questionnaires relating to health habits, but the biospecimens (e.g., blood, urine, toenails) collected from participants have allowed for research into disease mechanisms. The pictures below show just a few of the key research findings from the Nurses’ Health Study.

History. (n.d.). Retrieved from http://www.nurseshealthstudy.org/about-nhs/history

The Alameda County Study was designed to investigate normal daily routines and social-support factors to determine which might be risk factors for poor health and mortality in a real community. In 1965, Lester Breslow invited a sample of the population of Alameda County, California to participate in a longitudinal study on health status, social networks, and other personal characteristics. The behavior of the 6,928 people was examined over 20 years.

This study discovered seven health habits, now known as the “Alameda 7,” to be associated with physical health status and mortality in the long run. Here are the 7 habits of highly healthy people:

1. Having never smoked
2. Drinking less than five drinks in one sitting
3. Sleeping 7-8 hours a night
4. Exercising
5. Maintaining desirable weight for height
6. Avoid snacks
7. Eat breakfast regularly

Breslow found that a 45-year-old who followed at least 6 of the 7 habits had a life expectancy of 11 years longer than that of a person who followed 3 or fewer. And these weren’t years stricken with disease and complication. These were strong, functional years.

What happened to Lester Breslow? He died peacefully in his home at the age of 97. He did not smoke or drink, walked regularly, practiced moderation and enjoyed tending his vegetable garden. Not a bad life.

Schoenborn, C. A. (1986). Health Habits of U.S. adults, 1985: The “Alameda 7” revisited. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477675/

Alameda County Study. (n.d.). Retrieved from http://www.epi.umn.edu/cvdepi/study-synopsis/alameda-county-study/