Relating Personal Identity to Participation

Relating Personal Identity to Participation

How Do We Make Decisions?

When people make choices they tend to use one of two strategies says James March, a professor of political science at Stanford university. The first approach is rational: individuals weigh the pros and cons of a particular behavior. For example, if you are like me, in the morning when your alarm goes off you might be tempted to continue to hit the snooze button indefinitely. However, I know if I did, I would miss my morning class and have to spend my afternoon figuring out what I missed. So I get up.

This is the kind of model which has the potential to describe why the health of our society may continue to worsen, and why public health efforts which seek to educate individuals about the ill effects of certain behaviors, may alienate the populations they intend to serve.
 Another model for how people decide is based on a sense of personal identity. According to this model, individuals make decisions by asking themselves “what kind of person am I, what kind of situation is this, and how would a person like me behave in this situation?” This is the kind of model which has the potential to describe why the health of our society may continue to worsen, and why public health efforts which seek to educate individuals about the ill effects of certain behaviors, may alienate the populations they intend to serve.

It goes without saying that America is full of wonderful people, and Americans cultivate personal identities which promote their values. Interestingly enough, the very fact that identity is such a complex concept, may make room for health promotion, so long as individuals are given the space to explore how health is already a part of their identity and values

Will Identity in America Always Promote Unhealthiness or Can Identity Help America Move Forward?

In 1960 two researchers from Stanford University conducted an experiment. To begin with, the researchers traveled door to door in a wealthy neighborhood in Palo Alto. At each house in the neighborhood they asked if residents would be willing to have a gigantic, ugly billboard which read “Drive Carefully” installed on their lawn. The residents were told the billboard was an initiative from a non-profit group called citizens for safe driving. As expected most (83%) of households turned the billboard down.

In a similar but different neighborhood the researchers tried something different. At first they went around asking residents if they would be willing to put a tiny piece of paper, the size of a business card in their car window. The paper read “Be a Safe Driver”, and residents were told it was intended to promote safe driving. Most residents agreed to this modest request. From here, the researchers waited two weeks, and then asked if they could put the same billboard that had been offered to the first neighborhood. Amazingly, this time 76% of homeowners agreed!

Researchers went to a neighborhood and asked residents to sign a petition to “keep California beautiful”. Most people agreed. The researchers waited two weeks and then returned to ask about putting the hideous billboard people’s yards. This time, of the people who signed the petition, half also said yes to the billboard.
 Next the researchers took the study one step further. The researchers went to a different but similar neighborhood and asked residents to sign a petition to “keep California beautiful”. Again most people agreed. Next, the researchers waited two weeks and then returned to ask about putting the hideous billboard people’s yards. This time, of the people who signed the petition half also said yes to the billboard, twice as many as when residents were asked without any prior manipulation.

The researchers explained their results by talking about identity. They said that when people accepted a card about safe drivers, they began to identify with the cause more strongly than before taking any action. Said another way, people began to believe “I am the kind of person who cares about safe driving”, and this paved the way for them to agree to an unreasonable nuisance, the billboard.

Even more interesting is that when people said yes to keeping California beautiful, they were still more likely to agree to the billboard, even though the billboard and petition did not relate to each other. To explain this outcome the researchers proposed that people who signed the petition began to associate themselves with taking action in general.  They began to believe, I am the kind of person who does this sort of thing, the kind of person who accepts requests, and cares about social causes. This kind of thinking, made people more likely to agree to the billboard.

So How Do These Results Relate to Health?

Often times when practitioners ask individuals to participate in healthcare they are really asking individuals to change some aspect of their lifestyle. This is a bit like asking individuals to put a hideous billboard in their lawn, only minutes after meeting them.

Often times when practitioners ask individuals to participate in healthcare they are really asking individuals to change some aspect of their lifestyle. This is a bit like asking individuals to put a hideous billboard in their lawn, only minutes after meeting them. Perhaps by reading this blog you will begin to feel like you are the kind of person who cares about reducing your impact on the healthcare system. Or, perhaps by considering what aspects of your identity already promote health, you can begin to feel like you are the kind of person who takes care of yourself, you are the kind of person who takes medication as prescribed, and you are the kind of person that communicates your preferences to your providers.It is the goal of this project to be like a business card, one which reads “I care about health and health care improvement”. This is the kind of buy in which may allow individuals to begin to identify with health and healthcare improvement.

Small steps lead the way to big changes. Ask yourself how your identity promotes health in your life and share your thoughts!

The goal of this project is to be like a business card, one which reads “I care about health and health care improvement”. This is the kind of buy-in which may allow individuals to begin to identify with health and healthcare improvement.

References:
  1. Heath, C. and Heath, D. Made to Stick: Why Some Ideas Survive and Others Die. New York: Random House. 2007.
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