Behaviour Modification: Daily Water Intake

Behaviour

Modification

The Journey in increasing my daily Water Intake

By Natasha Engelhardt

Individuals are a product of their life experiences, with the ability to create and modify behaviour throughout a lifetime. Known as behaviour modification, this process of alteration has the ultimate goal in improving an aspect of human life through the analysis, and implementation of sequential procedures (Miltenberger, 2011). With this in mind, it is through the application of the Transtheoretical Stages of Change Model that I have endeavored to modify an increase in my daily water consumption, with the intention to ultimately enhance my overall health and wellness.

Although providing no energy, water is an essential nutrient in the health and survival of the human body, required in amounts that exceeds the body’s ability to produce it (Nutrient Reference Values, 2012). Accounting for 50-80% of total body weight (Nutrient Reference Values, 2012), it is involved in every biochemical reaction, playing a crucial role in digestion, the removal of waste products, thermoregulation, and the transportation, absorption, and dissolving of nutrients (Kleiner, 1999). Yet, each day water is lost through the process of urination, respiration and perspiration, and in order for these bodily functions to occur water must be continually replaced through our daily diet. (Corbin et. al, 2011). At least 20% of water necessary each day is consumed through the foods you eat, with direct consumption of water the most effective and beneficial method of rehydration (Jegtvig, 2012). As recently suggested, dehydration can occur as a result of as little as 2% of a loss in body weight (Nutrient Reference Values, 2012), negatively impairing physiological responses, with symptoms such as thirst, headaches, dry-skin fatigue, joint and muscle pain an indication that these fluids must be replaced immediately (Jegtbig, 2012). As guided by the Australian Government’s Nutrient Reference Values, for woman aged between 19-30 it is recommended that each day 2.1 liters of fluids (approximately 8-glasses), including water, milk and other beverages are to be consumed, with 2.8 liters including the fluid content in both food and water. These values provide a guide for the average person, with the requirements for each individual varying according to environmental conditions, physical activity, and metabolism (Nutrient Reference Values, 2012). Throughout the behavior modification process I will be using the Nutrient Reference Values to guide my water intake. As a result, through increasing my daily water consumption I will improve the functioning of my internal body systems, ultimately looking and feeling healthier, in enhancing my quality of life.

The Transtheoretical Model, also known as the Stages of Change Model is an integrative and comprehensive model of behavior change, drawn from all major theories of psychotherapy (Woods, Mutrie & Scott, 2002). It involves understanding how individuals change their behavior through the use of cognitive, affective, evaluative and behavioural strategies. (Armitage, 2009). The model proposes that behaviour modification involves six stages, with progression through each neither linear, but instead rather cyclical with patterns of adoption, maintenance, relapse, and re-adoption occurring over time (Travel Smart, 2012). These stages include pre-contemplation, contemplation, preparation, action, maintenance, and termination, with the model unique and advantageous in itself in demonstrating that behaviour is influenced in different ways depending on the stage of change a person has reached (Corbin et. al, 2011). For successful behavior change, it is essential to match interventions specifically to their stage of change. Without carefully analysis and a planned intervention, people will remain stuck in the early stages, due to a lack of motivation to progress in modifying their behavioural outcomes (COMMGAP, 2009).

Behavioural

Modification

In applying the Stages of Change Model to modify an increase in my daily water consumption, according to DiClemente (2007) I am currently in the contemplation stage as I am well aware that I need to increase my water consumption, yet have not made any commitments in addressing this. For those in the contemplation stage by informing individuals of the benefits in modifying their behavior is usually beneficially in initiating action, however, as a well educated student with knowledge on the importance of water for optimal health, rather than lacking education, it is a lack of motivation acting as the major barrier in preventing action. As a full-time university student, working part-time with social and sporting commitments throughout the day I find it difficult to intentionally reflect on how much water I have consumed, with in some instances not having access to a water bottle at all times. Although having the self-efficacy, it is an effort to ensure I drink adequate water, and personally have found it difficult and often inconvenient to drink 2.1 liters throughout the day. Motivation can often be increased through creating a vision of oneself, and setting out achievable goals to be rewarded in modifying behavior (Dacey, 2009). As stated by Brug et. al (2005), intention is an important predictor of behavior, and in relation to the contemplation stage, I am considering change, and although having previously rejected action, have the intention to eventually set out specific goals and modify behavior. In doing this, it is expected that having something to work towards that is decided upon will increase motivation, and as a result increase water intake in the process of behavior modification.

Base-line data acts as a critical reference point in assessing change and through analysis of my 2-week water consumption log it will guide the implementations in modifying behavior through goal setting, and also measuring the level of change that has occurred post-implementation (United Nations).

Goals

Product Goal: To increase my water consumption each day over an 8-week period to eventually drink 2.1 liters of water and maintain this indefinitely.

Process Goals:

1.Carry a 1-liter water bottle with me throughout the duration of the day

With reference to my diary log, the days in which I had my drink bottle with me encouraged water consumption and ultimately increased my water intake throughout the day. This can be seen on Day 3 where I drank 1600mls as water was easily accessible and it was easily consumed as I could sip whilst still engaging in the course of my day when compared to not having access to a drink bottle.

2. Drink a glass of water with each meal and reward myself by having time on facebook if I have consumed my goal of water intake for that day.

In relation to the Theory of Planned Behaviour, by planning to consume a glass of water with each meal often determines behaviours, and by intending to do so each day will positively increase water consumption. These intentions reflect an act that is desirable and in having knowledge on the positive benefits of water on my health, will increase my motivation to carry out this planned behaviour (Moss, 2008). By rewarding myself in completion of my specific goals of water consumption for each day is a form of positive reinforcement, with the aim to encourage desirable behaviour (Zaineb, 2010). As I enjoy socialising on facebook every now and then, this enables motivation from within, as I know that once I achieve my water intake for the day that I can enjoy the reward as a result.

3. Set a reminder each morning on my phone to remember to bring my drink bottle.

In relation to process goal number 1, by having access to a drink bottle throughout the day increases water intake, and by setting reminders on my phone this will ensure that this process goal can and will occur.

This goal-based plan for the next 8 weeks on specific water consumption provides a gradual and easily attainable process in developing a habit to increase water intake. For goals to be successful they must be realistic, and by easing myself into increasing my water consumption will ensure that motivation levels are maintained, and success of my goal is attainable. Based on the theory of progressive overload, by gradually increasing my water intake each week up until week 8, I will have adapted this into my lifestyle, ensuring maitnance each day (Schnidler, 2002).

Barriers Identified:

In particular I think that biggest barrier I will face will be drinking the water itself, as prior to intervention am only used to drinking much smaller amounts each day, and personally get sick of drinking. I think be drinking throughout the day rather than drinking my 2.1 litres all at once will help in overcoming this, with it intended to become part of my everyday routine.

WEEK GOAL WATER CONSUMPTION AVERAGE WATER COMSUMPTION

1 1250mls 1200mls

2 1500mls 1300mls

3 1750mls 1450mls

4 2100mls 1400mls

5 2100mls 1300mls

6 2100mls 1600mls

7 2100mls 1800mls

8 2100mls 1800mls

I think it is important to highlight however, as I knew that I was recording my water consumption for my self-report, this did motivate me to drink increased amounts of water than usual, influencing the accuracy of these results (Corbin et. al, 2011). As previously mentioned, the recommendations of water for each individual vary, and are dependant on environmental factors, metabolism and engagement in physical activity. With regards to my program implementation, this hasn’t been specifically taken into considered due to the difficulty in underpinning the unique nature of the human body and it’s system. Ultimately when reflecting on water consumption the notion that these results are not explicitly accurate and this should be taken into consideration.

As I did implement and attempt to modify behaviour, with regards to the Stages of Change Model I would classify myself as being in the action stage, with meaningful adaptations to behaviour. The action stage is classified in where the individual has made the decision to modify behaviour, and in doing this has planned progressive steps in achievement. Progress is not always linear, and throughout this stage individuals may often move forward or backwards in meeting their specified goals (Miltenberger, 2011). In analysing my water consumption log post-implementation, it is evident that change has been made, yet progression has not been stable or consistent. From weeks 4-5 a decrease in water consumption can be seen. This could be explained through the variable nature of the action stage, in which the individual is beginning the process of modification and is adjusting to these changes.

Although these improvements in water consumption have not been substantial with regards to time, in comparison to my base-line data, the implementation of specific goals provided a guide in enabling motivation, which was initially my barrier in the contemplation stage (DiClemente, 2007).

In evaluation of increasing my water consumption over an 8-week period, although I did not consistently meet my specific goals each week, I did however increase my overall water intake. If I were to implement this behaviour modification again, I would enable the period of implementation over an increased duration of time, to enable adaptation to these behavioural modifications, to enable greater consistency and therefore progress into the maintenance stage (Woods, Mutrie & Scott, 2002). In reflection, my process goals although with the right intentions, were not carried out as effectively in action, and although were implemented, were not consistent in producing achievement of my product goal. In the future, I would try to implement behavior change with the social support of a friends or family member. As stated in Corbin et. al, (2011), by enlisting in social support maintains motivation to work towards a shared goal. If I was doing this program with a friend it may have enabled me to constantly bring my drink bottle to university, and therefore increase my water intake throughout the day.

Conclusion

In conclusion, through implementation of the Stages of Change Model, although I did not achieve my product goal specifically, I did however increase my water intake over the 8-week period, resulting in an overall increase in health and wellbeing.

REFERENCES:

Armitage, C. J. (2009). Is there utility in the transtheoretical model? British Journal of Health Psychology, 14(2), 195-210.

Brug, J., Oenema, A., & Ferreira, I. (2005). Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions. International Journal of Behavioral Nutrition and Physical Acitvity, 2(2).

COMMGAP. (2009). Theories of Behavior Change. Retrieved from https://docs.google.com/a/student.monash.edu/viewer?a=v&q=cache:drhPcCq2jksJ:siteresources.worldbank.org/EXTGOVACC/Resources/BehaviorChangeweb.pdf+&hl=en&gl=au&pid=bl&srcid=ADGEESjDMAmDqog999BJbeGYsX0Pu2a0PEIv-kXMc2yiD1S1QIl-BM2mbgx87V3zSd8ZT4ZMJz-cDu7PH-oJg_qYZ_-QtXsQiofBd8VB7e8ljMlTBXcEGsMWpXsw1VC_9VkeNwRGNsBd&sig=AHIEtbQ8YvduO_wnF6Gm3O3JUjIxO2kITgCorbin, C., Welk, G., Corbin, W., & Welk, K. (2011). Concepts of Fitness and Wellness: Mcgraw Hill.

Dacey, M. (2009). Link motivation and the stages of change to encourage exercise. Functional U, 7(1), 1-7.

DiClemente, C. C. (2007). The Transtheoretical Model of Intentional Behaviour Change. Drugs and Alcohol Today, 7(1), 29-33.

Jetvig, S. (2012). You Need To Drink More Water. Retrieved from http://nutrition.about.com/od/hydrationwater/a/waterarticle.htm

Miltenberger, R. G. (2011). Behavior Modification: Principles and procedures Retrieved from http://books.google.com.au/books?id=MmGBWERu0m8C&printsec=frontcover&dq=behaviour+modification&source=bl&ots=ANF4kgWf4A&sig=y2mCiaBG9gqhssWyW40HnTgnBTg&hl=en&sa=X&ei=7SF4UODrDMuZiAfvtoCIAQ&ved=0CDcQ6AEwAQ#v=onepage&q=behaviour%20modification&f=false

Kleiner, S. (1999). Water: An Essential But Overlooked Nutrient. Journal of the American Dietetic Association, 99(2), 200-206.

Moss, S. (2008). Theory of Planned Behaviour. Retrieved from http://www.psych-it.com.au/Psychlopedia/article.asp?id=69

Nutrient Reference Values: Water. (2012), from www.nrv.gov.au/nutrients/water.htm

Schindler, M. (2002). WHY YOU NEED REALISTIC GOALS. Shape, 21(7), 25.

Travel Smart. (2012). Theories and models of behaviour change. Retrieved from http://www.transport.vic.gov.au/projects/travelsmart/travelsmart-resources/travelsmart-research-documents

United Nations: Baseline Assessments (Quantitative and Qualitative). Retrieved from http://www.endvawnow.org/en/articles/339-baseline-assessments-quantitative-and-qualitative.html

Woods, C., Mutrie, N., & Scott, M. (2002). Physical activity intervention: a Transtheoretical Model-based intervention designed to help sedentary young adults become active. Health Education Research, 17(4), 451-460. doi: 10.1093/her/17.4.451

Zaineb, A. (2010). Positive Reinforcement To Improve An Individual's Behaviour. Retrieved from http://blog.commlabindia.com/elearning/positive-reinforcement

Week 1: Drink 5 glass of water each day (approx. 1250mls)

Week 2: Drink 6 glasses of water each day (approx 1500mls)

Week 3: Drink 7 glasses of water each day (approx 1750 mls)

Week 4: Drink 8 glassy of water each day (approx 2000mls)

Week 5: Drink 8 glasses of water each day

Week 6: Drink 8 glasses of water each day

Week 7: Drink 8 glasses of water each day

Week 8: Drink 8 glasses of water each day

Although not overly unexpected, the greatest barrier in influencing my water intake over the 8 week period was the fact I was tired of drinking water, and although motivated to continue, I found it challenging, and almost as though I had to force myself to drink water as I knew it was beneficial to my health. In overcoming this I added lemon juice and ice as often as I could to give the water some flavour and make it more appealing to drink. From week 6-8 this increased my overall water intake and maintained motivation to continue (Corbin et. al, 2011). Over this time, I did feel an increase in energy throughout the day, with reduced fatigue and concentration levels.

With the intention to serve as a motivational technique, goal setting is aimed in enhancing productivity (Weingberg & Weigand, 1993), and works to provide vision, and direction for modifying behaviour. With regards to increasing my daily water intake, I have outlined a product goal as my final outcome, which will be achieved through a series of process goals to guide my behavior modification (Stenberg, 2009).

Implementation &

Evaluation

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Self

Assessment

Introduction