Making Better Decisions

When businesses consider making financial investments, they base decisions on cost/benefit analysis. Investors look at both short and long-term costs and outcomes. The more granular the analysis, the better it can inform a decision. For example, a hospital considering investing in a new MRI machine would consider the cost and depreciation of durable equipment, overhead (the facility housing the equipment), and personnel needed to operate and maintain it, balancing that against profits from patient imaging studies.

A similar approach can help you to make more informed decisions regarding behavioral change. The technique, called decisional balance, involves listing the pros and cons of a behavior change on a sheet of paper, with pros on one side and cons on the other. Similar to the business case, you might want to think both short and long term. What are the immediate costs in terms of time, effort, and expense of making this change? Will there be immediate benefits, and if so, how long will it take to begin seeing the fruits of your labor?

What are the long-term costs? Maintaining a new behavior may mean changing priorities for how you spend your time, considering existing obligations to your employer, friends, family, and community organizations (church, meeting groups, etc.). If you decide to invest in home exercise equipment, you should consider the costs of upkeep and in some cases, monthly subscriptions. A diet program may change your weekly grocery expenses and involve a health coach or registered dietician.

The hardest type of returns-on-investment to calculate are intangibles. For example, we know that increasing physical activity can yield long-term health benefit, but their nature can be hard to define. Dietary improvements may or may not lead to desired weight loss. If you are going to be successful in long-term behavior change, you need to find tangible evidence of its benefits. For example, increasing your physical activity may enable you to join a local pickleball league and meet new friends, or play with your grandkids. Healthier eating habits may reduce the amount or number of medications you take daily. Even if you don?t lose as much weight as you had hoped to, your clothes will likely fit better.

Creating a decisional balance sheet is a form of behavioral activation: you are taking concrete steps towards positive lifestyle change. Putting all of this in writing will give you an idea of how feasible your proposed change is, or how you might modify it (think baby steps) to make the change more actionable. During the process of change, refer to your decisional balance sheet to adjust strategies. Just as in business, a clear understanding of costs and benefits is an important step towards successful change.

Nina Russin, a veteran journalist for over 30 years, is currently pursuing her doctoral degree at Arizona State University College of Health Solutions.


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