Based on analysis of tens of thousands of adult interviews throughout the United States, the evidence shows that the majority of adults move through three developmental stages of adapting to health: the Pre-Adaptive stage, the Adaptive Patterns stage, and the Post-Adaptive stage.
Pre-Adaptive Stage
In the Pre-Adaptive Stage adults have minimal involvement in health decisions. Parents or guardians continue to make health decisions for these adults after aged 18 and into their early and perhaps late twenties. The locus of health decision-making control is in the hands of others.
In this stage young adults' express adaptive ambiguity around health issues. Adaptive ambiguity is a state of uncertainty where no real preferences are expressed. This is sometimes due to a lack of self-knowledge of preferences as a result of limited experience in health decision-making. Adaptive ambiguity is when there is little motivation to optimize defined goals, affective likes and dislikes, or physical capabilities. Adults in the Pre-Adaptive stage fail to express adaptive preferences and so experience low levels of adaptive coping stress.
Adaptive Patterns Stage
As adults reach their late twenties they take on greater control over health decisions, specially if children enter the picture. The locus of health decision-making control moves within them. This forces the emergence of personal preferences, habits, and perceived capabilities that start to interact with and shape health decision-making.
A growing number of strong adaptive health preferences or health-related "prime directives" also emerge further complicating health decision making. The need to optimize multiple priorities increases coping stress.
The pressure to optimize as many needs and preferences as possible takes health decision-making beyond the capabilities of conscious deliberation (i.e., free will) and into nonconscious processes. Nonconscious dynamics influence decision-making in ways that optimize as many outcomes as possible.
Inexorably, past behavior plays a greater role in shaping future behavior. Habits and goal-directed actions undermine free will. Continued exposure to similar health-related situations leads to habitual semi-automatic patterns of response. This has multiple systemic and psychological benefits. Adaptive coping stress is minimized. Self-regulatory efforts to minimize and optimize energy expenditures if more efficient. Adaptive homeostasis stays within safety limits.
The increased complexity pushes adults into the Adaptive Patterns stage and towards conformity to one or more of the PATH. An adult's dominant PATH is the one that best fits their optimized adaptive preferences and capabilities.
Post-Adaptive Stage
Adults approach the Post Adaptive stage generally sometime after the age of 75 years old. In the Post-Adaptive Stage, either through increasing frailty, cognitive decline, or both, adults lose the ability to make health-related decisions.
At this stage, adult children or other care takers assume the role of health decision-maker. The locus of health decision-making control stops being internal and shifts to external control.
When this occurs the influence of those health-related preferences, prime directives, and habits that have shaped the adult's behavior for many decades diminishes. The expression of adaptive ambiguity returns and the elderly adult returns to a state very similar to the Pre-Adaptive stage.
In the Pre-Adaptive Stage adults have minimal involvement in health decisions. Parents or guardians continue to make health decisions for these adults after aged 18 and into their early and perhaps late twenties. The locus of health decision-making control is in the hands of others.
In this stage young adults' express adaptive ambiguity around health issues. Adaptive ambiguity is a state of uncertainty where no real preferences are expressed. This is sometimes due to a lack of self-knowledge of preferences as a result of limited experience in health decision-making. Adaptive ambiguity is when there is little motivation to optimize defined goals, affective likes and dislikes, or physical capabilities. Adults in the Pre-Adaptive stage fail to express adaptive preferences and so experience low levels of adaptive coping stress.
Adaptive Patterns Stage
As adults reach their late twenties they take on greater control over health decisions, specially if children enter the picture. The locus of health decision-making control moves within them. This forces the emergence of personal preferences, habits, and perceived capabilities that start to interact with and shape health decision-making.
A growing number of strong adaptive health preferences or health-related "prime directives" also emerge further complicating health decision making. The need to optimize multiple priorities increases coping stress.
The pressure to optimize as many needs and preferences as possible takes health decision-making beyond the capabilities of conscious deliberation (i.e., free will) and into nonconscious processes. Nonconscious dynamics influence decision-making in ways that optimize as many outcomes as possible.
Inexorably, past behavior plays a greater role in shaping future behavior. Habits and goal-directed actions undermine free will. Continued exposure to similar health-related situations leads to habitual semi-automatic patterns of response. This has multiple systemic and psychological benefits. Adaptive coping stress is minimized. Self-regulatory efforts to minimize and optimize energy expenditures if more efficient. Adaptive homeostasis stays within safety limits.
The increased complexity pushes adults into the Adaptive Patterns stage and towards conformity to one or more of the PATH. An adult's dominant PATH is the one that best fits their optimized adaptive preferences and capabilities.
Post-Adaptive Stage
Adults approach the Post Adaptive stage generally sometime after the age of 75 years old. In the Post-Adaptive Stage, either through increasing frailty, cognitive decline, or both, adults lose the ability to make health-related decisions.
At this stage, adult children or other care takers assume the role of health decision-maker. The locus of health decision-making control stops being internal and shifts to external control.
When this occurs the influence of those health-related preferences, prime directives, and habits that have shaped the adult's behavior for many decades diminishes. The expression of adaptive ambiguity returns and the elderly adult returns to a state very similar to the Pre-Adaptive stage.
New opportunities
The Patterns of Adapting to Health (PATH) reveal new opportunities for:
- Understanding individual resistance to multiple health behavior change (MHBC)
- Understanding the interaction of population health behavior and social determinants
- improving return on health care consumer marketing and advertising by targeting the factors shaping health and health care decision-making
- improving return on quantitative and qualitative consumer marketing research
- improving community health by directly targeting behavioral patterns impacting health and medical expenditures flowing from or into your organization.