The final theme that emerged from women’s responses was self-actualisation. Rooted in psychological theory, self-actualisation is conceptualised as realising one’s greater potential. Hence, self-actualisation encompassed women’s discovery of being the most that they can be. After NLH, women exhibited tenets of self-actualisation, realising their potential for health achievement. More specifically, women perceived this achievement by focusing on small steps forward and adopting a positive perspective. This shift enabled women to become more self- compassionate, overcome personal barriers and recognise their greater capacity for health under physical, mental and social dimensions of wellbeing. Additionally, discovering the integration between health dimensions and domains unlocked women’s greater potential to care for themselves.
By adopting a strengths-based approach that emphasised women’s achievements, women were more readily able to see themselves as reaching their potential. Women explained how their positive approach to health highlighted their progress and de-emphasised failures:
…the self-talk that I would give myself is a lot more positive than before. I’m learning to celebrate the things that I have done well and to look at my failures as an opportunity for learning and growth and to know that it aint a failure unless I decide to give up (P39, 28 years, post-intervention).
As a consequence of placing greater emphasis on their strengths and achievements, women realised their worth and overcame disempowering social normative discourse. Women described being kinder to themselves and thinking of themselves more fondly after NLH. Women’s self-appreciation also translated to their perceptions of their bodies, evident by their
reports of becoming more attuned to their bodies and their functionality. Thus, women embraced their greater potential to connect with themselves and their bodies.
Much more positive in thoughts related to my body, and even more so in thoughts related to myself (P25, 27 years, post-intervention).
Women also self-actualised by realising their progress as they accomplished small goals. Accordingly, women described being more aware of their achievements and realised their greater ability to accomplish health goals. Women explained how identifying their progress made them feel empowered:
I am more aware that I do have the ability and control to make health changes as I have achieved my goals within the programme – which makes you feel stronger and empowered (P60, 25 years, post-intervention).
Women also mentioned that identifying their progress was encouraging for continued HPB achievement and thus supported a sustainable health practice:
The ability to keep taking small steps and making gradual changes in order to succeed in my health goals rather than just giving up (P28, 19 years, follow up).
Additionally, women described how focusing on small steps forward enabled them to overcome personal barriers. Some women acknowledged transitioning from an “all or nothing” health approach; an approach that comprised inconsistent HPB achievement and feelings of failure, to a health practice that was more sustainable by focusing on small achievements:
I realised that I set myself unrealistic goals sometimes and that I can be unnecessarily hard on myself when things don’t go to plan. Instead of taking the ‘all or nothing’ approach like I did prior to the programme, I know now that small steps forward are good and worthy of recognition as success (P56, 28 years, follow up).
150 Chapter 5 – NLH Outcomes In contrast to women who formerly employed an “all or nothing approach,” others struggled stepping out of their comfort zone prior to participating in NLH. Women reported how focusing on small steps forwards during NLH enabled them to try new things and overcome these barriers:
The most important would be that many goals at once are manageable and are within my reach. Mental boundaries that I set for myself have often restrained me towards goals like exercise and eating healthy. For me, that has been a constant battle between knowing what is good for me and not acting in a way that would help me succeed. This programme has done wonders in terms of fighting this inhibition to stay within my comfort zone when it comes to exercising or participating, and learning new ways to great habitual behaviour in order to eat healthy and care for myself appropriately. Constant checks with where I am today and where I would like to be in a week has come from this programme, something I would never practice a year ago. I would always say that that run can wait until tomorrow and give in to laziness, but after many months of baby steps and seeing little spouts of progression, motivation has replaced excuses (P24, 23 years, follow up).
Women also reported that focusing on small steps forward made it easier to “reset” if they fell out of good health habits. As previously mentioned (health literacy), regardless of their initial approach to health, women’s experiences of health were dynamic and their motivation fluctuated dependent upon external and internal factors:
It [NLH] helped me to focus on my good efforts, regardless of how small they were/the frequency. I have a less ‘self-punishing’ attitude towards health goals and I don’t worry about what I haven’t done that I would have liked to. I don’t put pressure on myself to follow something and am a lot more positive about starting from a few steps back if I get into bad habits (P4, 25 years, follow up).
Subsequently, women’s realisation of their ability to accomplish new activities and overcome personal barriers contributed to women’s sense of self-worth. Women’s accounts revealed that women became increasingly self-aware of realising their progression fostered greater self-worth and self-confidence.
I tried many different things that I probably would not have if I did not participate in the programme. I became more self-aware of myself and things I was able to accomplish, which made me appreciate myself more! (P38, 23 years, follow up).
Women provided examples of how they realised their greater capacities for physical, mental and social dimensions of health. Under a physical dimension, women reported improvements to their fitness, flexibility and strength. For instance, several women realised their improved ability to participate in physical activities (e.g., running, walking) longer and further than before:
…it [NLH] let me know what I am able to *make* the change on my behaviour, i.e., I can exercise!! (At least, I didn’t like exercise before the programme and exercising usually couldn’t last long) (P3, 36 years, follow up).
For mental wellbeing, women commonly reported reductions in stress and improved ability to manage and evaluate stressors. Women reported that better stress management consequently improved their energy levels, sleep and realise their potential for other activities contributing to their wellbeing (e.g., physical activity, activities for enjoyment and wellness). Women also discovered their improved ability for affective and cognitive management:
Yes, mental health has improved. Able to control and evaluate emotions better than before (P12, 26 years, post-intervention).
Women also described their greater achievement for health under a social dimension. Women discovered their ability to improve communication and confidence in their social interactions. Such improvements were beneficial for social relationships:
152 Chapter 5 – NLH Outcomes Socially, able to stay cool and positive when interacting with other people without
letting my personal worries affect the relationships (P3, 36 years, post- intervention).
Finally, women mentioned that developing a holistic health perspective contributed to their self-actualisation. More specifically, women realised their greater potential to achieve health by gaining a deeper understanding for the multiple dimensions of their physical, mental and social wellbeing as well as realising a broader range of HPBs that contributed to their wellbeing:
I have 100% achieved a balance because of this programme. I think this is the best my overall health has ever been (P40, 23 years, post-intervention).
Women self-actualised by shifting to a positive health perspective by focusing on achievable goals and recognising their small steps forward. This shift enabled women to independently identify their progress as they achieved HPBs. Additionally, focusing on small, positive steps enabled women to overcome personal barriers and adopt a more sustainable approach to their HPBs. Women described that this transition supported them to reduce feelings of failure and develop a greater self-confidence and self-worth. Additionally, women realised their greater potential to achieve health across multiple health dimensions. Lastly, women’s development of a holistic health perspective extended their ability to care for and experience their health to a greater degree.
I became more aware of how different factors the programme focused on worked together to make me feel my best (P46, 23 years, post-intervention).