Baseline Predictors of Singular Action Among Participants With Multiple Health Behavior Risks.

Miryam Yusufov,Joseph S Rossi,Andrea L Paiva,Colleen A Redding,Wayne F Velicer,Bryan Blissmer,James O Prochaska

doi:10.1177/0890117116646341

Miryam Yusufov, Joseph S Rossi + Show 5 more

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https://doi.org/10.1177/0890117116646341

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Abstract

Previous studies found that treatment effects can change two behaviors, but not one. This study examined baseline transtheoretical model constructs as three alternative predictors (stage of change, effort, and severity) of singular action among participants with co-occurring health behavior risks. The study examined participants at risk for three pairs of behaviors (sun and smoking; smoking and diet; and diet and sun). Analyses were conducted with participants who changed only one behavior in a pair (singular action). School and home-based behavior change programs recruited participants via schools, worksites, and physician practices. School, worksite, medical, and home-based prevention programs were the study setting. The sample (N = 3213) was age 44.6 years (SD, 11.1 years), 94.6% white, and 63.7% female. Stages of change, effort, and severity variables were measured. Pooled data were analyzed using logistic regressions from three randomized controlled trials. Across all three behaviors, stage of change, effort, and severity effects were consistently related to behavior change at 24 months. Change efforts on one behavior were related to change on another behavior. Baseline sun severity (odds ratio, .97 [.94, 1.00]; p = .046) and smoking severity (odds ratio, .89 [.80, .98]; p = .019) were significant predictors of change on diet at final follow-up. Stage of change was the biggest predictor. Problem severity was the smallest predictor of change at 2-year follow-up. Four of six predictors were within behaviors, whereas two were between.

Highlights

Modifiable behaviors make a substantial contribution to preventable deaths in the United States
Since preventable risk factors for chronic disease and premature death are commonly problem behaviors (Noar, Benac, Harris, 2007), health promotion via behavior change could contribute to a substantial reduction in United States health care costs, suffering, disability and death.multiple behavior change is valuable because most medical conditions have multiple potential behavioral causes
The present study is a secondary data analysis that investigates the three of the four effects (Stage, Effort, Severity, Treatment) of the Transtheoretical Model (TTM) within multiple health behavior change. Data used for this project were drawn from a National Cancer Institute (NCI) funded center grant (P01; CA27821, Principle Investigator, Prochaska) assessing the effectiveness of school, worksite, medical, and home-based prevention programs intended for multiple cancer risk behavior reduction

Summary

Introduction

Modifiable behaviors make a substantial contribution to preventable deaths in the United States. In the year 2000, approximately 71 percent of preventable deaths in the United States were related to four vital and modifiable behaviors: physical inactivity, tobacco use, alcohol use, and unhealthy diet (Mokdad et al, 2004; Berrigan et al, 2003, Doll et al, 1981; McGinnis et al, 1993). This data suggests that it may be important to develop new paradigms of change to accommodate multiple behavior risks (e.g. lack of physical activity and high-fat diet). Examining changes in co-occurring behaviors may contribute to prevention of modifiable causes of morbidity and mortality

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