Characteristics of Individuals on The Precontemplation. Contemplation and Preparation Stages of Change

Abstract

LEARNING OUTCOME: To compare individuals self-staged in the precontemplation (PC), contemplation (C), and preparation (P) stages of change to individuals who staged themselves into action and maintenance but did not meet the behavioral criterion for assignment to these post-action stages of change.This survey was administered to a proactively recruited random sample of 4S1 adults (age=41±13.8 years) living in Massachusetts. Participants completed a phone interview that included a series of algorithms and scales designed to measure Transtheoretical Model constructs, and a mailed self-administered NCI/Block Food Frequency Questionnaire. Subjects were predominately female (62%), married (58%) and employed outside the home (63%). Based on their responses to the staging algorithms, subjects were divided into two groups: those who were in the PC, C and P stages of change based on intentions to avoid high fat foods (I, n=223), and those who believed they were avoiding high fat foods but did not meet the behavioral criterion of less than 30% energy as fat (R, n=91). Subjects in the R group were reassigned to PC, C or P based on intention to reduce dietary fat below their current intake. Mean percent energy from fat was lower among those in the R group (33.7%±9.0)) than those in the I group (36.6%±5.1), t(281)=3.6, p<.001. A 2×3 multivariate analysis of variance was performed on four dependent variables (DVs): percent energy as fat, temptation to eat high fat foods, and the pros and cons of adopting lower fat eating habits. Results indicated that the DVs were significantly affected by both group (I or R) F(4,371) = 4.11, p< 005, and stage of change (PC, C or P), F(4,386) = 6.41, p<.005. Post hoc analysis (Bonferroni adjustment) indicated the cons of change (barriers) were lower among those who had been reassigned to PC than to those who were initially staged in PC, t(213)=3.12, p<.005. Both the cons of change and temptation were lower among those reassigned to P than among those initially staged in P (cons: t(81) =2.94, p<005: temptation: t(80)=4.65, p<-005). Analysis of variance indicated that the pros of change were higher among those in P and C than among those in PC. The cons were more important to those in C than to those in PC, and temptation was higher among those in C and P than among those in PC. This research reinforces the need for stage specific interventions, and emphasizes the need for individual tailoring within stage of change.