Abstract
The transtheoretical model is an influential theoretical model in health psychology, particularly in its application to smoking cessation research. Decisional Balance (DB) and Temptations are key constructs within this framework. This study examines the psychometric properties of the DB and Temptations scales for smoking in a predominantly African-American sample of urban adolescent girls. We used confirmatory factor analysis to compare the fit of previously published factor structures in smokers (n = 233) and nonsmokers (n = 598). External validity was tested by examining stages of change differences in the retained subscales. Results supported the internal and external validity of the DB scale for smokers and nonsmokers. Notably, previously published three-factor (Social Pros, Coping Pros, Cons) and four-factor (Cons split into "Aesthetic Cons" and "Health Cons") models fit equally well, with Cons subscales correlating highly. For Temptations, a previously published three-factor (Negative Affect, Social, Weight Control) hierarchical model fit well in nonsmokers. In smokers, previously published subscales were reliably measured, but their structural relationship remained unclear. Stage difference tests showed medium to large effect sizes of DB and Temptation subscales in smokers and nonsmokers. The use of DB was validated for both smokers and nonsmokers in this sample of primarily African-American adolescent females, where Cons can be combined or separated into "Aesthetic Cons" and "Health Cons" based on practical utility and preference. For Temptations, more research is needed but large stage differences in Temptations subscales underscore the importance of this concept in smoking acquisition and cessation.
Highlights
The transtheoretical model (TTM)[1,2] is an influential theoretical model in health psychology, in its application to smoking cessation research
This study examines the psychometric properties of the Decisional Balance (DB) and Temptations scales for smoking in a predominantly African American sample of urban adolescent girls
Stage advancement is accompanied by shifts in two core TTM constructs: Decisional Balance (DB) and Temptations, which are the focus of this paper
Summary
The transtheoretical model (TTM)[1,2] is an influential theoretical model in health psychology, in its application to smoking cessation research It posits that the process of health behavior change can be conceptualized as movement through five stages of change, during which individuals need to use distinct strategies in order to reach and sustain behavior change. Computer-delivered interventions that tailor feedback to each of these core TTM constructs have been shown to be efficacious for smoking cessation in both adults[5] and adolescents[6]. Because these interventions are computer-delivered, they are disseminable and as such represent an important intervention option, as long as they apply across a range of populations. For Temptations, more research is needed but large stage differences in Temptations subscales underscore the importance of this concept in smoking acquisition and cessation
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