Early Stages Of Change Research Articles

THE TRANSTHEORETICAL MODEL OF BEHAVIOR CHANGE: ITS POTENTIAL USE WITH YOUTH

2011 PURPOSE: The potential application of the Transtheoretical Model of Behavior Change (TMBC) to youth exercise behavior was explored. METHODS: Subjects (n = 191) completed a questionnaire designed to evaluate their self reported physical activity levels, stages of change, processes of change and self-efficacy for exercise. Subjects' body composition and fitness levels were also measured. RESULTS: Distribution of the sample across the stages was: precontemplation, n = 15; contemplation, n = 20; preparation, n = 35; action, n = 30; and maintenance, n = 91. Analysis of the biological/behavioral measures (fitness level, body composition, reported physical activity level) indicated that there were significant differences (p < 0.05) between stages of change for all measures. Post hoc analysis indicated that those in the later stages of change were more fit, had lower body composition and were more active than those in earlier stages. Analysis of the psychological measures (ten processes of change and self-efficacy for exercise) indicated that there were significant differences (p < 0.05) between stages of change for self-efficacy and several processes of change. Post hoc analysis indicated that later stages of change scored significantly higher on the self-efficacy scale and used processes of change more often than earlier stages of change. Significant differences were found between genders for body composition and eight of the ten processes of change. DISCUSSION: Overall the results indicate that the TMBC has potential for use with younger populations.

Transtheoretical Measures for Adolescent and Adult Smokers: Similarities and Differences

Background.The prevalence of smoking among adolescents has remained stable and has increased in the past few years. Longitudinal results from a multitude of efforts to reduce adolescent smoking have been mostly disappointing.Methods.This paper discusses, in light of the theoretical knowledge obtained among adults and the empirical data collected among adults and adolescents, the applicability of the central concepts of the Trantheoretical Model of Change to the adolescent smoking problem.Results.According to the stage of change distributions, adolescent smokers appeared to be somewhat less prepared to quit than adults. Both adults and adolescents utilize identical cognitive and behavioral activities to change their smoking although teens' process use appears to differ from that of adults at each stage of change. According to the decisional balance measure, the pros of smoking among adults and teens exceeded the cons in early stages of change and then reversed once smokers took action to quit. The levels of temptations to smoke among adults and adolescents were almost identical at each stage.Conclusions.Both age groups turned out to be remarkably similar in the Transtheoretical measures, and, except for the processes of change, both groups exhibited similar behavior at different stages of the smoking cessation process.

Cognitive Behavioral Strategies for Persons with Mental Illness and Substance Abuse Problems

Abstract Cognitive behavioral strategies for treatment of alcohol and other drug use are reviewed. These strategies are organized according to the person's readiness for change. Persons in an early stage of change may benefit from considering the advantages and disadvantages of continued drug use. Persons who admit they have a problem with drug use might participate in skills training, cue exposure, and contingent reinforcement. Most persons who are able to obtain sobriety will relapse, at some point, so relapse prevention and life-style change approaches will help them prepare for situations where lapses have occurred in the past. Staff working in rehabilitation settings need to consider how to adapt these approaches to persons who both abuse alcohol and other drugs AND are also challenged by severe mental illness.

Dynamic typology clustering within the stages of change for smoking cessation

Dynamic typology clustering was employed to find homogeneous subgroups of smokers within each of three early stages of change (precontemplation, contemplation, preparation) in a representative sample of smokers. Individual change profiles were created by coding the stage of change for each subject at five consecutive assessment points over a 2-year period (baseline and 6, 12, 18, and 24 months). A total of 446 unique change profiles were found in the sample of 2,088 smokers who had complete data for all five time points. The sample was initially split into three groups determined by baseline stage of change. Within each initial stage, subgroups that shared similar patterns of change were interpreted by examining the shape and elevation of the change profiles. Four major types of profiles emerged: a stable profile, a progressing profile, a vacillating profile, and a regressing profile. External validation revealed significant differences among the dynamic typology subtypes on key transtheoretical model constructs (processes of change, decisional balance, situational temptations). These results both support and complement key construct relationships within the transtheoretical model and can provide important predictive information to direct and enhance treatment interventions for smoking cessation.

Variations in self-determination across the stages of change for exercise in adults.

This study explored the relationship between self-determination in the regulation of exercise behavior and stage of change for exercise. Deci and Ryan (1985, 1990) outlined a continuum of behavioral regulation that ranges from non-self-determined regulation (external regulation) to completely self-determined regulation (intrinsic regulation). Prochaska and DiClemente (1984) outlined five stages of behavior change that range from no thoughts of changing (precontemplation) to maintenance of change (maintenance). In our study, 314 individuals completed measures of regulation in exercise behavior and stage of change for exercise. Discriminant function analysis revealed that those in the latter stages of change were more self-determined in their behavioral regulation than those in the early stages of change. An analysis of variance indicated that self-determination increased from the lower to the upper stages of change. Results endorse the importance of motivational considerations in understanding the change process.

Stages of Change of Smoking Cessation: Relationships With Other Health Behaviors

Health behaviors are often intercorrelated, suggesting that these behaviors may be manifestations of underlying attitudes toward health. Changes in these attitudes may cause simultaneous changes in several health behaviors. As individuals progress among the stages of change of one health behavior, such as smoking cessation, they may make changes in other health behaviors as well. This study evaluated the hypothesis that subjects in the later stages of change of smoking cessation would practice more healthful behaviors than subjects in the early stages of change. Subjects were 929 respondents in the California Behavioral Risk Factor Surveillance Study who were current smokers or had quit smoking within the past year. Subjects in the more advanced stages of smoking cessation showed more healthful levels of alcohol use and exercise than subjects in the earlier stages. These results suggest that people may make improvements in several health behaviors concurrently. If so, lifestyle-based health promotion programs may be able to take advantage of shifts in attitudes toward health behavior to modify several health behaviors simultaneously.

Applying the transtheoretical model to a representative sample of smokers

Interrelationships among key constructs of the Transtheoretical Model are examined for the first time on a large ( N = 4,144) representative sample of smokers. The posited relationships between the early Stages of Change (Precontemplation, Contemplation, Preparation) and the Processes of Change, Decisional Balance, and Situational Temptation are generally supported. Precontemplators are found to use the Processes of Change the least and those in Preparation use them the most. Precontemplators also have the least negative attitudes toward their smoking behavior. Precontemplators and Contemplators are tempted to smoke in more situations than those in Preparation. Precontemplators are also the most addicted to smoking, followed by those in Contemplation and Preparation, respectively, when examined on traditional measures of smoking behavior. The implications for smoking cessation efforts are also discussed.

THE POTENTIAL HEALTH IMPACT OF GLOBAL CLIMATE CHANGE

It is well known that airpollution can affect human health directly and indirectly. The direct effects as a result of inhalation or dermal contact are widely studied and reasonably well characterized. However, great uncertainty still exists about the magnitude and rate of global climate change. The potential adverse impact on man warrants attention even in these early stages of change. This paper summarises information on the potential health impacts of climate change, published in international literature since 1986 with special reference to the South African situation.

Public Personnel Administration and the Constitution: An Emergent Approach

D uring the past decade the courts have almost completely transformed the nature of the constitutional position of public employees in the United States. This transformation has largely resulted in an expansion of the constitutional rights and protections afforded public employees in their relationship with government in its role as employer. In the early stages of change, judicial decisions tended to destroy prevailing doctrines without replacing them with much more than a demand that the balance between the rights of public employees and public employers be redressed. It is now possible, however, to identify a consistent line of judicial reasoning that has been emerging and to assess, in a preliminary way, its importance for public personnel administration.