Experiential Processes Of Change Research Articles

Research On The Physical Activity Of Beijing Adolescents Based On The Trans-theoretical Model

Background Due to the increasing academic pressure, the leisure physical activity of Chinese youth decreased year by year. Moderate exercise promotes the growth and development of children and adolescents. The trans-theoretical model (TTM) has important guiding significance for the study of adolescents’PA. PURPOSE: TTM is an integrative model of intentional change consisting of stages of change, processes of change, decisional balance and self-efficacy. We based on the TTM to investigate the participation of PA among adolescents in Beijing, aiming to explore the factors affecting the level of PA of Chinese adolescents, and provide a theoretical basis for future intervention studies. METHODS: We used the method of sampling survey to investigate the current situation of youth PA in different regions of Beijing. A total of 944 participants (594 women, 350 men), with a mean age of 13.24 ± 0.74 years and a mean body mass index of 20.22 ± 4.04 kg/m2 were included. TTM was investigated using the stages of change scale, the processes of change scale, the decisional balance scale, and the self-efficacy in exercise scale. PA level was assessed by the Physical Activity Questionnaire for Adolescents (PAQ-A). Hierarchical multiple regression models were performed with the total score of PA as dependent variables, demographic variables and TTM as independent variables to test the prediction of PA level. RESULTS: The prediction model of the PA level using demographic variables is not significant, F(7,936) < 1, P = 0.808. After adding the TTM variable, the prediction model was significant, F(12,931) = 69.035, P = 0.000. Body mass index(β = 0.012), behavioral processes of change(β = 0.474) and self-efficacy(β = 0.185) were significant predictors. Age(β = 0.003), gender(β = -0.006), single-parent family(β = -0.046), only-child family(β = 0.028), father' education(β = -0.019), mother' education(β = -0.011), experiential processes of change(β = -0.099), pros scores(β = -0.038) and cons scores(β = -0.031) were not significant predictors. CONCLUSIONS: A cross-theoretical model can measure the health behavior change of adolescents' healthy behavior. TTM can also predict the real health behavior changes of adolescents in Beijing.

The Creative Cycle Processes Model of Spontaneous Imagery Narratives Applied to the Ayahuasca Shamanic Journey

AbstractAyahuasca is an Amazonian psychoactive shamanic brew that often elicits spontaneous, intense, and meaningful imagery narratives related to psychological and physical healing, problem solving, knowledge acquisition, community cohesion, creativity, and spiritual development. My EEG and phenomenology ayahuasca research found it caused the greatest changes in EEG beta coherence from 25 to 30 cycles per second compared to a resting state before ayahuasca ingestion. Enhanced beta coherence indexes significantly greater information exchange between cortical regions and is congruent with the reported enhanced richness, complexity, and profundity of ayahuasca experiences. I developed the creative cycle processes model that identifies in ayahuasca reports distinct experiential change processes and describes how these processes, neuroscience, psychotherapy, mythological, and other transdisciplinary evidence can be coherently integrated to explain ayahuasca benefits. The model suggests three change process stages together underlie one emergent dynamic creative cycle process. The sequential stages are Form dismantling and healing processes, form creation processes, where novel forms spontaneously combine, and form expression processes, where emergent experiences are embodied. The model suggests that these three stages repeat cyclically in human development in an ongoing process of dismantling and generation producing more creative experiences and expressive forms.

범이론모형(Transtheoretical Model) 기반의 운동행위강화 프로그램이 고혈압 노인의 혈압 및 신체활동량에 미치는 효과

본 연구는 범이론모형에 기반하여 운동행위강화 프로그램을 개발하고 이를 고혈압 노인에게 적용하여 혈압 및 신체활동량에 미치는 효과를 규명하고자 하였다. 연구대상자는 서울시 소재 노인복지관에 내원하며 연구에 참여를 허락한 65세 이상 고혈압 노인 41명으로 실험군 20명, 대조군 21명이었다. 실험군에게는 범이론모형에 기반한 운동행위강화 프로그램을 8주 동안 적용하였다. 연구결과 실험군은 대조군에 비하여 운동행위 변화단계, 전체 변화과정 점수, 행위적 변화과정 점수, 운동 자기효능감, 신체활동량이 유의하게 증가하였으나, 경험적 변화과정 점수, 의사결정균형, 혈압 등은 유의한 차이가 없었다. 이러한 결과를 바탕으로 운동행위강화 중재는 비활동 고혈압 노인의 운동행위로의 이행과 신체활동량을 증진시키는데 효과가 있음을 확인하였다. 본 프로그램이 지역사회에 거주하는 고혈압 노인에게 적용된다면 운동습관을 형성하게 하여 고혈압 합병증을 예방하는데 기여할 것으로 기대된다. This study was done to evaluate the effects of a transtheoretical model (TTM) based exercise behavior improving program for older adults with hypertension on the stage of change, processes of change, decisional balance, exercise self-efficacy, blood pressure and physical activity. A non-equivalent control pre-post design was used for this study. The subjects were 41 adults over 65 years of age with hypertension who did not practice regular exercise. The experimental group (n=20) received the 8-week TTM based exercise behavior improving program. The control group received hypertension self care management education. Descriptive analysis, <TEX>$x^2$</TEX>-test, t-test, paired t-test were used for analyzing the data using SPSS for Windows 14.0. As a results, there was a significant increase in stage of change, total score for processes of change, behavioral process of change, exercise self-efficacy, total physical activity, and walking in the experimental group compared to the control group. But, there were no significant differences between the two groups on the experiential processes of change, decisional balance, and blood pressure. The results of this study suggest that a TTM based exercise behavior improving program has positive effects on improving exercise behavior among older adults with hypertension.

Construct validity of four exercise stage of change measures in adults

Measuring readiness to exercise, or exercise stage of change (ESOC), is an important first step when counseling adults about exercise. However, minimal construct validity testing of ESOC measures has been reported. With a sample of 95 adults, we estimated the construct validity of four ESOC measures with commonly used response formats (true/false, ladder, 5 choice, interview). Participants completed all four ESOC measures in random order as well as six validation measures: physical activity performed, exercise self-efficacy, decisional balance pros and cons, and behavioral and experiential processes of change. Few participants were in the earliest stage of change. The true/false measure demonstrated the strongest validity. Further studies are needed in diverse samples with more representation across the stages of change.

The Transtheoretical Model: An Exploratory Look at Its Applicability to Injury Rehabilitation

The transtheoretical model has been widely used in the investigation of how people adapt to new behaviors; however, the literature appears to be lacking documentation of any assessment/s administered to injured athletes to determine their readiness for rehabilitation, which depending on the severity of the injury, could possibly represent a behavior change for that individual. To validate the application of the transtheoretical model to injury rehabilitation and assess the impact of stages of change on athletes' adherence and compliance rates. Descriptive correlational. Large Mid Atlantic Division I institution. Seventy injured athletes. Readiness was assessed using the Transtheoretical Model. Adherence was assessed using the percentage of rehabilitation attendance and compliance was assessed using the Sport Injury Rehabilitation Scale. Participants who were advanced in their stages of change generally reported an increase in self efficacy, utilization of pros versus cons, and the use of behavioral processes instead of experiential processes of change. No significant relationships were found between stages of change and athletes' adherence and compliance. Although no statistical significance was found between stages of change and adherence and compliance the results did validate the application of the transtheoretical model to injury rehabilitation.

The Processes of Change for Exercise Behavior in Individuals Living with HIV

The processes of change are the experiential and behavioral activities than an individual engages in as they move through the stages of change. Interventions should be designed to incorporate stage appropriate activities in order to facilitate movement from one stage to the next. However, little research has examined the differences in the use of the processes of change across the five stages of change in healthy populations and it has never been examined among individuals living with HIV. PURPOSE: To examine the differences between the ten processes of change, explained by the stage of change in individuals accessing HIV-related care services. METHODS: Cross-sectional data were collected from 208 individuals accessing HIV-related care services from February - April 2006 in a large Southeastern city. Participants completed a questionnaire which assessed their stage of change for exercise as well as the behavioral and experiential processes of change. RESULTS: Univariate analyses revealed significant differences between the stages of change for six of the ten processes of change (p<.001). The largest proportion of variance was derived from the behavioral processes: self-liberation (n2 = 0.24), counter conditioning (n2 = 0.24), reinforcement management (n2 = 0.18) and self-liberation (n2 = 0.14). Only two of the experiential processes were significantly different by stage: consciousness-raising (n2 = 0.09) and dramatic relief (n2 = 0.08). CONCLUSIONS: The use of the processes of change was significantly different across the stages of change for six of ten processes. These results are consistent with studies in healthy populations, which suggest that designing a stage-matched exercise intervention, which incorporates activities based on the processes of change, is appropriate for individuals living with HIV.

An Application of the Transtheoretical Model to the Exercise Behavior of Individuals Accessing HIV-related Services

Clinical research suggests that exercise is beneficial for individuals living with HIV; however, there is little research examining the exercise behavior of individuals living with this disease in a community setting. Furthermore, the trans theoretical model (TTM) of exercise behavior has been widely used to identify the readiness to begin planned exercise behavior in healthy populations, but it has not been widely applied individuals living with HIV who are engaged in HIV-related care services. PURPOSE: To examine 1) the distribution of the stages of change for exercise among individuals accessing HIV-related care services, 2) the differences between the TTM constructs explained by the stage of change, and 3) whether the TTM constructs predict the stages of change better than chance alone. METHODS: Cross-sectional data were collected from 208 individuals accessing HIV-related care services from February - April 2006. Participants completed questionnaires for each TTM construct (processes of change, self-efficacy, and decisional-balance) and a measure of physical activity MET level. RESULTS: Univariate analyses revealed significant differences between stages of change for each of the TTM constructs (p<05). The largest proportion of variance was derived from the behavioral processes (n2 = 0.22) followed by self-efficacy (n2 = 0.15), the experiential processes of change (n2 = 0.14), and decisional-balance (n2 = 0.11). Predictive discriminant analysis revealed that participants in precontemplation were accurately classified 48% of the time, contemplators 25% of the time, preparers 70% of the time, and individuals in maintenance 63% of the time. None of the individuals in action were classified correctly. CONCLUSIONS: This was one of the first studies to examine the TTM for exercise behavior among individuals accessing HIV-related care services. Overall, the results are consistent with other studies in healthy populations, suggesting that stage-matched interventions based on this model can be developed for individuals accessing HIV-related care services.

Predictive value of the transtheoretical model to smoking cessation in hospitalized patients with cardiovascular disease

Several authors have questioned the transtheoretical model. Determining the predictive value of each cognitive-behavioural element within this model could explain the multiple successes reported in smoking cessation programmes. The purpose of this study was to predict point-prevalent smoking abstinence at 2 and 6 months, using the constructs of the transtheoretical model, when applied to a pooled sample of individuals who were hospitalized for a cardiovascular event. The study follows a predictive correlation design. Recently hospitalized patients (n=168) with cardiovascular disease were pooled from a randomized, controlled trial. Independent variables of the predictive transtheoretical model comprise stages and processes of change, pros and cons to quit smoking (decisional balance), self-efficacy, and social support. These were evaluated at baseline, 2 and 6 months. Compared to smokers, individuals who abstained from smoking at 2 and 6 months were more confident at baseline to remain non-smokers, perceived less pros and cons to continue smoking, utilized less consciousness raising and self-re-evaluation experiential processes of change, and received more positive reinforcement from their social network with regard to their smoke-free behaviour. Self-efficacy and stages of change at baseline were predictive of smoking abstinence after 6 months. Other variables found to be predictive of smoking abstinence at 6 months were an increase in self-efficacy; an increase in positive social support behaviour and a decrease of the pros within the decisional balance. The results partially support the predictive value of the transtheoretical model constructs in smoking cessation for cardiovascular disease patients.

MOVING BEYOND THE TRANSTHEORETICAL MODEL

MOVING BEYOND THE TRANSTHEORETICAL MODEL

Application of the Transtheoretical Model to Fruit and Vegetable Consumption among Economically Disadvantaged African-American Adolescents: Preliminary Findings

To examine the application of the transtheoretical model (TTM) to fruit and vegetable consumption among economically disadvantaged African-American adolescents. Scales for measuring decisional balance, situational self-efficacy, and processes of change for fruit and vegetable consumption were developed and pretested with 57 economically disadvantaged African-American adolescents. The scales and measures for assessing stages of change, demographic variables, and fruit and vegetable consumption were administered to a separate sample of 262 participants. t-tests for independent samples and analysis of variance were used to examine differences in TTM variables and fruit and vegetable consumption across stages of change. Two-factor solutions for decisional balance and processes of change and a three-factor solution for situational self-efficacy provided the best fit to the data. Alpha coefficients of reliability for the scales ranged from .77 (experiential change processes) to .91 (pros). Participants in action-maintenance stages evidenced higher pros, self-efficacy, and fruit and vegetable consumption and significantly lower cons than did participants in precontemplation and contemplation-preparation stages. Also, participants in action-maintenance stages used processes of change more frequently than did those in precontemplation-contemplation-preparation stages. The use of experiential and behavioral processes within these stages did not differ significantly, as posited. Observed differences in TTM variables and fruit and vegetable consumption by stage of change in this sample of economically disadvantaged African-American adolescents were consistent with theory and previous applications of the model to fruit and vegetable consumption in adults. With replication studies, the TTM may be appropriate for designing interventions to increase fruit and vegetable consumption among this population.

Psychometric evaluation of the smoking cessation Processes of Change scale in an adolescent sample

The Processes of Change are the cognitions, behaviors, and emotions that people employ to change their behaviors. However, the processes of change remain the least studied dimension of the transtheoretical model. The present study presents a psychometric evaluation of the short form of the processes of change inventory for smoking cessation in an adolescent sample of 798 ninth-grade smokers from 22 Rhode Island high schools. The majority of the sample was white (87.2%), split approximately evenly as regards to gender (48.1% female), with an average age of 14.3 (SD = 0.6) years of age. The same hierarchical model established on the adult sample was fit to the 20-item inventory. This model included 10 primary factors representing the processes of change and two second order factors that grouped the processes into five behavioral and five experiential processes of change. Model fit indices (RMSEA = 0.08, CFI = 0.92) supported the hypothesized structure. External validation was established by testing for stage differences in the use of the ten processes. A significant MANOVA ( F(4, 793) = 18.517, p < 0.001) and separate ANOVAs demonstrated that the use of all ten processes increased across the stages, as predicted by the transtheoretical model of behavior change. The processes of change help guide researchers, clinicians, and intervention program developers towards effective strategies to assist individuals at all stages of change progress towards healthier behaviors.

What is the right thing at the right time? Interactions between stages and processes of change among smokers who make a quit attempt.

C. A. Perz, C. C. DiClemente, and J. P. Carbonari (1996) claim support for the transtheoretical model notion that success in smoking cessation involves doing the right thing at the right time: emphasising experiential change processes during the contemplation and preparation stages and shifting to behavioral process activities during action. A key methodological limitation of Perz et al. was their failure to control for stage of change, a measure that has been shown to be predictive of cessation. This study replicates the prospective findings of Perz et al. in a different data set, then controls for stage of change when it is predictive of cessation, and finds that the measures of "appropriate" change process use developed by Perz et al. no longer predict cessation. The authors conclude that stage of change, in particular the distinction between smoking and not smoking, is more important than change process use in predicting cessation outcomes.

Validation of a Stages of Exercise Change Questionnaire

The purpose of this study was to examine evidence for the validity of a stages of change measure of the Transtheoretical Model for exercise behavior. Participants were 152 university students (53.3% women, 71.6% Caucasian, M age = 19.18 years) who completed processes of change, self-efficacy, decisional balance, stages of change, and exercise behavior questionnaires as well as a maximal treadmill test. Participants in the action and maintenance stages had the highest strenuous (PC/C/P < A/M) and moderate (PC/C < A/M) self-reported exercise behavior. Those in the maintenance stage had the highest estimated aerobic fitness (PC/P < M). The differences between the early stages (PC, C, and P) and the later stages (A and M) as described by the first function were primarily due to the behavioral process of change. The differences between the extreme stages (PC and M) and the middle stages (C, P, and A) were due to the experiential processes of change and the pros of decisional balance. The hypothesized patterns ofstage differences were partially supported. Failure to obtain full support may have been due to methodological issues or inherent difficulties in detecting evidence for the validity of stages of change measures.

Predicting increases in readiness to quit smoking: A prospective analysis using the contemplation ladder

Most smokers are not motivated to quit. The transtheoretical model posits mechanisms (processes of change and pros and cons) by which smokers might increase their stage of readiness to quit. While cross-sectional relationships among the stages of change, processes of change, and pros and cons are well established, there is little evidence that processes of change and pros and cons predict progressive stage movements. This study uses data from a large worksite-based cancer prevention study (the Working Well Trial) to test the hypothesis that processes of change and the pros and cons of smoking predict progressive movement up the contemplation ladder, which is an alternative measure of motivation to quit smoking based on social cognitive theory. The results indicate that experiential processes of change promote increases in readiness to quit smoking. This study provides further evidence for the predictive validity of the contemplation ladder and sheds light on how unmotivated, nonvolunteer smokers can be motivated to consider cessation.

Nonprogressing profiles in smoking cessation: What keeps people refractory to self-change?

A 2-year cross-sequential analysis of informal self-change efforts at smoking cessation evaluated the use of coping operations and the mediation of cognitive judgments among four composite profiles. Subjects (N = 544) were grouped by stage of readiness to change (contemplation, action, relapse, and maintenance) and assessed every 6 months on 10 change processes, self-efficacy, and the decisional balance between the "pros" and "cons" of smoking. Two change status profiles, contemplation to maintenance, and relapse to maintenance, were selected as exemplars of optimal linear progress; two others, chronic contemplation and chronic relapse, illustrated nonprogressing patterns in which subjects remained stuck in the same stage for 2 years. Multivariate and univariate ANOVA results indicated that nonprogressing smokers overutilize certain experiential change processes rather than underutilizing behavioral strategies, as was predicted. Implications of these results for specialized self-help interventions are discussed in the context of a comprehensive model of change for the addictive behaviors.

Self-change processes, self-efficacy and self-concept in relapse and maintenance of cessation of smoking.

The study compared 38 maintainers and 24 relapsers who had quit smoking on their own. The results suggest that successful self-changers relied more on inner-directed, experiential processes of change, while the relapsers relied more on environmental change processes. Successful changers experienced markedly higher levels of self-efficacy, while relapsers reported least confidence in coping with situations that evoke negative emotions. The maintainers experience high congruence between their basic self-concepts and their concepts of self as non-smokers. The relapsers see themselves as more anxious, dependent, and helpless in their role as smokers. The results are discussed in terms of how greater reliance on experiential processes of self-change can lead to more successful attempts at cessation of smoking than reliance on environmental processes of change.