Stages Of Change Model Research Articles

The research progress on stages of change model' s application to chronic pain management

Chronic pain can cause physical, mental and social effects. In order to reduce the harm caused by it, pain self-management is playing an increasingly important role at present. The stage of model has been used in the field of chronic pain, and it has excited great interest among clinicians and researchers in recent years. It is a psychological model which describes the process of behavior change. On the basis of this model, patients with chronic pain go through specific of change when attempting to selfmanage pain, and these stages reflect patient motivation for pain self-management. For example, patients in the pre-contemplation stage are not motivated to self-manage pain. In order to make clinical practice more effective,nursing intervention should be targeted at various groups. This article is to review the publications which the stages of model is studied in patients with chronic pain and to renew or improve the current existing nursing model. Key words: Stages of model; Chronic pain; Self-management; Review literature

Assessing the Stages of Change Among African American Women in a Weight Management Program.

The objective of this study was to assess the relationship between stage of change (SOC) and behavioral outcomes among African American women entering obesity treatment in two settings. Fifty-five overweight/obese (body mass index = 26.50-48.13), but otherwise healthy African American women, 23 to 56 years old, attended a 13-week weight loss-treatment program that took place at churches (n = 36) or a university (n = 19). Participants were weighed, completed SOC measures, and had a physical fitness test at pre- and posttreatment. Pretreatment measures of SOC placed 47% of the participants as actors, 31% as contemplators, and 22% as maintainers. Of the 45 women who reported posttreatment SOC, 7% regressed, 44% did not change, and 31% progressed in SOC. Pretreatment SOC predicted posttreatment weight loss in the church setting but not in the university setting. At churches, contemplators lost more weight than actors and maintainers. The church may be a more conducive setting for weight change behaviors for African American women who are categorized as contemplators in the SOC model.

Health Behavior Change Challenge: Understanding Stages of Change

Objectives: After completing their own health behavior change challenge (HBCC) activity, students will be able to understand better, first hand, the complexities of implementing health behavior change. More specifically, students will increase their understanding of the barriers target audiences’ face by participating in their own personal challenge. They will also be able to identify and apply stages of change (Transtheoretical Stages of Change model) and other health communication models (Health Belief Model), theories, and concepts. At the same time, students will come to develop a deep appreciation of their own barriers, competitions, and motivations for positive health change. Courses: Health Communication, Health Communication Campaigns, Communication Theory

The long-term learning effect of training in stage of change for smoking cessation: a three-year follow up of community pharmacy staff's knowledge and attitudes

AbstractObjectiveA randomised controlled trial has already demonstrated that a training workshop on smoking cessation counselling for pharmacists and their assistants, based on the stage of change model, had a positive effect on the knowledge and attitudes of pharmacy personnel for at least a year, and was associated with increased and more useful counselling, and higher smoking cessation rates. An extension of the study aimed to monitor the duration of the training effect and so help to determine the optimum time span for refresher training. This paper reports the results of two further annual follow-ups.MethodA previously developed and validated self-completion questionnaire assessing knowledge and attitudes was re-administered to intervention and control personnel at 24 and 36 months. One hundred and thirty-four questionnaires were completed at 24 months (85 per cent response rate) and 124 (83 per cent) at 36 months.SettingCommunity pharmacies in Grampian, Scotland, United Kingdom.Key findingsThe training had a significant effect on knowledge for at least three years, since at both 24 and 36 months the intervention pharmacy teams had a significantly greater knowledge and understanding of the model than the controls (24 months, P=0.0001; 36 months, P=0.031). At 24 months, the intervention pharmacy teams were significantly more confident in their ability to counsel smokers (P=0.021) and were more positive about the outcome of smoking cessation counselling provided in community pharmacies (P=0.043). These attitudinal differences were no longer statistically significant at 36 months.ConclusionThis study has demonstrated the long-term benefit of the stage of change training over a three-year period, for both community pharmacists and their staff, on knowledge and attitudes.

Socioeconomic variation in recall and perceived effectiveness of campaign advertisements to promote smoking cessation

There are large disparities in cigarette smoking rates by socioeconomic status (SES) in many countries. There is mixed evidence about the relative effectiveness of smoking cessation media campaigns in promoting quitting between lower and higher SES populations, and studies suggest that some types of ad content may have differential effects by SES. We analyzed data from five waves of the New York Media Tracking Survey Online (MTSO), a web survey involving over 7000 adult smokers conducted between 2007 and 2009, to assess SES variation in response to smoking cessation ads. Smokers with low levels of education and income less often recalled ads focused on how to quit, and perceived them as less effective, than ads using graphic imagery or personal testimonials to convey why to quit. Contrary to predictions offered by the Stages of Change Model, we found no evidence that variation in readiness to quit smoking explained patterns of response by education. Results offer guidance for theorists and campaign planners in developing campaigns that are likely to promote cessation among less educated populations.

Sexual behavior, stages of condom use, and self-efficacy among college students in Taiwan

The purposes of this study were: (1) to assess sexual behaviors and condom use behaviors; (2) to compare sexual behaviors and condom use behaviors between gender groups; and (3) to explore differences in specific items of self-efficacy to practicing condom use by the transtheoretical model stages of readiness to change among college students in Taiwan. A survey of students at two universities yielded 996 valid responses. The survey questions collected reports of demographic information, sexual history, condom use in general, and likely condom use in specific situations in relation to self-efficacy. Only 27.8% (n=277) reported ever having had sex, of these only 31.4% used condoms every time (those in action and maintenance). Condom use among women was lower than among men with men 5.1 times more likely to use condoms to prevent sexually transmitted infections (OR=5.1, 95% CI: 2.14–12.16, p=0.0002). The stages of change model with reported attitudes (self-efficacy) toward condom use in specific situations. The Tukey–Kramer multiple comparisons showed that participants in the maintenance stage reported significantly higher scores than those in the pre-contemplation, contemplation, and preparation stages for all 10 self-efficacy items (p<0.0001). Circumstances that are the most challenging for condom adherence across the stages are: partner preference to forego use, situations involving alcohol and drug use, and perceived low-risk scenarios. College students in Taiwan would benefit from targeted interventions that link risky sex to alcohol, and that address the interpersonal pressure within relationships that compel women students to practice unsafe sex.

Predictors of success to weight-loss intervention program in individuals at high risk for type 2 diabetes

This study aimed at identifying predictors of success (retention after one year of intervention with ≥5% weight loss) in subjects at high risk for type 2 diabetes enrolled in a lifestyle modification program. Fifty-one individuals with BMI ≥27 kg/m 2 and pre-diabetes or metabolic syndrome were enrolled in an individualized multidisciplinary lifestyle intervention to induce weight loss. Subjects were assessed initially with a 16-item weight-loss readiness tool (WLRT) based on stages of change model; a 6-min walk test; and anthropometric measures. The most significant independent factor associated with no success was a lower result to the question “I am capable of doing more physical activity” ( P = 0.001). The second significant independent predictor was ≤0.5% weight loss 6 weeks after initiating intervention ( P = 0.01). Excluding subjects with both criteria would have reduced by 52% the number of subjects eligible for the program, decreased the dropout rate from 30% to 17%, and increased the proportion of subjects with ≥5% weight loss at one year from 51% to 80%. Importantly, only 4% of subjects would have been falsely identified as non-responders. These results indicate that a practical WLRT, in combination with early weight-loss response, is helpful to identify subjects with greater chances of success to lifestyle intervention.

AIDS Prevention Studies Based on the Stages of Change Model

AIDS Prevention Studies Based on the Stages of Change Model

Translating patient education theory into practice: Developing material to address the cardiovascular education needs of people with rheumatoid arthritis

ObjectiveThis paper describes the rationale and design of a theory-informed patient education programme addressing cardiovascular disease for people with rheumatoid arthritis (RA) to illustrate how theory can explicitly be translated into practice. MethodsA steering group of rheumatologists and psychologists was convened to design the programme. The Common Sense Model, the Theory of Planned Behaviour and the Stages of Change Model were used to underpin the topics and activities in the programme. User involvement was sought. The programme was formatted into a manual and the reading age of the materials was calculated. ResultsA small group 8-week programme was designed. The structure of the patient education programme, including topics, underlying psychological theory as well as behaviour change techniques, is described. ConclusionThis patient education programme addresses a currently unmet educational need for patients with RA and uses theory to design, not just evaluate, the programme. This will allow both enhanced interpretation of the results when the programme is implemented and replication by other units if successful. Practice implicationsThe actual design and detail of education programmes merit wider dissemination to facilitate progress in the process of development and application.

Intensive Diabetes Management: Negotiating Evidence-based Practice

An exploration was completed of health professionals' experiences implementing evidence-based guidelines that promote intensive management (IM) for people with diabetes. In-depth, semi-structured interviews were conducted with 50 health professionals from across Canada. These professionals are considered to be opinion leaders in diabetes care. Interviews were audiotaped, transcribed verbatim, and coded with the assistance of NVivo software. Transcripts were analyzed using Potter and Wetherell's approach to discourse analysis. Participants noted that recent clinical trials validated intensive approaches to diabetes management. While they viewed the evidence as sound, they did not feel that it justified IM approaches in all situations. Evidence-based practice therefore gave way to individual patient considerations. Implementing behavioural strategies, such as the stages of change model, allowed participants to modify their practices in ways that accommodated both evidence-based and patient-focused practice paradigms. While evidence-based medicine influenced practice, it was only one discourse that shaped the way health professionals approached diabetes care.

Compreensão das mudanças comportamentais do usuário no Programa Saúde da Família por meio da participação habilitadora

This study aimed to understand how users from Family Health Program (FHP) make their decision about health-illness. It was used the Stages of Change Model from Prochaska and DiClemente to identify the level of change of FHP users. It was a qualitative research developed with users and FHP health professionals from Crato, Ceará State, Brazil. The data were collected by semi-structured interviews, focal group and observation from May to September in 2005. They were organized by means of content analysis and analyzed in the light of theoretical reference. The changes of the FHP users are depicted as following: in the pre-contemplation stage the emphasis is on disease and care itself. In the contemplation stage, the care is on the family. It is centred in the cure and treatment of diseases. In the determination stage, we have some improvement concerning prevention in the family, with registers of looking around. In the action stage, behaviour from the user to reach autonomy and emancipation is registered. These results seem to indicate ascendency in FHP users' learning and participation towards health promotion.

A case study of nutrition education based on the stage of change model in an elementary school

A case study of nutrition education based on the stage of change model in an elementary school

Incorporating the Stages of Change Model in Solution Focused Brief Therapy With Non-Substance Abusing Families: A Novel and Integrative Approach

Both the Stages of Change Model (transtheoretical model [TTM]) and solution focused brief therapy (SFBT) are widely used when counseling substance abusing clients, and there is broad support in the literature to document their effectiveness. Likewise, SFBT has also been applied in the martial and family counseling setting with good results. The authors found no documentation in the literature integrating the TTM and SFBT as a therapeutic technique. As both models are widely used, accepted, and have been empirically validated, after reviewing the pertinent literature, the authors propose a methodology incorporating both the TTM and the SFBT when working with non-substance abusing clients and their families.

Use of the Stages of Change Transtheoretical Model in End-of-Life Planning Conversations

Reports in the end-of-life literature reveal that patients and health care professionals, including social workers, nurses, and physicians, avoid discussions about preparation for such care. End-of-life care discussion barriers include, but are not limited to, professionals feeling unprepared to have the discussions and patients' lack of readiness to discuss planning for this care. Another barrier is the lack of a structured framework to initiate these discussions, especially with clients with advanced illnesses who may not acknowledge that they are at high risk for needing end-of-life care in the future. In a controlled trial of an Advanced Illness Coordinated Care Program, social workers initiated end-of-life planning discussions using the Stages of Change model (SOC). This article describes how the social workers introduced end-of-life planning discussions using the SOC conceptual structure to illustrate the application of a conceptual framework for professionals working with advanced illness populations.

Does Motivational Interviewing Stages of Change Increase Treatment Retention among Persons Who Are Alcohol and Other Drug Dependent and HIV Infected?

Motivational interviewing (MI) and stages of change are clinical and theoretical techniques receiving considerable attention in the alcohol and other drug treatment arena. An attempt was made to evaluate whether the theoretical perspectives behind MI and the transtheoretical stages of change model would increase treatment retention and completion with persons who are both alcohol and other drug dependent and HIV infected. A post-test design was used to test the potential of MI to increase the number of days in treatment and completion rates. Results showed that utilizing MI and the stages of change model did not increase the number of days in treatment, nor was there an increase in treatment completion. Findings suggest that those with multiple problems requiring an array of change stages to monitor may not benefit from this model.

Food safety knowledge and practice by the stages of change model in school children.

In this study, 342 grade 4-6 elementary school students in Gyeonggi-do were recruited to determine their readiness to change food safety behavior and to compare their food safety knowledge and practices by the stages of change. The subjects were divided into three stages of change; the percentage of stage 1 (precontemplation) was 10.1%, the percentage of stage 2 (contemplation and preparation) was 62.4%, and that of stage 3 (action and maintenance) was 27.5%. Food safety knowledge scores in stage 3 (4.55) or stage 2 (4.50) children were significantly higher than those in stage 1 children (4.17) (P < 0.05). The two food safety behavior items "hand washing practice" and "avoidance of harmful food" were significantly different among the three groups (P < 0.05). Stages of change were significantly and positively correlated with food safety knowledge and practice. Age was significantly and negatively correlated with the total food safety behavior score (r = -0.142, P < 0.05). The most influential factor on the stage of change was a mother's instruction about food safety (P < 0.01).

A Preliminary Study of Dietary Habits Based on the Stage of Change Model among Dance Sport Coaches

A Preliminary Study of Dietary Habits Based on the Stage of Change Model among Dance Sport Coaches

Assessing readiness to work from a stages of change perspective: Implications for return to work

The Lam Assessment on Stages of Employment Readiness (LASER) was developed to assess welfare recipients' employment readiness. The LASER consists of 14 items corresponding to Prochaska's stages of change model (Prochaska, DiClemente and Norcross, 1992). A sample of 149 welfare recipients from a work training program participated in the study. The Confirmatory Factor Analysis (CFA) supported the three factors structure corresponding to Prochaska's Pre-Contemplation, Contemplation, and Action stages. A cluster analysis classified the sample into three groups according to their LASER scores. A six months follow-up on employment outcomes showed that those who were in Pre-contemplation stage had the poorest employment outcome (25%), those who were in the Action stage had the best outcome (56%) and those in the Contemplation stage were in between (38%). Implications for work rehabilitation and treatment matching were discussed.

Minus]plastic: influencing pro‐environmental attitudes among Singaporean youth

Plastics have much to offer as a modern convenience, but lack of responsible plastic waste management habits can lead to potentially harmful environmental effects. Past environmental initiatives revealed a lack of understanding about youth attitudes towards pro‐environmental issues. [minus]plastic, an online public environmental promotional campaign, encouraged Singaporean youth to recognize the importance of, adopt positive attitudes towards and subsequently adopt the practice of responsible plastic management. We propose the Temporal Incentives Model of Social Influence, based on Prochaska and DiClemente's stages of change model, to guide social campaign design. A pre‐post quantitative research design showed that the pre‐contemplation, contemplation and preparation stages progressed significantly after the campaign. The findings suggest that stimuli incorporating specialized information and small action steps allow migration to successive stages. With the strong presence of internet culture among Singaporean youth, the online medium was found effective in altering the attitudes of the campaign target audience, while exposure to the campaign messages proved useful in encouraging environmental learning among youth.

Leaving an Abusive Partner: Exploring Boundary Ambiguity Using the Stages of Change Model

The Stages of Change Model has helped researchers and practitioners explore the process of leaving an abusive partner, but it does not account for the changes in relational boundaries unique to this process. In this paper, we integrate the concept of boundary ambiguity into the Stages of Change Model to explore potential sources of boundary ambiguity in the process of leaving. We theorize that Boss’s two types of boundary ambiguity may be present at different points of the leaving process and are perceptual barriers to leaving permanently. We also theorize that potential sources of boundary ambiguity emerge from women and their partners’ decisions and actions in the process of leaving. Implications and future directions for research and practice are discussed.