Precontemplation Stage Of Change Research Articles

Readiness to Refrain from Carbonated Drinks among High School Female Students: The Transtheoretical Model of Change as a Theoretical Framework

Objective: This study is a part of randomized controlled trial. This study aims to identify high school female students’ readiness to refrain from carbonated drinks. Method: The study included a simple random sample of 144 high school female students who were recruited from Al-Russafa High School for females in Baghdad City. The study instrument consists of participants’ sociodemographic characteristics of age, living arrangement, and family’s socioeconomic status, Stages of Change for Carbonated Drinks Consumption Behavior Scale (Short Form), Stages of Change for Carbonated Drinks Consumption Behavior Scale (Continuous Measure), The Processes of Change for Carbonated Drinks Consumption Behavior Scale, The Self-Efficacy for Carbonated Drinks Consumption Behavior Scale which includes 18 Decisional Balance Scale for Carbonated Drinks Consumption Behavior. Data were analyzed using the statistical package for social science (SPSS) for Windows, version 26. Results: More than half are in the Precontemplation Stage of Change (n = 84; 58.3%), followed by those who are in the Preparation Stage of Change (n = 30; 20.8%), those who are in the Contemplation Stage of Change (n = 28; 19.5%), and those who are in the Maintenance Stage of Change (n = 2; 1.4%).The regression model displays that the family’s socioeconomic status, Self-Liberation, and students’ age positively predicted the Stages of Change to refrain from carbonated drinks (p-value = .004, .009, 035) respectively. Conclusion: The regression model displayed that Self-Liberation and students’ age positively predicted the Stages of Change to refrain from carbonated drinks. This finding implies that .The regression model displayed that students’ age positively predicted the Stages of Change to refrain from carbonated drinks. Keywords: Carbonated Drinks; Readiness to Refrain; High School Female Students.

Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity (P6-5.019)

<h3>Objective:</h3> To evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. <h3>Background:</h3> Weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. <h3>Design/Methods:</h3> Using a validated questionnaire, we assessed each patient’s stage of behavioral change according to the transtheoretical model (precontemplation, contemplation, preparation, action, and maintenance). We also examined 4 processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional reevaluation (EMR), weight management action (WMA), weight consequence evaluation, and supporting relationships. Process scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation, and preparation stages. <h3>Results:</h3> 44 patients met inclusion/exclusion criteria: 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (<i>n</i> = 29, 66%). Patients in the action and maintenance stages (<i>N</i> = 29) had higher EMR scores (mean 79, SD 13 vs. mean 68, SD 19, <i>t</i> = 2.0, <i>p</i> = 0.03) and WMA scores (mean 69, SD 13 vs. mean 59, SD 19, <i>t</i> = 2.0, <i>p</i> = 0.03) as compared to those in the precontemplation, contemplation, and preparation stages (<i>N</i> = 15). <h3>Conclusions:</h3> Without counseling or specific intervention, two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change. <b>Disclosure:</b> Dr. Wilson has nothing to disclose. Hailey Orgass has nothing to disclose. An immediate family member of Dr. Dearborn-Tomazos has received personal compensation for serving as an employee of PTC Therapeutics. An immediate family member of Dr. Dearborn-Tomazos has received personal compensation for serving as an employee of Alexion Pharmaceuticals. Dr. Dearborn-Tomazos has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Qmetis. An immediate family member of Dr. Dearborn-Tomazos has stock in Alexion Pharmacueticals. The institution of Dr. Dearborn-Tomazos has received research support from BMS.

How Ready Are Gym Users to Refrain from Performance-Enhancing Substances? The Transtheoretical Model of Change as a Theoretical Framework

Methods: A descriptive predictive correlational design was be used to guide this study.The study included a convenience sample of male gym users who agreed to participate in this study. The study subjects were recruited from six private gyms.The study instrument includes subjects’ sociodemographic characteristics of age, living arrangement, family’s socioeconomic status, the performance-enhancing substances that the gym users use. It also includes the Transtheoretical Model of Change measures of Stages of Change for Performance-Enhancing Substances Scale (Short Form), the Stages of Change for Performance-Enhancing Substances Scale (Continuous Measure), the Processes of Change for Performance-Enhancing Substances Scale, the Self-Efficacy for Performance-Enhancing Substances Scale, the Decisional Balance Scale for Performance-Enhancing Substances. Data were analyzed using the statistical package for social science (SPSS) for windows, version 28. Results: The study results revealed that around a half are in the Precontemplation Stage of Change, followed by those who are in the Contemplation Stage of Change, those who are in the Action Stage of Change, those who are in the Termination Stage of Change, and those who are in the Preparation Stage of Change. Conclusion: The greater the Pros, the higher the Stages of Change for performance-enhancing substance use the gym user would therein.The greater the Social Liberation, the higher the Stages of Change for performance-enhancing substance use the gym user would therein. The greater the Helping Relationships, the higher the Stages of Change for performance-enhancing substance use the gym user would therein. Keywords: Gym Users; Performance-Enhancing Substances; Transtheoretical Model

Using the Transtheoretical Model of Change to Understand High School Students’ Hookah Smoking Behavior

Objective(s): The aim of this study is to understand high school students’ hookah smoking behavior. Methodology: Part of the study was an experimental randomized controlled trial used to guide this study. The study was carried out at Tuz High School for males in Tuz Khurmatu District, Salah-Aldeen Governorate. The study included a simple random sample of 144 high school students. The study instrument includes students’ sociodemographic data. It also includes the Stages of Change Scale for Hookah Smoking, The Processes of Change Scale for Hookah Smoking, The Self-Efficacy/ Temptation Scale for Hookah Smoking, and The Decisional Balance Scale for Hookah Smoking. Data were collected using a self-reported method for the period from November 1st, 2021 to March 31th, 2022. Data were analyzed using the statistical package for social science (SPSS) for Windows, version 26. Results: The study results revealed that more than two-fifth of subjects in the study group were in the Precontemplation Stages of Change, followed by those who were in the Contemplation, and those in the Preparation Stage of Change. The administered intervention made subjects use more Processes of Change, enhanced their Self-Efficacy and Decisional Balance of hookah smoking cessation. Conclusion: The Stage-matched intervention efficaciously made students use more Processes of Change of hookah smoking, enhanced their Self-Efficacy/Temptation of hookah smoking, and Decisional Balance of hookah smoking. The lower the Stage of Change, the poorer the Self-Efficacy for hookah smoking cessation.

The Role of Neural Reward Expectancy and Valuation in Readiness to Change Among Treatment Seeking Veterans With Alcohol Use Disorder (AUD)

Reward processing encompasses valuation, expectancy, effort, and response and has transdiagnostic relevance, including to addiction. We sought to identify the reward circuit basis of “gain” anticipation versus “loss” anticipation (anticipatory valuation bias) during the Monetary Incentive Delay (MID) task and the contribution of reward circuit anticipatory valuation bias in ambivalence toward reducing alcohol consumption (precontemplation stage of change).

Safe bicycle riding scales based on the transtheoretical model for adolescents: Development and validation

BackgroundDeaths from bicycle transport have increased by 30% in the past 10 years. This should be considered a problem from various aspects for this reason. Safe bicycle riding concerns not just wearing a helmet; it involves a wide range of matters that must be considered. MethodsThe universe of the study, which is of development and validation design, consisted of fifth, sixth, seventh and eighth grade students (N = 503) enrolled in a middle school located in Istanbul during the 2017–2018 academic year. The data were collected with a 25-item questionnaire on sociodemographic features and bicycle riding behavior, and the Transtheoretical Model of scales. The adolescents in the study group were between the ages of 9–14; 49.5% were female, 50.5% were male. Used in testing for validity and reliability were the Content validity index, exploratory factor analysis, confirmatory factor analysis, floor-ceiling effect, Hotelling's T2, Standard Error of Measurement, the paired sample t-test, and Pearson's correlation. ResultsThe internal consistency reliability coefficients of the scales are α = 0.79 for the Cognitive Change Process Scale, α = 0.82 for the Behavioral Change Process Scale, α = 0.77 for the Pros Scale of Decisional Balance, α = 0.79 for the Cons Scale of Decisional Balance, α = 0.78 for the Self–Efficacy Scale.It was found that the Cons Scale of Decisional Balance mean score was under average, all other scale mean scores were above the average. Of the adolescents, 24.5% were in the precontemplation stage of change regarding safe bicycle riding in the Transtheoretical Model. ConclusionsAdolescents' safe bicycle riding behaviors can be evaluated by using scales that are valid and reliable. With the interventions to be implemented, changes can be achieved in safe bicycle riding behaviors and these changes can be screened with the Transtheoretical Model scales.

Assessing relatives’ readiness for hereditary cancer cascade genetic testing

PurposeTo explore the readiness of living, untested first-degree relatives (FDRs) to have cascade genetic testing (CGT) for a hereditary predisposition to cancer. MethodsAdults with a hereditary predisposition to cancer completed an anonymous, online survey about their genetic testing and their FDRs’ vital status, awareness of the variant, uptake of CGT, and readiness for CGT among living, untested FDRs using transtheoretical model stages of change. ResultsOne hundred fifty participants completed the survey and reported 825 FDRs. Overall, 70.3% of FDRs were reportedly aware of the variant and 30.5% had completed CGT. Siblings had higher rates of awareness and CGT than parents or children (p < 0.001). Relatives’ sex was associated with awareness and CGT; mothers were aware and had CGT at higher rates than fathers (p = 0.049 and p < 0.001), sisters were aware and had CGT at higher rates than brothers (p = 0.041 and p = 0.002), and daughters had higher rates of awareness than sons (p = 0.038). Of 340 living, untested FDRs, 79.4% were in the precontemplation stage of change, with no difference by relatives’ sex or relationship to the participant. ConclusionsMost living, untested FDRs were in precontemplation stage, indicating they are not ready or planning to have CGT within the next six months.

Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care

PurposeTo characterize information elicited from adolescent/young adults with frequent cannabis use in Motivational Enhancement Therapy (MET), and determine whether differences exist across stages of change (SOC) for reducing use. Design and methodsPrimary care patients 15–24 years old using cannabis ≥3 times/week enrolled in a pilot randomized intervention trial. All youth were offered two 1-hour MET sessions. Content analysis was used to code and categorize main reasons for use, alternative behaviors, goals, values, pros and cons of change, and compared results between youth in Pre-Contemplation vs. Contemplation SOC. ResultsFifty-six youth completed MET session 1, 46 completed session 2. Most reported their main reason for use was related to emotional coping, negative feelings were a top-3 trigger, and distraction was an alternative way to meet their needs. Youth most frequently described progress in education or career/job as 1-year goals. More than half identified family as a very important value. They most frequently reported pros of using less related to achieving goals, self-improving, and saving money, and a con related to stress/coping. Compared to youth in Pre-Contemplation SOC, those in Contemplation were more likely to identify relationships as both a pro and con of using less cannabis. ConclusionsMET can reveal developmentally appropriate goals, healthy values, and ambivalence about cannabis use that can be used to facilitate movement along the stages of behavior change toward reduction/cessation. Practice implicationsBrief motivational therapy can be used in primary care to gather information important in helping youth to reduce cannabis use.

Time to address continued poor vegetable intake in Australia for prevention of chronic disease

BackgroundAustralian and most international Dietary Guidelines recommend people consume more fruits and vegetables (F&V) to maintain a healthy weight and reduce chronic disease risk. Previous Australian and international surveys have shown sub-optimal consumption of F&V. ObjectivesThis study aimed to assess adults' F&V consumption, knowledge of recommended servings, readiness to change, barriers/enabling factors, so that this knowledge might be used for campaigns that support improved consumption. Material and methodsAn online survey of a representative sample of adults living in New South Wales, Australia (n = 2474) measuring self-reported F&V consumption; attitudes towards F&V consumption; stage of change for increasing F&V; barriers to consumption; and knowledge of cancer-health benefits. ResultsF&V consumption was below recommendations, with vegetable consumption notably low. Only 10% of participants ate at least five servings of vegetables/day (median intake was two daily servings), and 57% consumed two servings fruit/day. There was poor recognition that intake of vegetables was inadequate and this was a barrier to improving vegetable consumption; with preferences for other foods, habit and cost also important barriers. Key barriers to increasing fruit intake were habit, preferences for other foods, perishability, and cost. For vegetable consumption, 49% of participants were in the pre-contemplation stage of change, whereas for fruits 56% were in the action/maintenance stage. Sixty-four percent of respondents believed that eating F&V would protect against cancer, with 56% reporting they thought not eating enough F&V would cause cancer. ImplicationsUnderstanding what motivates and prevents people from consuming F&V is important for developing effective health promotion programs. Similar to previous surveys, there has been little shift in F&V consumption. Social marketing campaigns have been shown to improve health-related behaviours, and this study may assist in identifying audience segmentation for better targeted campaigns.

A feasibility test of a brief motivational interview intervention to reduce dating abuse perpetration in a hospital setting.

To describe the intervention development process and feasibility testing of a hospital-based brief intervention to reduce the perpetration of adolescent dating abuse (ADA). To our knowledge, this intervention is the first to focus exclusively on ADA perpetration reduction via a motivational interview-type intervention in this setting. The rationale for and the six Intervention Mapping steps used to generate the intervention are described. Feasibility is conceptualized as intervention acceptability, demand, implementation, practicality, integration, and limited-efficacy. The Real Talk intervention was integrated smoothly into the emergency department setting. Participants did not experience any negative impact, and the vast majority (86%) reported that they felt helped. Quantitative assessments suggest that the intervention reduced the number of participants in the pre-contemplation stage of change regarding their use of relationship violence, and may have moved them forward into the action stage. Real Talk participants were more likely than those in the control group to tell friends to help them stay calm around their partner after drinking alcohol, and to talk with their doctor to get help for their problems. Real Talk was developed to meet an unmet need for tertiary ADA interventions in non-school settings. It was developed in accordance with a recommended framework, informed by theory, and subsequently tested for feasibility. Feasibility assessment results suggest that Real Talk can be implemented in health care settings and may influence attitudinal and behavioral outcomes in the desired directions.

P-18 * PATIENT'S TYPE FALLING UNDER THE CATEGORY OF ALCOHOL DEPENDENCE, HARMFUL USE OF ALCOHOL, AND HAZARDOUS DRINKING AND THE DIRECTION OF SUPPORT IN INPATIENTS OF GASTROENTEROLOGICAL MEDICINE DEPARTMENT

Introduction. In this investigation, 34.0% of 141 inpatients of gastroenterological medicine department with their consent had a score of 8 or higher in AUDIT. Types of those patients were investigated. Method. Alcohol abuse (diagnosed based on ICD-10) and hazardous drinking were analyzed for patients (n = 55) with an AUDIT score of 8 or higher. Patients were classified in a case-code matrix using age, gender, AUDIT score, diagnosis, presence/absence of alcohol abuse treatment, motivational stage by Prochaska, cognitive function, life expectancy as codes. This investigation was conducted with approval from the Ethical Committee of University of Tsukuba. There was no conflict of interest. Result. Types included patients with (1) alcohol abuse, in the preparation or later stage of change, with no previous treatment for alcohol abuse; (2) a history of alcohol abuse treatment and progressed physical disease due to relapse; (3) alcohol abuse and life expectancy of several months due to malignant disease; (4) alcohol abuse in the pre-contemplation stage of change, with impaired cognition function in some cases; and (5) harmful use of alcohol or hazardous drinking in the pre-contemplation stage of change. Conclusion. Support should be tailored by patients' type of alcohol abuse.

Green Eating and dietary quality in university students

Environmentally conscious eating, also known as Green Eating (GE), is hypothesized to improve dietary quality yet there is limited research on this topic in the United States (US). The aim of this study was to determine if GE was associated with dietary quality among 26 university students. GE Stage of Change (SOC) was assessed by an online survey administered to first and second year students. Subjects were eligible if they were in the precontemplation SOC (PC) (n=18) or the action/maintenance SOC (AM) (n=8). Three, 24‐hour food recalls were collected using the 2012 Nutrition Data System for Research program and 2005 Healthy Eating Index (HEI) scores were calculated. Mean body mass index was 24.5±4.3 kg/m2, mean age was 18.3±0.5 y, and the majority were female (65%). The groups did not differ by HEI (PC=56.4±12.3; AM = 59.6±12.9). AM consumed significantly more dietary fiber per day than PC (PC = 13.6±4.8 g; AM = 18.8±2.8 g) and consumed significantly less processed meats per week compared to PC (PC = 3.0±2.3 times per week; AM = 0.6±0.9 times per week) (p &lt; 0.05). There were no differences between groups for intake of saturated fat, sodium, fruits, or vegetables. Findings suggest better dietary quality among those practicing GE. Future research with larger sample sizes is needed as the promotion of GE may provide an opportunity to improve dietary quality in US university students. Research funded by the USDA.

Does Stage of Change Predict Improved Intimate Partner Violence Outcomes Following an Emergency Department Intervention?

The objective was to assess the effect of an emergency department (ED)-based computer screening and referral intervention on the safety-seeking behaviors of female intimate partner violence (IPV) victims at differing stages of change. The study also aimed to determine which personal and behavioral characteristics were associated with a positive change in safety-seeking behavior. The hypothesis was that women who were in contemplation or action stages of change would be more likely to endorse safety behaviors during follow-up. This was a prospective cohort study of female IPV victims at three urban EDs, using a computer kiosk to deliver targeted education about IPV to provide referrals to local resources. All noncritically ill adult English-speaking women triaged to the ED waiting room during study hours were eligible to participate. Women were screened for IPV using the validated Universal Violence Prevention Screening Protocol (UVPSP), and all IPV-positive women further responded to validated questionnaires for alcohol and drug abuse, depression, and IPV severity. The women were assigned a baseline stage of change using the University of Rhode Island Change Assessment (URICA) scale for readiness to change their IPV behaviors. Study participants were contacted at 1 week and 3 months to assess a variety of predetermined safety behaviors to prevent further IPV during that period. Descriptive analyses were performed to determine if stage of change at enrollment and a variety of specific sociodemographic characteristics were associated with taking protective action during follow-up. A total of 1,474 women were screened for IPV; 154 (10.4%) disclosed IPV and completed the full survey. Approximately half (47.4%) of the IPV victims were in the precontemplation stage of change, and 50.0% were in the contemplation stage. A total of 110 women returned at 1 week of follow-up (71.4%), and 63 (40.9%) women returned for the 3-month follow-up. Fifty-five percent of those who returned at 1 week and 73% of those who returned at 3 months took protective action against further IPV. Stage of change at enrollment was not significantly associated with taking protective action during follow-up. There was no association between demographic characteristics and taking protective action at 1 week or 3 months. Emergency department-based kiosk screening and health information delivery is a feasible method of health information dissemination for women experiencing IPV and was associated with a high proportion of study participants taking protective action. Stage of change was not associated with actual IPV protective measures.

ストレスの過小評価の信念を測定する尺度の作成

Stress estimation is involved in the production of stress management behavior. Stress underestimation could hinder efforts to adequately manage stress. This study developed a measure to assess stress underestimation beliefs. Questionnaire surveys were conducted by mail twice on 2,340 adults aged from 20 to 65 years. The data from the surveys were subject to factor analysis, from which we developed a 12-item scale to assess stress underestimation beliefs (SUB). The SUB included four subscales: "Excessive self-efficacy for managing stress," "Insensitivity to stress," "Overgeneralization of stress," and "Evasive attitude towards stress." The SUB had adequate internal consistency. Higher SUB scores were associated with being in the precontemplation stage of change in terms of stress management behaviors, working long overtime hours (more than 81 hours per month), and having fewer self-reported stress symptoms. The SUB is potentially useful for assessing stress underestimation in the context of stress management.

Assessment of Variables Associated with Smoking Cessation in Crohn’s Disease

Patients with Crohn's disease (CD) who smoke have a more complicated disease course. Our primary objective was to assess smoking related variables that were associated with smoking cessation versus continued smoking in patients with CD. A multi-center study identified CD patients who were seen at the University of Chicago and University of Calgary IBD clinics. Patients were categorized into three subgroups: lifetime non-smokers, current smokers, or ex-smokers. Participants completed questionnaires assessing their cigarette smoking behavior. Current smokers were prospectively followed for 6 months to assess smoking status and attempts to quit. Logistic regression analysis was performed to identify factors associated with smoking cessation. Three hundred patients were enrolled with 148 identifying themselves as lifetime non-smokers, 70 as current smokers, and 82 as ex-smokers. Patients who reported their first cigarette within 5 min of waking were more likely to be current smokers (OR = 21; 95% CI 3.94-107.3) as compared to patients who waited greater than 60 min. Current smokers were more likely to have one or more household members who smoked compared to ex-smokers (P < 0.05). Nearly half (49%) of the current smokers were in the precontemplation stage of change (i.e. no intention to quit smoking). At the 6-month follow-up, only 11% reported they quit smoking. Patients who report a short time to first cigarette in the morning may have more difficulty in smoking cessation. Current smokers were more likely to have another smoker in the household compared to ex-smokers. Current smokers had low levels of motivation to quit smoking and consequently with no intervention, very few quit 6 months after the baseline assessment.

Acceptability of the use of Motivational Interviewing to Reduce Underage Drinking in a Native American Community

Thirty-six Native American tribal leaders and members living on contiguous rural southwest California reservations were surveyed concerning their view of the acceptability of a motivational interviewing (MI) intervention with youth (aged 8–18 years) who are drinking and their families. The results suggest the following: (1) a substantial proportion of reservation youth would be willing to accept MI for behavior change; (2) relatively few are actually ready to change; (3) most reservation youth are in the precontemplation stage of change; and (4) MI may be well suited as an intervention to prevent underage drinking in that population. The study's limitations are noted.

Motivation to Quit Smoking among Relatives of Lung Cancer Patients

The purpose of this study was to determine the factors related to motivation to quit among smoking family members of lung cancer patients. Relatives of multidisciplinary lung cancer clinic patients were recruited during family members' treatment. Participants (N=29) were primarily female and Caucasian. The items assessed included the effect of their relative's disease on motivation to quit, intent to quit in the next 6 months, stage of change, perceived risk from smoking, and attitudes about being approached about cessation. Most indicated that their relative's disease had increased motivation to quit smoking (71%); 72% planned to quit within 6 months. One fourth (28%) were in precontemplation stage of change; 65% in contemplation; and 7% in preparation. The average perceived risk of developing lung cancer was 6.3. Two thirds were glad or very glad that someone had talked with them about quitting; 91% thought it was somewhat or very appropriate to talk about cessation with family members of lung cancer patients. Motivation to quit smoking was positively correlated with stage of change and perceived lung cancer risk. Public health nurses who interact with families of lung cancer patients may be able to promote cessation in an at-risk group that is motivated to quit smoking.

Global goal orientations: Prediction of sport and exercise involvement and smoking

Objective Two studies were conducted to investigate the assumption that a personal improvement goal in life is connected with adaptive self-regulatory strategies and high levels of self-efficacy that enable individuals to adopt regular physical activity and avoid smoking. On the other hand, it was hypothesized that health-related behaviours would have no connection with normative-referenced goals such as ego-enhancing and ego-protection goals in life. Method Study 1 focused on exercise in adulthood. Women ( N = 381) responded to instruments assessing stages and processes of change, self-efficacy, frequency of exercise and goal orientations in life. Study 2 was a two-year longitudinal investigation in adolescence. Students ( N = 1508) responded twice on self-reports of sport and exercise involvement, smoking, truancy and goal orientations in life. Results A personal improvement goal in life was connected with frequent exercise, high levels of self-efficacy and ten processes of change in the exercise domain. Women in the maintenance stage of change had higher scores on personal improvement scale than women in the precontemplation stage of change. Controlling for responses in Time 1, a personal improvement goal in life was positive predictor of sport and exercise involvement and negative predictor of smoking and truancy two years later. Ego-enhancing goal in life had no association with sport and exercise involvement or smoking. Ego-protection goal in life was positive predictor of no exercise at all in adolescence. Invariance of factor loadings across the two age groups suggested that global goal orientation retain the same meaning across adolescents and adults. Discussion Life-skills programs adopting self-regulation models to promote physical activity and to prevent from smoking should strengthen personal improvement goal in life.

Does precontemplation represent a homogeneous stage category? A latent class analysis on German smokers.

The authors examined the subtype structure of smokers classified in the precontemplation stage of change within the transtheoretical model. From a general practice-based sample of 1,499 daily smoking patients from Germany (participation rate 80%), they used a subgroup of 929 smokers who were classified in the precontemplation stage and applied latent class analysis, using the pros and cons of nonsmoking and smoking cessation self-efficacy as the defining variables. Cross-sectional validation of the emerging classes was based on smoking behavior and processes of change variables. For longitudinal validation, generalized estimation equation analyses were used on motivational and abstinence criteria from 6-, 12-, 18-, and 24-month follow-ups. A 4-class model best represented the data. Three subtypes (labeled progressive, immotive, and disengaged pessimistic) were similar to clusters identified in U.S. studies. The 4th (disengaged optimistic), by contrast, was reminiscent of a type that had previously only emerged in a Dutch study. Cross-sectional and longitudinal validation results confirmed the distinctiveness and predictive power of the classes. The findings highlight the importance of tailoring interventions for smoking behavior change to the needs of different subgroups of precontemplating smokers.

Exploring discontinuity in prediction of smoking cessation within the precontemplation stage of change

A stage model of health behaviour change assumes homogeneity within the stages, in terms of how predictors relate to stage progression. It is not known whether this assumption is valid for the Transtheoretical Model (TTM) stages of change. To test the homogeneity of the precontemplation stage of the TTM for smoking cessation. We hypothesized that if there was any discontinuity in prediction, it would be most likely to occur around a question which made a distinction between those who were "happy to smoke for the rest of their life" and those who "should quit, but are not currently thinking about it." Repeated measures design with telephone surveys conducted two weeks apart. Participants were 370 randomly selected precontemplators aged 18-40 years. Evidence of discontinuity in prediction was found within the precontemplation stage, but across a different split point than expected. More predictive power of a multivariate model was found among smokers who stated they were not interested in quitting, with this at least in part due to "wanting to smoke," than was found when the model was run on the overall sample. The study supported a possible discontinuity in prediction within the precontemplation stage, suggesting that the stage may not be uniform. Further research is required to confirm whether there is a discontinuity and, if so, to determine its precise location and identify the predictors for which there is a difference.