Stage Of Readiness For Change Research Articles

Development and Validation of Forman Readiness to Change Scale for Drug Addiction

Purpose: The present study aimed to develop an indigenous valid and reliable scale to measure the readiness to change in patients with drug addiction.
 Design/Methodology/Approach: approach in which theories behind the transtheoretical model of change and drug addiction were examined along with semi-structured interviews and Focus Group Discussions. Phase one of the present study was scale construction, for this purpose initial items pool was generated from literature, focus groups of ward boys and nurses, interviews of psychologists, and in-depth interviews of diagnosed patients of drug abuse. Major themes were extracted by using Interpretive Phenomenological Analysis and transformed into statements. For content validity, three experts were requested to rate items on a Likert-type scale and items were included or excluded by 1/3 ratio. For construct validity scale was administered on 100 diagnosed patients with drug addiction.
 Findings: Exploratory Factor Analysis (EFA) with the Varimax rotation method and Kaisar Normalization extracted three factors. The factors were named after stages of readiness for change including pre contemplation, contemplation and action stage.
 Implications/Originality/Value: This study contributed to psychometric research through the development of an indigenous scale to assess readiness to change on the transtheoretical model of behavior change in Pakistan. No such tool was found available presently to measure this and readiness was being measured on an international scale.

Explaining the structural model of desire for treatment based on addiction memory, the desire to use with the mediation of self-control in people seeking to quit

Background and Aim: Addiction means acquiring a habit and getting used to it, and it happens in such a way that quitting and giving up causes disruption in the overall functioning of the person, which is accompanied by physical, mental and behavioral discomfort. The present study was conducted with the aim of explaining the model of desire for addiction treatment based on the memory of addiction and the desire to use with the mediation of self-control in substance dependent people seeking to quit. Methods: The current research method was a correlational and predictive description. The statistical population of this study included substance dependent people who referred to addiction treatment clinics in Babol city in a period of four months. 209 participants were selected as a sample using a purposive sampling method and answered the questions of Chen et al.'s addiction memory intensity scale (2018), Tangney et al.'s (2004) self-control scale, stages of readiness for change and enthusiasm for change. Miller and Tonigan (1997) Addiction Treatment and Somoza et al. (1995) substance abuse scale responded. Data analysis was done using structural equation modeling method and LISREL software. Results: The results showed that the memory of addiction has a direct role in the desire for treatment (p<0.01, β=0.31); Addiction memory has a direct role in self-control (p<0.01, β=0.59); The desire to use has a direct role in the desire for treatment (p<0.01, β=0.39); Desire to use has a direct role in self-control (p<0.01, β=0.73); Self-control has a direct role in desire for treatment (p<0.01, β=0.79); Addiction memory plays an indirect role in desire for treatment with self-control mediation (p<0.01, β=0.47) and the desire to use has an indirect role in desire for treatment with self-control mediation (p<0.01, β=0.58). Conclusion: It can be concluded that the model of desire for addiction treatment based on the memory of addiction and the desire to use with the mediation of self-control is suitable for drug addicts seeking to quit.

Facilitating Behavior Change in Plastic Surgery Patients Who Inject Drugs Through Motivational Interviewing.

Background: Plastic surgeons treat a large volume of patients with upper limb morbidity resulting from intravenous drug use. The use of motivational interviewing by health care providers has demonstrated effectiveness in eliciting behavioral change, leading to improved health outcomes. This paper aims to explore the concept and process of motivational interviewing and its role in facilitating behavior change in the plastic surgery setting. Methods: The authors reviewed the literature on motivational interviewing in various health care settings. Results: Motivational interviewing, first developed in the field of psychology, has demonstrated effectiveness in facilitating behavior change in various clinical contexts, including brief clinical encounters. Using motivational interviewing guides the patient as they move through the stages of readiness for change in dealing with unhealthy behaviors. The authors demonstrate these techniques in a supplemental instructional video. Conclusions: Motivational interviewing is an evidence-based method for facilitating behavior change. All plastic surgeons should be prepared to use this person-centred counselling method in clinical practice.

Multiple Unhealthy Behaviors Share Equivalent Profiles of Readiness for Change in Patients with Type 2 Diabetes.

Few studies have considered more than one behavior, despite the tendency towards multiple behaviors, and there are none that have focused on a Latino population. We determined the concurrence of four unhealthy behaviors related to glycemic control and identified common cognitive factors at advanced stages of readiness for change in patients with type 2 diabetes treated in primary care. A cross-sectional study was carried out during August–December 2018 in northeastern Mexico. We consecutively included patients between 20 and 70 years who were without medical contraindication, physical impediment against exercise, pregnancy and edentulism, among other selection criteria (n = 407). Stages of behavior were measured according to the Transtheoretical Model. Pros, cons, self-efficacy, susceptibility, and severity data were collected by interview. Statistical analysis consisted of descriptive statistics and multiple logistic regression. A total of 36.7% exhibited more than one unhealthy behavior in precontemplation or contemplation (no interest or some interest in changing consumption of refined sugars and saturated fats, exercise, or oral hygiene behavior). Cons (p < 0.05) and self-efficacy (p < 0.001) were common to all four unhealthy behaviors, independent of potential confounders. Studies like ours facilitate the recognition of individuals with multiple unhealthy behaviors who share equivalent profiles of readiness for change before implementing public health programs.

Variable-length Cognitive Processing Therapy for posttraumatic stress disorder in active duty military: Outcomes and predictors

Cognitive Processing Therapy (CPT) is an evidence-based therapy recommended for posttraumatic stress disorder (PTSD). However, rates of improvement and remission are lower in veterans and active duty military compared to civilians. Although CPT was developed as a 12-session therapy, varying the number of sessions based on patient response has improved outcomes in a civilian study. This paper describes outcomes of a clinical trial of variable-length CPT among an active duty sample. Aims were to determine if service members would benefit from varying the dose of treatment and identify predictors of treatment length needed to reach good end-state (PTSD Checklist-5 ≤ 19). This was a within-subjects trial in which all participants received CPT (N = 127). Predictor variables included demographic, symptom, and trauma-related variables; internalizing/externalizing personality traits; and readiness for change. Varying treatment length resulted in more patients achieving good end-state. Best predictors of nonresponse or needing longer treatment were pretreatment depression and PTSD severity, internalizing temperament, being in precontemplation stage of readiness for change, and African American race. Controlling for differences in demographics and initial PTSD symptom severity, the outcomes using a variable-length CPT protocol were superior to the outcomes of a prior study using a fixed, 12-session CPT protocol. ClinicalTrials.gov IdentifierNCT023818.

Reaching nontreatment-seeking cannabis users: Testing an extended marijuana check-up intervention

Some adult cannabis users report negative consequences of use but do not seek treatment. Nonjudgmental, brief interventions incorporating motivational interviewing techniques may be able to reach users who otherwise would not seek treatment and increase their motivation to change use. Previous studies have shown brief interventions with this population are efficacious in reducing use, but the absolute amount of change has not clearly translated into meaningful reductions in associated negative consequences. The current study used a marijuana check-up (MCU) model to attract nontreatment-seeking adults who used cannabis at levels that may have caused negative consequences. The study randomly assigned participants to 2-session (n = 93) and 6-session (n = 93) versions of the intervention and followed them for 12 months. The study designed the extended 6-session condition to build on the efficacy of the previously tested 2-session intervention. The study hypothesized that the opportunity to continue to consider the consequences of cannabis use would have the greatest impact on those who were in earlier stages of readiness for change. We used cognitive behavioral techniques to assist with change efforts when indicated. Results showed significant reductions in the frequency and daily duration of cannabis use at all follow-ups in both intervention conditions. The extended 6-session condition produced greater change only on a measure of the number of periods of the day in which cannabis was used. Reductions in dependence symptoms and problems related to cannabis use occurred in both conditions, but there was no effect of intervention condition. Participants who were less ready to make changes at the outset decreased use and negative consequences the least. Results suggested that some benefit of the extended session format of the check-up in reducing daily use, but the lack of a corresponding reduction in consequences suggested that the original 2-session MCU may be more cost effective.

Evaluation of an interdisciplinary chronic pain program and predictors of readiness for change

ABSTRACT Background One in five Canadians experience chronic pain, and interdisciplinary pain programs are well established as the gold standard of treatment. However, not all patients are ready to engage in interdisciplinary treatment for chronic pain. Aims The aims of this study were to (1) first demonstrate changes in patient-related outcomes after attending a publicly funded 8-week interdisciplinary pain program and (2) evaluate pain-related predictors of readiness for change. Methods The institution’s research ethics board approved this study. One hundred twenty-nine patients completed questionnaires on the first and last day of attending the program. Paired sample t-tests were utilized to evaluate the changes in patient-related outcomes after attending the program, and linear regressions were utilized to evaluate pain-related predictors of the stages of change. Results Postprogram, there were significant decreases in pain-related interference, fear of pain/re-injury, pain catastrophizing, and symptoms of stress, depression, and anxiety and a significant increase in wellness-focused coping and self-efficacy. Postprogram, patients also demonstrated lower scores in precontemplation and contemplation and higher scores in action and maintenance stages of readiness for change. In predicting precontemplation, fear of pain/re-injury was the sole predictor, and self-efficacy was the sole predictor of the contemplation, action, and maintenance stages. Conclusion These results demonstrate the short-term benefits of an 8-week interdisciplinary pain program. It is suggested that preprogram interventions targeting kinesophobia for individuals who are precontemplative and self-efficacy for others may be important to facilitate patient engagement.

Safety Talk and Safety Culture: Discursive Repertoires as Indicators of Workplace Safety and Health Practice and Readiness to Change.

Small construction businesses (SCBs) account for a disproportionate share of occupational injuries, days lost, and fatalities in the US and other modern economies. Owner/managers of SCBs confront risks associated with their own and workers' safety and business survival, and their occupational safety and health (OSH) related values and practices are key drivers of safety and business outcomes. Given owner/mangers are the key to understanding and affecting change in smaller firms, as well as the pressing need for improved OSH in small firms particularly in construction, there is a critical need to better understand SCB owners' readiness to improve or adopt enhanced OSH activities in their business. Unfortunately, the social expectation to support safety can complicate efforts to evaluate owners' readiness. To get a more accurate understanding of the OSH values and practices of SCBs and the factors shaping SCB owners' readiness and intent to implement or improve safety and health programming by comparing their discourse on safety with their self-rated level of stage of change. In-depth, semi-structured interviews were conducted with 30 SCB owner managers. Respondents were asked to self-rate their safety program activity on a 5-point scale from unaware or ignorant ('haven't thought about it at all') to actively vigilant ('well-functioning safety and health program for at least 6 months'). They were also asked to discuss the role and meaning of OSH within their trade and company, as well as attitudes and inclinations toward improving or enhancing business safety practices. Respondents' self-rating of safety program activity was compared and contrasted with results from discourse analysis of their safety talk, or verbal descriptions of their safety values and activities. Borrowing from normative and stage theories of safety culture and behavioral change, these sometimes contradictory descriptions were taxonomized along a safety culture continuum and a range of safety cultures and stages of readiness for change were found. These included descriptions of strong safety cultures with intentions for improvement as well as descriptions of safety cultures with more reactive and pathological approaches to OSH, with indications of no intentions for improvement. Some owner/managers rated themselves as having an effective OSH program in place, yet described a dearth of OSH activity and/or value for OSH in their business. Assessing readiness to change is key to improving OSH performance, and more work is needed to effectively assess SCB OSH readiness and thus enable greater adoption of best practices.

Self-assessment and readiness for change in dysphonic patients.

To examine whether there is an association between vocal self-assessment and readiness for change in dysphonic patients. 151 patients with vocal complaints and diagnosis of dysphonia, between 18 and 65 years of age, 47 men and 104 women treated at the voice clinic of a public institution participated in the study. Four self-assessment instruments were applied, including the Voice-Related Quality of Life (V-RQOL), the Voice Handicap Index (VHI) and the Voice Symptom Scale (VoiSS), and the use of URICA-VOICE instrument to verify the patients stage of readiness for change. All instruments were applied immediately before the start of vocal therapy. The variables were correlated and compared using inferential statistics. Most patients were in the contemplation stage (76.2%, n = 115), 22 (14.6%) were in the pre-contemplation stage and 14 (9.3%) in the action stage. There was a negative correlation between the score in URICA-VOICE and the socio-emotional domain and total score V-RQOL. There was a positive correlation between the score URICA-VOICE and full social, emotional and functional VHI, as well as between the score URICA-VOICE and full fields, limitation and emotional VoiSS. Only the social-emotional domain V-RQOL and emotional in VoiSS values showed statistically significant differences between the motivational stages. There is association between vocal self-assessment and readiness for change in dysphonic patients. Patients with major impact on quality of life in voice in V-RQOL and higher frequency of vocal symptoms mentioned in the VoiSS show greater readiness for change.

Motivational Readiness of Community College Students Engaging in Physical Activity

This study investigated the Stages of Motivational Readiness for Change (SMRC) related to the physical activity of community college students. The transtheoretical model was the basis for examining frequency and intentions of physical activity, relationships between behaviors, and demographic variables such as age, gender, income, relationship status, dependents, GPA, and BMI. A conceptual model was also created to depict statistically significant predictability for the stage of readiness for change, BMI, intention to use facilities, and current physical activity frequency. Findings revealed that stages varied according to gender, relationship status, and having children. In addition, SMRC was found to be a key predictor of students' current physical activity habits. Understanding the SMRC is helpful for administrators to determine levels of physical activity as it can provide a greater understanding of student mindset and result in determining appropriate programs, marketing strategies, and facility improvements for students to become more physically active.

The language of money

ABSTRACTThis article examines the relationship of personal finance in a narrative-based treatment strategy as applied to couples. It builds on behavioral economics as the undergirding of an approach to financial literacy. By matching the treatment strategy with the stages of readiness for change, couples are able to gradually adopt a financially prudent lifestyle. The authors argue that the couples’ conflicts about personal financial behaviors are a proxy of underlying problems in intimacy. The use of a narrative-based theory addresses how personal finances are used to control relationships.

Readiness for behavioral change and variation in food consumption among adolescents from a school-based community trial in Duque de Caxias, RJ.

To investigate the influence of the stage of readiness for changes in food consumption variation among adolescents participating in school-based community trial in Duque de Caxias (RJ), Brazil. It is a secondary analysis of a one-year randomized community trial to prevent excessive weight gain in students attending the 5th grade in 20 public schools in the municipality of Duque de Caxias. The activities conducted discouraged the consumption of sweetened beverages and cookies and encouraged the consumption of fruits and beans. A food frequency questionnaire was applied at the beginning and at the end of the study. The stages of readiness for behavioral change vary in a scale from (1) "I don't think of changing diet" to (5) "I'm already changing my diet successfully". For the longitudinal analyses, we used generalized linear mixed models. There was a greater change in the consumption of fruit and soft drinks among participants in the intervention group who were in the action stage, compared to participants who did not think about changing their diet. The proposed strategy may be used to identify population groups with motivation for changes in dietary behavior.

Childhood Overweight: Parental Perceptions and Readiness for Change

Although the national health crisis of childhood obesity is a well-documented problem, few if any clinical interventions have had success in curbing its growth. In fact, childhood obesity, along with its associated morbidities, continues to climb even in the face of increased awareness. Research shows that factors contributing to obesity are almost entirely modifiable on some level. Furthermore, specific behavior changes have been shown to result in positive outcomes, yet these changes have not been widely implemented by practitioners, families, or individuals. The transtheoretical model of health behavior change offers insight into assessing individuals and targeting interventions for behavior change. This article focuses on guiding school nurses to assess parents of school-age children at risk for obesity for readiness for health behavior change, then choosing parent-focused interventions based on their stage of readiness for change.

Perceptions of Weight and Health Practices in Hispanic Children: A Mixed-Methods Study.

Background. Perception of weight by parents of obese children may be associated with willingness to engage in behavior change. The relationship between parents' perception of their child's weight and their health beliefs and practices is poorly understood, especially among the Hispanic population which experiences disparities in childhood obesity. This study sought to explore the relationship between perceptions of weight and health beliefs and practices in a Hispanic population. Methods. A cross-sectional, mixed-methods approach was used with semistructured interviews conducted with parent-child (2–5 years old) dyads in a primarily Hispanic, low-income population. Parents were queried on their perceptions of their child's health, health practices, activities, behaviors, and beliefs. A grounded theory approach was used to analyze participants' discussion of health practices and behaviors. Results. Forty parent-child dyads completed the interview. Most (58%) of the parents of overweight and obese children misclassified their child's weight status. The qualitative analysis showed that accurate perception of weight was associated with internal motivation and more concrete ideas of what healthy meant for their child. Conclusions. The qualitative data suggest there may be populations at different stages of readiness for change among parents of overweight and obese children, incorporating this understanding should be considered for interventions.

Identifying barriers to remaining physically active after rehabilitation: differences in perception between physical therapists and older adult patients.

Cross-sectional study. To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, P<.05), lack of willpower (χ2 = 21.91, P<.01), and lack of skill (χ2 = 12.46, P<.05). Women ranked fear of injury higher than men did (χ2 = 6.76, P<.01). Understanding readiness for change in and barriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.

Clinician's Commentary on Graham and Connelly

Clinician's Commentary on Graham and Connelly

Reducing risk with e-based support for adherence to lifestyle change in hypertension (REACH): protocol for a multicentred randomised controlled trial

IntroductionWeb-based lifestyle counselling designed to improve adherence to self-management behaviours for diet, exercise and medication has been shown to reduce blood pressure (BP). However, the long-term clinical outcome of these...

Standardization Study of Internet Addiction Improvement Motivation Scale

ObjectiveThe purpose of this study was to develop a scale to measure motivation to improve Internet addiction. Motivation is known to be important to treat Internet addiction successfully. The reliability of the scale was assessed, and its concurrent validity was evaluated.MethodsNinety-two adolescents participated in this study. The basic demographic characteristics were recorded and the Korean version of the Stages of Readiness for Change and Eagerness for Treatment Scale for Internet Addiction (K-SOCRATES-I) was administered. Subsequently, the Internet Addiction Improvement Motivation Scale was developed using 10 questions based on the theory of motivation enhancement therapy and its precursor version designed for smoking cessation.ResultsThe motivation scale was composed of three subscales through factor analysis; each subscale had an adequate degree of reliability. In addition, the motivation scale had a high degree of validity based on its significant correlation with the K-SOCRATES-I. A cut-off score, which can be used to screen out individuals with low motivation, was suggested.ConclusionThe Internet Addiction Improvement Motivation Scale, composed of 10 questions developed in this study, was deemed a highly reliable and valid scale to measure a respondent's motivation to be treated for Internet addiction.

Standardization Study of the Korean Version of the Stages of Change Readiness and Treatment Eagerness Scale for Smoking Cessation (K-SOCRATES-S) and Its Predictive Validity

ObjectiveThe purpose of the study was to develop the Korean version of the Stage of Change Readiness and Treatment Eagerness Scale for Smoking Cessation (K-SOCRATES-S) based on the Korean version of the Stages of Readiness for Change and Eagerness for Treatment scale (K-SOCRATES). This paper also demonstrates its reliability and validity among patients with nicotine dependence in South Korea.MethodsAt seven healthcare promotion centers in Gyeonggi-do, 333 male smokers aged 20 to 70 who visited smoking cessation clinic were recruited for this study and the K-SOCRATES-S was administered. After three months, the number of respondents who successfully stopped smoking was assessed by testing their urine cotinine level. Subsequently, exploratory factor analysis was performed to verify the reliability and validity of the K-SOCRATES-S. Also, a logistic regression analysis was performed to examine the variables that can predict the successful cessation of smoking on subscales of the K-SOCRATES-S.ResultsExploratory factor analysis of the K-SOCRATES-S showed that the scale consisted of three factors: Taking Steps, Recognition, and Ambivalence. The scales measuring Taking Steps and Recognition in this scale had a significantly positive correlation with the scores observed on Kim's smoking cessation motivation scale. The scales measuring Taking Steps and Recognition had a significantly negative correlation with Ambivalence. Overall, the results indicate that the K-SOCRATES-K scale showed high validity.ConclusionThe K-SOCRATES-S developed in the present study is highly reliable and valid for predicting a patient's likelihood of success in quitting smoking among patients who want to cease smoking.

Fruit and vegetables should be targeted separately in health promotion programmes: differences in consumption levels, barriers, knowledge and stages of readiness for change

The aim of the present study was to investigate whether fruit and vegetables should be treated as separate groups in health promotion programmes by examining consumption levels, barriers, knowledge and the association between stage of change and potential predictors of fruit and vegetable intake. Computer-assisted telephone interview survey of the target population. Hunter and New England regions of New South Wales, Australia. A total of 1403 parents and carers of primary-school-aged children. Consumption levels and knowledge of recommended intakes and serving size were greater for fruit than for vegetables. There were some differences in the main barriers to the consumption of fruit compared with those cited for vegetables. There was little congruence between the stages of change for fruit consumption and those for vegetable consumption. For fruit, knowledge of serving size and recommended intake, perceptions of adequate consumption, changes made to family intake and educational attainment were all correlated with stage of change categorisation. For vegetables, knowledge of recommended intake, perceptions of adequate consumption and changes made to family intake were correlated with stage of change categorisation. Significant differences in consumption levels, barriers, knowledge and stages of readiness for change can be shown when fruit and vegetables are treated as separate groups. Health promotion planners may need to consider interventions that focus on improving vegetable consumption in preference to fruit consumption. Messages about the recommended number of servings and serving size must be simplified and this may be achieved by targeting messages towards vegetable consumption.