Transtheoretical Model Constructs Research Articles

Investigating the Factors Related to the Reduction of Salt Consumption in Women in Southern Iran: Application of ،ranstheoretical Model

Introduction: Reducing salt consumption in population is one of the easiest, most efficient and cost-effective ways to reduce the burden of cardiovascular diseases. The present study was conducted with the aim of investigating the factors related to the reduction of salt consumption using transtheoretical model among women in southern Iran.
 Methods: This was a cross-sectional study (descriptive-analytical) conducted from November 2022 to February 2023 on women of 18-59 who visited comprehensive health centers in Bastak city. A total number of 452 subjects were selected using convenient sampling method. Data were collected using a questionnaire with three sections: demographic information, a researcher-made questionnaire based on transtheoretical model constructs, and salt consumption reduction questionnaire. Data were analyzed using Kruskal-Wallis tests, Pearson's correlation and regression analysis with SPSS software (v. 22).
 Results: The results showed that participants were between 18 and52 with a mean of 35/51±10/13. 23/5% of the participants were in pre-contemplation stage, 21/7% in the contemplation stage, 20/8% in preparation stage, 11/3% in action stage, and 22/8% in maintenance stage. Pearson correlation analysis results indicated that there were significant positive relationships between cognitive processes (r= 0/44, p<0/01), behavioral processes (r= 0/54, p<0/01), self-efficacy (r=0/43, p<0/01) , decision balance (r= 0/37, p<0/01), and salt consumption reduction behavior; but, there was a significant negative correlation between temptation and salt consumption reduction behavior (r=-0.34, p<0/01). Moreover, regression analysis results revealed that age, counter conditioning, self-efficacy, raising awareness, decision balance, helping relationships, and temptation can predict 38/1% of the total variance in salt consumption reduction behavior (p<0/05).
 Conclusion: According to the findings, self-efficacy, temptation, cognitive and behavioral change processes, and advantages and disadvantages of salt reduction play a major role in salt consumption reduction behavior. It is suggested that these variables be taken into account in developing and implementing educational interventions.

Effects of a Workplace mHealth Intervention for Smoking Behaviour: A Quasi Experimental Study Protocol

Introduction: Tobacco smoking causes various chronic diseases and adds costs to healthcare systems. The current smoking cessation interventions mostly target smokers who are ready to quit and are reactive in recruitment. Recently, mobile phones have become a new tool for promoting smoking cessation. The aim of this paper is to present a study protocol on a quasi-experimental study investigating the effects of a workplace mHealth intervention for smoking behaviour. Methods: A quasi-experimental study will be conducted among employees in an academic institution in Malaysia. The intervention group will receive a theory based WhaSTOP module via WhatsApp and will be compared with the control group (receive usual care). The primary outcomes are stage movement and the number of cigarettes per day. The secondary outcomes include knowledge of smoking, quit attempt, nicotine dependence, 7-day point prevalence of smoking abstinence, and the Transtheoretical Model constructs. A generalised estimating equation analysis will be performed to determine the effects of the intervention. Discussion: This protocol will provide a novel method to proactively approach smokers regardless of readiness to quit and to guide them through the stages of change so that they will be ready to take action to quit. This research will also provide insight into whether the intervention can be utilised as an additional tool for smokers at the workplace to quit smoking. Trial Registration: The trial was registered with the Iranian Registry of Clinical Trials (Registry Number IRCT20220415054539N1).

Transtheoretical Model for Exercise: Measure Redevelopment and Assessing the Role of Barriers in a Diverse Population.

To redevelop and improve Transtheoretical Model (TTM) exercise measures for Black and Hispanic/Latinx adults. The redeveloped scales will address barriers to exercise potentially relevant to populations of color in the United States (US). Cross-sectional, split-half measure development. Online survey in the US. 450 Black and/or Hispanic/Latinx adults. Demographics, exercise engagement (IPAQ-SF), stage of change (SOC), decisional balance (DCBL), self-efficacy (SE), and barriers to exercise. Split-half exploratory (EFA) and confirmatory factor analyses (CFA) were executed to establish measurement structure and fit, followed by multivariate analyses to assess constructs by SOC. EFA/CFA for DCBL revealed three factors (α = .85, .70, .75) which represented Pros of exercise, Cons of exercise related to time and safety, and Cons of exercise related to physical or emotional discomfort. Model fit was adequate (CFI = .89). For SE, two factors (α = .85, .77) resulted with good model fit (CFI = .91). These factors reflected self-efficacy to exercise when confronted with generally challenging situations, and self-efficacy to exercise when specifically experiencing affective difficulties, such as depression or anxiety. Lastly, a novel Barriers measure resulted in three factors (α = .82, .77, .76), representing barriers encountered due to family responsibilities, work obligations, and health challenges, with good model fit (CFI = .95). Shifts in the core TTM constructs by SOC largely mapped onto the theoretical trends expected under the TTM. This study produced systematically developed TTM exercise measures for Black and Hispanic/Latinx adults in the US that address and incorporate important barriers to exercise. This research represents an important step forward in broadening the inclusion of diverse populations to TTM measure development processes and may lead to a better understanding of relevant factors impeding exercise engagement in the US.

Effect of cigarette smoking cessation educational intervention based on the trans-theoretical model using motivational interviewing on Egyptian males' smoking knowledge and behavior: A randomized controlled trial

Background & Aim: The trans-theoretical model suggests that stage-matched interventions improve the effectiveness of behavior changes such as quitting. This study aims to examine the effect of stage-matched smoking cessation educational intervention based on the trans-theoretical model using motivational interviewing on Egyptian males' knowledge, stage movement, and smoking cessation rate.
 Methods & Materials: A randomized controlled trial was conducted in the main building of Damanhour University, Egypt. The participants were selected using simple random sampling (N=165), then allocated to both experimental (N=82) and control (N=83) groups using the randomization block technique. Data was collected using a structured interview schedule. The instrument contained five parts: Personal Characteristics and Smoking data, Fagerstrom Tolerance Questionnaire, Tobacco Cessation Readiness Scale, Smoking Knowledge Scale, and trans-theoretical Model constructs questionnaire. The experimental group received ten months of educational intervention using face-to-face and phone-based motivational interviewing.
 Results: A significantly higher stage movement was revealed among the experimental group post-intervention (80.5%); 35.4% transitioned to the preparation stage, 32.9% were in the action stage, and 12.2% were in the maintenance stage. According to the ANCOVA test, significant negative mean differences post-intervention was achieved for nicotine dependence and decision pros (P=0.000) with a large effect size (η2=0.341, η2=0.503). However, significant positive mean differences were proved for other variables (knowledge, tobacco cessation readiness, and TTM constructs) (P<0.05) with a large effect size (η2>0.14). Stage analysis revealed significant mean differences in most studied variables, where the action stage had the highest significant mean improvements (P<0.05).
 Conclusion: The trans-theoretical model-based educational intervention using motivational interviewing effectively improves smoking knowledge and facilitates quitting with successful stage movement among Egyptian male smokers.

The Transtheoretical model’s processes of change in the heart of a physical activity intervention: A series of n-of-1

The objectives were a) to test whether a Processes of Change (POC)-personalized Transtheoretical model (TTM)-based intervention could increase physical activity (PA) among inactive adults, and b) to examine whether the intervention increased the level of TTM theoretical constructs. The following hypotheses were formulated: 1) PA levels will be significantly higher during and after the intervention in comparison to baseline measures; 2) the level of targeted POCs will increase during the intervention; 3) non targeted POCs will stay stable, and 4) self-efficacy and decisional balance levels will increase during the intervention. A series of N-of-1 with A (1 to 2-week)-B(10-week)-A'(2-week) design were conducted with 12 inactive adults. Behavioral counselors used behavior change techniques to target TTM constructs and supervise PA. Interventions were individualized based on the 5 POCs with the lowest pre-intervention level. Device-based and subjective PA along with TTM measures were collected weekly online. PA data were analyzed with piecewise linear models. A visual analysis was run to examine the TTM constructs. Device, self-reported and TTM data were available for five, seven and five participants, respectively. A significant self-reported PA increase for six participants was found during the phase B and A2. A significant device-measured PA increase was observed in two participants during the study. A substantial increase of targeted POC from baseline for all participants with available data was observed. This study provides the first evidence of behavioral and psychological effects of a POC-personalized TTM-based intervention in inactive adults.

Stages of dairy product consumption among Iranian female high school students based on transtheoretical model: The case of osteoporosis prevention.

Background: As nutritional needs increase in adolescence, dairy consumption can play a key role in health and disease prevention; however, unfortunately, inadequate consumption of milk and dairy products has often been reported in adolescents. Aim: The purpose of this study was to investigate the relation between decisional balance, self-efficacy, and the processes of change with the stages of change for dairy consumption in female high school students in Shaft county located in the west of Gilan Province, Iran. Methods: A total of 385 female high school students in Shaft County were studied through the census method in 2019. The data collection instrument was a valid and reliable questionnaire consisting of demographic information, stages of change and items of transtheoretical model constructs including the processes of change (cognitive process: consciousness-raising, dramatic relief, self-reevaluation, environmental reevaluation, and social liberation; behavioral process: self-liberation, counter conditioning, reinforcement management, stimulus control and helping relationships), decisional balance and self-efficacy. Data were analyzed using SPSS 21 software. Results: A total of 208 (54%), 53 (13.8%), 56 (14.5%), 32 (8.3%) and 36 (9.4%) students were in the pre-contemplate, contemplation, preparation, action and maintenance stages, respectively. As the subjects progressed through the stage of change for dairy consumption, an increase in the mean score of self-efficacy, decisional balance, and processes of change was observed (P < 0.01). Conclusion: The constructs of the transtheoretical model should be considered in designing educational interventions to promote dairy consumption with regard to the stage of change for dairy consumption in the subjects.

The Effect of Stage-Matched Educational Intervention on Behavior Change and Glycemic Control in Elderly Patients with Diabetes

Objective: Diabetes is a chronic and common global disease that requires particular care behaviors for the rest of life. People with diabetes can be trained to achieve optimal self-care. The present study was conducted to determine the effect of stage-matched educational intervention on behavior change and glycemic control in elderly patients with diabetes. Materials and methods: In this controlled clinical trial, 110 type 2 elderly patients with diabetes were selected randomly from health centers in Malard city, Iran, and were assigned to the control and experimental group equally. Data collection instruments were: demographics questions, scales to assess transtheoretical model constructs and stage of change, and blood samples for determining FBS and HbA1c. The mentioned variables were measured before, 1, and 3 months after the stage-matched educational intervention. The educational intervention consisted of 2 group intensive training sessions of about 45 minutes and daily messages via mobile phone for 3 months. The educational topics were about healthy diet and caring behaviors. Data were analyzed using SPSS 25.0 and independent &amp; paired t-test, chi-square, one-way ANOVA, and ANCOVA. The significance level was considered less than 0.05. Results: The mean age of study participants was (66.5 ± 3.91) years. Also, the average duration of diabetes was (7.18 ± 4.21) years, and 50% had a Junior high school education. A significant decrease was found in mean FBS (from 187 ± 43.4 to 136.42 ± 36.34, p &lt; 0.05) and HbA1c (from 8.28 ± 1.26 to 7.26 ± 1.10, p &lt; 0.05) in the experimental group, and also the mean of self-care behaviors in the experimental group increased significantly from baseline (from 1.51 ± 1.71 to 1.45 ± 0.92, p &lt; 0.05). Conclusions: Educational intervention based on the stages-of-change model can improve glycemic control and behaviors related to controlling diabetes, so it is necessary to pay attention to essential psychological variables in designing educational interventions in order to control blood glucose in patients with diabetes.

Structural equation model of psychological constructs of transtheoretical model, motives for physical activity, and amount of physical activity among people with type 2 diabetes mellitus in Malaysia.

This study aimed determine the structural relationship between psychological constructs of the transtheoretical model (TTM; processes of change, decisional balance, and exercise self-efficacy), motives for physical activity (PA), and amount of PA among Malaysians with type 2 diabetes mellitus (T2DM). All participants were recruited from the Hospital Universiti Sains Malaysia using a cross-sectional study design with purposive) sampling method. A total of 331 participants were recruited for the present study. Before participation in the study, they were informed that participation in the study was totally voluntary. Those who agreed to participate voluntarily were required to complete the self-administered questionnaire set, which included the processes of change, decisional balance, exercise self-efficacy, physical activity and leisure motivation, and international physical activity questionnaires. Data analysis of structural equation modeling was performed using Mplus 8. From the 331 participants, most of whom were male (52%) and Malay (89.4%), with a mean age of 62.6 years (standard deviation = 10.29). The final structural equation model fit the data well based on several fit indices [Root Mean Square Error of Approximation (RMSEA) = 0.059, Comparative Fit Index (CFI) = 0.953, Tucker-Lewis Index (TLI) = 0.925, Standardized Root Mean Square Residual (SRMR) = 0.031]. A total of 16 significant path relationships linked between the TTM, motives for PA, and amount of PA. The pros of decisional balance, others' expectations, and psychological condition were constructs that directly affected PA, whereas the other constructs had a significant indirect relationship with the amount of PA. A positive mindset is crucial in deciding a behavioral change toward an active lifestyle in people with T2DM.

Application of the transtheoretical model to understand physical activity in college students

The present study investigated the physical activity level of college students, the differences in the Transtheoretical Model (TTM) constructs by the stage of physical activity, and the theorized association of the TTM constructs with the stage of physical activity in college students. A total of 598 Korean college students (mean age = 21.52 years, SD = 2.59) from Seoul National University of Science and Technology, South Korea were voluntarily participated in the study. The standardized measures in Korean were applied to assess the study participants’ physical activity and the TTM constructs. Results indicated that there are significant differences in the physical activity distributions by gender. Moreover, the current findings revealed that all of the TTM constructs and physical activity differentiated college students across the stages of physical activity and that overall classification accuracy across the stages of physical activity was 53.0%. The study increases awareness but also influences perceptions regarding theoretically based and practically important physical activity strategies for public health professionals and health care providers.

Factors predicting nutritional knowledge, illness perceptions, and dietary adherence among hypertensive middle-aged women: Application of transtheoretical model.

BACKGROUND:Healthy dietary adherence might be one of the effective and modifiable factors for hypertension (HTN) control; therefor, empowering patients for self-care management including healthy food patterns play a key role in guiding their care, in partnership with health care providers. This study aimed to identify the factors predicting nutritional knowledge, illness perceptions, and adherence to a diet based on transtheoretical model (TTM) among hypertensive middle-aged women.MATERIALS AND METHODS:A cross-sectional survey was conducted on 164 patients with HTN attending west health centers of Tehran, Iran, in 2020. Simple random sampling was used. Sociodemographic characteristics of the respondents were collected, a valid and reliable measure on nutritional knowledge, illness perceptions, and adherence to diet, and a researcher-made measure based on TTM constructs through in-person interview was applied. Descriptive statistics and general linear model were utilized for data analysis using SPSS version 25. The significance level was considered less than 0.05.RESULTS:Mean and standard deviation of participants was 50.82 ± 8.77 years. Multivariate regression analysis indicated that family income (P < 0.001) and body mass index (P < 0.001) predicted nutritional knowledge and adherence to diet, respectively. Decisional balance and self-efficacy constructs predicted nutrition knowledge and illness perceptions (P < 0.001). In adherence to diet, overcoming the temptation construct was indicated as the only predictor (P < 0.001).CONCLUSION:Study findings highlighted the necessity of tailoring and implementing interventions based on TTM using appropriate strategies to promote quality of HTN management approach in nutritional knowledge, illness perceptions, and dietary adherence.

Designing and Psychometrics of a Questionnaire of Stretching Movement Assessment in the Workplace Based on the Trans-theoretical Model

Background: The trans-theoretical model is a model that is very sensitive to changes in the minor progress of behavior. Therefore, the trans-theoretical model is more practical than other patterns of behavior change, which have been considered all or no to measure physical activity. This study aimed to standardize and determine the validity and reliability of the tensile movement questionnaire at the University of Medical Sciences employees.&#x0D; methods: In this study, after searching the texts and the study of the same questionnaires and tools and among the available and related tools, the initial questionnaire was designed. First, the validity and content of the questionnaire were measured using experts' comments. Then, the ability to understand the questionnaire based on the opinions of 10 employees was investigated. Finally, to determine the reliability with the experimental-open test method, 30 employees, Cronbach's alpha, and the correlation coefficient were obtained using SPSS software.&#x0D; Results: After performing the necessary reforms with experts' opinions, finally, the questionnaire with increasing the number of questions of the field of self-efficacy from 6 to 7 questions, the reduction of the number of questions of the interests of stretching movements from 10 to 5 questions, increasing the number of questions of the barriers of stretching movements from 4 to 7 questions and increasing the number of questions of In the validation stage, each 40 of the questions had acceptable content validity (8.0 to 99.0). Also, at least 80% of the questions were diagnosed in terms of the target group acceptable. Cronbach's alpha coefficient and correlation coefficient were 86.0 and 7.0, respectively.&#x0D; Conclusion: A designed questionnaire based on the trans-theoretical model constructs to assess educational intervention to enhance the tensile movements of employees has acceptable reliability and validity.

Relationships of physical activity with the transtheoretical model constructs among Korean adults

ABSTRACT The current study investigates the physical activity distribution of Korea adults, examines the differences in the TTM constructs by the stage of physical activity, and identify the relationship between physical activity and the TTM constructs. A total of 799 adults (male: 326, female: 473, age = 46.8 years) recruited from S district in Seoul, Korea. Four Korean-version questionnaires were used to identify the stages of physical activity and its related psychological variables: stage of physical activity change scale, decision balance scale for physical activity, exercise self-efficacy scale, and processes of change scale for physical activity. Results indicated that a significant difference among male and female adults for physical activity stage distribution emerged (χ2 = 67.2, df = 4, p <.001). Data were analyzed by frequency analysis, χ2 test, MANOVA, and regression analysis. Self-efficacy, pros, cons, cognitive processes of change and behavioral processes of change differentiated across the stages of physical activity. Furthermore, the findings revealed that adults’ physical activity was significantly correlated with the TTM constructs, and that the TTM constructs had a statistically significant impact on the physical activity. The current study provides starting points for interventions aimed at increasing physical activity levels based on the TTM.

The Effects of Trans-Theoretical Model and Fear of Dental Care on Dental Cleaning Behavior among Students

Background: Fear of dental care prevents dental cleaning behavior and increases the prevalence of dental caries. This study was conducted to determine the effect of Trans-Theoretical Model constructs and fear of dental care on the dental cleaning behavior of students. Materials and Methods: This cross-sectional study was carried out in Sanandaj city, Iran, in 2017. Using multi-stage sampling, 1,344 male and female students were included in the study. They completed a self-report questionnaire, including demographic information, Trans-Theoretical Model constructs and fear of dental care. Data were analyzed using SPSS software (version 22.0). Results: A total of 1,344 male and female students with a mean age of 15.22±2.64 years participated in the study; from the perspective of students, dental caries (88.4%) was the most frequent illness and tongue inflammation (0.6%) was the least frequent disease.Overall, 32.9% of the students used no tools for cleaning their teeth. Fear of dental care and perceived barriers were reduced significantly during the stages of dental cleaning behavior (p<0.05) and perceived self-efficacy and perceived benefits were significantly increased (p<0.001). The odds of dental cleaning behavior increased with self-efficacy (OR=1.34, 95%CI=1.22-1.48, p<0.05), and decreased with fear of dental care (OR=0.90, 95%CI=0.80-0.98, p<0.01). Conclusion: The findings showed dental cleaning behavior among students was at a low level and various factors such as perceived self-efficacy, benefits and barriers and fear of dental care influenced its performance.

Test of Relationship between the Transtheoretical Model Constructs and Physical Activity in Malaysian College Students

The purpose of this study was to examine the relationship between the Transtheoretical Model constructs and physical activity in college students. A total of 562 college students in the Sains University of Malaysia participated in this study. Four Malaysian-version questionnaires were used to explore possible associations between the TTM constructs and physical activity. Data were analyzed using descriptive analysis, correlation analysis, and structural equation modeling. Results indicated that stages of changes affect self-efficacy, pros, cons, and processes of change. The findings also showed significant inter-relationships among the TTM constructs. Among all the variables examined, only processes of changes affect physical activity. The findings suggest that stages of change in an individual will affect the self-efficacy level, the ability to make a positive and negative decision and perform according to their behavior. By making the correct decision and taking action accordingly, physical activity will be increased.

Application of the Transtheoretical Model to Physical Activity and Exercise Behaviors in African-American Adolescents.

Objectives: In this study, we examined the inter-relationships between Transtheoretical Model (TTM) constructs (stages of change, self-efficacy, decisional balance, processes of change) and determined the utility of TTM to predict physical activity in African-American youth. Methods: A community-based sample of 109 African-American youth (62% girls, age: 14.8 ± 0.2 years) were included in this analysis. TTM constructs were assessed using the Patient-Centered Assessment and Counseling for Exercise questionnaire. Moderate-to-vigorous physical activity (MVPA) and total physical activity (TPA) were measured objectively using accelerometry. Results: Higher self-efficacy was observed at higher stages of change in both boys and girls (p = .02). Despite higher MVPA (p < .001) and TPA (p < .001) in boys, there were no sex differences in TTM constructs (p > .05). Stages of change predicted MVPA in girls, with those in the maintenance stage reporting significantly more MVPA compared to those in precontemplation/contemplation (p = .03) and preparation stages (p = .04). Cons predicted higher TPA in boys only (p = .02). Conclusions: These findings suggest specific TTM constructs relate to physical activity in African-American youth and the importance of these constructs may differ by sex.

The effect of a psycho-educational intervention on weight management in obese military personnel

ABSTRACTObesity is a serious health problem for many population groups, including military personnel. Model-based health education programs have been shown to be effective in reducing weight. This study assessed the efficacy of an educational intervention based on a trans-theoretical model (TTM) targeting weight loss among active duty military. A single group experimental study using a before-after design was conducted in 49 military personnel with obesity. Constructs such as self-efficacy, decisional balance, stages of change, and processes of change as well as anthropometric measures including weight, waist circumference, and body mass index (BMI) were assessed at three times (baseline, 2 months after the intervention, and 4 months later). The intervention consisted of 10 educational sessions developed based on TTM constructs. At baseline, 30 (61%) and 19 (39%) persons were in the pre-action and action stages, respectively. By 2 months after the intervention, only 24 persons (49%) were in pre-action stages and 25 (51%) were in the action stages. Four months later, one (2%) and 43 (88%) were in pre-action and action stages. The mean changes in self-efficacy (25.7 ± 4.1 to 29.3 ± 2.4), decisional balance (9.2 ± 3.6 to 13.8 ± 1.9), total cognitive (74.7 ± 8.5 to 84.7 ± 6.3), and total behavioral change (60.8 ± 9.8 to 71.7 ± 7.8) were significantly different across the three time points. Reductions in weight (99.8 ± 10.4 to 93.0 ± 9.6), waist circumference (105.9 ± 14.2 to 100.2 ± 13.0), and BMI (32.5 ± 5.2 to 30.3 ± 4.5) from baseline to 4 months after the intervention were also significant (p < 0.05). An educational program based on TTM may be effective in reducing weight among obese military staff.

The effectiveness of a model-based health education intervention to improve ergonomic posture in office computer workers: a randomized controlled trial.

Lack of knowledge about computer ergonomics predisposes users to musculoskeletal and visual disorders. The present study examined the effect of a trans-theoretical model (TTM)-based educational program on work-related posture in office computer users. This experimental study examined 102 hospital personnel whose primary job involved working at a computer. Participants were randomized to intervention and control groups. An educational intervention based on TTM was conducted over five sessions. A self-report questionnaire was used to collect data including stages of change, processes of change, pros and cons of change, and self-efficacy. A pen-paper-based observational method (i.e., Rapid Office Strain Assessment or ROSA) was used for assessing work posture. A visual analogue scale assessed pain intensity. Data were collected at baseline and 3-month follow-up. Significant differences were found on TTM's constructs and ROSA score between intervention and control groups at follow-up (p < 0.05). The mean ROSA score decreased from 5.65 (SD 1.03) to 3.95 (SD 0.83) in the intervention group, while no significant change was found in the control group. Pain intensity also decreased significantly among those in the intervention vs. control group (p < 0.001). An educational intervention based on TTM was effective in improving ergonomic posture in computer workers. Further research is needed to determine if these results can be generalized to computer workers in other settings.

The Relationships Between constructs of Trans-theoretical Model and Physical Activity in Patients with Hypertension

The Relationships Between constructs of Trans-theoretical Model and Physical Activity in Patients with Hypertension

Examining Stage of Change Differences in NCAA Student-Athletes’ Readiness for Psychological Skills Training

To enhance the specificity of psychological skills training (PST) interventions, the purpose of the current study was to examine stage of change and gender differences in the combination of transtheoretical model (TTM) constructs (i.e., decisional balance pros and cons, self-efficacy, cognitive and behavioral processes of change) among collegiate student-athletes. Participants (N = 602) completed all TTM measures, and a factorial multivariate analysis of variance (MANOVA) was conducted to examine the effects of stage of change and gender on the combination of TTM constructs. No significant interaction effect was identified, yet significant main effects of stage of change and gender were identified. Post hoc tests revealed unique linear combinations of decisional balance, self-efficacy, and processes of change for each stage of change contrast. Taken together, study findings may be used to enhance the specificity of behavior change interventions when delivering PST programs to both male and female collegiate student-athletes.

The Effect of Education on Reducing Fast Food Consumption in Obese Iranian Female Adolescents: An Application of the Transtheoretical Model and the Theory of Planned Behaviour

Background: The number of reported food illnesses in Iran has increased over the past 10 years. Objectives: The present study aimed at investigating the effect of education, based on the transtheoretical model (TTM) and the theory of planned behaviour (subjective norm and perceived behavioural control), on reducing fast food consumption in obese Iranian female adolescents. Methods: In this quasi-experimental study, data were collected through a survey. This study included 420 obese Iranian female adolescents, aged 15 to 18 years, who were gathered from 12 schools in city of Sabzevar in Iran during 2014 tand 2016. Using a questionnaire, the demographic and anthropometric characteristics, transtheoretical model (TTM) constructs, subjective norm, and perceived behavioural control were measured and analysed. Results: The average rates of perceived behavioral control (11.949 ± 2.876), subjective norms (16.515 ± 4.877), stages of change (6.355 ± 1.342), processes of change (8.614 ± 3.406), and self-efficacy (22.447 ± 6.783) in the education group were meaningfully increased (P value 0.05). Also, no statistically meaningful difference was obtained in decisional balance between the 2 groups after the intervention (P = 0/924). Conclusions: The results of this study suggest that the use of TTM (except with decisional balance) focuses on the perceived behavioural control, and subjective norms can be used in educational interventions and have useful results.