Transtheoretical Model Stages Research Articles

Review of Current Health Education Theories

This article presents a review of current theories and models in health education. Articles published in 2003 in the American Journal of Health Education, the American Journal of Health Behavior, Health Education and Behavior, Health Education Research, and the International Electronic Journal of Health Education, were reviewed. Concepts and constructs for each theory and model used are presented. The three predominant theories and models in this literature, The Transtheoretical Model (Stages of Change Theory), the Theory of Reasoned Action/Planned Behavior, and the Social Cognitive Theory are examined in greater detail.

Readiness to change as a predictor of outcome in batterer treatment.

The current study examined stage of change as a predictor of outcome in batterer treatment. Men (N=119) were classified into the transtheoretical model's stages of change and assessed 3 times over treatment. Hierarchical linear modeling revealed significant variation in men's progress, predictable from their stage of change. As hypothesized, men in the precontemplation stage showed little positive change in empathy, communication, or abusive behavior, whereas men in the contemplation and action stages showed positive growth in all of these domains. These effects occurred in the initial 10 weeks of treatment, after which men progressed at a more homogeneous rate. Interpretation is complicated by pretreatment differences that draw into question stage-related patterns in final outcome. Implications for general models of abuse cessation and for stage-specific trajectories are discussed.

Student attendance at dental checkups: An application of the Transtheoretical Model

Objective To examine the application of key constructs of the Transtheoretical Model (stages of change and decisional balance) to attendance at dental checkups with a student sample. Method A questionnaire was completed by 224 students from the University of Derby. They were asked to report their intention and behaviour in relation to dental checkups (reflecting the stage framework) as well as rating 31 statements representing the Pros and Cons of dental checkups. Results Thirty (13.7 per cent) participants were classified into precontemplation, 69 (31.5 per cent) contemplation, 18 (8.2 per cent) preparation, 86 (39.3 per cent) action and 16 (7.3 per cent) maintenance. Support for the application of the stages of change model to dental checkups was found. The decisional balance measure (Pros and Cons) reflected hypothesised differences across the stages of change. Conclusion The findings suggest that applying the stages of change construct to dental checkup attendance can assist us in designing interventions that are more appropriately targeted by stage of change. For the large proportion of students not attending, we suggest minimising the Cons and maximising the Pros of dental checkups.

Self-Determination Theory as an Organizing Framework to Investigate Women'S Physical Activity Behavior

The purpose of this paper is to explore the literature on the status of women's health behavior and the benefits of physical activity using Self-Determination Theory (SDT) as an organizing framewrok for syntbcsizing and interpreing the extant research. The Health Belief Model and the Transtheoretical Model (Stages of Change) are included in that framework. Women's physical activity behaviors are examined through the lens of SDT with the intention of identifying strategies to design theoretically based intervention programs to increase women's participation in physical activity. Interventions that have been succcessful in modifying exercise behavior in women have been characterzed as individualized, flexible, and tailored to meet women's specific needs. SDT can be used to direct future research by investigating how autonomy, relatedness, and competence can be incorporate in program to increase women's self-determination with regard to heir physical activity and ultimately facilitate internalized, intrinsic motivation leading to loag-term behavior change

Adolescents, Alcohol, and Substance Abuse: Reaching Teens Through Brief Interventions

Back to table of contents Previous article Next article Book Forum: Adolescent Substance AbuseFull AccessAdolescents, Alcohol, and Substance Abuse: Reaching Teens Through Brief InterventionsPHILIP E. VEENHUIS, M.D., M.P.H., PHILIP E. VEENHUISSearch for more papers by this author, M.D., M.P.H., Raleigh, N.C.Published Online:1 Nov 2002https://doi.org/10.1176/appi.ajp.159.11.1958AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Many years ago, public health and mental health were separated, probably so that mental health could achieve full status with other diseases. Later, mental health and substance abuse were separated, probably for the sake of substance abuse, which tended to be ignored by mental health. Public health methods had massive success in the developed world in eliminating or reducing the impact of infectious diseases (at least until the advent of HIV and bioterrorism) and has had some success with chronic diseases (heart disease, cancer). Public health and psychiatry especially merge when organizing efforts at preventing and treating substance abuse. Most diseases managed and treated by psychiatrists have uncertain combinations of genetic diatheses and environmental stress. In the instance of substance abuse, the balance of agent/host/environment permits intervention. That is to say, if you can keep substances away from vulnerable people, primary prevention is possible and early prevention indicated. Surely there is no better population to target than the young. Now comes a book that thoughtfully introduces approaches to the problem of substance abuse in adolescents.The book developed from a conference in October 1998 convened for the purpose of exploring adolescent substance abuse and early intervention. Most of the chapters come from presentations made at that conference with some added as significant gaps in the conference format were identified. However, this book differs from many books coming from such conferences because of its consistent format and superb editing. Where there are repetitious issues among the chapters they are acknowledged, and reference is made to earlier or later chapters. In addition, each chapter starts by defining the problem, discusses evidence or research-based issues, and ends with an excellent summary. Each chapter is very well referenced.The editors start by taking on the issue of “confrontation” as the only acceptable approach to treat substance abuse. They state, “It was a stack of cards. There is not and never has been scientific evidence to support the belief that people with substance abuse disorders show abnormally high levels of primitive defense mechanisms such as denial.” Throughout the book the emphasis is on the fact that early intervention is especially possible in adolescence. The transtheoretical model (stages of change model) of DiClemente and Prochaska provides an orientation for some of the discussions of interventions.The book is divided after the introduction into three parts: Background and Context: Theory, Developmental, and Measurement Considerations; Empirical Illustrations: Clinical Applications and Brief Interventions; and Future Directions, a short final section emphasizing the importance of transdisciplinary research. Each chapter is so well done that I almost hesitate to single out individual chapters. Part 2 of the book will be of most interest to clinicians, but the background and context chapters are well worth the time to read. Chapters on motivational enhancement for alcohol-involved adolescents, alcohol skills training for college students, and integrative behavior and family therapy are excellent reviews of “how to do this.” There is an important chapter on comorbid disorders that should be read by every professional who works with adolescents. A sign of the times is the chapter on the high utility of the Internet for information and treatment.This book may well stir up some conflict in the field. There is conflict about sex education between those who believe in such education and those who believe that in some way sex education gives adolescents license to begin sexual activity. The latter group wishes there to be no such educational offerings or only offerings that exclusively endorse premarital chastity. There is a parallel conflict in substance abuse treatment regarding total abstinence as the only acceptable treatment approach and the harm reduction models described in parts of this book. This work will not resolve the issue of pluralistic approaches, but it does have evidence-based approaches as its strength.This is an excellent book in all respects. It is very readable (though not a quick read) and shows careful, even meticulous editing. All mental health professionals who work with adolescents and their families will find it of great value.Edited by Peter M. Monti, Suzanne M. Colby, and Tracy A. O’Leary. New York, Guilford Publications, 2001, 350 pp., $37.00. FiguresReferencesCited byDetailsCited ByNone Volume 159Issue 11 November 2002Pages 1958-1959 Metrics History Published online 1 November 2002 Published in print 1 November 2002

A critical examination of the application of the Transtheoretical Model's stages of change to dietary behaviours.

This paper proposes that the application of the Transtheoretical Model's stages of change to dietary behaviours may be fundamentally problematic due to the difference in nature between dietary behaviours and the addictive behaviours upon which the model was originally based. It was considered that specific problems associated with stage categorization for dietary change would include: problems due to the potential mismatch between a person's perceived and actual dietary behaviour; and problems due to the use of specific time periods to distinguish between different stages. A total of 541 volunteers completed questionnaires that measured their stage of change with respect to one of three dietary behaviours (healthy eating, eating a low-fat diet, and eating five portions of fruit and vegetables per day). Results indicate that people who were actively making a change (actors) or maintaining a change (maintainers) had done so for a range of different periods of time, with no specific cut-off point being evident. Also, more realistic stage categorizations were evident for the most specific dietary behaviours where there was least likelihood of a mismatch between perceived and actual dietary behaviour. Problems associated with issues of operationalization of the model and the application of the stage model to dietary change are discussed.

Using the transtheoretical model to facilitate behavior change in patients with chronic illness.

Nurse practitioners spend a considerable amount of time encouraging patients with chronic illness to acquire positive behaviors such as exercising and self-monitoring, and to stop negative behaviors like smoking and intake of foods high in fat. These lifestyle changes can be facilitated through use of the transtheoretical model of stages and processes of behavior change. The significance is that it assists health care providers in developing interventions that are specifically focused for the patient depending on stage of readiness to change. The application of the model in the practice setting is discussed, and a specific example of activities developed for use in patients with asthma is given. The protocols can be adapted for any patient who needs to make lifestyle behavior changes.

Longitudinal changes in stages of change for condom use in women.

This study identifies how women naturally progress through the Transtheoretical Model stages of condom use over a 1 year period, using the longitudinal dynamic methodology of latent transition analysis (LTA). As part of a larger study of human immunodeficiency virus risk in women, participants were assessed for their stage of condom use two times, 1 year apart. A total of 491 women who completed both assessments of the study were included in this analysis. Stage of condom use was assessed using two questions, which placed women into one of five stages of change for condom use (alpha = .90). Latent transition analysis identified the best-fitting model of naturalistic stage progression, which included both forward and backward movement. Precontemplation and maintenance were found to be the most stable stages (more than 50% of the participants remaining in that stage 1 year later), and the action stage was the least stable (15% remaining in this stage). Transition probabilities for all stages showed a high rate of relapse in the sample. A high proportion of women will remain within their stage of condom use over a 1-year period if no intervention is introduced. Interventions that are aimed at increasing condom use in women need to incorporate relapse prevention. In addition, the transition probabilities for the stages will help establish reasonable rates of change for intervention programs.

Working toward freedom from violence. The process of change in battered women.

This article explores the utility of applying the Transtheoretical Model of behavior change to the problems facing battered women with a goal of understanding and systematically measuring how battered women work to overcome the abuse in their lives. The central constructs of the Transtheoretical Model—stages of change, processes of change, decisional balance, self-efficacy—are described with supporting research, and the relevance of this model for the issues with which battered women deal is discussed. An awareness of the process and stages of change may be useful for members of the criminal justice system and the helping professions in their dealings with victims of abuse.

The transtheoretical model's stages and processes of change and their relation to premature termination.

The transtheoretical model's stages and processes of change and their relation to premature termination.

The transtheoretical model's stages and processes of change and their relation to premature termination.

This study explored the issue of premature termination by using the client readiness variables reflected in the stages of change and processes of change proposed in J. O. Prochaska and C. C. DiClemente's (1982) transtheoretical model. This study used these variables in an attempt to distinguish between premature and nonpremature terminators in a college counseling center. Results indicated that the two termination groups were distinguishable on stages and processes of change, though some results were not predicted by the transtheoretical theory or model. Recommendations are made for future research to identify and predict clients at risk for premature termination and to determine how to avert such termination