Is there utility in the transtheoretical model?

Department of Psychology, University of Sheffield, Sheffield, UK.
British Journal of Health Psychology (Impact Factor: 2.7). 11/2008; 14(Pt 2):195-210. DOI: 10.1348/135910708X368991
Source: PubMed

ABSTRACT The transtheoretical model is arguably the dominant model of health behaviour change, having received unprecedented research attention, yet it has simultaneously attracted exceptional criticism. However, the criticisms have been directed almost exclusively at the stages of change, just one of fourteen components of the transtheoretical model, which may have diverted attention away from more fruitful avenues of research based on the model.
Narrative review.
The evidence would suggest some flaws in the concept of stages of change as currently articulated in the transtheoretical model. On a conceptual level, even studies incorporating the five stages of change point to a model that better fits Gollwitzer (1993) and Heckhausen's (1991) idea of a motivational phase followed by a volitional phase. Potentially the processes of change components of the transtheoretical model may actually prove the most useful, yet have been under-researched, at least experimentally. Three studies that successfully utilise the processes of change to reduce alcohol consumption, encourage smoking cessation and increase physical activity are described.
Elements of the transtheoretical model offer promise in developing effective health behaviour change interventions, but the question arises as to whether extracting these elements undermines completely the idea of a transtheoretical model.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJETIVO: Avaliar o estágio de prontidão para mudança do comportamento (EPMC) alimentar e de atividade física de adolescentes e verificar a associação entre as variáveis gênero, faixa etária e classificação do índice de massa corpórea (IMC) com o EPMC.MÉTODOS: Foram avaliados 145 adolescentes entre dez e 18 anos interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade (PMTO). As avaliações incluíram, além dos EPMC, parâmetros antropométricos. A análise estatística envolveu a aplicação do teste t de Student para amostras independentes e do teste de Mann-Whitney na comparação entre os grupos. O teste do qui-quadrado de tendência foi utilizado para verificar se houve ou não associação entre as variáveis do estudo, sendo significante p<0,05.RESULTADOS: Em relação ao comportamento alimentar (quantidade e tamanho das porções), verificou-se associação entre IMC e o EPMC. Também foi observado que os adolescentes mais velhos apresentaram EPMC mais avançado em relação ao consumo de frutas e verduras. O mesmo se verificou em relação à prática habitual de atividade física.CONCLUSÕES: Há associação entre IMC e o EPMC relacionado ao comportamento alimentar (quantidade e tamanho das porções), do mesmo modo que entre a idade e o EPMC relacionado ao consumo de frutas e vegetais e prática habitual de atividade física. Recomenda-se a realização de estudos experimentais a fim de verificar se o EPMC tem poder preditivo em programas de intervenção destinados ao tratamento do excesso de peso.
    Revista Paulista de Pediatria 06/2012; 30(2):237-243.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To introduce the topic of this paper -persuasive technologies for digital lifestyle coaching- let us present the story of Jane. A few months ago Jane's doctor diagnosed her with diabetes. Since one year Jane feels constantly tired. Her doctor told her that this is due to her diabetes. The doctor prescribed a medicine and advised Jane to visit a diabetes nurse. The nurse explains Jane that being active, watching her food intake, and taking her medication on time, she could control her diabetes. Jane's condition is not improving and she admits she has problems to adjust her new lifestyle. The nurse introduces a digital coaching system, which is able to coach Jane by monitoring her activity, her medication intake, and glucose levels. The system gives Jane the right feedback on the right time. The system includes an activity monitor, a digital pillbox and applications on different devices. Jane is enthusiastic about the system and she would like to try it. At home she installs the different applications and enters her daily medication intake moments and moments when she measures her glucose level. The next day when Jane wakes up she measures her glucose level and enters the result into the system through her smartphone and compares the current level with the values of the last five days. Because Jane is in a hurry this morning she forgot to take her medication. When Jane arrives at the office she got a medication reminder on her laptop and she takes her medication. This morning she had a meeting with her colleagues. During this meeting she receives a reminder on her mobile phone to upload her activity data. Back at the office she connects her activity monitor to her laptop to upload her activity data. In the meantime she goes for a coffee, and when she walks to the coffee machine she receive a message of her coach that tells her that her activity level is too low and that she should consider doing something physically active in the following hours. During lunch time Jane goes on a walk. After her lunch she measures her glucose level again and enters the value in the system on her laptop. After work she goes home to prepare dinner. She uses the system to find a nice and healthy dish. After her meal, Jane watches the news on television. Before turning on the TV, she connects her activity monitor to her laptop to upload her activity level. On her TV she receives a congratulatory message as she has achieved her activity goal for today. Before she goes to sleep she takes her medication from her digital pillbox. Three months later Jane visits her nurse again. After some test it becomes clear that Jane has her diabetes much better under control and the nurse advise her to take less medication. Jane is not alone. Many people suffer from a chronic disease and better live a healthier life. One billion adults worldwide are overweight, and 300 million of these are clinically obese. Since the 1980s, obesity has spread at an alarming rate. Across OECD countries, one in 2 adults is currently overweight and 1 in 6 is obese. The rate of overweight people is projected to increase by a further 1% per year for the next 10 years in some countries. These numbers demonstrate a global epidemic one whose victims suffer from heart disease, stroke, hypertension and diabetes. Many of these diseases are provoked or aggravated by lifestyle choices related to diet and physical exercise. Many people like Jane need help from a medical coach to support them in coping with the new situation they find themselves in when they hear that they suffer from diabetes. It has been argued that technology has played a role in allowing many adults to maintain a sedentary lifestyle. Technologies can also help encourage people to live a healthier lifestyle. Persuasive technology refers to technologies that are used to persuade people of a certain opinion or to change their behavior or life style. There is a difference between the technology of persuasion and persuasive technology. The science and technology of persuasion are part of rhetoric, the classic art of persuasion and argumentation. Persuasive technology builds on social psychology in particular theories about behavior change and theories about persuasive communication.
    Thirteenth International Symposium on Social Communication, Santiago de Cuba, Cuba; 01/2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The obesity epidemic is a global challenge that requires evidence-based intervention to slow the emergence of weight-related illness in children and adolescents. Thus, effective treatments are urgently needed. This study aimed to analyze whether there is relationship between the initial stage of readiness for behavior change (SRBC) and the results obtained through participation in a multidisciplinary program of obesity treatment (MPOT). The study included 113 overweight or obese children and adolescents who participated in an intervention for 16 weeks, in which the categorical variable was the SRBC. The dependent variables included: anthropometric measures of body composition, hemodynamic parameters (e.g., blood pressure values), and health-related physical fitness. Although stages 1 and 2 had greater improvements in flexibility than those in stage 5, and stage 1 had greater percentage changes in abdominal strength than those in stage 5, children and adolescents in the highest stage had greater percentage changes for anthropometric, hemodynamic and cardiorespiratory fitness suggesting an impact of the stage of change on the effects of a MPOT. This study suggests that SRBC plays a role in obesity treatment in Brazilian children and adolescents and warrants consideration when enrolling patients to intervention. Copyright © 2014. Published by Elsevier Ltd.
    Appetite 12/2014; · 2.52 Impact Factor