Is there utility in the transtheoretical model?
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.
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.
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ABSTRACT: Fourteen different measures were investigated as predictors of change in smoking status for self-change efforts at smoking cessation. Adult subjects (N = 866) were classified into five stages of change: precontemplation, contemplation, action, maintenance, and relapse. Subjects were assessed on 10 change processes, self-efficacy, temptations to smoke, and their decisions weighing the advantages and disadvantages of smoking; and these 14 variables were used as predictors of change in smoking status 6 months later. Six significant functions were found which predicted movement for each of the stages. These predictors are both theoretical interest and practical significance because they may be modified in self-change efforts to overcome addictive behaviors. Overall, the change processes of self-reevaluation and the helping relationship and the self-efficacy and decisional balance variables were the most efficacious predictor variables. A general pattern emerged in which processes oriented more toward environmental events, such as dramatic relief and social liberation, tended to predict failure or no progress whereas more experientially oriented processes predicted progress.Addictive Behaviors 02/1985; · 2.02 Impact Factor
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ABSTRACT: Clinicians and researchers applying the transtheoretical model (J.O. Prochaska, C.C. DiClemente, & J.C. Norcross, 1992) to health promotion often assume that relationships of processes and stages observed in smoking cessation can be generalized to other problems. A reanalysis of 47 cross-sectional studies determined that use of change processes varies by stage, but the sequencing of processes is not consistent across health problems. In smoking cessation, cognitive processes were used in earlier stages than were behavioral processes. In exercise adoption and diet change, use of behavioral and cognitive processes increased together. Results for substance abuse and psychotherapy were less consistent. Substituting new behaviors, making a commitment, considering consequences, seeking information, controlling cues, and using rewards varied most by stage. Future longitudinal studies should assess these processes as potential mediators of lifestyle change.Health Psychology 11/2000; 19(6):593-604. · 3.83 Impact Factor
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ABSTRACT: This study examined the application of constructs concerning stage of readiness to change and self-efficacy to exercise. We developed two scales to measure stages of change for exercise behavior. Prevalence information on a sample of 1,063 government employees and 429 hospital employees was then obtained. Next, the ability of a questionnaire measuring exercise self-efficacy to differentiate employees according to stage of readiness to change was tested. Results from both stages-of-change scales revealed that 34-39% of employees were regularly participating in physical activity. Scores on efficacy items significantly differentiated employees at most stages. Results indicated employees who had not yet begun to exercise, in contrast with those who exercised regularly, had little confidence in their ability to exercise. Continued work at understanding the stages of exercise behavior and exercise self-efficacy could yield important information for enhancing exercise adoption and adherence.Research quarterly for exercise and sport 04/1992; 63(1):60-6. · 1.11 Impact Factor