Transtheoretical Principles and Processes for Adopting Physical Activity: A Longitudinal 24-Month Comparison of Maintainers, Relapsers, and Nonchangers

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Jessica M. Lipschitz University of Rhode Island

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Miryam Yusufov University of Rhode Island

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Andrea Paiva University of Rhode Island

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Colleen A. Redding University of Rhode Island

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Joseph S. Rossi University of Rhode Island

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Sara Johnson Pro-Change Behavior Systems, Inc.

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Bryan Blissmer University of Rhode Island

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N. Simay Gokbayrak University of Rhode Island

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Wayne F. Velicer University of Rhode Island

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James O. Prochaska University of Rhode Island

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This study examined longitudinal differences in use of transtheoretical model (TTM) behavior change constructs in maintainers (who reached and maintained exercise guidelines), relapsers (who reached guidelines, then regressed), and nonchangers (who did not reach guidelines). Data from two population-based TTM-tailored randomized trial intervention groups targeting exercise behavior (N = 1050) were pooled, and analyses assessed differences in TTM constructs between the three groups at baseline, 12 months, and 24 months. Findings indicated that relapsers tended to use TTM variables similarly to maintainers with the exception of self-efficacy, consciousness raising, and most behavioral processes of change, at 24 months. Nonchangers, however, used all TTM variables less than maintainers at nearly every time point. Findings suggest that relapsers remain more active than nonchangers in terms of use of change processes. Poor response to interventions (nonchangers) may be predicted by low baseline engagement in change processes. Although relapsers reverted to physical inactivity, their overall greater use of TTM constructs suggests that their efforts to change remain better than those of the stable nonchanger group. Future research can focus on treatment engagement strategies to help the stable nonchangers initiate change and to help relapsers to maintain treatment gains.

Jessica M. Lipschitz, Miryam Yusufov, Andrea Paiva, Colleen A. Redding, and Joseph S. Rossi are each with the Department of Psychology and with the Cancer Prevention Research Center, University of Rhode Island, Kingston, Rhode Island. Sara Johnson is with Pro-Change Behavior Systems, Inc., Kingston, Rhode Island. Bryan Blissmer is with the Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island. N. Simay Gokbayrak is with the Department of Psychology, University of Rhode Island, Kingston, Rhode Island. Wayne F. Velicer and James O. Prochaska are each with the Cancer Prevention Research Center, University of Rhode Island, Kingston, Rhode Island.

Address author correspondence to Miryam Yusufov at miryam_yusufov@uri.edu.
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