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Colin A. Armstrong, James F. Sallis, Melbourne F. Hovell and C. Richard Hofstetter

Components of the transtheoretical model of change were examined in a prospective study of the adoption of vigorous exercise in adults. Respondents to a random mail survey were resurveyed 2 years later. Those who reported no vigorous exercise at baseline were classified as either contemplators (n = 213) or precontemplators (n = 188). Contemplators had higher baseline self-efficacy scores than precontemplators (p < .001). In multivariate analyses, baseline stage of change was a significant predictor (p < .0005) of later adoption of vigorous exercise, even after controlling for differences in age, gender, and self-efficacy. During the first 6 months postbaseline, contemplators were nearly twice as likely as precontemplators to progress to the stage of action (46% vs. 24%), and four times more likely to progress to the stage of maintenance (25% vs. 6%). Use of the transtheoretical model in the study of exercise was supported in this prospective examination of exercise in a community sample.

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Corjena Cheung, Jean Wyman, Cynthia Gross, Jennifer Peters, Mary Findorff and Holly Stock

The transtheoretical model (TTM) was developed as a guide for understanding behavior change. Little attention has been given, however, to the appropriateness of the TTM for explaining the adoption of exercise behavior in older adults. The purposes of this study were to determine the reliability of the TTM instruments and validate TTM predictions in 86 community-dwelling older adults (mean age 75.1 ± 7.0 years, 87% women) who were participants in a 16-week walking program. TTM construct scales—self-efficacy, decisional balance (pros and cons), and processes of change (behavioral and cognitive)—were generally reliable (all α > .78). Behavioral processes of change increased from baseline to follow-up, but pros, cons, and cognitive processes did not change among participants who became regular exercisers. Stage of change did not predict exercise adoption, but baseline self-efficacy predicted walking behavior. These results lend partial support to the TTM in predicting exercise behavior.

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Trish Gorely and Sandy Gordon

This study examined the structure of the transtheoretical model (TM) in exercise behavior change among adults age 50–65 years (n = 583). The purpose was to examine the relationship between stage of change and the constructs of processes of change, self-efficacy, and decisional balance. The results showed that 5 of the 10 processes of change, self-efficacy, and both pros and cons make significant and unique contributions to discrimination between the stages. Specifically, the use of the processes of change was shown to fluctuate across the stages, self-efficacy was shown to increase from precontemplation to maintenance, and the balance between pros and cons was shown to change from precontemplation to maintenance. The similarity of these results to previous literature suggests that the process of behavior change hypothesized within the TM holds across different age groups and cultures. Several implications for intervention design and suggestions for further research are discussed.

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Zachary C. Pope, Beth A. Lewis and Zan Gao

Background:

The Transtheoretical Model (TTM) has been widely used to understand individuals’ physical activity (PA) correlates and behavior. However, the theory’s application among children in exergaming remains unknown.

Purpose:

Investigate the effects of an exergaming program on children’s TTM-based PA correlates and PA levels.

Methods:

At pretest and posttest, 212 upper elementary children (mean age = 11.17 years) from the greater Mountain West Region were administered measures regarding stages of change (SOC) for PA behavior, decisional balance for PA behaviors, PA self-efficacy, and self-reported PA levels. Following the pretest, a weekly 30-minute, 18-week Dance Dance Revolution (DDR) program was implemented. Children were classified into 3 SOC groups: progressive children (ie, progressed to a higher SOC stage); stable children (ie, remained at the same SOC stage); and regressive children (ie, regressed to a lower SOC stage).

Results:

Progressive children had greater increased PA levels than regressive children (P < .01) from pretest to posttest. Similarly, progressive children had greater increased self-efficacy (P < .05) and decision balance (P < .05) than regressive children.

Conclusions:

The findings indicate that progressive children had more improvements on self-efficacy, decisional balance, and PA levels than regressive children over time. Implications of findings are discussed.

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Jessica M. Lipschitz, Miryam Yusufov, Andrea Paiva, Colleen A. Redding, Joseph S. Rossi, Sara Johnson, Bryan Blissmer, N. Simay Gokbayrak, Wayne F. Velicer and James O. Prochaska

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.

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Carolyn Rabin, Bernardine M. Pinto and Georita M. Frierson

Physical activity (PA) interventions diminish some of the physical and psychosocial sequelae of breast cancer diagnosis and treatment. To increase intervention efficacy and portability, it is necessary to determine the factors mediating intervention effects on physical and psychosocial outcomes. This study presents mediator analyses from a randomized controlled trial of a home-based PA intervention (focused primarily on brisk walking) for breast cancer survivors. Eighty-six survivors were randomized to PA or contact control groups (mean age = 53.42 years, SD = 9.08 and 52.86 years, SD = 10.38 respectively; mean time since diagnosis < 2 years). The PA intervention was based on the transtheoretical model (TTM). Kraemerʼs approach was used to test hypothesized mediators. TTM variables did not mediate intervention effects on PA. Data indicate that increases in moderate-intensity PA and improved fitness may mediate intervention effects on vigor (β = .21; p = .01) and fatigue (β = .24; p = .05) and suggest the value of future research on these potential mediators.

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Beth A. Lewis, LeighAnn H. Forsyth, Bernardine M. Pinto, Beth C. Bock, Mary Roberts and Bess H. Marcus

Behavioral science theories have been used to develop physical activity interventions; however, little is known as to whether these interventions are effective due to changes in constructs related to these theories. Specifically, if the intervention is successful, does it work for the reasons hypothesized by the theory underlying it? The purpose of this study was to examine the importance of particular theoretical constructs among participants (n = 150) who had been randomly assigned to a physical activity intervention based on the Transtheoretical Model and Social Cognitive Theory (i.e., tailored group) or to a standard care group. Participants in the tailored group reported greater increases in behavioral processes and self-efficacy from baseline to 3 months than participants in the standard-care group. No between-group differences were found for cognitive processes and decisional balance. This study demonstrates that theory-based physical activity interventions may be effective through changes in particular theoretical constructs.

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Ashley A. Hansen, Joanne E. Perry, John W. Lace, Zachary C. Merz, Taylor L. Montgomery and Michael J. Ross

. Therefore, consistent with the goal of grounding sport psychology practice in clinical psychology methodology, the current paper provides preliminary support for a new assessment measure that serves as a transtheoretical monitoring instrument for applied sport psychology practice and fills the present gap

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Akitomo Yasunaga, Yukari Kawano, Yumiko Kamahori and Kyoko Noguchi

Background:

The purpose of the current study was to examine the association between the level of exercise behavior and individual and environmental factors related to exercise behavior among female Japanese undergraduate students.

Methods:

The participants were 2482 female Japanese undergraduate students. Participants’ level of exercise behavior was measured by the stage of change to exercise in the transtheoretical model. Individual and environmental factors related to exercise behavior were assessed using body mass index, self-efficacy, social support, perceived positive and negative aspects of exercise, perceived neighborhood environment, attitude toward physical education lessons in childhood and puberty, and depression.

Results:

Scores for self-efficacy, social support, positive aspects of exercise, and perceived neighborhood environment were significantly higher among women who were more active compared with those who were inactive. On the other hand, scores for negative aspects of exercise and depression were greater among inactive women compared with those who were insufficiently active and/or active. In addition, past attitude toward exercise in primary school, junior high school, and high school was associated with current level of exercise behavior.

Conclusions:

This cross-sectional study confirmed that psychosocial and environmental factors were closely associated with level of exercise behavior among female Japanese undergraduate students.

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Ilca M.S. Diniz, Maria de Fátima S. Duarte, Karen G. Peres, Elusa S.A. de Oliveira and Angélia Berndt

Objective:

The objective of this study was to assess the effectiveness of an educational intervention on active commuting by bicycle.

Methods:

An intervention study with workers from a metallurgical industry in Santa Catarina state, Brazil was carried out in 2011. A total of 464 individuals were placed in the intervention group (IG) and 468 in the control group (CG). The intervention consisted of strategies based on the transtheoretical model and stages of behavior change. The intervention group took part in activities for 6 months, including 23 meetings. The statistical analysis included intergroup comparison (IG × CG) at baseline and after the intervention. Intragroup analysis was performed 6 months after the intervention. Student’s t-test, chi-square, and McNemar tests were used to analyze the data.

Results:

Of the original total, 876 individuals (94%) participated in the study. The proportion of participants that used bicycles to commute to work (IG) increased significantly from baseline (45.3%) to the final interventional period (47.5%). No difference was found between the CG and the IG group after the interventional period.

Conclusion:

We suggest taking these findings into consideration in further studies to understand better the role of educational intervention on active commuting by bicycle.