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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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Michael J. O’Connor

Student display of regular physical activity has been presented as a principal component of the definition of a physically educated student (National Association for Sport and Physical Education, 1991). What strategies can a physical educator employ to facilitate the adoption and maintenance of physical activity? The transtheoretical model offers an explanation of the structure of change that occurs when adults attempt to change behavior. Although the model was derived from the modification of addictive and problem behaviors, the transtheoretical model shows promise for providing a theoretical foundation for the acquisition of positive behaviors such as physical activity. This paper explains the basic constructs of the transtheoretical model and discusses application of strategies that a physical educator in postsecondary and community settings may employ to facilitate the adoption and maintenance of physical activity.

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Thad R. Leffingwell, Steven P. Rider and Jean M. Williams

In an effort to apply the transtheoretical model of change to the area of psychological skills training, questionnaires measuring stage of change, decisional balance, and self-efficacy were developed and cross-validated on two samples of NCAA Division I intercollegiate student-athletes. The measures showed good internal reliability and construct validity and exhibited hypothesized functional relationships with each other. In addition, the stage of change measure predicted sport psychology consultations initialed by athletes during the year following questionnaire administration and may prove to be a useful tool in predicting subsequent initiation of individual sport psychology consultation. Several potentially useful lines of research are discussed and recommendations are made regarding the development of sport psychology interventions tailored according to athletes’ stage of change.

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Damien Clement

Context:

The transtheoretical model has been widely used in the investigation of how people adapt to new behaviors; however, the literature appears to be lacking documentation of any assessment/s administered to injured athletes to determine their readiness for rehabilitation, which depending on the severity of the injury, could possibly represent a behavior change for that individual.

Objective:

To validate the application of the transtheoretical model to injury rehabilitation and assess the impact of stages of change on athletes’ adherence and compliance rates.

Design:

Descriptive correlational.

Setting:

Large Mid Atlantic Division I institution.

Participants:

Seventy injured athletes.

Main Outcome Measures:

Readiness was assessed using the Transtheoretical Model. Adherence was assessed using the percentage of rehabilitation attendance and compliance was assessed using the Sport Injury Rehabilitation Scale.

Results:

Participants who were advanced in their stages of change generally reported an increase in self efficacy, utilization of pros versus cons, and the use of behavioral processes instead of experiential processes of change. No significant relationships were found between stages of change and athletes’ adherence and compliance.

Conclusion:

Although no statistical significance was found between stages of change and adherence and compliance the results did validate the application of the transtheoretical model to injury rehabilitation.

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Ralph Maddison and Harry Prapavessis

The purpose of this study was to examine whether variables in the Transtheoretical Model (TTM) acted more as predictors than as consequences of exercise behavior (stage of change). Students from 13 New Zealand high schools (N = 1,434) completed questionnaires corresponding to variables in the TTM (i.e., stage of exercise change, processes of change, self-efficacy, and decisional balance) at two time periods separated by 6 months. Reciprocal relationships were found between exercise behavior and the TTM variables. The TTM might be a useful framework for understanding longitudinal exercise behavior in the adolescent population.

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Stefania Korologou, Vassilis Barkoukis, Lambros Lazuras and Haralambos Tsorbatzoudis

The current study used the transtheoretical model (TTM) as a guiding theoretical framework to assess differences in processes of change, decisional balance, and self-efficacy among deaf individuals with different levels of physical activity. Overall, 146 participants (M age = 26.4 yr, SD = 4.28) completed anonymous questionnaires assessing the dimensions of the TTM, stages of change, processes of change, decisional balance, and self-efficacy. Analysis of variance showed that both experiential and behavioral processes of change were higher in the preparation, action, and maintenance stages than in the other stages. Accordingly, the benefits of physical activity participation were stronger in the preparation stage, whereas the costs were more evident in the precontemplation stage. Finally, self-efficacy at the preparation stage was higher than in the other stages. The findings revealed how different stages of physical activity participation can be explained through the TTM, and the implications for physical activity intervention are discussed.

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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.