Self-efficacy, decisional balance and the stages of change for smoking cessation in a German sample

1999 ◽  
Vol 58 (2) ◽  
pp. 101-110 ◽  
Author(s):  
Stefan Keller ◽  
Claudio R. Nigg ◽  
Christian Jäkle ◽  
Erika Baum ◽  
Heinz-Dieter Basler
Keyword(s):  
Smoking Cessation ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Smoking Behavior ◽  
Linear Increase ◽  
Decisional Balance ◽  
German Sample ◽  
Effective Interventions ◽  
Relationship Of

The Transtheoretical Model (TTM) has been shown to be a powerful basis for describing and explaining behavior change and designing effective interventions. Previous research has documented its usefulness in the context of smoking cessation as well as other areas but predominantly in US samples. The goal of this study was to provide further data on the applicability of the TTM and the relationship of some of its core constructs (stage of change, self-efficacy, decisional balance) in a German sample of smokers and ex-smokers. Participants (N = 401) were ever-smokers (age M = 47 years, range 35-65, 62% male) who participated in a health check-up for cardiovascular risk factors at their general practitioner's office. For current smokers, significant differences in the number of quit attempts across the stages of change supported the criterion validity of the staging algorithm; differences in number of cigarettes per day were non-significant. Self-efficacy for non-smoking behavior showed an almost linear increase across the stages of change, with significant differences between pre-action and action stages. The pros for smoking cessation also increased significantly across the stages, mainly due to a significantly lower perception of pros by participants in the Precontemplation stage. As expected, the cons for smoking cessation decreased significantly, being lower in Action and Maintenance than in earlier stages. Although the generalizability of the results for the stage distribution is limited by the selectivity of the sample, the results underline the applicability and replicability of these TTM core constructs for smoking cessation with newly developed instruments in a German sample.

Educational Intervention Enhances Consumers' Readiness To Adopt Food Thermometer Use When Cooking Small Cuts of Meat: An Application of the Transtheoretical Model

2005 ◽  
Vol 68 (9) ◽  
pp. 1874-1883 ◽  
Author(s):  
MASAMI T. TAKEUCHI ◽  
MIRIAM EDLEFSEN ◽  
SANDRA M. McCURDY ◽  
VIRGINIA N. HILLERS
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Intervention Program ◽  
Decisional Balance ◽  
Processes Of Change ◽  
Safety Risks ◽  
Raising Awareness ◽  
Readiness To Adopt ◽  
Educational Campaigns

An intervention to promote use of food thermometers when cooking small cuts of meat was conducted using the Transtheoretical Model. Objectives were to (i) increase use of food thermometers by home food preparers, (ii) improve consumers' attitudes regarding use of a food thermometer, and (iii) examine relationships between stages of change and decisional balance, self-efficacy, and processes of change. A randomly selected group of residents of Washington and Idaho (n = 2,500) were invited to participate in the research; 295 persons completed all phases of the multistep intervention. Following the intervention program, there was a significant increase in food thermometer use when cooking small cuts of meat (P < 0.01); those persons classified in action and maintenance stages increased from 9 to 34%. Ownership of thermometers also significantly increased (P < 0.05). The three constructs related to the Transtheoretical Model that were used in the study (decisional balance, self-efficacy, and processes of change) were very useful for examining differences among people at different stages of change because the responses for each set of questions differed positively and significantly (P < 0.01) as stages of change classifications advanced from precontemplation (no interest in thermometer use) to action and maintenance (individuals who use food thermometers). Additional educational campaigns designed to increase use of food thermometers are needed. Because most consumers are currently in the precontemplation stage, food thermometer campaigns will be most effective when they are focused on raising awareness of the food safety risks and the benefits of using food thermometers when cooking small cuts of meat.

scholarly journals Predictive Value of the Transtheoretical Model to Smoking Cessation in Hospitalized Patients with Cardiovascular Disease

2007 ◽  
Vol 30 (3) ◽  
pp. 35
Author(s):  
Maud-Christine Chouinard ◽  
Sylvie Robichaud-Ekstrand
Keyword(s):  
Cardiovascular Disease ◽  
Smoking Cessation ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Predictive Value ◽  
Self Efficacy ◽  
Hospitalized Patients ◽  
Processes Of Change ◽  
Smoking Abstinence ◽  
Pros And Cons

Background: Several authors have questioned the Transtheoretical Model (TTM). Determining the predictive value of each cognitive-behavioural element within this model could explain the successes reported in smoking cessation programs. The purpose of this study was to predict point-prevalent smoking abstinence and progression through stages of change at 2 and 6 months, using the constructs of the TTM, when applied to a pooled sample of individuals who were hospitalized for a cardiovascular event. Methods: In a predictive correlation design, recently hospitalized patients (N = 168) with cardiovascular disease (CVD) were pooled from a randomized controlled trial. Independent variables of the predictive TTM comprise stages and processes of change, pros and cons to quit smoking (decisional balance), self-efficacy, and social support. These were evaluated at baseline, 2 and 6 months. Results: Compared with smokers, individuals who abstained from smoking at 2 and 6 months were more confident at baseline to remain non-smokers, perceived less pros and cons to continue smoking, utilized less consciousness raising and self-reevaluation experiential processes of change, and received more positive reinforcement from their social network with regard to their smoke-free behaviour. Self-efficacy at baseline was the only element which predicted that patients would progress through the stages of change between hospital discharge and 6 months. Conclusions: Self-efficacy was the only element which predicted smoking abstinence and progression through stages of change. Observations about the other elements are congruent with the TTM. This study provides important information regarding the application of the TTM to smoking cessation in CVD patients.

Transtheoretical Model and Stages of Change in Health and Risk Messaging

2017 ◽  
Author(s):  
Seth M. Noar
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Health Behavior Change ◽  
Decisional Balance ◽  
Message Design ◽  
Tailored Interventions ◽  
Theoretical Approaches

The Transtheoretical Model (TTM) is an integrative health behavior change theory that describes the process of how people change their behavior. The central organizing construct in the theory is stages of change, which are five distinct stages of readiness to change behavior, ranging from not ready to change (precontemplation), thinking about change (contemplation), preparing to change (preparation), changing (action), and maintaining the change (maintenance). Movement through the stages may be nonlinear, and cycling and recycling through the stages is viewed as a natural part of the change process. Other model constructs explain what drives individuals forward through the stages of change. Decisional balance involves a weighing of pros and cons of changing behavior, while self-efficacy involves situation-specific confidence that one can change. Increases in pros, deceases in cons, and increases in self-efficacy propel people forward through the stages of change. The processes of change are experiential and behavioral strategies that people use to change their behavior. In early stages of change, people use experiential strategies while they use behaviorally oriented strategies in later stages of change. The TTM holds significant implications for message design. Most notably, messages should be targeted and tailored to stages of change, and where possible, to other model variables as well. Studies indicate that the TTM has been successfully applied to health communication campaigns, and to a larger extent, to computer-tailored interventions to change health behavior. Meta-analyses indicate that scores of computer-tailored interventions have been efficacious, including many based upon the TTM and stages of change. New applications of the model include a focus on novel health behaviors, multiple behavior change, and advancing an understanding of message design in the context of the TTM in combination with other theoretical approaches.

scholarly journals Characteristics in Stages of Change and Decisional Balance among Smokers: The Burden of Obstructive Lung Diseases (BOLD)-Australia Study

2019 ◽  
Vol 16 (18) ◽  
pp. 3372
Author(s):  
Marsha A. Ivey ◽  
Graeme P. Maguire ◽  
Brett G. Toelle ◽  
Guy B. Marks ◽  
Michael J. Abramson ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Lung Diseases ◽  
Decisional Balance ◽  
Smoking History ◽  
Health Providers ◽  
Negative Consequences ◽  
Obstructive Lung Diseases ◽  
Readiness To Quit

Smoking cessation remains a health promotion target. Applying the Transtheoretical Model to Australian Burden of Obstructive Lung Diseases (BOLD) data, we examined differences in stages of change (SoC) and readiness to quit decisional behaviours. Factors were identified likely to influence readiness of smokers, ≥40 years old, to quit. Analysis was restricted to current smokers classified to one of three stages: pre-contemplation (PC), contemplation (C) or preparation (P) to quit. Their ability to balance positive and negative consequences was measured using decisional balance. Among 314 smokers, 43.0% females and 60.8% overweight/obese, the distribution of SoC was: 38.1% PC, 38.3% C and 23.5% P. Overweight/obesity was associated with readiness to quit in stages C and P and there were more negative than positive attitudes towards smoking in those stages. Males were significantly heavier smokers in PC and C stages. Females used smoking cessation medication more frequently in PC stage, were more embarrassed about smoking and had greater negative reinforcements from smoking. Age started smoking and factors related to smoking history were associated with readiness to quit and increased the odds of being in stage C or P. An overweight/obese smoker was likely to be contemplating or preparing to quit. In these stages, smokers have more negative attitudes toward smoking. Starting smoking later, taking advice on cessation from health providers and using quit medications indicate increased readiness to quit. Evaluating these factors in smokers and developing cessation gain-framed messages may prove useful to healthcare providers.

CHANGES IN SELF-EFFICACY AND DECISIONAL BALANCE FOLLOWING AN INTERVENTION TO INCREASE CONSUMPTION OF CALCIUM-RICH FOODS

2006 ◽  
Vol 34 (8) ◽  
pp. 1007-1016
Author(s):  
Kambiz Karimzadeh Shirazi ◽  
Shamsaddin Niknami ◽  
Louise Wallace ◽  
Alireza Hidarnia ◽  
Elaheh Rahimi ◽  
...  
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Decisional Balance ◽  
Control Group ◽  
Pros And Cons ◽  
Randomized Control ◽  
Group Self ◽  
Experimental Group ◽  
Control Study

In this randomized control study the changes in Transtheoretical Model (TTM; Prochaska & DiClemente, 1983) constructs (Self-Efficacy, Decisional Balance) after a tailored stage-based education program to increase calcium consumption in 40–65-year-old women were investigated. Postintervention, significantly more of the experimental group in comparison to the control group improved their calcium consumption stage of change. In the experimental group self-efficacy and pros of calcium consumption increased and cons decreased for those who had positive progression in stages of change but these constructs remained unchanged in individuals in the control group. The tailored education based on the TTM is an effective method of assisting women to progress through the calcium-rich foods consumption stages of change and can cause more actualized results for self-efficacy, pros and cons in the manner predicted by TTM.

Using the Transtheoretical Model to Examine the Effects of Exergaming on Physical Activity Among Children

2015 ◽  
Vol 12 (9) ◽  
pp. 1205-1212 ◽  
Author(s):  
Zachary C. Pope ◽  
Beth A. Lewis ◽  
Zan Gao
Keyword(s):  
Physical Activity ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Decisional Balance ◽  
Upper Elementary ◽  
Decision Balance ◽  
Mountain West ◽  
And Behavior ◽  
Dance Dance Revolution

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.

scholarly journals The impact on adolescents of a Transtheoretical Model-based programme on fruit and vegetable consumption

2019 ◽  
Vol 22 (13) ◽  
pp. 2500-2508 ◽  
Author(s):  
Kamer Gur ◽  
Saime Erol ◽  
Hasibe Kadioglu ◽  
Ayse Ergun ◽  
Rukiye Boluktas
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Vegetable Consumption ◽  
Daily Basis ◽  
Decisional Balance ◽  
Fruit And Vegetable ◽  
Model Based ◽  
Post Test ◽  
The Impact

AbstractObjective:The present study aimed to evaluate the impact of a Transtheoretical Model-based programme titled ‘Fruit &amp; Vegetable-Friendly’ on the fruit and vegetable (F&amp;V) consumption of adolescents.Design:A quasi-experimental study. The ‘Fruit &amp; Vegetable-Friendly’, a multicomponent intervention based on the Transtheoretical Model, was completed in eight weeks. The data were collected one week before the intervention, one week after the completion of the intervention and six months after the post-test with an F&amp;V intake questionnaire and the stages of change, processes of change (α = 0·91), situational self-efficacy (α = 0·91) and decisional balance (α = 0·90 for pros, α = 0·87 for cons) scales. Data were analysed with the Friedman, Wilcoxon and marginal homogeneity tests.Setting:A public secondary school in Istanbul, Turkey.Participants:Seven hundred and two adolescents.Results:The mean (sd) F&amp;V intake of adolescents in the passive stages rose from the daily average at the time of the pre-test of 3·40 (1·79) portions to 5·45 (2·54) portions on the post-test and to 5·75 (2·70) portions on the follow-up test (P &lt; 0·01). While the students in the passive stages represented 41·6 % of the participants prior to the programme, this rate fell to 23·7 % at the post-test and to 22·7 % at the follow-up. Students in the active stages first represented 58·5 % of the participants; this rate rose to 76·4 % at the post-test and to 77·2 % at the follow-up test.Conclusions:The programme was effective in increasing the amount of F&amp;V the adolescents consumed on a daily basis.

Development and Preliminary Psychometric Evaluation of Decisional Balance and Self-Efficacy Measures for Managing Anxiety in a National Sample of Clinically Anxious Adults

2016 ◽  
Vol 32 (1) ◽  
pp. 215-223
Author(s):  
Jessica M. Lipschitz ◽  
Andrea L. Paiva ◽  
Colleen A. Redding ◽  
Deborah Levesque ◽  
Joseph S. Rossi ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Online Survey ◽  
The United States ◽  
Decisional Balance ◽  
Cross Sectional Survey ◽  
Core Element ◽  
Measurement Models ◽  
Confirmatory Factor

Purpose: Anxiety is the most common and costly mental illness in the United States. Reducing avoidance is a core element of evidence-based treatments. Past research shows readiness to address avoidance affects outcomes. Investigating avoidance from a transtheoretical model (TTM) perspective could facilitate tailored approaches for individuals with low readiness. This study developed and examined psychometric properties of TTM measures for addressing anxiety-based avoidance. Design: Cross-sectional survey. Setting: Community centers, online survey. Participants: Five hundred ninety-four individuals aged 18 to 70 with clinically significant anxiety. Measures: Overall Anxiety Severity Questionnaire, stages of change, decisional balance, and self-efficacy. Analysis: The sample was randomly split into halves for principal component analyses (PCAs) and confirmatory factor analyses (CFAs) to test measurement models. Further analyses examined relationships between constructs. Results: For decisional balance, PCA indicated two 5-item factors (pros and cons). Confirmatory factor analysis supported a 2-factor correlated model, Satorra-Bentler scaled chi-square [Formula: see text], comparative fit index (CFI = 0.94), root mean square error of approximation (RMSEA = 0.07), pros: α = 0.87, ρ = 0.87, cons: α = 0.75, and ρ = 0.75. For self-efficacy, PCA indicated one 6-item factor supported by CFA, [Formula: see text], P < .01, CFI = 0.98, RMSEA = 0.09, α = 0.90, ρ = 0.87. As hypothesized, significant cross-stage differences were observed for pros and self-efficacy, and significant relationships between anxiety severity and pros, cons, and self-efficacy were found. Conclusion: Findings show strong psychometric properties and support the application of a readiness-based model to anxiety. In contrast to findings of other behaviors, cons remain high in action and maintenance. These measures provide a solid empirical foundation to develop TTM-tailored interventions to enhance engagement in treatment.

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