scholarly journals 0476 Readiness and Stages of Change in a Behavioral Sleep Medicine Clinical Sample: From Pre-Contemplation to Struggling to Maintain Change

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A182-A183
Author(s):  
G Amatrudo ◽  
K Puzino ◽  
E Bourchtein ◽  
S L Calhoun ◽  
J Fernandez-Mendoza
Keyword(s):  
Rhode Island ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Behavioral Treatment ◽  
Readiness To Change ◽  
Clinical Sample ◽  
Significant Proportion ◽  
Sleep Medicine ◽  
Treatment Center ◽  
Penn State

Abstract Introduction Stages of change in the transtheoretical model are used to assess a patient’s readiness to change, which may help providers tailor behavioral treatment (BT). As research has focused on substance abuse, there is a significant lack of data in individuals presenting for behavioral sleep medicine (BSM) treatment. Methods 146 consecutive patients (46.1±16.0 years, 61.6% female, 19.9% minority) who were evaluated at the BSM program of Penn State Hershey Sleep Research & Treatment Center completed the University of Rhode Island Change Assessment Scale (URICA) assessing readiness to change (RtC) and pre-contemplation (P), contemplation (C), preparation/action (A) and struggling to maintain (M) stages of change. Subjects also completed the Insomnia Treatment Acceptability Scale (ITAS) and Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS). Results The average RtC score was 9.4, with 21.9% of the sample in stage P, 56.2% in C and 21.9% in A. The average P (53.2±7.6), C (49.1±10.1), A (48.8±12.3) and M (37.7±9.1) scores suggested an overall “contemplation cluster profile”. Higher RtC (r=0.37), C (r=0.31) and A (r=0.24) scores were associated with greater acceptability of BT, while higher P scores were associated with lower acceptability of BT (r=-0.22). In contrast, higher M scores were associated with greater acceptability of pharmacological treatment (r=0.21) as well as higher DBAS scores, including sleep medication expectations (r=0.23). Conclusion Patients attending a BSM program typically present at a contemplation stage, which indicates intention to start changing sleep behaviors within the next few months with some ambivalence in regards to pros/cons of such change. A significant proportion of patients struggle to maintain change and present with higher acceptability for pharmacological interventions, which may hinder the effectiveness of BT and may require specific therapeutic approaches. Support Department of Psychiatry, Penn State College of Medicine

scholarly journals A systematic review of the transtheoretical model of behaviour change and alcohol use

Psychologica ◽  
2014 ◽  
Vol 57 (1) ◽  
pp. 7-22
Author(s):  
Flaviane Bevilaqua Felicíssimo ◽  
Víviam Vargas Barros ◽  
Sabrina Maura Pereira ◽  
Natália Quintela Rocha ◽  
Lélio Moura Lourenço
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Rhode Island ◽  
Behaviour Change ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Change Processes ◽  
Processes Of Change ◽  
Change Assessment

Introdução: O estudo sobre o álcool tem aumentado em todo o mundo devido ao seu impacto social e econômico, e as doenças relacionadas ao uso de álcool estarem entre os distúrbios mais comuns de abuso de substâncias. Desta forma, faz-se necessário investigar os métodos mais eficazes e adequados de tratamento para diferentes populações. Método: Este trabalho analisou a literatura científica sobre o Modelo Transteórico de Mudança de Comportamento relacionados ao consumo de álcool. Foram consultadas as bases de dados Scopus, PubMed, PsycINFO, PepsiCo e Lilacs, utilizando os descritores transtheoretical model, transtheoretical approach, stages of change, processes of change e cycle of change cruzado com o descritor alcoholism, no período de dez anos (2001 a 2011). Principais resultados: A maioria das pesquisas encontradas utilizavam métodos longitudinais e quantitativos, além de uma prevalência no uso dos questionários Readiness to Change Questionnaire e University of Rhode Island Change Assessment utilizados na mensuração do ModeloTransteórico. Os resultados indicaram que outras variáveis podem influenciar o comportamento do indivíduo em relação à sua fase de mudança de comportamento e identificou problemas relacionados ao uso de álcool em pacientes que procuravam tratamento para outras condições de saúde. Esta constatação reforça a necessidade de práticas de triagens para a prevenção dos agravos relacionados ao uso de álcool.Implicações: O modelo Transteórico é importante no processo de mudança de comportamento, uma vez que permite a identificação dos estágios e a escolha de intervenções mais adequadas ao estágio do paciente, além de evitar que esforços sejam feitos na direção contrária à necessidade do usuário. Conclusão: Ressalta-se a necessidade de mais estudos na área, especialmente em relação às práticas de profissionais de saúde.

Stages of Change in Batterers and Their Response to Treatment

2008 ◽  
Vol 23 (4) ◽  
pp. 476-492 ◽  
Author(s):  
Pamela C. Alexander ◽  
Eugene Morris
Keyword(s):  
Rhode Island ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Partner Violence ◽  
Readiness To Change ◽  
Violent Behavior ◽  
Stage Of Change ◽  
Response To Treatment ◽  
Future Research ◽  
Cluster 2

One important dimension of individual differences among batterers is their readiness to change. According to the transtheoretical model (Prochaska & DiClemente, 1984), all individuals go through precontemplation, contemplation, preparation, action, and maintenance before a change in behavior is accomplished. The applicability of this model to intimate partner violence was assessed by administering the University of Rhode Island Change Assessment (URICA) scales (with reference to their domestic violent behavior) to 210 court-ordered male batterers. Their responses were clustered, and two clusters were derived and then compared on other measures. As hypothesized, cluster 2 individuals (characterized by a profile of URICA scale scores suggesting an earlier stage of change) self-reported less initial distress (depression, anxiety, and alcohol abuse), less violence, and fewer problems with anger than cluster 1 individuals (characterized by URICA scale sores suggesting a later stage of change), although partners reported no difference in violence perpetrated by the two clusters. Cluster 1 individuals evidenced greater improvement in self-reported depression, anxiety, and anger control. Strategies to engage the more resistant cluster 2 individuals as well as suggestions for future research are considered.

Therapeutic Dynamics of Aggression, Readiness to Change, and Recidivism in a Partner Violent Men Typology

2021 ◽  
pp. 001112872110364
Author(s):  
Natalia Redondo ◽  
Marina J. Muñoz-Rivas ◽  
Arthur L. Cantos ◽  
Jose Luis Graña
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Partner Violence ◽  
Behavioral Interventions ◽  
Readiness To Change ◽  
Drop Out ◽  
Short Term ◽  
Violent Men ◽  
Partner Violent Men

The Transtheoretical Model (TTM) of behavior change predicts that patients go through different stages of change prior to changing their problematic behavior. This study aims to evaluate the utility and validity of this model in a sample of 549 court-ordered partner violent men. Three types of perpetrators with respect to their readiness to change were revealed. Those in more advantage stage of change use more processes to change their problem and present with higher levels of intimate partner violence (IPV). Low readiness to change levels and treatment drop-out predict short-term criminal justice recidivism, while treatment drop-out predicts medium and long-term recidivism. Results highlight the applicability of the TTM in IPV and its usefulness in designing behavioral interventions with this population.

scholarly journals The profile of client's readiness for change and preference to typical processes of change

Psihologija ◽  
2004 ◽  
Vol 37 (1) ◽  
pp. 89-108 ◽  
Author(s):  
Vesna Gavrilov-Jerkovic
Keyword(s):  
Stages Of Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Readiness For Change ◽  
Transtheoretical Model Of Change ◽  
Processes Of Change ◽  
Theoretical Part ◽  
Research Author ◽  
Paper Author

In the theoretical part of this paper author considers the difficulties to define phenomenon of patient's readiness to change and proposes dimensions of transtheoretical model of change, that is, stages of change and processes as conceptual frames for exceeding those difficulties. Through the research author investigates the possibility to identify typical profiles of patient's readiness from the data about measured levels of particular stages of change. The results infer that several typical profiles of readiness can be identified and that it is possible that these profiles could be connected with tendency of patients to prefer passive or action-restructure processes of change.

scholarly journals Transtheoretical model-based nutritional interventions in adolescents: a systematic review

2020 ◽  
Author(s):  
Jennifer Nakabayashi Langamer ◽  
Giselle Rha-isa Melo ◽  
Natacha Toral
Keyword(s):  
Behavior Change ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Eating Habits ◽  
Readiness To Change ◽  
Decisional Balance ◽  
Publication Date ◽  
Nutritional Interventions ◽  
Behavior Change Theories ◽  
Positive Results

Abstract Background Literature has shown a tendency of inadequate eating habits among youth, consequently, nutritional interventions are required. The Transtheoretical Model (TTM) classifies individuals based on their readiness to change. This model is widely used for health education interventions and it has been associated with positive results. Purpose This review aimed to describe how the TTM has been applied to nutritional interventions for adolescents. Methods The Adolec, Google Scholar, LILACS, PsycINFO, PubMed, Science Direct and Web of Science databases were searched. Only full original articles written in English, Spanish or Portuguese on randomized controlled trials and quasi-experimental designs that applied the TTM to nutritional interventions targeting adolescents were included, with no restrictions on publication date. Results The initial search yielded 3779 results, of which 13 were included. Two more articles were added after a search update, totaling 15 articles. The included adolescents were mostly recruited from schools, and the duration of the studies ranged from one month to three years. The TTM was used alone or combined with other behavior-change theories. Nine interventions had positive results. The participants in six studies progressed through stages of change or improved decisional balance. Conclusion There are some limitations related to the studies included in this review, such as the differences in design and intervention exposure time, as well as using the TTM in association with other behavior-change theories. Nevertheless, the TTM seems to be a successful strategy for nutritional intervention in adolescents. Further studies comparing the TTM with other behavior-change theories should be conducted to better understand its effectiveness.

scholarly journals Stages of Change Model for Participation in Physical Activity during Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Lene Annette Hagen Haakstad ◽  
Nanna Voldner ◽  
Kari Bø
Keyword(s):  
Physical Activity ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Exercise Program ◽  
Activity Level ◽  
University Hospital ◽  
Pelvic Girdle Pain ◽  
Physically Active ◽  
Stage 4

Background. The transtheoretical model (TTM) has been successful in promoting health behavioral change in the general population. However, there is a scant knowledge about physical activity in relation to the TTM during pregnancy. Hence, the aims of the present study were (1) to assess readiness to become or stay physically active according to the TTM and (2) to compare background and health variables across the TTM.Methods. Healthy pregnant women (n=467) were allocated to the study from Oslo University Hospital, Norway. The participants filled in a validated self-administered questionnaire, physical activity pregnancy questionnaire (PAPQ) in gestation, weeks 32–36. The questionnaire contained 53 questions with one particular question addressing the TTM and the five stages: (1) precontemplation stage, (2) contemplation stage, (3) preparation stage, (4) action stage, and (5) maintenance stage.Results. More than half of the participants (53%) were involved in regular exercise (stages 4-5); however, only six specified that they had recently started an exercise program (stage 4). About 33% reported engaging in some physical activity, but not regularly (stage 3). The results showed that receiving advice from health professionals to exercise during pregnancy increased the likeliness of being in stages 4-5, while higher age, multiparity, pregravid overweight, unhealthy eating habits, pelvic girdle pain, and urinary incontinence were more prevalent with low readiness to change exercise habits (stages 1–3).Conclusion. According to the TTM, more than half of the participants reported to be physically active. Moreover, most of the participants classified as inactive showed a high motivational readiness or intention to increase their physical activity level. Hence, pregnancy may be a window of opportunity for the establishment of long-term physical activity habits.

scholarly journals The transtheoretical model and substance dependence: theoretical and practical aspects

2009 ◽  
Vol 31 (4) ◽  
pp. 362-368 ◽  
Author(s):  
Fabiana Andrioni De Biaze Vilela ◽  
Flávia Serebrenic Jungerman ◽  
Ronaldo Laranjeira ◽  
Russel Callaghan
Keyword(s):  
Substance Abuse ◽  
Rhode Island ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Substance Dependence ◽  
Human Subjects ◽  
Stage Of Change ◽  
Point Of View ◽  
Addictive Behaviors ◽  
Cross Sectional

OBJECTIVE: This paper aims to present and discuss the Transtheoretical Model and its importance for the treatment of substance abuse disorders. METHOD: A literature review was made based on articles from the last 10 years in substance use with human subjects found in PubMed (Medline) and the Scientific Electronic Library Online, as well as on the main books written by the creators of the model. From the initial collection of articles related to the Transtheoretical Model, the University of Rhode Island Assessment and substance abuse, those related to other health conditions were excluded. Although articles related to hospitalization were also excluded, as were those related to the Minnesota Model, treatment proposals were included. RESULTS: Although the TTM has been studied for over 20 years, new concerns regarding the initial idea continue to arise. Such concerns include the cross-sectional design of studies employing the model, as well as the prescriptive versus descriptive point of view. DISCUSSION: The review of the Transtheoretical Model brought intentional behavior change to light, which could broaden the understanding of addictive behaviors. Together with its concepts of processes and stages of change, the Transtheoretical Model provides professionals with the idea that the effectiveness of therapy is dependent upon the capability of the therapist to match the technique to the current motivational stage of the patient in the process of change. This demonstrates the importance of identifying the stage of change of the patient when they present for treatment. Here, we describe the principal elements of the Transtheoretical Model, as well as the instruments currently used to identify the stage of change. Finally, criticisms and limitations of the model are discussed.

Are Women Ready to Prevent Osteoporosis? Change Stages for Preventive Behaviors

2021 ◽  
pp. 109019812199302
Author(s):  
Patricia Clark ◽  
Pilar Lavielle
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Calcium Intake ◽  
Readiness To Change ◽  
Preventive Behaviors ◽  
Negative Attitudes ◽  
Large Cities ◽  
History Of

Objective Evaluate the prevention behaviors for osteoporosis (OP) in women (physical activity and calcium intake) and their readiness to perform these behaviors. Method Women aged ≥30 years in four large cities of Mexico were interviewed. The geographical areas were selected randomly and stratified according to socioeconomic status and age. A questionnaire designed to assess OP-related prevention behaviors, as well as attitudes and stages of change of the transtheoretical model toward these behaviors, was used. Results Eight hundred and six women were interviewed: 4.2% reported diagnosis of osteopenia, 5% of OP, 2.3% had suffered a fracture, and 11.9% had a family history of OP. A large proportion of participants did not do physical activity (56.2%) and did not have the recommended intake of calcium (61.3%). More than 80% of these participants were in lower stages of change (precontemplation and contemplation) for performing physical activity and 86.4% for calcium intake, which means a lack of readiness to change their behaviors. The absence of readiness to change preventive behaviors was related to negative attitudes toward both behaviors ( OR = 1.81, 95% CI [1.04, 3.14] physical activity; OR = 3.09, 95% CI [1.81, 5.29] calcium intake). Both of these behaviors were associated with known risk factors for OP. Conclusion Very high percentage of women are not ready to perform the behaviors necessary to maintain bone health. This phenomenon was not as a result of clinical risk factors for OP but because of the negative attitudes and beliefs of women related to physical activity and calcium intake.

scholarly journals 0742 Hypersomnia Severity Index: Reliability and Validity in a Behavioral Sleep Medicine Clinical Sample

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A282-A282
Author(s):  
G Amatrudo ◽  
K Puzino ◽  
E Bourchetin ◽  
S L Calhoun ◽  
J Fernandez-Mendoza
Keyword(s):  
Sleep Disorders ◽  
Convergent Validity ◽  
Reliability And Validity ◽  
Severity Index ◽  
Sleep Medicine ◽  
Criterion Validity ◽  
Treatment Center ◽  
Clinical Samples ◽  
Patient Reported ◽  
Penn State

Abstract Introduction There is a need for patient-reported outcome measures of central disorders of hypersomnolence (CDH) that adequately assess both essential features and associated daytime impact. The Hypersomnia Severity Index (HSI) was designed to assess severity, distress and impairment of hypersomnolence in persons with psychiatric disorders. Little data is available regarding its psychometric properties in clinical samples with diverse sleep disorders, including CDH. Methods 158 consecutive patients (44.11±16.38 years old, 70.9% female, 19.6% minority) who were evaluated at the Behavioral Sleep Medicine (BSM) program of Penn State Hershey Sleep Research & Treatment Center completed the HSI and the Epworth Sleepiness Scale (ESS). All patients were diagnosed using ICSD-3 criteria, with 10 % receiving a diagnosis of CDH, 54% of insomnia disorder (ID) and 36% of other sleep disorders (oSD). Results The HSI showed satisfactory internal consistency (Cronbach’s α=0.79) and item-total correlations (r=0.42-0.67), except for item 1 (r=0.17). Principal component analysis provided a 2-factor structure (HSI-Symptoms and HSI-Impact) explaining 56.20% of the variance. Convergent validity with ESS was optimal (r=0.65) but greater for HSI-Symptoms (r=0.69) than HSI-Impact (r=0.39). Criterion validity showed significantly higher scores in subjects with CDH (22.63±7.57) and significantly lower scores in subjects with ID (16.96±5.96) as compared to those with oSD (18.65±6.65); however, these divergent scores were primarily driven by the HSI-Symptoms score (p<0.01) rather than the HSI-Impact score (p>0.12). Conclusion The HSI shows satisfactory indices of reliability and validity in a clinically-diverse sleep disorders sample. Its criterion validity is supported by its divergent association with insomnia vs. hypersomnia disorders. Future studies should examine cut-off score for the HSI to reliably identify CDH and test its sensitivity to treatment effects. Support Department of Psychiatry, Penn State College of Medicine

Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change

2007 ◽  
Vol 41 (7) ◽  
pp. 590-597 ◽  
Author(s):  
Kathleen Rooney ◽  
Caroline Hunt ◽  
Leanne Humphreys ◽  
David Harding ◽  
Miriam Mullen ◽  
...  
Keyword(s):  
Transtheoretical Model ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Readiness To Change ◽  
Processes Of Change ◽  
Post Traumatic Stress ◽  
Predictive Utility ◽  
Post Traumatic

Objective: Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders. Method: A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM. Results: Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes. Conclusions: Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.

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