scholarly journals Stages and Processes of Change for Weight Loss in Acute Stroke or TIA Patients Living with Obesity

2021 ◽  
Author(s):  
Mitch Wilson ◽  
Hailey Orgass ◽  
Jennifer Dearborn-Tomazos
Keyword(s):  
Weight Loss ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Stage Of Change ◽  
Processes Of Change ◽  
Vascular Risk ◽  
Stroke Patients ◽  
Exclusion Criteria ◽  
Validated Questionnaire ◽  
Maintenance Stage

Background: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. Objective: To evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. Methods: Using a validated questionnaire, we assessed each patient’s stage of behavioral change according to the Transtheoretical Model (precontemplation, contemplation, preparation, action and maintenance). We also examined four processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional re-evaluation (EMR), weight management action (WMA), weight consequence evaluation (WCE), and supporting relationships (SR). Processes scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation and preparation stages. Results: Out of 49 patients who provided informed consent, 44 met the inclusion/exclusion criteria. Of these 44 patients, 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (n=29, 66%). Patients in the action and maintenance stages (N=29) had higher EMR scores (mean 79, SD 13 vs mean 68, SD 19, t=2.0, p=0.03) and WMA scores (mean 69, SD 13 vs mean 59, SD 19, t=2.0, p=0.03) as compared to those in the precontemplation, contemplation and preparation stages (N=15). Conclusions: Our results suggest that without counseling or specific intervention, approximately two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss and therefore more likely to succeed in intensive lifestyle-based interventions targeted towards weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change.

Exercise Behavior among New Zealand Adolescents: A Test of the Transtheoretical Model

2006 ◽  
Vol 18 (3) ◽  
pp. 351-363 ◽  
Author(s):  
Ralph Maddison ◽  
Harry Prapavessis
Keyword(s):  
New Zealand ◽  
Transtheoretical Model ◽  
Stage Of Change ◽  
Decisional Balance ◽  
Exercise Behavior ◽  
Change Processes ◽  
Processes Of Change ◽  
Reciprocal Relationships ◽  
Adolescent Population ◽  
Time Periods

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.

Single-Item vs Multiple-Item Measures of Stage of Change in Compliance with Prescribed Medications

2004 ◽  
Vol 94 (1) ◽  
pp. 115-124 ◽  
Author(s):  
Christopher L. Cook ◽  
Matthew Perri
Keyword(s):  
Health Behaviors ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Stage Of Change ◽  
Multiple Choice ◽  
Single Item ◽  
Multiple Item ◽  
Change Measure

The Stage of Change construct from the Transtheoretical Model of behavioral change has been widely utilized in the assessment of various health behaviors. The majority of these tests measure the Stage of Change construct using the single-item, multiple-choice format. This study validated the use of a single-item measure in measuring readiness to comply with taking a prescribed medication. A sample of 161 subjects tested the multiple-item Stage of Change measure, then a refined multiple-item survey was tested with 59 subjects. With the latter survey, discriminating subjects at the differing stages of change dimensions was difficult. A correlation of .91 was found for stage classifications between ratings on the single-item and multiple-item scales. The use of the single-item measure seems reasonable when assessing stage of change in compliance with prescribed medication.

scholarly journals Az együttműködés növelésének eszközei a testsúlykontrollban

2019 ◽  
Vol 160 (43) ◽  
pp. 1687-1697
Author(s):  
Edit Czeglédi
Keyword(s):  
Weight Loss ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Weight Control ◽  
Health Risk Behaviors ◽  
Point Of View ◽  
Behavior Motivation ◽  
Health Related ◽  
Clinically Significant

Abstract: Long-term successful weight control poses a huge challenge to people who are overweight and treat them in the obesogenic environment. After reaching a clinically significant (5–10%) weight loss, the goal is to maintain the weight loss achieved. However, this requires virtually constant resistance to temptations and requires sustained effort in terms of dietary restriction and physical activity, which requires a strong motivational base. From the point of view of behavior, motivation is the probability that the patient starts, pursues, or persistently follows a strategy that triggers change, that is, in the case of obesity, is committed to health-related behaviors that support weight management and abandons health risk behaviors that hinders weight control efforts. The present study describes the transtheoretical model of behavioral change and provides examples of practical ways to increase motivation and adherence at all stages of behavioral change. All this can contribute to the work of primary care and outpatient care professionals in supporting weight loss patients with excess weight. Orv Hetil. 2019; 160(43): 1687–1697.

Abstract 1269 Physician Diagnosis of Overweight Predicts Weight Loss Attempts in Patients with Cardiovascular Disease and Central Obesity

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Siddharth Singh ◽  
Virend K Somers ◽  
Matthew M Clark ◽  
Donald D Hensrud ◽  
Kristin Vickers Douglas ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Weight Loss ◽  
Transtheoretical Model ◽  
Behavioral Change ◽  
Central Obesity ◽  
Sociodemographic Factors ◽  
Multivariate Models ◽  
Overweight Status ◽  
Nationally Representative ◽  
Artery Disease

Central obesity has been associated with adverse events in patients with cardiovascular disease (CVD). We undertook this study to evaluate predictors of overweight awareness, desire to lose weight and weight loss attempts in patients with CVD and central obesity. Association of physician-rendered diagnosis of overweight with weight loss attempts was also evaluated. Data from National Health and Nutrition Examination Survey (NHANES) 1999 –2004 were used. CVD was defined as self-referred history of coronary artery disease or stroke. Central obesity was determined based on a waist circumference > 102 cm in men and > 88 cm in women. Motivational factors considered as determinant for behavioral change that were evaluated included: participants’ awareness of their overweight status; desire to lose weight; any weight loss attempts in last year. We examined demographic, anthropometric and clinical determinants of each stage of change using multivariate models. Of the 1484 participants with CVD that were identified in NHANES, 824 had central obesity (56%). 76% of centrally obese participants were aware of their overweight status and 79% were desirous of losing weight. Despite this awareness and desire, only 41% of centrally obese had attempted weight loss in the last year. Only 61% reported that they had been informed that they were overweight by physicians. On multivariate analysis, after adjusting for sociodemographic factors and body mass index, physician rendered diagnosis of overweight was a significant predictor of weight loss attempts (OR=2.5, 95% CI 1.3– 4.9, p= 0.006). Awareness of one’s overweight status strongly predicted desire to lose weight in multivariate models (OR=107.6, 95 % CI 42.9 –270.0, p<.0001) and desire to lose weight was linked to recent attempts to lose weight (OR 10.4, 95 % CI 2.8– 39.2, p= 0.0005), confirming that the Transtheoretical Model of behavioral change applies to the study population. In a nationally representative sample of participants with CVD and central obesity, physician-rendered diagnosis of overweight emerged as an important predictor of weight loss attempts. Efforts to promote weight loss should focus on interventions based on Transtheoretical Model of behavioral change.

An Examination of the Transtheoretical Model and Exercise Behavior in Older Adults

1995 ◽  
Vol 17 (3) ◽  
pp. 312-324 ◽  
Author(s):  
Trish Gorely ◽  
Sandy Gordon
Keyword(s):  
Behavior Change ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Stage Of Change ◽  
Age Groups ◽  
Decisional Balance ◽  
Exercise Behavior ◽  
Processes Of Change ◽  
Pros And Cons ◽  
The Relationship

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.

Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables

2017 ◽  
Vol 19 (1) ◽  
pp. 134-144 ◽  
Author(s):  
Stacie Scruggs ◽  
Scherezade K. Mama ◽  
Cindy L. Carmack ◽  
Tommy Douglas ◽  
Pamela Diamond ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Transtheoretical Model ◽  
Self Efficacy ◽  
Breast Cancer Survivors ◽  
Physical Activity Intervention ◽  
Stage Of Change ◽  
Intervention Group ◽  
Processes Of Change

This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.

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.

scholarly journals The Transtheoretical Model in Weight Management: Validation of the Processes of Change Questionnaire

Obesity Facts ◽  
2011 ◽  
Vol 4 (6) ◽  
pp. 433-442 ◽  
Author(s):  
Ana Andrés ◽  
Carmina Saldaña ◽  
Juana Gómez-Benito
Keyword(s):  
Weight Management ◽  
Transtheoretical Model ◽  
Processes Of Change

scholarly journals Applying the transtheoretical model to eating behaviour change: challenges and opportunities

1999 ◽  
Vol 12 (2) ◽  
pp. 281-317 ◽  
Author(s):  
Caroline C. Horwath
Keyword(s):  
Behaviour Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Eating Behaviour ◽  
Decisional Balance ◽  
Classification Systems ◽  
Dietary Behaviour ◽  
Processes Of Change ◽  
Summary Table ◽  
Stage Theories

AbstractThis review provides a rigorous investigation of the question of whether the transtheoretical model (TTM) (or stages of change model) is applicable to eating behaviour change. The TTM is currently the most popular of a number of stage theories being used to examine health behaviour change. Stage theories specify an ordered set of ‘stages of readiness to change’ into which people can be classified and identify the factors that can facilitate movement from one stage to the next. If eating behaviour change follows a stage process, then nutritionists could identify the predominant stage or stages in a population and focus resources on those issues most likely to move people to the next stage (e.g. from no intention of changing, to thinking about changing). In addressing this question, the review draws on the defining characteristics of stage theories as clarified by Weinstein et al. (1998), provides an in-depth coverage of methodological considerations, and a detailed summary table of dietary studies applying the TTM. Specific recommendations are made for improving the accuracy of dietary stage classifications. Among the key conclusions are: (1) dietary studies using the TTM have been hampered by a focus on nutritional outcomes such as dietary fat reduction, rather than clearly understood food behaviours (e.g. five servings of fruit and vegetables per day); (2) accurate stage classification systems are possible for food-based goals, but major misclassification problems occur with nutrient-based goals; (3) observation of an association between stage and dietary intake is not sufficient to demonstrate the validity of the model for dietary behaviour; (4) there is a need for valid questionnaires to measure all aspects of the TTM, and more research on the whole model, particularly the ‘processes of change’, rather than on single constructs such as ‘stage’ (5) cross-sectional studies generally support the predicted patterns of between-stage differences in decisional balance, self-efficacy, and processes of change; (6) studies which test the key hypothesis that different factors are important in distinguishing different stages are rare, as are prospective studies and stage-matched interventions. Only such studies can conclusively determine whether the TTM is applicable to eating behaviour. Since the ultimate test of the TTM will be the effectiveness of stage-matched dietary interventions, the review ends by exploring the requirements for such studies.

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