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

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.

1999 ◽  
Vol 12 (2) ◽  
pp. 281-317 ◽  
Author(s):  
Caroline C. Horwath

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.


Psihologija ◽  
2004 ◽  
Vol 37 (1) ◽  
pp. 89-108 ◽  
Author(s):  
Vesna Gavrilov-Jerkovic

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.


Psychologica ◽  
2014 ◽  
Vol 1 (57) ◽  
pp. 7-22
Author(s):  
Flaviane Bevilaqua Felicíssimo ◽  
Víviam Vargas de Barros ◽  
Sabrina Maura Pereira ◽  
Natália Quintela Rocha ◽  
Lélio Moura Lourenço

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A182-A183
Author(s):  
G Amatrudo ◽  
K Puzino ◽  
E Bourchtein ◽  
S L Calhoun ◽  
J Fernandez-Mendoza

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


2008 ◽  
Vol 23 (4) ◽  
pp. 476-492 ◽  
Author(s):  
Pamela C. Alexander ◽  
Eugene Morris

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.


2006 ◽  
Vol 35 (5) ◽  
pp. 603-618 ◽  
Author(s):  
Emely De Vet ◽  
Jascha De Nooijer ◽  
Nanne K. De Vries ◽  
Johannes Brug

In a longitudinal study, it is examined whether the transtheoretical processes of change do predict stage transitions in fruit intake. A random sample of an existing Internet research panel resulted in a cohort of 735 adults, who were examined three times with electronic questionnaires assessing stages of change, processes of change, and fruit intake. Cross-sectional differences were found for the processes of change between precontemplation and all further stages. Experiential as well as behavioral processes increased from precontemplation to action with similar patterns. Both experiential and behavioral processes predicted forward transition out of precontemplation and forward transition into action, whereas only behavioral processes predicted forward transition out of contemplation. The results indicate that the transtheoretical processes of change predict stage transitions for fruit intake, but that the pattern of relevant processes for fruit intake is not as straightforward as outlined by the transtheoretical model of behavior change.


2007 ◽  
Vol 41 (7) ◽  
pp. 590-597 ◽  
Author(s):  
Kathleen Rooney ◽  
Caroline Hunt ◽  
Leanne Humphreys ◽  
David Harding ◽  
Miriam Mullen ◽  
...  

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.


2021 ◽  
pp. 001112872110364
Author(s):  
Natalia Redondo ◽  
Marina J. Muñoz-Rivas ◽  
Arthur L. Cantos ◽  
Jose Luis Graña

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.


2021 ◽  
Author(s):  
Frank J Schwebel ◽  
Jude G. Chavez ◽  
Matthew Pearson

The Transtheoretical Model supports that readiness to change should predict actual substance-related behavior change, though this relationship is surprisingly modest. Across several behavioral domains, individuals tend to have unrealistic expectations regarding the amount of effort and time required to successfully change one’s behaviors, dubbed the False Hope Syndrome. Based on the False Hope Syndrome, we expect that the standard method of measuring self-reported readiness to change is inaccurate and overestimated. To test this hypothesis, we experimentally manipulated the level of cognitive effort or focus on the practical implications of changing substance use prior to completing readiness to change measures. College students from a large southwestern university who reported using substances in the past 30 days (n = 345) were recruited from a psychology department participant pool to complete this experimental study online. Participants were randomized to one of three conditions: 1) standard low effort condition, 2) medium effort condition (had to select likes/dislikes of substance use, and negative consequences of changing one’s use), and 3) high effort condition (also provided text responses to how they would handle difficult situations related to changing their substance use). We conducted one-way ANOVAs with Tukey post-hoc comparisons to examine differences on three measures of readiness to change: the University of Rhode Island Change Assessment (URICA) scale for overall substance use as well as the readiness and motivation rulers for overall substance use, alcohol use, and cannabis use. Contrary to our hypothesis, all significant statistical tests supported higher cognitive effort conditions reporting higher readiness to change. Although effect sizes were modest, higher cognitive effort appeared to increase self-reported readiness to change substance use. To address the present study’s limitations, additional work is needed to test how self-reported readiness to change relates to actual behavior change when assessed under the different effort conditions.


2005 ◽  
Vol 68 (9) ◽  
pp. 1874-1883 ◽  
Author(s):  
MASAMI T. TAKEUCHI ◽  
MIRIAM EDLEFSEN ◽  
SANDRA M. McCURDY ◽  
VIRGINIA N. HILLERS

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.


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