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

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.

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Assessing the Validity of a Single-Item HIV Risk Stage-of-Change Measure

Journal of Drug Education ◽

10.2190/de.38.1.c ◽

2008 ◽

Vol 38 (1) ◽

pp. 27-37

Author(s):

Lucy E. Napper ◽

Catherine M. Branson ◽

Dennis G. Fisher ◽

Grace L. Reynolds ◽

Michelle M. Wood

Keyword(s):

Hiv Risk ◽

Stage Of Change ◽

Single Item ◽

Change Measure

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Interrelationships of Health Related Behaviors among Young Adults

Californian Journal of Health Promotion ◽

10.32398/cjhp.v7isi.1996 ◽

2009 ◽

Vol 7 (SI) ◽

pp. 07-22

Author(s):

Erica R. Scioli ◽

Henry Biller ◽

Joseph Rossi ◽

Deborah Riebe ◽

Anthony Scioli

Keyword(s):

Stages Of Change ◽

Transtheoretical Model ◽

Smoking Status ◽

Adult Population ◽

Stage Of Change ◽

Smoking Behavior ◽

Psychology Students ◽

Internet Survey ◽

Smoking Behaviors ◽

Health Related

Obesity and smoking continue to be some of the nation’s top health concerns. This study explored the interrelationships among exercise, nutrition and smoking behaviors among young college adults. Undergraduate psychology students (N=612) completed an internet survey that included measures of exercise, nutrition and smoking behaviors. Analyses revealed that more males were exercising while more females were eating nutritiously. The Transtheoretical Model constructs stage of change for exercise and eating nutritiously were significantly related. There were no significant differences found for smoking behavior across the stages of change for exercise or nutrition. Health professionals and researchers should not assume that regular exercise is associated with a non-smoking status or that a non-smoking status is associated with consuming a more nutritious diet. Further research and intervention is strongly urged targeted towards both men and women among the young college adult population.

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Stages of Change, Self-Efficacy, and the Adoption of Vigorous Exercise: A Prospective Analysis

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.15.4.390 ◽

1993 ◽

Vol 15 (4) ◽

pp. 390-402 ◽

Cited By ~ 52

Author(s):

Colin A. Armstrong ◽

James F. Sallis ◽

Melbourne F. Hovell ◽

C. Richard Hofstetter

Keyword(s):

Stages Of Change ◽

Transtheoretical Model ◽

Self Efficacy ◽

Multivariate Analyses ◽

Community Sample ◽

Stage Of Change ◽

Mail Survey ◽

Transtheoretical Model Of Change ◽

Vigorous Exercise ◽

A Prospective Study

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

Cerebrovascular Diseases Extra ◽

10.1159/000521387 ◽

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.

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Stages of Change

Psychotherapy Relationships that Work ◽

10.1093/med-psych/9780190843960.003.0010 ◽

2019 ◽

pp. 296-328 ◽

Cited By ~ 1

Author(s):

Paul Krebs ◽

John C. Norcross ◽

Joseph M. Nicholson ◽

James O. Prochaska

Keyword(s):

Treatment Outcomes ◽

Behavioral Health ◽

Stages Of Change ◽

Transtheoretical Model ◽

Meta Analysis ◽

Stage Of Change ◽

Psychotherapy Outcomes ◽

Individual Client ◽

Stage Matching ◽

The Individual

The transtheoretical model and the stages of change are often used to adapt treatment to the individual client. This chapter aims to review the stages of change and popular measures of change readiness in psychotherapy and to conduct a meta-analysis of the relation between readiness measures and psychotherapy outcomes. This chapter reports data from 76 studies, encompassing 25,917 patients. Moderate-sized effects (d =.41) were found for the association between stages and psychotherapy success. Outcomes were a function of pretreatment stage of change; that is, the farther a patient is along the stages, the better the treatment outcomes. The chapter concludes with limitations of the research, diversity considerations, and therapeutic practices for stage matching in psychotherapy specifically and behavioral health more generally.

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Stages of Change in Batterers and Their Response to Treatment

Violence and Victims ◽

10.1891/0886-6708.23.4.476 ◽

2008 ◽

Vol 23 (4) ◽

pp. 476-492 ◽

Cited By ~ 22

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.

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Exploring consumer boycott intelligence towards Israel-related companies in Malaysia

Journal of Islamic Marketing ◽

10.1108/jima-06-2017-0070 ◽

2019 ◽

Vol 10 (1) ◽

pp. 208-226 ◽

Cited By ~ 2

Author(s):

Hanizah Hamzah ◽

Hasrina Mustafa

Keyword(s):

Stages Of Change ◽

Transtheoretical Model ◽

Online Survey ◽

Theory Of Planned Behaviour ◽

Stage Of Change ◽

Kuala Lumpur ◽

Socially Responsible ◽

Content Type ◽

Factors Affecting ◽

Intention To Participate

Purpose Drawing on the transtheoretical model (TTM) into the theory of planned behaviour (TPB) framework, this study aims to understand the factors affecting the intention of Malaysian consumers to boycott products and services from companies perceived to be supporting or funding Israel and identify specific TPB variables that are important at each stage of change. Design/methodology/approach Data collected were based on an online survey among 177 respondents working in Malaysian conglomerates based in Kuala Lumpur. Findings The results show moderate intention to participate in the boycott among the respondents with attitude towards boycott, subjective norm and perceived behavioural control of boycott have significant relationship with intention to participate in the boycott towards Israel. The study also found significant linear increases of TPB constructs across the stages of change, which indicated significant influence of all TPB constructs at each stage of change. Originality/value Consumer boycott is not unheard of in Malaysia, but empirical research in the area is still lacking. As markets expand, the consumers also evolve to become more knowledgeable and ethical in their consumption, sometimes choosing to boycott to coerce the companies or brands to be environmentally, ethically and socially responsible. Findings from this study are expected to benefit NGOs or associations that intend to develop more effective campaigns to encourage consumers to use boycott to drive social or ethical causes.

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The transtheoretical model and substance dependence: theoretical and practical aspects

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462009005000010 ◽

2009 ◽

Vol 31 (4) ◽

pp. 362-368 ◽

Cited By ~ 11

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.

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Predictors of physical activity behavior change based on the current stage of change—an analysis of young people from Hawai’i

Journal of Behavioral Medicine ◽

10.1007/s10865-021-00255-5 ◽

2021 ◽

Author(s):

Eliane S. Engels ◽

Claudio R. Nigg ◽

Anne K. Reimers

Keyword(s):

Physical Activity ◽

Family Support ◽

Stages Of Change ◽

Transtheoretical Model ◽

Self Efficacy ◽

Vigorous Physical Activity ◽

Stage Of Change ◽

Physical Activity Behavior ◽

Social Predictors ◽

Current Stage

AbstractThis study investigated the corresponding change between psycho-social predictors and physical activity (PA) behavior and if these relationships were dependent on the stages of change from the Transtheoretical Model in Minority American adolescents. We conducted a longitudinal field study with N = 357 students aged 13–18 years (M = 14.24 years, SD = 0.88); predominantly Filipino (61.2%) using a test–retest design assessing psycho-social PA predictors (enjoyment, self-efficacy, family support, friends’ support, knowledge, stage of change) and moderate-to-vigorous physical activity (MVPA) at two time points over six months. Hierarchical regression results indicated that a positive change of enjoyment, knowledge about PA and family support predicted a change of MVPA, independently of stage. The time-varying covariation showed the importance of the current stage of change for enjoyment, self-efficacy and support of friends for a change of MVPA. Overall, our findings suggest that an individual’s current stage of change should be considered to determine individually appropriate starting points and goals for designing interventions to promote PA among Minority American adolescents.

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