Match the stages of the transtheoretical model with the appropriate behavior.
The Transtheoretical Model (TTM) is an integrative model to conceptualize the process of intentional behavior change. The TTM includes and integrates key constructs from other theories into a comprehensive theory of change that can be applied to a variety of behaviors, populations, and settings—hence, the name Transtheoretical. Show The TTM
The Stages of Change Precontemplation Not Ready Contemplation Getting Ready Preparation Ready Action Making Change Maintenance Keeping Up Change Stages of change lie at the heart of the TTM. The TTM recognizes behavior change as a process that unfolds over time, involving progress through a series of stages. While the time a person remains in each stage is variable, the tasks required to move to the next stage are not. Certain principles and processes of change work best at each stage to reduce resistance, facilitate progress, and prevent relapse. Those principles include decisional balance, self-efficacy, and processes of change. Only a minority (usually less than 20%) of a population at risk is prepared to take action at any given time. Thus, action-oriented guidance is not well suited for individuals in the early stages. Individually tailored guidance based on the TTM results in increased engagement in the change process because it appeals to the whole population rather than the minority ready to take action. While progression through the stages of change can occur in a linear fashion, a nonlinear progression is common. Often, individuals recycle through the stages or regress to earlier stages from later ones. Precontemplation Stage 1 No plan to take action People in the Precontemplation stage do not intend to take action in the foreseeable future, usually defined as the next six months. Being uninformed or under informed about the consequences of one’s behavior may cause a person to be in the Precontemplation stage. Multiple unsuccessful attempts at change can lead to demoralization about the ability to change. Precontemplators are often characterized in other theories as resistant, unmotivated, or nonadherent. The fact is, traditional programs were not ready for such individuals and were not designed to meet their needs. Contemplation Stage 2 Plan to take action Contemplation is the stage in which people intend to change in the next six months. They are more aware of the pros of changing, but are also acutely aware of the cons. The relative equal weighting between the costs and benefits of changing can produce profound ambivalence that can cause people to remain in this stage for long periods of time. This phenomenon is often characterized as chronic contemplation. Individuals in the Contemplation stage are not ready for traditional action-oriented programs that expect participants to act immediately. Preparation Stage 3 Ready to take action Preparation is the stage in which people intend to take action in the immediate future, usually measured as the next month. Typically, they have already taken some steps toward action in the past year (e.g., quitting smoking for 24 hours). These individuals have a plan of action, such as joining a gym, consulting a counselor, talking to their physician, or relying on a self-change approach. These are the people who should be recruited for action-oriented programs. Action Stage 4 Made the change Action is the stage in which people have made specific observable changes in their lifestyles within the past six months. Because action is observable, the overall process of behavior change often has been equated with action. But in the TTM, Action is only one of five stages. Typically, not all modifications of behavior count as Action. In most applications, people have to attain a criterion that scientists and professionals agree is sufficient to reduce risk of disease. For example, while reducing the number of cigarettes can be an important step in the cessation process, total abstinence from smoking is the criteria for being in Action. Maintenance Stage 5 Made the change Maintenance is the stage in which people have made and sustained a specific behavior change for quite some time, typically defined as at least 6 months. While they are still working to prevent relapse, they do not apply change processes as frequently as do people in Action. Individuals in the Maintenance stage are less tempted to relapse and are increasingly more confident that they can continue their changes. Decisional Balance Decision making was conceptualized by Janis and Mann as a decisional “balance sheet” of comparative potential gains and losses. Two components of decisional balance, the pros and the cons, have become core constructs in the Transtheoretical Model. As individuals progress through the stages of change, decisional balance shifts in critical ways. When an individual is in the Precontemplation stage, the pros in favor of behavior change are outweighed by the relative cons for change. In the Contemplation stage, the pros and cons tend to carry equal weight, leaving the individual ambivalent about change. If the decisional balance is tipped, however, such that the pros in favor of changing outweigh the cons for maintaining the unhealthy behavior, many individuals move to the Preparation or even Action stage. As individuals enter the Maintenance stage, the pros in favor of maintaining the behavior change outweigh the cons of maintaining the change. Self-Efficacy The TTM integrates elements of Bandura’s self-efficacy theory. This construct reflects the degree of confidence individuals have in maintaining their desired behavior change in situations that often trigger relapse. Confidence typically increases linearly across the stages of change. Processes of Change While the stages of change are useful in explaining when changes in cognition, emotion, and behavior take place, the processes of change help to explain how those changes occur. These ten covert and overt processes need to be differentially applied to successfully progress through the stages of change and attain the desired behavior change. These ten processes can be divided into two groups: experiential processes and behavioral processes. Experiential Processes Consciousness Raising Dramatic Relief Environmental Reevaluation Self-Reevaluation Social Liberation Behavioral Processes Self-Liberation Counter Conditioning Helping Relationships Reinforcement Management Stimulus Control Tailoring Matters In addition to numerous randomized clinical trials, systematic meta-analyses of tailored health behavior change interventions have demonstrated greater effects in programs that are dynamically tailored on each of the Transtheoretical Model constructs. Critical Assumptions of the TTM The Transtheoretical Model is also based on critical assumptions about the nature of behavior change and population health interventions that can best facilitate such change. The following set of assumptions drives Transtheoretical Model theory, research, and practice:
Breakthroughs in Behavior Change 1980sDiscovered the Stages of Change and the dynamic principles and processes of change related to each stage 1990sDeveloped the first computer-tailored intervention based on the Transtheoretical Model of Behavior Change Demonstrated tailored interventions for smoking cessation effective even when more than 80% were not ready to quit Applied the Transtheoretical Model to a variety of behaviors beyond smoking cessation 2000sDemonstrated that Transtheoretical Model-based interventions for simultaneous multiple behavior change are effective Applied the Transtheoretical Model to a wide variety of new behavior change challenges Served entire populations with inclusive proactive and home-based care Early 2010sImplemented innovative strategies to ensure greater impact on multiple behaviors with fewer demands on patients and providers Increased the efficacy of our best practices by adding tailored text messages Gained synergistic insights into how changing one behavior increases the chance of changing other behaviors (coaction) Improved well-being by increasing productivity and thriving Late 2010sDeveloped a Clinical Dashboard to provide evidence-based stage matched behavior change messages for clinicians to deliver to patients Integrated TTM solutions with Electronic Medical Records to improve patient care Incorporated social determinants of health into TTM-based interventions 2020sDeployed TTM-based HealthKit enabled app Deployed TTM-based interactive, two-way text messaging solutions Developed evidence-based programs to boost resilience Applied TTM to messaging campaigns to reduce vaccine hesitancy To learn about the application of the TTM, visit our Evidence page. For more information on the TTMTTM eLEARNING Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114. PMID: 1329589. Prochaska, J.O., Redding, C.A., & Evers, K. (2002). The Transtheoretical Model and Stages of Change. In K. Glanz, B.K. Rimer & F.M. Lewis, (Eds.) Health Behavior and Health Education: Theory, Research, and Practice (3rd Ed.). San Francisco, CA: Jossey-Bass, Inc. What are the 5 stages of the Transtheoretical model of behavior change?Based on more than 15 years of research, the TTM has found that individuals move through a series of five stages (precontemplation, contemplation, preparation, action, maintenance) in the adoption of healthy behaviors or cessation of unhealthy ones.
What are the 6 stages of Transtheoretical model?The TTM is not a theory but a model; different behavioral theories and constructs can be applied to various stages of the model where they may be most effective. The TTM posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination.
What are the 10 processes of the Transtheoretical model?The ten processes of change are consciousness raising, counterconditioning, dramatic relief,environmental reevaluation, helping relationships, reinforcement management, self-liberation,self-reevaluation, social-liberation, and stimulus control.
What are the 5 parts of the stages of change?The Stages of Change. The stages of change are:. Stage One: Precontemplation. ... . Stage Two: Contemplation. ... . Stage Three: Preparation/Determination. ... . Stage Four: Action/Willpower. ... . Stage Five: Maintenance. ... . Techniques to help you progress through your change plan.. |