Showing papers on "Transtheoretical model published in 1993"

Attitudes, knowledge, and stages of change: a survey of exercise patterns in older Australian women.

Abstract: This article describes a telephone survey of attitudes and behavior relevant to exercise adoption among 286 Australian women aged 50 to 64. Stages of change identified by the transtheoretical model of behavior change were related to attitudes, knowledge, and demographic variables. In comparison with exercisers, precontemplators were older, had lower exercise knowledge, perceived lower levels of family support for exercise, expected fewer psychological benefits from exercise, and rated exercise as less important than avoiding smoking. The main significant difference between contemplators and those in the action or maintenance stage involved the perception of practical barriers. Despite the limitations of this cross-sectional self-report study, it identifies attitudes and knowledge as potential targets for intervention with middle-aged women.

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

Abstract: 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.

Condom Use Assertiveness and the Stages of Change With Main and Other Partners

Abstract: A measure assessing an individual's ability to assert the use of condoms was developed using, N= 248, heterosexually active college men and women. Both principal component analysis (PCA) and structural equation modeling (SEM) procedures were performed. External validity for the assertion for condom use measure was established by integrating the measure with the stages of change dimension from the transtheoretical model of behavior change. The transtheoretical model posits that both the cessation of high-risk behaviors and the acquisition of health behaviors involve the progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. The results indicated that individuals were further along in the stages of change for using condoms with a casual partner, as compared to a steady partner. The degree to which assertive condom use behavior was engaged in was related to an individual's stage of readiness for using condoms with the two types of partners. The utility of stage-matched intervention strategies, as opposed to the action-oriented approaches to modify high-risk sexual behavior, is discussed.

The transtheoretical model applied to safer sex behavior among university students: A cross-sectional investigation

Abstract: This study applied the transtheoretical model of behavior change to safer sex adoption in a cross-sectional sample of 352 college students. The transtheoretical model has received empirical support in other areas of health behavior change and has important implications for intervention development. Variables assessed include the stages of change, decisional balance, confidence, temptation, processes of change , perceived risk, perceived severity , social desirability , and behavioral variables. Where possible , the sample was split randomly to conduct exploratory and confirmatory analyses. The Pros and Cons of safer sex were best represented by a 4-factor model instead of the usual 2-factor model. The new factors described concerns for self and relationship in safer sex decision making. Confidence in safer sex and Temptation for unsafe sex both revealed 5 lower-order situational factors : sexual arousal , perceived low risk, negative affect, substance use, and partner pressure. Processes of safer sex adoption analyses revealed all ten hypothetical processes of change , and one less common process , interpersonal systems control. MANOV As and discriminant function analyses examined stage and gender differences. Different subsets of variables (transtheoretical model , demographics , and health beliefs model) were entered into several discriminant function analyses in order to predict AIDS risk group. The combination which best predicted AIDS risk group included variables from all sources, supporting theoretical eclecticism. Finally , a large cross-sectional structural equations model was developed using c1.ll model-based constructs. These constructs were used to predict be_havioral constructs , risky and safer sexual behavior, which were intercorrelated r = -.323. Reducing this large structural model to include only significant paths left 3 transtheoretical constructs accounting for nearly 31 % of the variance in risky sexual b~havior and 11 % of the variance in safer sexual behavior. These three variables were: experiential processes, behavioral processes, and confidence in safer sex. Results support the application of the transtheoretical model to safer sex adoption, as well as supporting model-based predictions about construct relationships in this area, with specific content-related differences between safer sex and other problem areas emerging for each scale. These results have important implications for AIDS risk reduction intervention development. ACKNOWLEDGMENTS One cannot devote as much time as is necessary to a dissertation without a lot of support. There are many people to whom I am grateful for supporting me both academically and emotionally as I earned my degree. In my mind , their names arise in time sequence, not in order of importance, and that is how I will list them. Some of these friends and colleagues I met by chance, for example , the rest of my class: Sherri Nelson Fitts, Tony Giuliano, Pam Gibson, Ellen Kenner , and Terry Fitzgerald. There are many other friends and colleagues, to whom I am equally grateful: Pam Deiter, Chris Fiore Lerner, Dena Rosenbloom, Bob Porter, Mary Liz Callaway, Jeff Bellis, Sue Rossi, Matt Snow, Chris Dunstan , Judy Goldman , and Linelle Blais , among others. I have grown during the discussion , informal and formal supervision, and experience with each of them. My many supervisors have each supported me in different and helpful ways: Harriet Singer, Frank Sparadeo, Hanoch Livneh, Larry Grebstein, .Allan Berman, Jim Prochaska, Trish Morokoff, Roger Mitchell, and Judith Lubiner from RI. From California, I feel grateful to Lorraine Sterman, Jean Holroyd, David Wellisch, Mary Neal, Deborah Cresswell, Val Herman, Fran Rockwell, Tom Kennon, Fawzy Fawzy , and Julia Schwartz .. Almost all the URI Psychology department faculty have taught me in one course or another, and to them I am grateful, especially to Wayne Velicer , Lisa Harlow , John Stevenson , Al Lott, Jerry Cohen, Paul Florin, Charlie Collyer, Dom Valentino, Kat Quina , and those already listed. Many URI staff members have also been helpful, chiefly: Jean Mayer , Elaine Taylor, and Terri Hodson. The Cancer Prevention Research Center, a.k.a. the Self Change Lab, has obviously has a strong influence on me, teaching me research methodology and critical thinking in both health and clinical psychology. I am grateful to "the lab"

Developing and evaluating HIV prevention programs in two modalities: women at risk of HIV infection and unplanned pregnancies.

Abstract: The Centers for Disease Control and Preventions Prevention of Human Immunodeficiency Virus (HIV) in Women and Infants Demonstration Projects underway in 8 US cities use behavioral theory to guide the design and evaluation of community-based interventions. The first collaborative project is using street-based interventions and the diffusion of preventive messages through womens social networks to reduce HIV transmission and unplanned pregnancy among high-risk women; the second seeks to influence reproductive decision making through peer advocacy and the placement of preventive services in facilities women attend for other needs (e.g. homeless shelters drug treatment centers). Both projects are informed by the Transtheoretical Model of Behavior Change (also known as Stages of Change) which views risk reduction as a gradual continuous dynamic process. Structured interviews were conducted with 238 women from 7 of the 8 project sites to assess the applicability of this model to contraceptive and condom use and to develop stage algorithms. Most women fell into the Precontemplation Preparation and Maintenance stages. Condom use was significantly more likely with casual or paying partners than with main sexual partners. Cognitive and emotional processes including increased awareness of the impact of risk behaviors on self and others were facilitative of change in the Precontemplative stage while behavioral processes such as skills building and self-efficacy were salient in later stages. Trained peer advocates were able to arrive at accurate stage assessments in 94% of cases.

The Transtheoretical Model and Exercise Behavior: A Comparison of Five Staging Methods

Abstract: This project is an examination of one of the first studies that applied the Transtheoretical Model of Behavior Change to the area of exercise. A core concept of the Transtheoretical Model is the temporal dimension represented by the stages of change. A variety of alternative staging methods have been developed. This study compared a continuous measure of stage membership and four discrete algorithms to stage exercise behavior in the context of a worksite program. In Study I, a previously developed continuous measure of stage membership, the (URICA), was adapted to the area of exercise behavior (URICA-E). The structure of the instrument was replicated using Confirmatory Factor Analysis. One, two, three and four factor models were compared, and a correlated four factor model, representing the four stages of Precontemplation, Contemplation, Action and Maintenance, was found to have the best fit. Fit was improved by reducing the number of items. The 16 item version was confirmed in a second sample. A Cluster Analysis was performed using the fuur standardized scale scores of the 16 item version of the URICA-E. Nine distinct clusters were found and replicated in a cross validation. Profiles were interpreted and found to have a number of similarities when compared to the profiles previously reported in population using the URICA. In Study II, four discrete algorithms were examined