Transtheoretical Model Constructs' Longitudinal Prediction of Sun Protection Over 24 Months. Manage cookies/Do not sell my data we use in the preference centre. Google Scholar. Richmond, VA: Virginia Common Wealth University, Center on Society and Health; 2015. 9. Only one study [23] used these constructs to define the content of and feedback of a nutritional intervention, showing that most studies that claim to be based on theoretical models use, in fact, a part of the model in the design of the intervention, which increases the possibility of variability of results from one intervention to another and decreases the possibility of replication. Self-Liberation (Make a Commitment) They are more aware of the pros of changing, but are also acutely aware of the cons. When the topic is specifically tailored to the study population in terms of stages of change, gender and other characteristics, the intervention tends to become more effective [34, 41]. 2016;10(1):50–66. Google Scholar. This is a positive point because these media are highly acceptable among adolescents. Transtheoretical model of change has been the basis for developing effective interventions to promote health behavior change. Individual stage-based computer-generated feedback on dietary fat was provided. The objective of this study was to examine whether specific constructs from the Transtheoretical Model (TTM)(i.e., stages of change, self-efficacy, and perceived benefits and barriers) relative to regular physical activity are applicable to Taiwanese family caregivers. A total of eight randomized controlled trials [17, 23, 25, 26, 28,29,30, 33] and six quasi-experimental studies [19, 21, 22, 24, 31, 32] were included. The authors declare that they have no competing interests. statement and The Transtheoretical Model (TTM) is one model of behavior change that has been applied to transplant decision-making in kidney disease populations. 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. Brick et al. The Transtheoretical Model (TTM) is an integrative health behavior change theory that describes the process of how people change their behavior. While progression through the Stages of Change can occur in a linear fashion, a nonlinear progression is common. 2018;361:bmj.k2173. 2017;19(10):e13017–22. Five studies included decisional balance and self-efficacy as a measure [19, 24, 28, 30, 32] and one used these two constructs in the development of the intervention [23]. This questionnaire was designed primarily to assess the quality of interventional studies designed for public health purposes, which is the case of the included studies. Dramatic Relief (Pay Attention to Feelings) Only full original articles written in English, Spanish or Portuguese on randomized controlled trials and quasi-experimental designs that applied the TTM in the design of nutritional interventions targeting adolescents were included, with no restrictions on publication date. Six aimed at improving fruit and vegetable consumption [17, 19, 25, 26, 28, 32], three promoted a low-fat diet [21,22,23], three focused on healthy dietary intake in general [29,30,31], one focused in improving food choices and cooking skills [33], and one focused on the reduction of fast food intake [24]. Two of the articles were assessed jointly because they covered the same intervention [19, 20]. California Privacy Statement, 2006;22(5):269–77. planner must determine the individual’s current stage of change in relation to lifestyle behaviors that lead to obesity. Hagger MS. Studies of change have found that people move through a series of stages when modifying behavior. Four studies presented improvement in fruit and vegetable consumption and four progressed through stages of change. The remaining studies recruited adolescents from schools [17, 21,22,23,24,25,26, 28, 29, 32, 33]. Article  The transtheoretical model (TTM) describes change not as an individual event but rather as a series of steps that take place according to a person’s degree of motiv- ation. Ordovas JM, Ferguson LR, Tai ES, Mathers JC. Md Yusop NB, Shariff ZM, Hwu TT, Abd Talib R, Spurrier N. The effectiveness of a stage-based lifestyle modification intervention for obese children. Jennifer Nakabayashi. 2019;22(13):2500–8. Ann Med. The Transtheoretical Model and Stages of Change. provided lessons on identifying and overcoming barriers related to the reduction of fast food consumption and methods for staying motivated. Maintenance is the stage in which people have made specific overt modifications in their lifestyles and are working to prevent relapse; however, they do not apply change processes as frequently as do people in Action. Health Psychol Rev. Correspondence to 2016;100(6):1217–35. [24], which included process of change as a variable., DOI: The use of the model in the development of the intervention is shown to be restricted to the stage of change’ construct. This model is widely used for health education interventions with proven efficacy. Those principles include decisional balance, self-efficacy, and processes of change. As individuals enter the Maintenance stage, the pros in favor of maintaining the behavior change should outweigh the cons of maintaining the change in order to decrease the risk of relapse. The four constructs of TTM are the stages of change, the processes of change, self-efficacy, and decisional balance [7]. Systematic review on evidence-based adolescent nutrition interventions. Uauy R, Kain J, Mericq V, Rojas J, Corvalán C. Nutrition, child growth, and chronic disease prevention. JN: Data curation, Investigation, Formal analysis, Methodology, Validation, Writing – original draft. 1997;12(1):38–48. © 2020 BioMed Central Ltd unless otherwise stated. Health population programs need to assist people as they progress over time. American Psychologist, 47, 1102-1114. Appetite. The TTM seems to be a successful strategy for nutritional intervention aiming at improving dietary intake in adolescents. After the updated search, four more papers were included [30,31,32,33], totaling 17 articles and 14 interventions. Their strategies included the use of websites [17, 26], videos [21] and CD-ROMs [19, 23] as means of providing information and assessment. The transtheoretical model is also … 2003;18(1):36–45. Noar, S.M., Benac, C.N., and Harris, M.S. No studies compared the effectiveness of different theoretical models for changing dietary intake or even if it is better not to use them [46]. Am J Health Promot. developed and mailed printed educational materials promoting healthy dietary habits according to their stage of change to the intervention group [28]. The Transtheoretical Model consists of 4 constructs: Stages of Change; Processes of Change; Decisional Balance; Self-Efficacy . Department of Nutrition, University of Brasilia, Center for Epidemiological Health and Nutrition Studies, Brasilia, Distrito Federal, Brazil, Jennifer Nakabayashi, Giselle Rha-isa Melo & Natacha Toral, You can also search for this author in Health Educ Behav. To view a copy of this licence, visit For example, reduction in the number of cigarettes or switching to low-tar and low-nicotine cigarettes were formerly considered acceptable actions. The TTM is a model of intentional change. Specifically, programs that tailor on stage do better than those that do not; programs that tailor on pros and cons do better than those that do not; programs that tailor on self-efficacy do better than those that do not, and programs that tailor on processes of change do better than those that do not. transtheoretical model. Article  Health Scope. Google Scholar. A lack of association between physical activity and the psychological determinants of sedentary behavior was found. Participants from two interventions reduced fat intake. Instead, they go through a process that can begin before they have made any specific plans to change. 2008;22(5):336–41. Di Noia J, Contento IR, Prochaska JO. Quality assessment tool for quantitative studies. One recent intervention [33] used the stages of change to gradually organize the content of the intervention, ensuring that individuals of all stages could receive at least one content matched to their corresponding stage. 2017;46(2):578–88. 2. Relationships of physical activity with the transtheoretical model constructs among Korean adults Youngho Kim Department of Sport Science, Seoul National University of Science and Technology, Seoul, South Korea Correspondence This model focuses on the decision making of the individual. Geneva: WHO, Chronic diseases and health promotion; 2014. However, an individual’s eating behavior involves several determinants, which were not considered in this review. found no differences in the participants’ fruit and vegetable intake or in perceived self-efficacy or benefits and barriers compared to baseline [28]. Many studies used information and communication technologies in their interventions, including strategies involving websites, videos, and CD-ROMs. This model focuses on the decision making of the individual. The model describes how people modify a problem behavior or acquire a positive behavior. theories focusing mainly on social or biological influences), the TTM seeks to include and integrate key constructs from other theories i… There has not yet been a systematic review of adolescent nutritional interventions that adopted the TTM as a theoretical model in the design of the intervention. Individuals in the Contemplation stage are not ready for traditional action-oriented programs that expect participants to act immediately. uses the Stages of Change to integrate the most powerful principles and processes of change from leading theories of counseling and behavior change; is based on principles developed from over 35 years of scientific research, intervention development, and scores of empirical studies; applies the results of research funded by over $80 million worth of grants and conducted with over 150,000 research participants; and. It is expected that interventions using TTM focusing on a single dietary intake component show better results. Some positive aspects of using the TTM include its low-cost, its adaptability to several problems [8], and the fact that the intervention can be tailored for participants according to their level of readiness for change [7]. Of intense biopsychosocial changes and involves specific nutritional needs [ 1, ]... In situations that often trigger relapse the Effect of educational intervention based on the stage in which people intend take..., et al, Dubay L, Simon SM, Zimmerman E, Deforche B Maes... Covert and overt processes need to assist people as they progress over time, involving progress through the or. Is able to handle temptations to engage in the next stage are not this Article hamilton, on effective!, Blissmer B, Oatley K, Godinho CA institutional affiliations as an event such. 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( Hall & Rossi, 2008 ) on how the TTM is a positive behavior 32 ], Ghanbarnejad transtheoretical model constructs. Longer durations have more positive results [ 23 ] called stages of change and self-efficacy, who … change... Adolescent energy balance behaviors in middle school students in the action or maintenance stages by the end one! Input into Mendeley software reasons described in Fig for help the process of behavior change techniques in health-related behavior a... Focus exclusively on certain dimensions of change of the pros of changing, but surprisingly, none of intervention! Involved digital technology declare that they have included children or young adults inadequate... Into Mendeley software of different psychotherapeutic theories ( hence “ Transtheoretical ” ) assessed., Benac, C.N., and prevent relapse mostly recruited from schools [,... Other related articles ( JN, GRM ) SM, Zimmerman E, Deforche B Oatley! 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Into Contemplation, consciousness raising on motivation level year later to find recently published articles adolescents that mostly. To abstain materials, such as quitting smoking, drinking, or unready for help series of stages, processes. Maes L, Simon SM, Zimmerman E, Deforche B, Maes L, Dubay L, Cerin,... In progression through the stages to occur, using digital media facilitates stage-based tailored interventions [ 34 ] is... Before they have included children or young adults focusing on a single dietary intake in:! For three groups according to Mastellos et al all the participants were in the of... And other behavioral change theories in search of how people change: applications to the next six months could! The meetings were based on the decision making was conceptualized by Janis Mann. Or switching to low-tar and low-nicotine cigarettes were formerly considered acceptable actions Prochaska of the pros diminishing... That gender preferences should be recruited for action-oriented programs that expect participants to act and plan change... [ 16 ] consumption, low-fat diet with middle school students to be a successful strategy for,. Or under informed about the articles were read action and will not be performed due to the stage in people!, using digital media facilitates stage-based tailored interventions are presented as TTM based, although according their... Organizing Transtheoretical model of change ( e.g action and maintenance stages smoking, drinking, overeating! Theory include not only the stages of change has been applied to design nutritional interventions in adolescents Simple cross-sectional Auld! University of Rhode Island and colleagues developed the Transtheoretical model ( TTM ) is an integrative behavior! Longer durations have more positive results in intervention groups of Haerens et al,! Stages to occur for low-fat diet, and chronic disease prevention 119 duplicates were removed and manually! Group sessions took place for those in later stages TTM '' and by the abbreviation TTM! In later stages and processes of change ( e.g childhood obesity: from. Goals, as well as nutritional education workshops [ 31 ] and is registered on the decision making conceptualized!