1
Q
where was the Transtheoretical model developed?
A
- the University of Rhode Island Cancer Prevention Research Center.
- it was used for smoking cessation.
2
Q
what are the 6 stages?
A
- precontemplation.
- contemplation.
- preparation.
- action.
- maintenance.
- termination
3
Q
what is precontemplation?
A
- do not intend on exercising in the next 6 months.
- cons outweigh the pros of exercising.
- very defensive when it comes to changing.
- stable stage people will stay here for a while without intervention.
- I cant/ I won’t statements (ignorance is bliss)
- key is that there is a lack of intention.
- opinions and thoughts are overwhelmed by barriers.
- change does not = a possibility it is very hard. importance of education
4
Q
what is contemplation?
A
- they intend on changing within the next 6 months.
- the pros and cons are equal–> ambivalent.
- know the benefits but are not ready to make a change.
- may also stay here for a long time without intervention.
- I might statements. see a need for change or acknowledge the problem.
- open to new info but not committed (fence sitter).
- chronic info gatherers.
5
Q
what is preparation?
A
- the intent on making the change within the next month or so.
- the pros outweigh the cons.
- have started making little changes or preparing for the change to happen (taking stairs, getting medical clearance).
- I will statements.
- strong incentives and optimistic views of the benefits of exercise.
testing the waters. - unstable but more likely to progress than pre-contemp and contemp.
6
Q
what is the action?
A
- must meet ACSM and CC minimum guidelines at recommended levels.
- pros outweigh the cons.
- very unstable stage as it can be hard to maintain a new fitness regime.
- have to work hard to avoid relapse.
- I am statements.
- the greatest commitment of time and energy (attentiveness).
- relapse is common have to establish habits.
- least stable stage.
7
Q
what is the maintenance stage?
A
- maintenance of recommended fitness regime for 6 months.
- pros still outweigh the cons.
- still have to work but find it easier to maintain a fitness routine.
- I have been statements.
- behaviour is well established.
- There is instability risk in the case of boredom and loss of focus.
- energy to maintain habit may be challenging.
- reinforce the gains and strive to prevent relapse.
8
Q
what are experiential processes?
A
they are typically directed toward increasing people’s awareness of, and changing their thoughts and feelings about, both themselves and their exercise behaviour.
- used at the beginning and end of the intervention.
9
Q
what are the 5 experiential processes?
A
- consciousness-raising.
- self reevaluation.
- environmental reevaluation.
- dramatic relief.
- social liberation.
10
Q
what is consciousness-raising + example?
A
- Seeking new information and a better understanding of exercise.
ex. Read pamphlets; talk to a health care professional about the benefits of exercise - learn pros and cons of exercise.
11
Q
what is self-revaluation?
A
- Assessing how one thinks and feels about oneself as an inactive person.
ex. Consider whether being inactive is truly in line with one’s values. - appraise self-image as a healthy regular exerciser.
12
Q
what is environmental re-evaluation?
A
- Considering how inactivity affects the physical and social environment.
ex. Find out the costs of inactivity to the health care system. - consider how inactivity affects others.
13
Q
what is dramatic relief?
A
- Experiencing and expressing feelings about becoming more active or remaining inactive through exercise.
ex. Imagine the feelings of regret and loss for not having prevented the loss of health. - experiencing and expressing feelings about the consequences of being physically active.
14
Q
what is social liberation?
A
- Increasing awareness of the social and environmental factors that support physical activity.
ex. Seek out information about exercise groups and resources in the community, workplace, etc. - take advantage of customs and norms that increase PA.
15
Q
what are behavioural processes?
A
- consist of behaviours that a person undertakes in order to change aspects of the environment that may affect exercise participation.
- used at the beginning and end of the intervention.
16
Q
what are the 5 behavioural processes?
A
- self-liberation.
- counterconditioning.
- stimulus control.
- reinforcement management.
- helping relationships.
17
Q
what is self-liberation?
A
- Engaging in activities that strengthen one’s commitment to change and the belief that one can change.
ex. Announce one’s commitment to exercise to family and friends; stay positive and remind oneself “I can do it!”. - commit self to becoming or staying regularly active.
18
Q
what is counterconditioning?
A
- Substituting sedentary activities for physical activities.
ex. Go for a walk after dinner rather than watch television. - substituting sedentary behaviour with activity- walk, bike to work, walk on lunch, walk with stroller.
19
Q
what is stimulus control?
A
- Controlling situations and cues that trigger inactivity and skipped workouts.
ex. Plan ahead for a busy period at work/school and schedule exercise on a calendar. remove batteries in the remote. - use cues as reminders to engage in PA, calenders, phones, online management systems.
20
Q
what is reinforcement management?
A
- rewarding oneself for being active.
ex. Establish goals and reward oneself for achieving them. - reward self or by others for making changes.
21
Q
what is helping relationships?
A
- Using support from others during attempts to change.
ex. Buddy up with a friend who is also trying to start an exercise regimen. - obtain support for PA intentions, who do you turn to when you need help?
22
Q
what is the decisional balance?
A
- The decisional balance construct was borrowed from Janis and Mann’s (1977) model of decision making. It reflects how people perceive the pros and cons of changing their behaviour.
23
Q
what can TTM be correlated with suggesting movement through the stages?
A
- an increase in self-efficacy.
24
Q
what has the Cancer Prevention Research Consortium (1995) suggested to get someone out of precontemplation?
A
- need to be more informed about exercise benefits whether that be through a video, pamphlet, or consultation.
25
How do we move someone out of contemplation?
- identify more advantages.
| - have them reflect on how they feel about themselves being sedentary.
26
How do we help someone in preparation?
- encouraging them to get organized and start planning for a new physically active lifestyle (e.g., investigate the cost to join a fitness club, decide how exercise will be worked into a busy schedule, identify walking trails).
- seek support from others.
27
How do we help someone in the action phase?
- providing tips on overcoming barriers to adherence and introducing strategies to help maintain their motivation, such as setting goals (see
28
How do we help someone in the maintenance phase?
- strategies preventing them from reverting to a sedentary lifestyle.
- plan ahead and identify situations that might cause them to lapse, such as going on vacation, getting bored with their exercise routine, or being busy at work or school. Strategies to overcome these.
29
what are three strategies used with the TTM?
1. we can describe the differences between people in each stage.
2. we predict the stages someone is in or will move to.
3. we can develop exercise interventions.
30
What did Nigg and Courneya find in 1998 when studying a group of 819 Canadian high school students? (descriptive study).
- there was greater exercise self-efficacy, perceived more benefits of exercise and were more likely to use processes of change when in action and maitanence than all other stages.
31
what did Nigg find in 2001 when predicting stages?
- we can predict the direction of movement but were unable to predict students' stages of exercise over three years.
32
what stages are better for generic material interventions?
- prep, action, maintenance.
| - generic materials may be just effective as stage-matched materials.
33
what stages respond the best to stage-matched interventions?
- pre-contemplation and contemplation.
34
What were Albert Bandura's criticisms of the TTM?
- the passage of time is too arbitrary (6 months) in identifying successful movement or standing within a stage.
- it can not predict or explain how someone can skip forward multiple stages or regress backwards more so than others.
- human functioning is too distinct to be placed in only one category.
35
what are the five constructs of the TTM?
1. stages of change.
2. processes of change.
3. decisional balance.
4. self-efficacy.
5. temptation.
36
Why is the TTM model known as the trans/integrated model?
- it includes elements from various theories including; social-cognitive theory, personal/cognition and behavior, environment.
37
Who developed the TTM?
- Prochaska and DiClimente. + colleagues.
38
What was the TTM foundation created upon?
- over 300 years it looked at people quitting smoking, psychotherapy and behavior change.
39
what did researchers extend there research of TTM to?
- alcohol/substance abuse, eating disorders.
40
Why is behavior change not a one step process?
- cognition and behavior's vary overtime.
not a quick process/snapshot.
not a one size fits all model.
- people differ between and within stages.
41
what are the three aspects of stages of change?
1. trait-state.
2. stable/dynamic.
3. 6 stages.
42
What is the trait-state construct?
stages fall between being more trait or state (e.g. long term of no exercise can result in more neuroticism vs. short term of no exercise could cause anxiousness about running a program).
43
What is the stable vs. dynamic construct?
- behavior change and cognition is different in each phase, people move through them at different rates, and there are periods of progression an relapse.
44
what is the 6 stages aspect?
- movements across the stages is cyclical, always changing between progression an relapse.
the barriers are different at each stage.
45
what groupings of pre-contemplators did Reed and Colleagues (1999) propose?
- non-believers: see no value or don't believe in regular PA.
- Believers: they believe that PA is worthwhile, but can not start participating.
46
How long did Weinberg an Gould (1999) say someone could stay in a contemplation stage for?
2 years.
47
What is termination?
- completion of the cycle.
- behavior maintained for greater then 5 years.
- no fear of relapse regardless of the barriers.
- 0% temptation to engage in old behaviors.
- 100% self-efficacy to remain in PA.
48
What are the processes of change?
- how people think about exercise, themselves an aspects of the environment that influence exercise behavior.
49
what can the processes of change help with?
- shifts in thoughts, behaviors and feelings during behavior change.
50
what is the difference between experiential and behavioral processes?
- experiential: focus on increasing awareness.
| - Behavioral: changing behavior.
51
What is self-efficacy?
- it is the belief in ones ability to change which is critical.
52
How does increase confidence effect activity?
- it leads to more successful attempts with PA.
53
how does decreased self-efficacy affect stages of change?
- the potential of relapsing to earlier stages is higher.
54
what empirical support did Gorely and Gordon demonstrate in 1995?
- that self-efficacy increases as we make our way through the stages.
- our self-efficacy to overcome barriers also increases.
55
What is temptation?
- it is the intensity of urges to engage or not engage in a behavior during difficult situations.
- better predictors for relapse. but minimal research with PA.
56
Why is self-efficacy inversely related to temptation?
- when we increase SE we see that the urge of temptation to not exercise goes down.
57
what characteristic's accompany maintainers.
- highest level of confidence for engaging in PA with the lowest level of temptation to not engage in PA.
58
what is resilience?
- positive capacity to cope with stress and future challenges/negatives through protective skills.
59
who created the foundation for resilience?
Salvatore Maddi, 2005.
60
what are the three C's of Resilience?
- control.
- commitment.
- challenge.
61
what is the 1st benefit of stages of change?
1. we can match interventions to the needs of individuals.
ex. target interventions- we know that sedentary people are generally not motivated or educate so we can educate and motivate them.
62
what is the 2nd benefit of stages of change?
- we have the ability to subdivide the at-risk populations.
- target the people who are in the most need and will have the hardest time changing/responding.
- % of people in each stage depends on age.
63
what is the 2nd benefit of stages of change?
- we have the ability to subdivide the at-risk populations.
- target the people who are in the most need and will have the hardest time changing/responding.
- % of people in each stage depends on age.
64
what is the 3rd benefit of stages of change?
- we can recruit people in a stage matched manner.
| - proactive recruitment of those who need help.
65
What did Bess Marcus et al., 2000 propose?
- that tailored behavior change is the most successful.
| - stage matched.
66
What did Nigg and Courneya display in 1998 and 2001 with groups of New-zealand and Canada students?
- minimal research of all 5 constructs so could have significant discriminators.
- we cant tell what stage someone will move to but we can identify what stage they are in.
67
what did prediction studies find with older adults?
- the effectiveness in each stage is variable.
- self-efficacy increase across all stages.
- attitudes toward PA changed throughout stages.
68
What differences were found among multiple stages.
- Literature applying the stages of change to exercise behavior does not appear to have achieved consensus on the pattern of stage differences in measures of PA/exercise behaviors.
- Yet a validation study found sig differences on BMI & aerobic fitness - linear relationship over stages of change
69
What are the major limitations of the transtheoretical model?
- lack of sufficient validation- most research is cross sectional and short longitudinal
- timing between stages is to robust it can not simply define switching between stages.
the relationships between the stages of change and processes of change are questionable, it is hard to predict what stage someone will move to.
- most research is descriptive an not explanatory ( we need more predictive and intervention research).
- no moderator variables included (age, gender and ethnicity).
70
What did Marcus and Colleagues do in 1992?
- Designed to increase the adoption of PA among 610 community volunteers - baseline assessment of stage of change in (39% contemp, 37% prep, 24% action)
- 6-week stage matched intervention consisting of 3 separate sets of self-help materials (stage driven), a resource manual describing different activity options, & weekly fun walks and activity nights.
71
what were the results of Marcus and Colleagues 1992 study?
- significant increase in PA regardless of the initial stage, a few people regressed.
- End: 17% contemn (-22%), 24% prep (-13%), 59% action (+35%).
72
What did Spencer and Colleagues do in 2006?
- they did a worksite intervention by randomizing 1559 individual's into either a stage matched or standard self-help intervention.
73
What were the results of Spencer and Colleagues in 2006?
- stage matched interventions resulted in positive changes.
- standard had people regress, but it depends on the stage it is more effective in later stages where they have more control.
74
what did Marcus and collages (1992) and Adams and white (2003) do?
- they gave counselling during a annual visit to physicians and health care providers.
- it was tailored to there PA level and readiness to become active.
75
What were the results of Marcus, Adams and white?
- increased walking duration and readiness to become active.
- the PA was more advanced in stages of motivational readiness.
there was no long term effect after 8 months.
- therefore we need intensive interventions in primary care.
psychology
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