Transtheoretical Model

There have been studies conducted on the effectiveness of the transtheoretical model (TTM) in improving the level of physical activity at worksites worldwide, but no such studies have been conducted in South Africa. The aim of this study was to determine the predictive validity and effects of using the Transtheoretical Model to increase the physical activity of healthcare workers in a public hospital in South Africa. A quasi-experimental design in the form of a single-group, pretest-posttest model was used to examine the possible relationship between an exposure to interventions, attitude, knowledge, and an increased level of physical activity. Two hundred hospital staff members (medical and nonmedical staff) were randomly selected for participation in the study. The following variables were measured: TTM stages of physical activity, knowledge and attitudes, fitness level, body mass index, and level of exposure to the intervention. The interventions designed were based on the concep...

The World Health Organization has documented the impact that a balanced diet has on disease prevention. Overconsumption of meat can lead to obesity, arteriosclerosis, thrombosis, type 2 diabetes and many life-threatening diseases. A new group of proteins has currently emerged in the scientific community of alternative nutrition called “alternative proteins”. Several interventions have been introduced by a large number of healthcare providers in order to promote and enhance people’s dietary habits. Two of the most prevalent models of health-related behaviour modification are the transtheoretical—stages of change—model (TM) and motivational interviewing (MI). The purpose of this study is to research and examine how the ΤΜ and MI could be effectively implemented in the diet of health professionals through alterations of eating habits. The population of the study is to comprise health professionals from «AΤΤΙΚOΝ» University General Hospital, Athens, Greece. The sample of participants is...

Background: The use of motivational interviewing (MI) for changing unhealthy behaviour for muskuloskeletal patients forces us to find methods for its effectiveness evaluation. One of the solutions could be the transtheoretical model (TTM). It is a stagebased theory of behaviour changes. Movement through the stages is hypothesized to be caused by the processes of change, decisional balance and temptation. The purpose of this study is to find out how TTM can show health behaviour changes for patients with musculoskeletal disorders. Methods: One to four MI sessions has been successfully applied for 35 patients with musculoskeletal disorders during their rehabilitation treatment period. TTM's Readiness to Change Questionnaire was used to evaluate behaviour changes at the beginning and at the end of MI treatment. Findings: There were 6 patients at precontemplation, 19 at contemplation and 10 at action stages at the beginning of MI sessions. Results showed that 11 patients stayed at contemplation stage and 9 were already at action stage already changing their behavior, but 3 patients moved from precontemplation to contemplation stage, 3 patients moved from precontemplation to action stage and 8 patients moved from contemplation to action stage after MI interventions. Conclusions and recommendations: MI sessions seem to be effective in changing health behaviour for patients with musculoskeletal disorders. TTM evaluates health behaviour changes even after brief intervention.

Physical activity (PA) is a relevant component of the treatment of Type 2 diabetes mellitus (T2DM). However, to prevent its related morbidities, PA requires an immediate and lasting change of lifestyle. Exercise self-efficacy and body satisfaction were used in a sample of older adults with T2DM, classified in different stages of change, to predict levels of PA. Results show that exercise self-efficacy increases linearly from precontemplation to maintenance stage, while body satisfaction shows an inverted U shape. However, only stages of change, other than exercise self-efficacy, add a significant and noticeable contribution to prediction of levels of PA. This evidence claims a tailored approach to PA in older adults with T2DM and advises behavioural health interventions based on exercise selfefficacy.

Identifying determinants and mechanisms of adolescent smoking cessation 4 Adolescents' movement towards cessation of smoking: Role and relative value of the processes of change and nicotine dependence 5 Associations between the transtheoretical processes of change, nicotine dependence, and adolescent smokers' transition through the stages of change 6 Excuses to continue smoking: The role of disengagement beliefs in smoking cessation 7 Adolescents' excuses to continue smoking: The role of disengagement beliefs and nicotine dependence in smoking cessation 8 Mechanisms of adolescent smoking cessation: The roles of readiness to quit, nicotine dependence, and smoking of parents and peers 9 Predicting nicotine dependence profiles among adolescent smokers: The roles of personal and social-environmental factors 10 Adolescents' smoking cessation: The effects of craving and withdrawal symptoms during abstinence and ad libitum smoking

Individuals with elevated depressive symptoms and substance use disorders (SUDs) have particular difficulties quitting smoking and few treatments benefit these individuals. The current study compared five session BA-enhanced smoking cessation treatment + nicotine replacement therapy (BADAS) to smoking cessation treatment as usual (TAU; nicotine replacement therapy + Clearing the Air self-help manual). We hypothesized that participants in BADAS would be less likely to relapse, would have higher abstinence rates, would smoke fewer cigarettes, would exhibit decreases in depressive symptoms, and would have increases in environmental reward, as compared to TAU. Participants in residential treatment with elevated depressive

ObjectivesThe study aims at evaluating the suitability of applying the transtheoretical model (TTM) stage‐of‐change construct to the treatment with dialectical behaviour therapy (DBT) of borderline personality disorder (BPD).DesignStages of change were assessed by means of the University of Rhode Island Change Assessment (URICA) scale prior to and after 3 months DBT skills group psychotherapy.MethodThe sample was comprised of 79 people with BPD (86% of females) at pre‐treatment, and 42 patients (80% of females) at post‐treatment. All patients were referred from clinical services and diagnosed by means of two semi‐structured interviews.ResultsIn pre‐treatment assessment, precontemplation scores correlated significantly and negatively with the other subscales (contemplation, action, and maintenance) and these three subscales also correlated significantly and positively with each other. The precontemplation stage was directly related to drop‐out from the DBT group. The action subscale ...

Introduction: Tobacco smoking causes various chronic diseases and adds costs to healthcare systems. The current smoking cessation interventions mostly target smokers who are ready to quit and are reactive in recruitment. Recently, mobile phones have become a new tool for promoting smoking cessation. The aim of this paper is to present a study protocol on a quasi-experimental study investigating the effects of a workplace mHealth intervention for smoking behaviour. Methods: A quasi-experimental study will be conducted among employees in an academic institution in Malaysia. The intervention group will receive a theory based WhaSTOP module via WhatsApp and will be compared with the control group (receive usual care). The primary outcomes are stage movement and the number of cigarettes per day. The secondary outcomes include knowledge of smoking, quit attempt, nicotine dependence, 7-day point prevalence of smoking abstinence, and the Transtheoretical Model constructs. A generalised estimating equation analysis will be performed to determine the effects of the intervention. Discussion: This protocol will provide a novel method to proactively approach smokers regardless of readiness to quit and to guide them through the stages of change so that they will be ready to take action to quit. This research will also provide insight into whether the intervention can be utilised as an additional tool for smokers at the workplace to quit smoking. Trial Registration: The trial was registered with the Iranian Registry of Clinical Trials (Registry Number IRCT20220415054539N1).

Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficien...

This study examined service-learning (SL) beliefs and participation among faculty in different stages of involvement to develop tailored resources and support. A representative sample of 1,200 faculty members at a major public university in Southeast United States was recruited. The study used the transtheoretical model (TTM) as an innovative way to group SL involvement into five stages: unaware (U), pre-contemplation (PC), contemplation (C), preparation (Prep), and action and maintenance (A/M). Perceived benefits and barriers at different levels were assessed. The distribution among faculty who completed the online survey ( n = 450, 60% males) across stages was 20% (U), 31% (PC), 16% (C), 10% (Prep), and 23% (A/M). Analyses showed significant differences on the 4 SL beliefs, F(3, 358) ranged from 7.05 to 78.31, all p< .001, across stages. This study provides the first valuable empirical data to support the application of TTM to the SL arena and identified salient variables influ...

The Transtheoretical Model of Change (TTM) is an established model outlining five stages of change within a psychotherapeutic context: pre-contemplation, contemplation, preparation, action, and maintenance. Research shows that these models benefit patients and clinicians by enhancing their understanding of complex processes and identifying optimal therapeutic support for an individual at a specific time. Although recognized as a promising approach for understanding suicidal thoughts and experiences, the TTM has not yet been applied to suicide recovery. In this study, we used a scoping review of qualitative articles describing recovery processes following a suicidal episode (N=57) and mapped studies outlining phases or stages (N=10) onto the TTM. The resulting model revealed a pattern of processes across each TTM stage of change. However, we found that the recovery process does not perfectly align with the TTM stages of change beyond contemplation. As a result, we developed a three-s...

The Transtheoretical Model (TTM, the "stage model") can guide development of programs to increase Medicare beneficiaries' readiness to make informed health plan choices. In this study, TTM staging algorithms were developed to assess readiness to engage in three types of informed choice: (1) learning about the Medicare program; (2) learning about Medicare health maintenance organizations (HMOs); and (3) reviewing different plan options. Stage of change based on all three algorithms is related to knowledge about the Medicare program and information-seeking. Findings provide evidence for the construct validity of the stage measures and for the applicability of the TTM to informed choice among beneficiaries.

Two methods of operationalizing readiness to quit smoking have been used extensively in prior research. An algorithm derived from the transtheoretical model classifies current smokers in distinct stages of precontemplation (not intending to quit in next 6 months), contemplation (serious intent to quit within 6 months), and preparation (serious intent to quit within 30 days). The Contemplation Ladder (CL) is a single-item continuous (0-10) rating. The current study, a secondary analysis of a clinical trial testing a method of inducing quit attempts, examined the convergent validity, one-month retest reliability, and predictive validity (for quit attempts) of the CL and the stages of change algorithm. Patients and Methods: Adult daily smokers (≥10 cigarettes/day; N = 278) completed the CL and stage of change algorithm measures and underwent an experimental manipulation intended to induce quit attempts. Four weeks later they completed the same measures and reported on whether they had attempted to quit smoking in the interim. Results: The CL and the staging algorithm showed strong convergent validity, with intercorrelations of 0.50 and 0.51 at baseline and follow-up assessments. Retest reliability was similar for each measure (CL r = 0.52; stage of change r = 0.57). Each showed predictive validity in that smokers who went on to make a quit attempt had scored significantly higher at baseline in readiness to quit. Conclusion: Researchers and clinicians can reasonably choose either measure of readiness to quit smoking with confidence that the results would parallel what would have been obtained with the other.

Cervical cancer incidence and mortality rates are disproportionally high among women living in Ohio Appalachia. This study used the Transtheoretical Model to examine screening barriers before and after a lay health advisor (LHA) intervention (2005-2009) to increase cervical cancer screening rates. Ohio Appalachian women (n = 90) who were in need of a Pap test, based on riskappropriate guidelines, and were randomized to a 10-month LHA intervention, received two inperson visits, two phone calls, and four mailed postcards targeted to the participant's stage of change. Findings revealed that 63% had forward stage movement ten months after the intervention. The most frequently reported screening barriers were time constraints, forgetting to make an appointment, and cost. Women reporting the following barriers: doctor not recommending the test, unable to afford the test, and being embarrassed, nervous, or afraid of getting a Pap test were less likely to be in the action stage. Understanding the stages of change related to Pap testing and reported barriers among this underserved population may help inform researchers and clinicians of this population's readiness for change and how to set realistic intervention goals.

Background and purpose: Childbearing is of great importance in social issues. This study was conducted to determine the effect of transtheoretical model-based education on women attitudes and stages of childbearing behavior change. Materials and methods: This clinical trial was performed using multi-stage random sampling in 75 women of reproductive age (38 in intervention group and 37 in control group) selected from nine health centers in Amol, Iran 2017. The intervention group attended five educational sessions, and then received online weekly trainings for six months while, the control group received routine education. Attitudes toward childbearing and stages of change in childbearing behavior were evaluated before, at 3 and 6 months after the education. Results: Mean scores for women attitude before, at 3 and 6 months after education were 171.81±22.55, 179.12±22.55, and 177.39±20.54 in intervention group and 166.31±19.37, 165.85±21.49, and 165.07±18.37 in control group, respectively. Findings indicated significant improvements in women attitude toward childbearing (P <0.001). But, frequency of women at different stages of childbearing behavior in intervention group was not significantly different from that of the controls (P = 0.281). Conclusion: Transtheoretical model-based education improved women attitudes toward childbearing, but failed to change the stages of childbearing behavior. Given the multiplicity of factors in childbearing, such findings were predictable. Therefore, it is necessary to carry out studies with longer pre-pregnancy consultations and increase in number of samples.

Research questions: To investigate how the daily physical activities of elderly patients can be enhanced by systematic counselling conducted by general practitioners (GPs). Methods: In this feasibility study with pre-post design, 29 people (14 females, mean age 72.2 years, SD = 6.1) were enrolled during routine visits by two general practitioners. A baseline assessment of current physical activity based on the stages according to the Transtheoretical Model was followed by a counselling session. The target behaviour was defined by performance of 30 minutes of daily moderate-intensity activities that increase the breathing rate, on five days per week. At the 2-month follow-up, subjects were assessed for improvement in stage of physical activity since baseline. After the end of the intervention, participating GPs and patients were asked questions focusing on the feasibility, acceptance and usefulness of counselling. Results: Interview results showed that the two GPs considered the counselling protocol easy to handle and useful for promoting physical activity. Counselling sessions were especially encouraging for the not sufficiently active people. Most of them would like to have additional counselling session. At baseline, 9 of 29 people were sufficiently active. After 2 months, this proportion was 21 of 29. The mean of the number of minutes of physical activity during the previous 4 weeks increased from 247 to 436 minutes (weekly). Conclusions: The programme was judged positively by the general practitioners and the participating elderly patients. Systematic counselling by general practitioners led to an increase in the physical activity behaviour. Therefore, a more rigorous randomised controlled trial with adequate followup is recommended.

Background & Objective: Behavioral change is one of the most powerful strategies for preventing osteoporosis .The aim of this study was to investigate the osteoporosis preventive behaviors in women based on the transtheoretical model. Instruments & Methods: This cross sectional descriptive-analytical study was performed on 400 women over 30 years covered by Fasa health care centers in 2018 that were selected by simple random sampling. The instruments of data collection included a personal information questionnaire, awareness, change stages, decision-making balance, selfefficacy in two parts of physical activity and dietary calcium, and a calcium intake questionnaire, as well as a checklist for physical activity and calcium intake performance. The data were analyzed by SPSS 22 software, using Pearson correlation coefficient, Chi-square, independent t-test, and multiple regression analysis. Results: The majority of the participants were involved with calcium intake performance (41.25%) and walking (46.25%) at the precontemplation stage. There was a direct correlation between calcium intake performance and self-efficacy of calcium intake (p=0.032; r=0.125) and an inverse correlation with perceived barriers of calcium intake (p=0.045; r=-0.187). There was a direct correlation between walking performance with exercise benefits (p=0.020; r=0.128) and exercise selfefficacy (p=0.032; r=0.184), and a reverse correlation with perceived barriers of exercise (p=0.040; r=-0.102). Totally, the variables under the study predicted 28.6% of the variance in walking and 30.2% of the variance in calcium intake behavior. Conclusion: Transtheoretical model structures can predict osteoporosis preventive behaviors in women. The predictive power of self-efficacy for walking behavior and calcium intake is more than other structures.

Background: Globally, 382 million people are estimated to have diabetes. To date there is paucity of evidence regarding predictor of regular physical activity among Type 2 diabetes mellitus patients with application of Transtheoretical model. Therefore the objective of this study was to determine predictors of regular physical activity among type 2 diabetes mellitus patients in Wolaita Sodo University hospital using the Trans-theoretical model. Method: Institutional based cross-sectional study was conducted on 400 systematic random selected Type 2 diabetes mellitus patients. One-way ANOVA was used to show mean scores differences of processes of change, decisional balance and self-efficacy across stages of change. Multivariable logistic regressions were also conducted. Result: Of the participants, 34.3% were physically active. The processes of change, the pros and the self-efficacy significantly increased from precontemplation to maintenance stage while the cons decreased across the stages (p<0.05). The result of multivariable logistic regression showed that pros, cons, self-efficacy, self-liberation and counter conditioning were predictors of physical activity. Conclusion: Type 2 diabetes mellitus patients' physical activity was very low. Stage matched intervention should be designed to increase processes of change, pros and self-efficacy from precontemplation to maintenance stages.

The transtheoretical model of change is one of the most accepted strategies to bring about an intentional change. It addresses the process of change in a structured manner which can be beneficially implemented to bring about positive changes to achieve habit breaking, tobacco and alcohol cessation. In addition, it may help acquire and establish positive habits such as maintenance of oral hygiene.

Single Occupancy Vehicle (SOV) transportation is a key contributor to climate change and numerous other environmental impacts. Alternative Transportation (AT) or Sustainable Transportation (ST), i.e. commuting by means other than SOV, represents one important step toward slowing climate change, improving communities and enhancing health. Communication and behavior change approaches can play a key role in encouraging commuters to choose more sustainable modes of transportation. The Transtheoretical model of behavior change (TTM) is a useful framework for understanding Transportation Behavior and ways to encourage sustainable alternatives. Few systematic applications of TTM to sustainable behavior exist to date. This report explains assessments and interventions designed to encourage Alternative Transportation. While the TTM Stages of Change Model is well established and world-renowned in the field of health promotion and related areas, very limited systematic work has been done related to transportation behavior. To develop tailored interventions, key TTM measures had to be developed: Stages for ST, Decisional Balance, and Self-Efficacy. These measures then became the cornerstone of TTM based interventions. Short and reliable measures for decisional balance and self-efficacy, and their associations with Stage of Changewere examined. University student volunteers (n=588) participated in this cross-sectional study. Through measurement development analyses using split-half cross validation procedures, we developed two internally consistent measures: a 20-item Decisional Balance measure with four hierarchically organized scales (Pros, Specific Pros, Cons, and Climate Change Doubt) and an 8-item Self-Efficacy scale. Both Decisional Balance and Self-Efficacy confirmed predicted associations with Stage of Change, supporting the application of TTM to Sustainable Transportation.

This paper presents initial research findings of a multi-year, multi-site interdisciplinary project designed to promote alternative transportation (AT) and to encourage mode shift from single occupancy vehicle commuting to transit, carpooling, walking or biking. The research is designed to lay the groundwork towards developing effective interventions to promote transportation behavior change, especially for those who are currently not ready for such a change. This study of students and staff at two public universities in the Northeast is designed to develop and test the methodology of applying the Transtheoretical Model (TTM), to transportation behavior. This behavior change model has been highly successful in the area of health promotion. In this study, it is combined with geospatial modeling to maximize impact on commuters. Transportation surveys at two New England universities measured commute patterns, behaviors, attitudes towards AT and geographical information (e.g., residence...

This paper presents findings of a two-campus project designed to assess alternative/sustainable transportation (AT), which is defined as commuting via non-SOVs (single occupancy vehicles) such as transit, carpooling, walking, or biking. One of the objectives was to test the application of a well-known behavior change model, the Transtheoretical Model of Change (TTM), to transportation behaviors. Additionally, geospatial analysis and visualization were applied using the TTM measures. The survey results show that commuting distances, transit connectivity, and status (i.e., students, staff, and faculty) affected commute modes and stages of readiness to use AT. Another important finding was that the survey data for AT replicated TTM relationship predictions between constructs and stages of change.

Promoting physical activity and sustainable transportation is essential in the face of rising health care costs, obesity rates, and other public health threats resulting from lack of physical activity. Targeted communications can encourage distinct population segments to adopt active and sustainable transportation modes. Our work is designed to promote the health, social, and environmental benefits of sustainable/active transportation (ST) using the Transtheoretical Model of Change (TTM), which has been successfully applied to a range of health, and more recently, sustainability behaviors. Earlier, measurement development confirmed both the structure of ST pros and cons and efficacy measures as well as the relationship between these constructs and ST stages of change, replicating results found for many other behaviors. The present paper discusses a brief pre-post video pilot intervention study designed for precontemplators and contemplators (N = 604) that was well received, effectiv...

Alcohol use disorder; treatment motivation; drinking goal; transtheoretical model of behavior change Motivation and drinking-related treatment goals in alcohol use disorder 2 ABSTRACT Background: Changing addictive behavior is a complex process with high demands on motivation. The Transtheoretical Model of Behavior Change provides a theoretical framework for explaining and predicting behavioral change, although its predictive value for addiction is somewhat inconsistent. Objective: The aim of the present study is to extend the Transtheoretical Model of Behavior Change by investigating not only treatment motivation but also the predictive value of the type of drinking-related treatment goal. Additional predictors, such as substance-related and sociodemographic variables, are also included in analyses seeking to predict return to drinking during relapse prevention treatment for alcohol use disorder. Methods: In this observational study, 99 inpatients from a treatment center for alcohol use disorder were recruited. Treatment motivation was assessed in accordance with the Transtheoretical Model of Behavior Change, drinking-related treatment goal through a self-report questionnaire, and substancerelated and sociodemographic variables via the clinic information system. Associations between the potential predictors and covariates were explored using stepwise logistic regression. Results: During treatment, 42.6% of participants had at least one relapse. Scoring higher on the action dimension at admission (OR = 0.81, p = .04) and being employed (OR = 0.37, p = .02) were significant predictors of abstinence during treatment. Conclusions: This study confirms that treatment motivation contributes to the prediction of treatment outcome, even when controlling for other variables. In future research, the underlying mechanisms of treatment motivation should be further explored.

Kumar oyunlarinin 3500 yil oncesinden bu yana artarak ve cesitlenerek gelmesinin nedeni bagimlilik yapabilme ozelligidir. Kumar bagimliligi ile birlikteligi sik gorulen madde bagimliliklarindan sigara icimi kisinin stresten uzaklasmak ya da zevk verici olarak kullanmasindan kaynaklanabilmektedir. Bagimlilik tedavilerinde kullanilabilen davranis degisiklik modellerinden Transteoretik model, kumar ile sigara bagimliligi birlikteliginde kullanildiginda kisinin hem kumar hem de sigara bagimliligindan kurtulmasinda etkili olabilmektedir. Bu makalenin amaci, bagimliliklarin birbiriyle olan iliskisi nedeniyle tedavi yaklasimlarinda ayni birliktelik olabilecegini vurgulamaktir.

We applied the Transtheoretical Model (TTM) to develop the Family Stage of Change (FSOC) screening tool. Our goal was to provide practitioners an instrument that measures families’ readiness to change obesity preventing behaviors, in order to optimize family-focused obesity-prevention intervention strategies. We evaluated instrument validity by comparing responses on the FSOC to related items on a validated family behavioral and environmental assessment (Family Nutrition and Physical Activity Assessment; FNPA) shown to predict child BMI. Study participants included parents and caregivers (N = 146) of children ages 2-14 years recruited through preschool, elementary, and middle school listservs. Descriptive analyses were conducted on the demographic data, and correlations were run to examine associations between FSOC and FNPA items, domains, and total scores. Strong positive correlations were observed between the individual items (0.44 to 0.75, p &lt; 0.001), domain scores (0.57 to 0....

Among rural families, rates of both child obesity and household food insecurity (FI) are higher compared to non-rural families. These disparities result from a complex interplay of social and environmental conditions that influence behavior. The Transtheoretical Model suggests individual readiness to change underlies success in modifying obesity-preventing behaviors; however, whether an association between readiness to change obesity-related behaviors and FI status among rural families exists is unknown. We examined the association between readiness to change family-level nutrition and physical activity (PA) behaviors that predict child obesity and family FI status within a sample of rural families to better understand these relationships. Families (n = 144) were recruited from six rural Oregon communities in 2013. Families completed a FI screener and the Family Stage of Change Survey (FSOC), a measure of readiness to change family-level nutrition and PA behaviors associated with ob...

Introduction Communicating the risks associated with nicotine and tobacco use to adolescents can be challenging, especially with the current tobacco market's attempt to capture the attention of youths. Text message interventions have emerged to address the need to improve tobacco risk communication. This article informs the design of a message library for tobacco risk communication that is based on the transtheoretical model and addresses the risk of multiple tobacco products. Methods We draw findings from this study from two phases. Phase 1 involved six remote focus group discussions (n = 25) and an in-depth interview, and Phase 2 involved online ideation sessions (n = 11) that led to the current version of the messages. We conducted the study within a larger project for the design and testing of a tobacco prevention program. With thematic analysis and the affinity mapping technique, two research team members identified repeated topics and relevant quotes to organize them into themes and subthemes. Results In Phase 1, thematic analysis revealed four major themes: 1) Adolescents' gap in tobacco knowledge, 2) Social influence and popularity, 3) Attitude toward marketing, and 4) Text message framing preferences. During Phase 2, participants generated 1-to-7 iterations of the original messages. Votings and discussions resulted in a library of 306 messages under 7 sections, categorized based on the processes of change from the transtheoretical model. Conclusion The current study presents key insights crucial for developing and evaluating a library of tobacco prevention text messages that is scientifically valid and successfully resonates with

Older adult health, while partially determined by genetics, is mostly determined by behavioral and lifestyle choices. Researchers and interventionists develop and administer behavioral health interventions with older adults, and interventions are advertised in any number of settings, for example, by providers in healthcare settings and by activity directors in senior centers or assisted living facilities. However, previous studies and metanalyses indicate that many interventions targeting older adults are unsuccessful in recruitment or in retention. While providers and activity directors may assume older adults are unwilling to participate in behavioral change, in reality, low participation may be caused by erroneous design and administration. The objective of this manuscript is to recommend to creators and implementers of behavioral interventions for older adults that they focus on two critical considerations: the contextual perspective pertaining to healthy aging as well as an app...

Sedentary behavior rates are higher among African-American men and women than in other American races and ethnicities, placing them at greater risk for chronic illness. Routine physical activity reduces the risk of chronic health problems such as: (a) overweight and obesity, (b) type 2 diabetes, (c) hypertension, (d) coronary artery disease, (e) stroke, (f) congestive heart failure, and (g) cancers. Assessment of African-Americans&#39; exercise attitudes in a church-based setting may provide information with which to develop effective interventions to improve physical activity. This descriptive, cross-sectional study used components of the Transtheoretical Model (TTM) to assess whether any associations exist between TTM constructs and regular exercise in African Americans. This exercise assessment included some environmental and cultural factors. Participant surveys included: (a) demographics, (b) stage of change for exercise, (c) decisional balance for exercise, (d) self-efficacy f...

Electronic nicotine products remain popular among college students. These products contain heavy metals, carcinogens and the addictive substance nicotine. By understanding where students are in their behavior change can help to determine and focus messages and campaigns. The aim of this study was to assess predictors of the Transtheoretical model in college-aged vaping. This study consisted of an online/Ipad delivery of a voluntary survey to 1249 young adults/college students at 5 universities (International and within the U.S.). Data was analyzed using Stata. Regression analysis was performed to assess predictors of the stages in the Transtheoretical Model of behavior change. Our study found that women tended to be further along in the stages of change as compared to their male counterparts. Additionally, the older students were more likely to be in maintenance stage as compared to the younger students. The students who vaped longer tended to not have advance into any of the stages of change besides precontemplation. Understanding where students are in the stages of change can help to inform behavioral message campaigns enabling more focused targeting of messages and efforts to reduce consumption. Electronic nicotine products are highly prevalent on college campuses, both nationally and internationally. The nicotine is addictive and may result in less of a desire or ability to quit as young adults age.

Background-Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported. Purpose-We describe the development, implementation, and process evaluation of an Internetdelivered dietary intervention program (myDIDeA) for diabetic patients in a developing country. Method-Specific dietary components to be included in the intervention module were first identified through a comprehensive review of literature and guidelines. The lesson plans and the study website were then developed based on the evidence, Transtheoretical Model's Stages of

Lack of adequate awareness specially among elderly is considered as one of the major barriers to follow healthy lifestyle. Objectives: This study conducted to investigate the effect of educational intervention on the adherence to treatment among Iranian elderly with hypertension. Materials & Methods: In this quasi-experimental study 88 participants allocated in control and intervention group. Using standard questionnaire, participants' adherence to treatment were evaluated after educational intervention. Data were analyzed via SPSS software, version 16. Results: Mean±SD of participants' age was 67.13±7.12 and 67.34±5.41, respectively in control and intervention groups. T-test shows significant differences between control and intervention group in all three dimensions of adherence in one and 3 months after intervention (P≤0.05). Conclusion: According to these finding educational intervention could improve patients' adherence to treatment, so it is recommended to educate elderly people with hypertension in order to increase their adherence to treatment. Further studies are recommended to discover the elderly HTN patients' needs.

Objective. To analyze the stage of change in food consumption with warning labels among Chilean university students. Materials and Methods. Cross-sectional study which applied surveys in universities from all over the country. Study included 4807 participants of 18 to 40 years of both sexes who were asked about the level of knowledge of the new food law and food consumption with warning signals, including questions regarding their willingness to behavior change according to Prochaska’s transtheoretical model. To compare continuous variables, Student’s t-test was used in the statistical package SPSS 22.0, and p &lt;0.05 was considered a significant difference. Results. Of the total number of respondents, 99.3% of the students indicated that they know about the food law, classifying foods with signals in the precontemplation stage. Compared by sex, we observed that women give greater importance to behavior change in all of foods (p &lt;0.001). Underweight students give less importance...

Substance use disorder is recognized as a chronic, relapsing condition, with a significant percentage of individuals experiencing relapse within one year of treatment. Understanding the intricate factors contributing to relapse is paramount for developing effective prevention and intervention strategies. Various theoretical frameworks offer insights into addiction relapse, shedding light on its underlying mechanisms. Social learning theory underscores the influence of observational learning, modelling behaviours, and reinforcement on addictive behaviours, advocating for tailored interventions to enhance relapse prevention. Marlatt and Gordon's Relapse Prevention (RP) Model targets cognitive processes and behavioural strategies, offering a comprehensive approach that is effective for overcoming addiction, despite its complexity. The transtheoretical model (TTM) provides a dynamic framework, tailoring interventions to an individual's stage of change and emphasizing longterm behaviour maintenance. The biopsychosocial model considers biological, psychological, and social factors and advocates for a holistic and individualized approach to relapse prevention. While these models share the need for tailored interventions and recognition of relapse complexity, they differ in their emphasis and application, highlighting the necessity of integrating multiple perspectives for a comprehensive understanding of addictive behaviours and relapse prevention. Therefore, it is recommended that clinicians and experts in the field of substance abuse employ multiple perspectives in approaching substance abuse relapse interventions.