The greatest challenge is stating the problem in a way that will allow a solution.

Sunday, January 20, 2013

Old Habits Die Hard: The Transtheoretical model of behavior change

The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination.

Making changes in your life involves having the courage to take action.  

Knowing that change making is important and even lifesaving is not always  enough impetus to get ourselves to take action.   

How you can help yourself take the first steps -action gains an impetus of its own:

Inertia and engrained habits can make change slow and difficult to instill whether you want to think differently, more positively for instance or lose that nasty 50 pounds of excess body fat you have acquired since leaving high school.  

The desire to make changes  in your life can come about by your doctor's orders or your realization that certain habits are ineffective tools for managing a life of achievement and making a contribution to your community.

Things like alcohol abuse, internet gambling or even watching too much television can rob you of hours in which you could be studying, exercising, looking for a new job or doing volunteer work in your community.

A key part of the new understanding is what’s known as

the transtheoretical model

which breaks the business of making changes and adopting new behaviors into

five key steps:

1. precontemplation, 
2. contemplation, 
3. preparation, 
4. action and 
5. maintenance. 

There’s probably not a single one of us who hasn’t spent time in all of those stages for any number of life issues.

Some of us never move to step five.

Some move and then slide back. 

making real changes means knowing how to make that critical jump from preparation to action, 

and then, despite temptations, not to  backslide into old patterns and habits.

*Blogger note: Feedback is not discussed here but we need to pay attention to measure the effects of changews we make and whether we are in effect, sticking to our new habits or backsliding and drifting back to procrastination, laziness or high calorie foods.

The transtheoretical model of health behavior change.


Cancer Prevention Research Center, University of Rhode Island, Kingston 02881-0808, USA. JOP@URIACC.URI.EDU


The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. 

Ten processes of change have been identified for producing progress along with decisional balance, self-efficacy, and temptations. Basic research has generated a rule of thumb for at-risk populations: 40% in precontemplation, 40% in contemplation, and 20% in preparation. 

Across 12 health behaviors, consistent patterns have been found between the pros and cons of changing and the stages of change. 

Applied research has demonstrated dramatic improvements in recruitment, retention, and progress using stage-matched interventions and proactive recruitment procedures. 

The most promising outcomes to data have been found with computer-based individualized and interactive interventions. 

The most promising enhancement to the computer-based programs are personalized counselors. 

One of the most striking results to date for stage-matched programs is the similarity between participants reactively recruited who reached us for help and those proactively recruited who we reached out to help. 

If results with stage-matched interventions continue to be replicated, health promotion programs will be able to produce unprecedented impacts on entire at-risk populations.
[PubMed - indexed for MEDLINE]