A randomized clinical trial of a population- and transtheoretical model-based stress-management intervention.

Evers, Kerry E.; Prochaska, James O.; Johnson, Janet L.; Mauriello, Leanne M.; Padula, Julie A.; Prochaska, Janice M.

doi:10.1037/0278-6133.25.4.521

Cited by 100 publications

(127 citation statements)

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Section: Discussionmentioning

confidence: 92%

“…In the national population trial funded by NIH, there was a true no treatment control group that showed only 40% progressing to effective stress management at six months. Further, the outcomes for both the TTM tailoring and control groups were maintained at 12 and 18 months follow-up (Evers et al, 2006).In this Oregon Worksite Wellness study, the TTM Tailoring (73.9%) and the MI Coaching (78.2%) had even greater efficacy than before (Evers et al, 2006). These results are important in their own right given the effects of stress on personal well-being, health, health care utilization and productivity.…”

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confidence: 85%

“…TTM-In addition to the HRI described above, TTM assessments and tailored feedback on each construct (stage, pros, cons, efficacy, processes) relevant to the participant's stage for a particular risk behavior were provided online using Pro-Change LifeStyle Management Programs (Evers et al, 2006; Johnson et al, in press). Participants could interact online with up to four tailored intervention programs (stress, exercise, smoking, weight management), depending on what they were at risk for at baseline (see Table 1).…”

Section: Interventionsmentioning

confidence: 99%

“…The intended outcome of these MI sessions was for clients to resolve ambivalence (a central goal), move through the stages of change (Prochaska, 1979), and follow through on desirable lifestyle change, which would ideally result in reduced health risks and improved health outcomes. Health coaches were supervised by a MI specialist who is part of the Motivational Interviewing Network of Trainers (MINT).TTM-In addition to the HRI described above, TTM assessments and tailored feedback on each construct (stage, pros, cons, efficacy, processes) relevant to the participant's stage for a particular risk behavior were provided online using Pro-Change LifeStyle Management Programs (Evers et al, 2006; Johnson et al, in press). Participants could interact online with up to four tailored intervention programs (stress, exercise, smoking, weight management), depending on what they were at risk for at baseline (see Table 1).…”

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confidence: 99%

“…TTM tailored print feedback has been found to be effective with a broad range of single health behaviors including smoking (e.g., Prochaska et al, 1993, stress (Evers et al, 2006), medication adherence mammography (Rakowski et al, 1998), diet (Greene et al, in press), sun protection (Weinstock et al, 2002), exercise (Marcus et al, 1998;Velicer et al, 2006), and depression (Levesque et al, 2007). TTM tailored print feedback has also been found effective when treating: 1) three health behaviors in a population of parents whose teens were participating in health promotion at school (Prochaska et al, 2004); 2) four behaviors in a population of primary care patients (Prochaska et al, 2005); 3) three behaviors in a population of patients with diabetes (Jones et al, 2003) and 4) three behaviors in a population of overweight individuals (Johnson et al, in press).…”

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confidence: 99%

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Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion

Prochaska¹,

Butterworth²,

Redding³

et al. 2008

Preventive Medicine

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Objective-This study was designed to compare the initial efficacy of Motivational Interviewing (MI), Online Transtheoretical Model (TTM) Tailored communications and a brief Health Risk Intervention (HRI) on four health risk factors (inactivity, BMI, stress and smoking) in a worksite sample.Method-A randomized clinical trial assigned employees to one of three recruitment strategies and one of the three treatments. The treatment protocol included an HRI session for everyone and in addition either a recommended three TTM online sessions or three MI in person or telephone sessions over 6 months. At the initial post-treatment assessment at six months, groups were compared on the percentage who had progressed from at-risk to taking effective action on each of the four risks.Results-Compared to the HRI only group, the MI and TTM groups had significantly more participants in the Action stage for exercise and effective stress management and significantly fewer risk behaviors at 6 months. MI and TTM group outcomes were not different. Conclusion: This was the first study to demonstrate that MI and online TTM could produce significant multiple behavior changes. Future research will examine the long-term impacts of each treatment, their cost effectiveness, effects on productivity and quality of life, and process variables mediating outcomes. KeywordsMultiple behavior change; Motivational Interviewing; TTM Tailoring; exercise; stress; smoking; BMI Increasingly it is recognized that a major barrier to dissemination of evidence-based health promotion programs is that most programs were not designed or developed to reach at-risk populations (Glasgow et al., 2003). They were designed for and evaluated on self-selected samples of at-risk individuals. For example, in the United States Public Health Services Corresponding Author: James O. Prochaska, Ph.D., Cancer Prevention Research Center, 2 Chafee Road, University of Rhode Island, Kingston, RI 02881, Tel: 401-874-2830, Fax: 401-874-5562, jop@uri.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. 1996 Clinical Guidelines for the Treatment of Tobacco, over 3,000 studies on tobacco were identified. The Guidelines were able to recommend a broad range of evidence-based interventions for motivated smokers; i.e., those prepared to quit in the next month (Fiore et al., 1996). There were no evidence-based interventions recommended for unmotivated smokers, even though they make up more than 80% of all U.S. smokers (Velicer et al., 1995) and more than 90% of daily smokers (Wewers et al., 2003). In the second edition of the Guidelines there w...

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Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 85%

Section: Interventionsmentioning

confidence: 99%

mentioning

confidence: 99%