Transtheoretical Principles and Processes for Adopting Physical Activity: A Longitudinal 24-Month Comparison of Maintainers, Relapsers, and Nonchangers

Abstract

This study examined longitudinal differences in use of transtheoretical model (TTM) behavior change constructs in maintainers (who reached and maintained exercise guidelines), relapsers (who reached guidelines, then regressed), and nonchangers (who did not reach guidelines). Data from two population-based TTM-tailored randomized trial intervention groups targeting exercise behavior (N = 1050) were pooled, and analyses assessed differences in TTM constructs between the three groups at baseline, 12 months, and 24 months. Findings indicated that relapsers tended to use TTM variables similarly to maintainers with the exception of self-efficacy, consciousness raising, and most behavioral processes of change, at 24 months. Nonchangers, however, used all TTM variables less than maintainers at nearly every time point. Findings suggest that relapsers remain more active than nonchangers in terms of use of change processes. Poor response to interventions (nonchangers) may be predicted by low baseline engagement in change processes. Although relapsers reverted to physical inactivity, their overall greater use of TTM constructs suggests that their efforts to change remain better than those of the stable nonchanger group. Future research can focus on treatment engagement strategies to help the stable nonchangers initiate change and to help relapsers to maintain treatment gains.

Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials

“…In fact, self-efficacy was able to predict the transition out of preaction stage, the retention in the maintenance stage of change, as the relapse to earlier stages. 33 , 34 , 35 …”

Factors Associated With Weight Intervention Participation Among People With Serious Mental Illness

“…Positive relationships between both an individual’s level of self-efficacy (SE) and readiness to change (RtC), and subsequent participation in weight loss interventions, have been demonstrated within the general population, as well as within the SMI population (Lipschitz, 2015; Marcus et al, 1992; Vancampfort et al, 2014). SE, an individual’s confidence in his/her ability to carry out a specific behavior, is a significant predictor of health-related behaviors both in the general population and amongst individuals with SMI (Bandura, 1977; Richardson et al, 2005).…”

Profiles of behavior change constructs for reducing alcohol use in women at risk of an alcohol-exposed pregnancy.

“…The primary focus of the controversy is whether the behavior change process is best represented by distinct stages or a more continuous process defined by early, more cognitive/experiential tasks and by later, more action oriented tasks. However, whether the change process is delineated by discrete stages or a continuous path, research provides considerable evidence that the TTM mechanisms and markers of change interact in consistent patterns as individuals move toward successful behavior change (DiClemente, 2003; Fava, Velicer, & Prochaska, 1995; Hall and Rossi, 2008; Heather, Hönekopp & Smailes on behalf of the UKATT Research Team, 2009; Lipschitz et al, 2015; Perz, DiClemente, & Carbonari, 1996; Prochaska, DiClemente, & Norcross, 1992; Prochaska, Velicer, Rossi, et al, 1994; Rosen, 2000), and that successful changers, with and without treatment, share common pathways to change (Sun, Prochaska, Velicer, & Laforge, 2007).…”