NUTR 3070 Chapter Notes - Chapter 10: Decisional Balance Sheet, Transtheoretical Model
11 May 2020
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Article Ten – Is There Something Beyond Stages of Change in the Transtheoretical Model? The
State of Art for Physical Activity - Romain
Purpose
• Transtheoretical model (TTM) & PA
o Although the stages of change (SOC) are the most popular part of the TTM,
notably because of their ease of use and scoring, they also constitute its most
descriptive construct; however, many interventions have focused on it
• This study sought to encourage researchers to go beyond stages of change when using
the TTM
o Stages of change are a construct, not a theory, and should not be used to tailor
PA interventions
o Theory based interventions are better (framework) & effectively increase PA
o The key regulatory components of the TTM (self-efficacy, decisional balance,
temptation, and change) should be used to individualize counseling to physical
activity.
o Moreover, the specific role of the processes of change in health education
towards a more physically active lifestyle represents a future area of research.
o World is facing increasing physical inactivity
Methods
• Narrative review with five objectives:
o briefly provide an overview of the TTM and the mediators of change on which it
is based,
o discuss studies examining longitudinal associations between PA change and TTM
mediators,
o outline TTM-validated questionnaires,
o examine the efficacy of TTM-based interventions for PA promotion,
o debate future TTM challenges.
Results
• SOC is influenced by mediators of change (decisional balance, temptation, self-efficacy,
and processes of change – POC)
Conclusions
• Old RCTs found that TTM-based interventions induce a small to medium effect size for
PA behavior change
o Recent reviews have found that using more of the TTM constructs (self-efficacy,
decisional balance, and change) result in a much larger effect size
o Self-efficacy and processes of change (POC) were the most effective components
to modulate PA, whereas SOC were not
• IN CONCLUSION: although TTM has some weaknesses, TTM-based interventions
increase PA levels in inactive adults when implemented beyond stages of change (SOC)
