PU505 Health Behavior Unit 7 Transtheoretical Model

Question 1

What is the essence sentence of this model?

Answer 1

Behavior change is a process that occurs in stages

Question 2

What are the constructs of the Transtheoretical Model?

Answer 2

Stages of change - when progress towards change happens

Decisional balance - weighing the pros and cons of change

Processes of change - how progress toward change happens

Self-efficacy - one’s belief in one’s ability to do something

Question 3

Why was this theory developed?

Answer 3

To understand HOW people change behaviors; in particular, addictive behaviors such as smoking and drug and alcohol use

Question 4

What is the concept of this theory?

Answer 4

Behavior change is a process that occurs in stages. As people attempt to change behavior, they move through different stages using a variety of processes to help them get from one stage to the next until the desired behavior is attained. Thus, this theory is referred to the stages of change.

Question 5

What are the 5 stages of change?

Answer 5

Pre-contemplation, contemplation, preparation, action, and maintenance.

Question 6

When are people in the pre-contemplation stage?

Answer 6

6 months before they start thinking about changing a behavior to the point when they do start thinking of the behavior.

• Typically, the person with the behavior, does not know that the behavior is unhealthy because they are uninformed or underinformed about the health consequences, or they aren’t ready to change a behavior they know they should. This can be underinformed or uninformed about the benefits of changing as well.
• Albacore vs chunk light tuna. Once you are AWARE of the mercury content of albacore tuna, you might think of changing your tuna eating behavior to chunk light tuna.

Question 7

What are other situations where someone might be in the pre-contemplation stage of change?

Answer 7

People are also in the pre-contemplation stage when they don’t or won’t recognize they have a problem or aren’t ready to admit it to themselves. We see this with depression (Levit et al., 2016), alcoholism, and when older people aren’t ready to admit they can’t drive anymore.

Question 8

When do people enter the contemplation stage of change?

Answer 8

When people move from pre-contemplation to contemplation, it means they recognize there is a problem and have started thinking about making a change. Really ANYTHING can cause someone to start thinking about change.

Question 9

What is the process of weighing the perceived pros (benefits) and cons (costs and barriers) of the new behavior against the old (Prochaska, 1994) and then making a decision?

Answer 9

Decisional balance.

Thinking about doing something and deciding to do something are two different things. Deciding to do something is the goal within the contemplation stage of change.

Question 10

What are other examples of decisional balance utilized in behavior change?

Answer 10

• Family planning and contraception use in sub-Sahara African families
• HPV vaccination among college students
• Condom use
• Women in domestic violence

Question 11

T/F Decisional balance within the contemplation stage of change holds true for behaviors changing from healthy to unhealthy, not just unhealthy to healthy.

Answer 11

True.

This can be applied to androgenic-anabolic steroids use.

Question 12

Once people start thinking of changing a behavior, they will make a decision and plan to change within how many months?

Answer 12

6 months.

However, this does not hold true for everyone. Sometimes this can be longer or shorter.

Question 13

What do we call someone when they are in the contemplation stage for longer than 6 months preventing them from making a decision?

Answer 13

When it takes more than 6 months to make a decision, this is behavioral procrastination or chronic contemplation.

Question 14

When does someone enter the preparation stage of the stages of change?

Answer 14

Once the decision to change is made, and is a very short stage which only last about a month.

Since people have made the decision, they want to start as soon as possible.

At this point, people work to get anything they need to make the change. Child care, transportation, tool, housing, etc.

Question 15

What determines the simplicity or complexity of the preparation stage of change?

Answer 15

It depends on the change being undertaken.

Question 16

After the preparation stage of change is complete, how many months are spent on putting the plan into action (action is a stage of change)?

Answer 16

The next 6 months are spent implementing or putting the plan into action.

People in this stage are in the active process of modifying their behavior with the goal being a changed behavior.

Question 17

When do people know if their action taken is successful, and the behavior is changed?

Answer 17

The new behavior is measured against the old one.

Question 18

What is the final stage of change in which people work (and sometimes struggle) to prevent relapsing to the old behavior and how long does this stage last?

Answer 18

Maintenance.

6 months after the action stage and can go on for 6 months to many years, as is the case with recovering alcoholics or other substance abusers.

Question 19

What does the construct of self-efficacy play a role in within the stages of change?

Answer 19

Not only does it play a major role in only how successful people are in changing their behavior, that is moving from pre-contemplation to maintenance, but also in MAINTAINING the change.

Question 20

What construct within TTM helps understand HOW change occurs?

The stages of change help us understand WHEN people change their behavior.

Answer 20

The processes of change (Prochaska & DiClemente, 1982).

Processes of change are the things people do that help them work through the stages of changing their behavior (de Freitas et al., 2020).

Question 21

How many processes of change are there that help people move through the changes cognitively or behaviorally?

Answer 21

10

Question 22

The categories of the processes of change are cognitive and behavioral. What are the processes of change for both? Cognitive (5) and Behavioral (5).

Answer 22

For Cognitive:
- Consciousness raising
- Dramatic relief
- Environmental reevaluation
- Social liberation
- Self-reevaluation

For Behavioral:
- Stimulus control
- Helping relationships
- Counter conditioning
- Reinforcement management
- Self-liberation

Question 23

What does the consciousness raising of the cognitive process of change include?

Answer 23

It is the process whereby people obtain information about themselves and the problem behavior. It is how people become aware of the problem, its causes, consequences, and what can be done about it.

Question 24

What, also referred as emotional arousal, deals with expressing feelings about or reacting emotionally to the behavior in question (Prochaska et al., 1992; Velicer et al., 1998) and the possible solutions?

Answer 24

Dramatic relief. (a cognitive process of change)

This can be talking to someone about how they loathe the behavior, admitting their behavior hurts people or costs money, etc.

Question 25

What does environmental reevaluation of the cognitive process of change include?

Answer 25

This process involves looking at the behavior being changed (old behavior) in light of its impact or effect on the physical and social environments.

This can be particularly useful in adopting more altruistic behaviors for instance, donating blood. Environmental reevaluation may take the form of thinking about how donating blood would help the larger community or how it might save a life (Amoyal et al., 2013).

Question 26

What is the process whereby options or alternatives are sought that support the new behavior?

Answer 26

Social liberation (a cognitive process of change)

Question 27

What does self-reevaluation of the cognitive process of change include?

Answer 27

It is the process in which people look at themselves with and without the problem behavior and assess the differences in their self-esteem,

Question 28

What is a behavioral process of change used when people remove the cues or triggers for the problem behavior from their environment?

Answer 28

Stimulus control.

You did this by no longer hanging out with friends who drank, removing the trigger to drink as well since other people were drinking around you.

Question 29

What is a behavioral process of change that are relationships with people who act as a support system for changing the unwanted, unhealthy behavior?

Answer 29

Helping relationships.

This could be a roommate who agrees to keep only fruit to snack on in the room or the sponsor in a 12-step program who is there whenever the urge to drink hits. It can be a neighbor who calls another neighbor at 7 a.m. to confirm they are meeting for their morning walk.

Question 30

What is a behavioral process of change where a healthier behavior is substituted for the unhealthy one?

Answer 30

Counter conditioning.

In my own words, these are healthier changes that happen during the time that would have been spent on unhealthy behaviors. Like reading 1 hour before bed, instead of playing video games.

Question 31

What is a behavioral process of change that constitutes rewards and punishments?

Answer 31

Reinforcement management.

Although fear or negative consequences can be used for changing unwanted behavior, rewards for engaging in targeted behavior are more natural.

Question 32

What is a behavioral process of change where people choose to change their behavior, believe they can, and commit to making the change?

Answer 32

Self-liberation. People free themselves from a behavior in which they no longer choose to engage.

Question 33

What are the stages, in order, of the transtheoretical model and their respective processes of change?

Answer 33

Precontemplation
- Consciousness raising
- Dramatic relief
- Environmental reevaluation

Contemplation
- Self-evaluation
- Social liberation
- Helping relationships
- Dramatic relief

Preparation
- Self-liberation

Action/Maintenance
- Counter conditioning
- Helping relationships
- Reinforcement management
- Stimulus control

Question 34

Processes and Strategies for moving through the stages of changes

Answer 34

Processes and Strategies for moving through the stages of changes

Question 35

Example: Strategies Used for Processes of Change in a Smoking Cessation Program

Answer 35

N/A

Question 36

What is an important part of program/intervention planning, implementation, and evaluation?

Answer 36

SMART objectives

Question 37

How are objective types referred as?

Answer 37

Process objectives

Behavioral objectives

Outcome objectives

Question 38

What are objectives that provide the groundwork or implementation necessary to achieve your other objectives?

Answer 38

Process objectives

Question 39

What are objectives that look at changing behaviors of people (what they are doing and saying) and the products (or results) of their behaviors?

Answer 39

Behavioral objectives

Question 40

What are objectives that are often the product or result of behavior change in many people?

They are focused on change that occurs as a result of the program/intervention strategies.

Answer 40

Outcome objectives