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Transtheoretical Model (transtheoretical + model)
Selected AbstractsProgressive stage transition does mean getting better: a further test of the Transtheoretical Model in recovery from alcohol problemsADDICTION, Issue 6 2009Nick Heather ABSTRACT Aims To test two central assumptions of the Transtheoretical Model (TTM) regarding recovery from alcohol problems: (i) individuals making a forward transition from pre-action to action stages will show greater drinking improvements than those remaining in pre-action stages; and (ii) individuals remaining in pre-action stages will not demonstrate improvements in drinking outcomes. Design and setting Large, multi-centre, randomized controlled trial of treatment for alcohol problems [United Kingdom Alcohol Treatment Trial (UKATT)]. Measurements Stage of change, drinks per drinking day and percentage days abstinent at baseline, 3- and 12-month follow-ups. Findings In support of TTM assumption 1, improvements in drinking outcomes were consistently greater among clients who showed a forward stage transition (Cohen's d = 0.68) than among those who did not (d = 0.10). Two tests of assumption 2 showed a significant improvement in drinking outcomes in non-transition groups, inconsistent with the TTM; one test showed a significant deterioration and the other showed equivalent drinking outcomes across time. An explanation is offered as to why, under the relevant assumption of the TTM, clients in non-transition groups showed small changes in drinking outcomes. Conclusions In contrast to a previous study by Callaghan and colleagues, our findings largely support the TTM account of recovery from alcohol problems in treatment. The discrepancy can be explained by the use in our study of a more reliable and valid method for assigning stage of change. [source] Do the Transtheoretical Model processes of change, decisional balance and temptation predict stage movement?ADDICTION, Issue 5 2009Evidence from smoking cessation in adolescents ABSTRACT Aims To examine the effects of processes of change (POC) on forward stage movement directly, indirectly through decisional balance and temptation, and total effects as a test of the key hypothesis of the Transtheoretical Model (TTM). Design Prospective cohort study. Setting United Kingdom. Participants A total of 1160 adolescents aged 13,14 years who were current or former smokers at baseline. Measurements Stage was assessed with the standard algorithm three times, once every 3 months. On each occasion the POC, decisional balance and temptation were measured with the standard questionnaires. Path analysis was used to examine the direct, indirectly mediated and total contribution of POC and the other constructs to stage movement 3 months later. Findings Four of the 24 analyses showed evidence that the theoretically appropriate POC predicted stage transition, with statistically significant total effects. Effect sizes were small. When the POC were summarized to experiential and behavioural process means, one transition from pre-contemplation was predicted by experiential processes and, contrary to the TTM, one transition predicted by behavioural processes. There was slightly more evidence that decisional balance (attitudes towards smoking) and temptation (ability to resist the urge to smoke) was associated with stage transition. Conclusions POC use was not associated generally with stage transition and evidence that effects, if missed, must be modest, giving no support to the central tenet of the TTM. [source] Does progressive stage transition mean getting better?ADDICTION, Issue 10 2007A test of the Transtheoretical Model in alcoholism recovery ABSTRACT Aims To test two central assumptions of stage movement in the Transtheoretical Model (TTM) vis-à-vis alcoholism recovery: (assumption 1) individuals making a forward transition to the action-oriented stages (i.e. preparation/action) will manifest relatively greater drinking improvements than their counterparts remaining in the pre-action stages (i.e. pre-contemplation, contemplation); and (assumption 2) individuals remaining in the pre-action stages across time will not demonstrate clinically relevant improvement in drinking outcomes. Design and setting Secondary data analyses of data from Project MATCH, a large multi-site alcoholism treatment-matching study. Measurements At baseline and 3 months post-treatment, the following variables were measured: stage-of-change (based on the University of Rhode Island Change Assessment measure and the most recent stage assignment algorithm), drinks per drinking day (DDD) and percentage days abstinent (PDA). Findings Six of the eight tests of assumptions 1 and 2 failed to support the basic tenets of the TTM. Our study demonstrated that individuals making a progressive stage transition to the action-oriented stages (i.e. preparation/action) do not necessarily manifest greater improvements in drinking-related behavior than individuals remaining in the pre-action stages (i.e. pre-contemplation, contemplation), and that individuals remaining in the pre-action stages over time actually do manifest statistically significant and clinically important improvements in drinking-related behavior. Conclusions Our findings challenge not only the criterion validity associated with stage movement in the TTM account of alcoholism recovery, but also recent TTM-based substance abuse treatment approaches which systematically promote forward stage transition as a primary clinical goal and marker of therapeutic success. [source] Does stage-based smoking cessation advice in pregnancy result in long-term quitters?ADDICTION, Issue 1 200518-month postpartum follow-up of a randomized controlled trial ABSTRACT Aims To evaluate the effect on quitting smoking at 18 months postpartum of smoking cessation interventions based on the Transtheoretical Model (TTM) delivered in pregnancy compared to current standard care. It has been claimed that TTM-based interventions will continue to create quitters after the end of the intervention period. Design Cluster randomized trial. Setting Antenatal clinics in general practices in the West Midlands, UK. Participants A total of 918 pregnant smokers originally enrolled in the trial, of which 393 women were followed-up at 18 months postpartum. Interventions One hundred general practices were randomized into the three trial arms. Midwives in these practices delivered three interventions: A (standard care), B (TTM-based self-help manuals) and C (TTM-based self-help manuals plus sessions with an interactive computer program giving individualized smoking cessation advice). Measurements Self-reported continuous and point prevalence abstinence since pregnancy. Findings When combined together, there was a slight and not significant benefit for both TTM arms compared to the control, with an odds ratio (OR) 95% confidence interval (CI) of 1.20 (0.29,4.88) for continuous abstinence. For point prevalence abstinence, the OR (95%CI) was 1.15 (0.66,2.03). Seven of the 54 (13%) women who had quit at the end of pregnancy were still quit 18 months later, and there was no evidence that the TTM-based interventions were superior in preventing relapse. Conclusions The TTM-based interventions may have shown some evidence of a short-term benefit for quitting in pregnancy but no benefit relative to standard care when followed-up in the longer-term. [source] The psychological determinants of low-rate daily smokingADDICTION, Issue 10 2004Jean-François Etter ABSTRACT Aims To compare low-rate daily smokers (one to five cigarettes/day) with other daily smokers, using the Transtheoretical Model of Change as a framework. Design Mail survey with a follow-up after 7 months. Setting A randomly selected population sample in French-speaking Switzerland, in 1998. Participants A total of 2338 daily smokers aged 25 + years, including 95 smokers of one to five cigarettes/day, 324 smokers of six to 10 cigarettes/day, 399 smokers of 11,15 cigarettes/day and 1520 smokers of 16 + cigarettes/day, and 1765 people (75% of 2338) at 7-month follow-up. Findings Compared with smokers of 16 + cigarettes/day, low-rate smokers of one to five cigarettes/day included more women (67% versus 46%, P < 0.001), were 4 years younger (P < 0.001), were less motivated to quit smoking (62% versus 37% in the ,precontemplation' stage of change, P < 0.001), thought that quitting would be easier (,3.4 points on a 0,10 scale, P < 0.001) and were less bothered by the risk of smoking. Low-rate smokers were taking control more actively over their smoking, e.g. they more often stayed away from places where people smoked, sat in the no-smoking sections in public places and tried to delay as much as they could their first cigarette of the day. Only 45% of low-rate smokers were still in the same category 7 months later. Conclusions For many smokers, low-rate smoking may result from a conscious effort to limit their cigarette consumption. Being a low-rate smoker was a temporary condition for most people. Low-rate smokers should be considered as a specific, although heterogeneous group. [source] Developing theory-based risk-reduction interventions for HIV-positive young people with haemophiliaHAEMOPHILIA, Issue 1 2001J. R. Schultz Eleven haemophilia treatment centres in the United States collaborated in the Hemophilia Behavioural Intervention Evaluation Projects (HBIEP) to develop theory-based interventions to reduce the risk of HIV transmission from seropositive adolescents and young adults with haemophilia. While the Transtheoretical Model of Behaviour Change and the Theory of Reasoned Action provided the theoretical underpinnings, the exact form in which these theories would be applied depended on developmental research. This paper presents the various phases of the process to develop the theory based interventions: literature review, qualitative interviews, quantitative surveys, a provider survey, a materials review, and the actual planning. All or portions of this process could be applied to the development of interventions for many behaviour-change projects. A description of the HBIEP interventions is also provided. [source] Physical Exercise in Chinese Older Adults: A Transtheoretical Model,JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2006Kee-Lee Chou Physical exercise has a positive impact on physical and mental health among older adults. This study identifies significant correlates of exercise behavior among Hong Kong Chinese older adults under the transtheoretical model. The data came from a survey of a representative community sample of 425 elderly respondents in Hong Kong. Using multiple regression models, the authors found that perceived benefits of exercise and self-efficacy for exercise were related significantly to exercise behavior, and their effects on exercise were mediated completely through the stages of changes in exercise. Although perceived barriers to exercise are significantly and negatively associated with exercise behavior, this relationship disappeared in multiple regression analysis after controlling demographic and several health-related variables. Findings suggest that perceived benefits and self-efficacy on exercise should be strengthened to motivate older adults to engage in a more active lifestyle. [source] Women's readiness to follow milk product consumption recommendations: design and evaluation of a ,stage of change' algorithmJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2001P. Gulliver Objective To investigate readiness to follow milk product consumption recommendations in two random samples of New Zealand women, using an algorithm designed and evaluated to assess the stage of change construct of the Transtheoretical Model. Protocol Women were classified according to stage of readiness to perform two goal behaviours: consumption of two or four servings of milk products per day. Stage classification, as determined by the algorithm, was evaluated by estimating mean calcium intake in each stage using a validated food frequency questionnaire. This was undertaken in two independent samples of women randomly selected from the electoral rolls of two cities in New Zealand's South Island. Results Over 60% of women were classified as maintaining an intake of two servings of milk products per day. Of those women not meeting the goal of two servings per day, 73% had no intention of increasing their consumption. Over 80% of women were in the precontemplation stage for consuming four servings of milk products per day. Mean calcium intakes were significantly higher in women classified in action and maintenance stages than in preaction stages of change for both goal behaviours. Conclusion Of those women not currently meeting the recommendation for two servings of milk products per day, most are in precontemplation, a stage characterized by resistance to change. Use of the staging algorithm developed in this study makes possible the classification of women according to their readiness to change, and thus the provision of appropriate stage-tailored advice. [source] Stages of Change, Processes of Change, and Social Support for Exercise and Weight Gain in Postpartum WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 2 2006Colleen Keller Objectives:, To test the extent to which social support and variables included in the Transtheoretical Model were explanatory for exercise initiation and weight maintenance in postpartum women. Design:, A cross-sectional descriptive design. Setting:, Data were collected in the participant's homes. Participants:, Postpartum women who had normal pregnancies were interviewed and measured on body fat, physical activity, and psychosocial scales. Main outcome measure:, (a) Stages of exercise change measure, (b) Seven Day Recall, (c) Friend and Family Support for Exercise Scale, (d) Processes of Change Questionnaire, and (e) body fat measures including body mass index and percent body fat. Results:, Forty percent reported engaging in vigorous activity less than 1 hour daily, 55% walked less than four city blocks daily, and 52% engaged in less than 2 hours of vigorous weekend activity. Multilinear regression showed that the processes of change contributed 36% to the body mass index, and 21% of the variance in waist-thigh ratio. Of the processes of change, environmental reevaluation correlated significantly with body mass index. Conclusion:, The impact of a woman's weight on others as well as information concerning the health effects of obesity and physical activity could enhance the initiation of exercise in the postpartum woman. JOGNN, 35, 232-240; 2006. DOI: 10.1111/J.1552-6909.2006.00030.x [source] Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patientsPSYCHO-ONCOLOGY, Issue 10 2006Cindy L. Carmack Taylor Abstract Background: Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). Method: A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. Results: Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. Conclusions: Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients. Copyright © 2006 John Wiley & Sons, Ltd. [source] Mismatch in the Transtheoretical Model?THE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2006Russell C. Callaghan PhD No abstract is available for this article. [source] Outcome Evaluation of ,Sharing the Gift of Life': An Organ and Tissue Donation Educational Program for American IndiansAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010N. L. Fahrenwald Culturally focused education about deceased donation is needed for American Indians (AIs). This study tested a program designed to impact intention to serve as a deceased donor for reservation dwelling AIs. A pre/posttest design and a community-based participatory research approach were used. The study was based upon the Transtheoretical Model. Adult participants (N = 1580, 58% women) were from four Northern Plains reservations. An outreach coordinator delivered the program using print and video materials. The outcome was stage of motivational readiness (SMR) to serve as a deceased donor. McNemar's test was used to compare pre- to postintervention changes in SMR. At baseline, 55% of participants were not thinking about being a donor (precontemplation stage) and 45% were thinking about it (contemplation stage). Postintervention, 43.1% of participants were unchanged in SMR and 56.9% progressed in SMR. Of those who progressed, 26.5% (n = 418) changed to the contemplation stage, 19.4% (n= 306) changed to the preparation stage (signed a donor card or joined a registry), and 11.1% (n = 175) confirmed a discussion of the decision with family (action stage). Progression in SMR from pre/post was significant, ,2(1) = 18.32, p < 0.05. The intervention resulted in important changes in deceased donor intentions for reservation dwelling AIs. [source] Evaluating Theories of Health Behavior Change: A Hierarchy of Criteria Applied to the Transtheoretical ModelAPPLIED PSYCHOLOGY, Issue 4 2008James O. Prochaska The most common criteria recommended by philosophers of science for evaluating theories were organised within a hierarchy ranging from the least to the most risky tests for theories of health behavior change. The hierarchy progressed across: (1) Clarity; (2) Consistency; (3) Parsimony; (4) Testable; (5) Predictive Power; (6) Explanatory Power; (7) Productivity; (8) Generalisable; (9) Integration; (10) Utility; (11) Efficacy; and (12) Impact. The hierarchy was applied to the Transtheoretical Model (TTM) as an example of a health behavior change theory. The application was from the perspective of critics and advocates of TTM. Examples of basic and applied research challenging and supporting TTM across the hierarchy of criteria are presented. The goal is to provide a model for comparing alternative theories and to evaluate progress across the hierarchy within a particular theory. As theories meet criteria at each step in the hierarchy, the research and applications they generate can have increasing impacts on the science and practice of health behavior change. Les critères les plus courants mis en avant par les philosophes des sciences pour l'évaluation des théories ont été structurés dans le cadre d'une hiérarchie allant des épreuves les moins aux plus exigeantes en ce qui concerne les théories portant sur les changements de comportement relatifs à la santé. Cette hiérarchie progresse ainsi: 1) Clarté; 2) Cohérence; 3) Economie; 4) Accès à la vérification; 5) Pouvoir prédictif ; 6) Pouvoir explicatif; 7) Valeur heuristique; 8) Possibilités de généralisation; 9) Intégration; 10) Utilité; 11) Efficacité; 12) Impact. Cette hiérarchie a été appliquée au Modèle Transthéorique (TTM) pris comme exemple de théorie du changement comportemental liéà la santé, aussi bien du point de vue des défenseurs que des critiques du TTM. On présente des exemples de recherches fondamentales et appliquées mettant à l'épreuve ou confirmant le TTM à partir de la hiérarchie des critères. L'objectif est d'avoir un modèle permettant de comparer différentes théories et d'évaluer la progression d'une théorie particulière le long de la hiérarchie. Comme les théories trouvent un critère à chaque échelon de la hiérarchie, les recherches et les applications qu'elles génèrent peuvent avoir des retombées croissantes sur la science et la pratique du changement de comportement relatif à la santé. [source] Cluster Subtypes within the Preparation Stage of Change for Sun Protection BehaviorAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2010Marimer Santiago-Rivas Objective: Numerous effective tailored interventions for smoking cessation and other behaviors have been developed based on the Transtheoretical Model. Recent studies have identified clusters within each stage of change. The goal of this study is to determine if replicable clusters exist within the Preparation stage of change for sun protection. Method: Secondary data analysis of baseline data from a sample of participants in a home-based expert system intervention was performed. Two random samples of approximately 128 participants were selected from subjects in the Preparation stage (N = 258). Cluster analyses were performed using Ward's Method on the standardised scores from the three scales of Pros, Cons, and Self-Efficacy. Interpretability of the pattern, pseudo F test, and dendograms were used to determine the number of clusters. Results: A four-cluster solution replicated across subsamples. Differences between clusters on eight of the nine Processes of Change, and on behavioral measures, were found. Discussion: The cluster solutions were robust, easily interpretable, and demonstrated good initial external validity. They replicated patterns found for other behaviors that have demonstrated long-term predictability and can provide the basis for a tailored intervention. [source] Smoking cessation intervention in parents of young children: a randomised controlled trialADDICTION, Issue 11 2005Abu Saleh M. Abdullah ABSTRACT Objective To examine whether telephone counselling based on the stages of change component of Transtheoretical model of behaviour change together with educational materials could help non-motivated smoking parents of young children to cease. Design Randomised controlled trial. Setting Hong Kong Special Administrative Region, PR China. Participants 952 smoker fathers and mothers of Chinese children aged 5 years. Intervention Participants were randomly allocated into two groups: the intervention group received printed self-help materials and three-session telephone-based smoking cessation counselling delivered by trained counsellors; the control group received printed self-help materials only. A structured questionnaire was used for data collection at baseline and at 1, 3 and 6 month follow up. Main outcome measures The main outcome is 7 day point prevalence quit rate at 6 months (defined as not smoking during the 7 days preceding the 6 month follow up) determined by self reports. Other secondary outcomes were self reported 24 h point prevalence quit rate and self-reported continuous quit rate and bio-chemically validated quit rate at 6 months. Results A total of 952 smoker fathers and mothers were randomized to the intervention (n = 467) and control (n = 485) groups. Most were daily smokers (92.4%) and the mean number of cigarettes smoked per day was 14.5 (SD = 8.9). By using intention-to-treat analysis, the 7 day point prevalence quit rate at 6 month follow up was significantly greater in the intervention group (15.3%; 68/444) than the control group (7.4%; 34/459) (P < 0.001). The absolute risk reduction was 7.9% (95% confidence interval: 3.78% to 12.01%). The number needed to treat to get one additional smoker to quit was 13 (95% CI: 8,26). The crude odds ratio of quitting was 2.3(95% CI: 1.5,3.5). The adjusted odds ratio was 2.1 (95% CI: 1.4,3.4) (adjusted for age, number of years smoked, and alcohol dependency). Conclusion Proactive telephone counselling is an effective aid to promote smoking cessation among parents of young children. [source] Collaborative care between professionals and non-professionals in the management of eating disorders: a description of workshops focussed on interpersonal maintaining factorsEUROPEAN EATING DISORDERS REVIEW, Issue 1 2007J. Treasure Abstract The aim of this paper is to describe the content and processes involved in a series of workshops for carers of people with an eating disorder. These workshops were designed to equip carers with the skills and knowledge needed to be a ,coach' and help the person with an eating disorder break free from the traps that block recovery. The first hurdle is to overcome the unhelpful patterns of interpersonal processes between the person with an eating disorder and their carers. In both naturalistic studies and randomised controlled trials (RCT), family factors have been implicated either as moderators or mediators of outcome. High levels of expressed emotion (EE), misattributions about the illness or unhelpful methods of engaging with the eating disorder symptoms contribute to this effect. These workshops aim to reduce EE such as over protection. Carers are introduced to the transtheoretical model of change and the principles of motivational interviewing so that they can help rather than hinder change. They learn how to use reflective listening to reduce confrontation and how to sidestep resistance. Carers learn what is needed to help their daughter change by reflecting on the processes involved in changing their own behaviours in relationship with the person with eating disorders. Once they recognise that they may need to change then they can use their skills, information and insight to help change eating disorder symptoms. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Predictors of mammography uptake in Korean women aged 40 years and overJOURNAL OF ADVANCED NURSING, Issue 2 2008Eunjung Ryu Abstract Title.,Predictors of mammography uptake in Korean women aged 40 years and over Aim., This paper is a report of a study performed to identify the predictors of mammography uptake for Korean women according to the stage of change, as determined by the transtheoretical model. Background., Although breast cancer is the most common female cancer in South Korea, its early detection rate here is low when compared with other developed countries. The transtheoretical model can be used to facilitate health promotion based on individual health behaviour and to devise stage-tailored interventions. Method., The participants were a convenience sample of 920 women aged ,40 years between December 2005 and February 2006. A cross-sectional design was used in which participants completed a questionnaire that consisted of measures of the transtheoretical model. To provide a standard of measure, the variables were converted from raw scores to standard scores and then to T scores (mean = 50, sd = 10). Logistic regression analysis was then used to estimate predictors of the stage of maintenance of mammography uptake. Findings., The most frequent stage of mammography uptake was ,contemplation'. Predictors of mammography uptake included decisional balance, commitment to regular screening and avoiding contact with the healthcare system. Commitment to regular screening and breast self-examination were strongly related to mammography maintenance. Conclusion., The results of this study can be used for the development of theory-based and empirically supported mammography uptake intervention strategies and programmes directed towards women aged ,40 years. [source] Physical Exercise in Chinese Older Adults: A Transtheoretical Model,JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2006Kee-Lee Chou Physical exercise has a positive impact on physical and mental health among older adults. This study identifies significant correlates of exercise behavior among Hong Kong Chinese older adults under the transtheoretical model. The data came from a survey of a representative community sample of 425 elderly respondents in Hong Kong. Using multiple regression models, the authors found that perceived benefits of exercise and self-efficacy for exercise were related significantly to exercise behavior, and their effects on exercise were mediated completely through the stages of changes in exercise. Although perceived barriers to exercise are significantly and negatively associated with exercise behavior, this relationship disappeared in multiple regression analysis after controlling demographic and several health-related variables. Findings suggest that perceived benefits and self-efficacy on exercise should be strengthened to motivate older adults to engage in a more active lifestyle. [source] Psychosocial Factors Associated With Stage of Change for Contraceptive Use Among Women at Increased Risk for HIV and STDsJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 5 2004Rebecca J. Cabral This study assessed the psychosocial factors associated with contraceptive use among inner-city women at risk for HIV/STDs by using the transtheoretical model of behavior change. The five-city study group of women aged 15 to 34 years was recruited from neighborhoods, social service agencies and shelters (n= 998). We measured stages of change for contraceptive use and assessed theoretically proposed factors associated with being at a higher stage. Variables such as perceived advantages of contraceptive use and normative support for use were very important at early stages, but less important in later stages. However, self-efficacy was important in both early (OR =1.5) and later (OR = 1.6) stages, suggesting that women's confidence in their ability to initiate and sustain contraceptive use is crucial. [source] Integrating the transtheoretical model into the management of overweight and obese adultsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2007Judy Gainey Seals NP, MSN (Cardiovascular Nurse Practitioner) Abstract Purpose: To show how the nurse practitioner (NP) can incorporate stage-specific interventions from the transtheoretical model in the management of overweight and obese adults. Data sources: Research articles, clinical articles, and government guidelines pertaining to the management of overweight and obesity in adults. Conclusions: Overweight and obesity are complex and chronic conditions that require lifelong management. The NP can help clients to safely and successfully lose weight by developing stage-specific interventions, by using an expert multidisciplinary team, and by providing ongoing monitoring and motivation. Implications for practice: The prevalence of overweight and obesity continues to increase at an alarming rate and is a major public health concern. The NP has an important role in the assessment and management of clients with this condition. [source] Obesity and Physical Activity in College Women: Implications for Clinical PracticeJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2004APRN-BC, Jacquelyn M. Clement PhD Purpose To investigate the relationships between levels of physical activity, health attitudes and behaviors, and specific health indicators in women attending college. Data Sources A convenience sample of 116 college women, ages 18 to 24 years, participated in this research study at a moderate-sized midwestern university. The data were obtained through self-administered questionnaire; trained technicians collected physiological measurements. Conclusions The young women in this study had, on average, normal body mass indexes (BMIs) and reported activity levels consistent with or greater than the Centers for Disease Control and Prevention/American College of Sports Medicine guidelines. Items used to assign participants into the appropriate stage of the transtheoretical model of change were correlated with participants' perceived personal physical activity levels. Similarly, the participants, whose scores fell in the higher stages of the transtheoretical model, reported greater levels of physical activity; consumption of more fruits, vegetables, and water; and less consumption of high-fat/high-calorie foods. Implications for Practice The years between ages 18 and 24 are a critical time in the lives of young women. During this period, they develop physical activity and nutrition habits that will affect their health across the life span. Because of the sometimes insidious development of major health problems, young women's current health status may not accurately reflect the possible longterm results of negative health habits. Nurse practitioners (NPs) have many opportunities to identify and address major factors that, if unattended, may threaten the life-long health status of women. Health teaching in the areas of physical activity and dietary habits may be useful even in young women who appear to be healthy, are of normal weight, and are physically active.Poor dietary habits, if unattended, may eventually contribute to the development of obesity and related illnesses. [source] Motivating Health: Strategies for the Nurse PractitionerJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2003Lynne S. Duran ARNP Purpose To provide the nurse practitioner (NP) with a practical prescription for acquiring expertise in health behavior change using integrated principles from the transtheoretical model of change and motivational interviewing. Data Sources Extensive literature review of current theory and research on health behavior change. Conclusion Expertise in motivating health behavior change is essential to effective health promotion and to the NP role. Implications for Practice Lifestyle choices are principal contributors to the leading causes of death and most chronic diseases in the United States. Traditional health behavior interventions are often ineffective in motivating and sustaining lifestyle change. [source] Tobacco Cessation Intervention in a Nurse Practitioner Managed ClinicJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2000Kathleen Reeve MSN ABSTRACT Tobacco cessation counseling by health care professionals has been associated with increased tobacco cessation rates. In this study we compare the effectiveness of two smoking cessation approaches administered by nurse practitioners , a stepped care approach (n = 34) and a routine care approach (n = 41), using a pre- and post-test control group study design. Additionally, this study was guided by the "stages of change" construct of the transtheoretical model. Study results indicated that nurse practitioners delivered consistent office-based advice about tobacco use. In addition, nurse practitioner smoking cessation interventions contributed to positive shifts in stage of change for smoking cessation. [source] Hemodialysis patient beliefs by stage of fluid adherenceRESEARCH IN NURSING & HEALTH, Issue 2 2001Janet L. Welch Abstract Fluid limitations are difficult for hemodialysis patients to follow, and factors related to fluid adherence are not well known. The primary purpose of this study, which was guided by the health belief model and the transtheoretical model for behavior change, was to determine whether differences exist in perceived benefits, barriers, susceptibility, seriousness, or self-efficacy among individuals in different stages of fluid adherence. In a cross-sectional descriptive design, 148 persons (mean age=53.9 years; 52% male) were interviewed using a structured format. Hemodialysis patients in the action/maintenance stage perceived significantly more benefits to fluid adherence than persons in the precontemplation stage. Persons who were in the action/maintenance stage perceived they were significantly more susceptible to pulmonary edema than persons in the contemplation stage. Stage-appropriate interventions may be needed to target specific beliefsabout fluid adherence. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24: 105,112, 2001 [source] | |||||||||||||