Transtheoretical model of behaviour change

doi:10.1017/CBO9780511543579.050

Transtheoretical model of behaviour change

from Psychology, health and illness

Published online by Cambridge University Press: 18 December 2014

Edited by

John Weinman and

Stephen Sutton: Affiliation:
University of Cambridge
Susan Ayers: Affiliation:
University of Sussex
Andrew Baum: Affiliation:
University of Pittsburgh
Chris McManus: Affiliation:
St Mary's Hospital Medical School
Stanton Newman: Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston: Affiliation:
Vanderbilt University School of Nursing
John Weinman: Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West: Affiliation:
St George's Hospital Medical School, University of London

Book contents

Get access

Summary

Stage theories of health behaviour assume that behaviour change involves movement through a set of discrete stages, that different factors influence the different stage transitions and that interventions should be matched to a person's stage (Sutton, 2005; Weinstein et al., 1998).

The transtheoretical model (TTM; Prochaska & DiClemente, 1983; Prochaska et al., 1992, 2002; Prochaska & Velicer, 1997) is the dominant stage model in health psychology and health promotion. It was developed in the 1980s by a group of researchers at the University of Rhode Island. The model has been used in a large number of studies of smoking cessation, but it has also been applied to a wide range of other health behaviours (Prochaska et al., 1994). Although it is often referred to simply as the stages of change model, the TTM includes several different constructs: the ‘stages of change’, the ‘pros and cons of changing’ (together known as ‘decisional balance’), ‘confidence and temptation’ and the ‘processes of change’. The TTM was an attempt to integrate these different constructs drawn from different theories of behaviour change and systems of psychotherapy into a single coherent model; hence the name transtheoretical (for example, see ‘Health belief model’, ‘Self-efficacy and health behaviour’ and ‘Theory of planned behaviour’).

The stages of change provide the basic organizing principle. The most widely used version of the model specifies five stages: precontemplation, contemplation, preparation, action and maintenance.

Type: Chapter
Information: Cambridge Handbook of Psychology, Health and Medicine , pp. 228 - 232

DOI: https://doi.org/10.1017/CBO9780511543579.050 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aveyard, P., Cheng, K. K., Almond, J.et al. (1999). Cluster randomized controlled trial of expert system based on the transtheoretical (“stages of change”) model for smoking prevention and cessation in schools. British Medical Journal, 319, 948–53.Google Scholar

Aveyard, P., Griffin, C., Lawrence, T. & Cheng, K. K. (2003). A controlled trial of an expert system and self-help manual intervention based on the stages of change versus standard self-help materials in smoking cessation. Addiction, 98, 345–54.Google Scholar

Aveyard, P., Sherratt, E., Almond, J.et al. (2001). The change-in-stage and updated smoking status results from a cluster-randomized trial of smoking prevention and cessation using the transtheoretical model among British adolescents. Preventive Medicine, 33, 313–24.Google Scholar

Bandura, A. (1986). Social foundations of thought and action: a social cognitive theory. New York: Prentice-Hall.

Bandura, A. (1997). The anatomy of stages. American Journal of Health Promotion, 12, 8–10.Google Scholar

Blissmer, B. & McAuley, E. (2002). Testing the requirements of stages of physical activity among adults: the comparative effectiveness of stage-matched, mismatched, standard care, and control interventions. Annals of Behavioral Medicine, 24, 181–9.Google Scholar

Borland, R. (2000). The Steps to Stop Program: Underlying theory and structure of the advice provided. Unpublished manuscript.

Borland, R., Balmford, J. & Hunt, D. (2004). The effectiveness of personally tailored computer-generated advice letters for smoking cessation. Addiction, 99, 369–77.Google Scholar

Borland, R., Balmford, J., Segan, C., Livingston, P. & Owen, N. (2003). The effectiveness of personalized smoking cessation strategies for callers to a Quitline service. Addiction, 98, 837–46.Google Scholar

Bridle, C., Riemsma, R. P., Pattenden, J.et al. (2005). Systematic review of the effectiveness of health interventions based on the transtheoretical model. Psychology and Health, 20, 283–301.Google Scholar

Carey, K. B., Purnine, D. M., Maisto, S. A. & Carey, M. P. (1999). Assessing readiness to change substance abuse: a critical review of instruments. Clinical Psychology Science and Practice, 6, 245–66.Google Scholar

Vries, H. & Mudde, A. N. (1998). Predicting stage transitions for smoking cessation applying the attitude–social influence–efficacy model. Psychology and Health, 13, 369–85.Google Scholar

DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K.et al. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59, 295–304.Google Scholar

DiClemente, C. C., Prochaska, J. O. & Gibertini, M. (1985). Self-efficacy and the stages of self-change of smoking. Cognitive Therapy and Research, 9, 181–200.Google Scholar

Dijkstra, A. & Vries, H. (2001). Do self-help interventions in health education lead to cognitive changes, and do cognitive changes lead to behavioural change?British Journal of Health Psychology, 6, 121–34.Google Scholar

Dijkstra, A., Vries, H., Roijackers, J. & Breukelen, G. (1998). Tailored interventions to communicate stage-matched information to smokers in different motivational stages. Journal of Consulting and Clinical Psychology, 66, 549–57.Google Scholar

Dijkstra, A., Tromp, D. & Conijn, B. (2003). Stage-specific psychological determinants of stage transition. British Journal of Health Psychology, 8, 423–37.Google Scholar

Hansen, J. (1999). The stages and processes of change for smoking cessation: testing the transtheoretical model. Dissertation Abstracts International, 59(9–B): 5083.Google Scholar

Herzog, T. A., Abrams, D. B., Emmons, K. M., Linnan, L. & Shadel, W. G. (1999). Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model. Health Psychology, 18, 369–75.Google Scholar

Joseph, J., Breslin, C., & Skinner, H. (1999). Critical perspectives on the transtheoretical model and stages of change. In Tucker, J. A., Donovan, D. M. & Marlatt, G. A. (Eds.). Changing addictive behavior: bridging clinical and public health strategies (pp. 160–90). New York: Guilford.

Lawrence, T., Aveyard, P., Evans, O. & Cheng, K. K. (2003). A cluster randomised controlled trial of smoking cessation in pregnant women comparing interventions based on the transtheoretical (stages of change) model to standard care. Tobacco Control, 12, 168–77.Google Scholar

Littell, J. H. & Girvin, H. (2002). Stages of change: a critique. Behavior Modification, 26, 223–73.Google Scholar

Marshall, S. J. & Biddle, S.J.H. (2001). The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. Annals of Behavioral Medicine, 23, 229–46.Google Scholar

Pallonen, U. E., Velicer, W. F., Prochaska, J. O.et al. (1998). Computer-based smoking cessation interventions in adolescents: description, feasibility, and six-month follow-up findings. Substance Use and Misuse, 33, 935–65.Google Scholar

Prochaska, J. O. & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–95.Google Scholar

Prochaska, J. O., DiClemente, C. C. & Norcross, J. C. (1992). In search of how people change: applications to addictive behaviors. American Psychologist, 47, 1102–14.Google Scholar

Prochaska, J. O., DiClemente, C. C., Velicer, W. F., Ginpil, S. & Norcross, J. C. (1985). Predicting change in smoking status for self-changers. Addictive Behaviors, 10, 395–406.Google Scholar

Prochaska, J. O., DiClemente, C. C., Velicer, W. F. & Rossi, J. S. (1993). Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. Health Psychology, 12, 399–405.Google Scholar

Prochaska, J. O., Redding, C. A., & Evers, K. E. (2002). The transtheoretical model and stages of change. In Glanz, K., Rimer, B. K. & Lewis, F. M. (Eds.). Health Behavior and Health Education: Theory, Research, and Practice (3rd edn., pp. 99–120). San Francisco: Jossey-Bass.

Prochaska, J. O. & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38–48.Google Scholar

Prochaska, J. O., Velicer, W. F., Fava, J. L., Rossi, J. S. & Tsoh, J. Y. (2001). Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation. Addictive Behaviors, 26, 583–602.Google Scholar

Prochaska, J. O., Velicer, W. F., Fava, J. L.et al. (2001). Counselor and stimulus control enhancements of a stage-matched expert system intervention for smokers in a managed care setting. Preventive Medicine, 32, 23–32.Google Scholar

Prochaska, J. O., Velicer, W. F., Rossi, J. S.et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13, 39–46.Google Scholar

Quinlan, K. B. & McCaul, K. D. (2000). Matched and mismatched interventions with young adult smokers: testing a stage theory. Health Psychology, 19, 165–71.Google Scholar

Riemsma, R. P., Pattenden, J., Bridle, C.et al. (2003). Systematic review of the effectiveness of stage based interventions to promote smoking cessation. British Medical Journal, 326, 1175–7.Google Scholar

Rosen, C. S. (2000). Is the sequencing of change processes by stage consistent across health problems? A meta-analysis. Health Psychology, 19, 593–604.Google Scholar

Segan, C. J., Borland, R. & Greenwood, K. M. (2002). Do transtheoretical model measures predict the transition from preparation to action in smoking cessation?Psychology and Health, 17, 417–35.Google Scholar

Segan, C. J., Borland, R. & Greenwood, K. M. (2006a). Can transtheoretical model measures predict relapse from the action stage of change among ex-smokers who quit after calling a quitline?Addictive Behaviors, 31, 414–28.Google Scholar

Segan, C.J., Borland, R. & Greenwood, K. M. (2006b). Do transtheoretical model measures predict forward stage transitions among smokers calling a quitline? Manuscript submitted for publication.

Spencer, L., Pagell, F., Hallion, M. E. & Adams, T. B. (2002). Applying the transtheoretical model to tobacco cessation and prevention: a review of the literature. American Journal of Health Promotion, 17, 7–71.Google Scholar

Sutton, S. (2000a). A critical review of the transtheoretical model applied to smoking cessation. In Norman, P., Abraham, C. & Conner, M. (Eds.). Understanding and changing health behaviour: from health beliefs to self-regulation (pp. 207–25). Reading, UK: Harwood Academic Press.

Sutton, S. (2000b). Interpreting cross-sectional data on stages of change. Psychology and Health, 15, 163–71.Google Scholar

Sutton, S. (2001). Back to the drawing board? A review of applications of the transtheoretical model to substance use. Addiction, 96, 175–86.Google Scholar

Sutton, S. (2005). Stage theories of health behaviour. In Conner, M. & Norman, P. (Eds.). Predicting health behaviour: research and practice with social cognition models (2nd edn., pp. 223–75). Buckingham, UK: Open University Press.

Sutton, S. (2006). Do the transtheoretical model variables predict stage transitions? A review of the longitudinal studies. Manuscript in preparation.

Sutton, S. R. (1996). Can “stages of change” provide guidance in the treatment of addictions? A critical examination of Prochaska and DiClemente's model. In Edwards, G. & Dare, C. (Eds.). Psychotherapy, psychological treatments and the addictions (pp. 189–205). Cambridge, UK: Cambridge University Press.

Velicer, W. F., Norman, G. J., Fava, J. L. & Prochaska, J. O. (1999). Testing 40 predictions from the transtheoretical model. Addictive Behaviors, 24, 455–69.Google Scholar

Weinstein, N. D., Rothman, A. J. & Sutton, S. R. (1998). Stage theories of health behavior: conceptual and methodological issues. Health Psychology, 17, 290–9.Google Scholar

Weinstein, N. D. & Sandman, P. M. (1992). A model of the precaution adoption process: evidence from home radon testing. Health Psychology, 11, 170–80.Google Scholar

Weinstein, N.D. & Sandman, P.M. (2002). The precaution adoption process model. In Glanz, K., Rimer, B. K. & Lewis, F. M. (Eds.). Health Behavior and Health Education: Theory, Research, and Practice (3rd edn., pp. 121–43). San Francisco: Jossey-Bass.

Book contents

Transtheoretical model of behaviour change

Summary

Access options

References

Save book to Kindle

Save book to Dropbox

Save book to Google Drive