Theorising about health behavior change should not be reduced to the motivation phase only, while omitting the subsequent action phase that is more decisive for behavior change. Advanced continuum models, therefore, need to include factors that help to bridge the intention–behavior gap. In doing so, it is implicitly assumed that there are at least two processes of behavior change, a motivational one that ends with an intention, and a volitional one that ends with successful performance. Thus, any extension of traditional continuum models in this direction implicitly adopts the idea of distinct processes, stages, or phases in health behavior change.
The Transtheoretical Model of Behavior Change (TTM; e.g. DiClemente & Prochaska, 1982; Prochaska & DiClemente, 1983; Prochaska, DiClemente, & Norcross, 1992; Velicer, Prochaska, & Redding, 2006), for example, has become the most popular stage model. It implies that different interventions are appropriate at different stages of health behavior change. The most common version of the TTM includes five discrete stages of health behavior change that are defined in terms of one's past behavior and future goals (precontemplation, contemplation, preparation, action, maintenance). The five stages are expected to be mutually exclusive and qualitatively different. People could make multiple attempts to progress from preaction to action stages. However, relapses could occur at any time, resulting in a spiral-like progression characterised by cycling and recycling through the behavior-change process.
In addition to the five stages of change, the TTM also includes ten processes of change, as well as the perceived pros and cons of changing, perceived self-efficacy, and temptation. These additional constructs are conceptualised as causes for the transitions between the stages, whereby it is assumed that different factors are responsible for different stage transitions. -
Applied Psychology
Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors
Version of Record online: 30 JAN 2008
DOI: 10.1111/j.1464-0597.2007.00325.x
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