The 'Trans-Theoretical Model' (TTM) of Behaviour Change (Week 1) Flashcards
state what it is meant by the key term - ‘Trans-Theoretical Model’ (TTM)
the TTM is a model that proposes that health behaviour change involves progress through 6 stages of change
transitions between stages in the TTM are driven by what 2 things ?
- self-efficacy
2. decisional balence
what 2 things are used to initiate and maintain behaviour changes ?
- experiential processes
2. behavioural processes
state the 6 stages of the TTM in order
- pre-contemplation (I won’t exercise)
- contemplation (I might exercise)
- preparation (I will exercise)
- action (I am exercising)
- maintenance (I am still exercising)
- termination (I will never stop exercising)
state 4 characteristics about the ‘pre-contemplation’ stage of the TTM model
- no desire to become active
- unaware of own health behaviours, risks or benefits
- client is demoralised and resistant to change (most stable stage)
- costs > benefits of exercising
state 5 characteristics about the ‘contemplation’ stage of the TTM model
- client is considering exercise - becoming more active
- ambivalent - still lacks confidence
- relatively stable stage
- awareness of risks and benefits
- costs and benefits of exercise are in equal balance
state what it is meant by the key term - ambivalence
having mixed feelings or contradictory ideas about something or someone
state 3 characteristics about the ‘preparation’ stage of the TTM model
- client is preparing to exercise - health screening, info gathering, equipment, sampling exercise, etc…
- benefits are marginally greater than costs
- confidence remains fragile - relapse is a risk
state 4 characteristics about the ‘action’ stage of the TTM model
- exercise now a regular part of routine
- client is achieving the recommended guidelines
- benefits > costs
- least stable stage (effort to avoid relapse/temptation)
state 4 characteristics about the ‘maintenance’ stage of the TTM model
- regular exercise for 6 months
- fully integrated into life
- benefits greatly outlay costs
- more stable - risk of relapse reduced, less effort required to change
state 4 characteristics about the ‘termination’ stage of the TTM model
- regular exercise for over 5 years
- no risk of relapse
- 16% of US exercisers fall into this stage (Cardinal. 1999)
- greater self-efficacy, reduced effect of temptations and reliance on supportive strategies (Fallon and Havsenblus. 2004)
state 2 stage-matched strategies to help in the ‘pre-contemplation’ stage of the TTM (Pekmezi et al., 2020)
- analyse yourself and your actions
2. assess the risks of your current behaviours
state 3 stage-matched strategies to help in the ‘contemplation’ stage of the TTM (Pekmezi et al., 2010)
- weigh pros and cons of behaviour change
- confirm readiness and ability to change
- identify barriers to change
state 3 stage-matched strategies to help in the ‘preparation’ stage of the TTM (Pekmezi et al., 2010)
- write down your goal(s)
- prepare a plan of action
- make a list of motivating statements
state 2 stage-matched strategies to help in the ‘action’ stage of the TTM (Pekmezi et al., 2010)
- reward your success
2. seek social support
state 2 stage-matched strategies to help in the ‘maintenance’ stage of the TTM (Pekmezi et al., 2010)
- develop coping strategies for temptations
2. remember to reward yourself
state 3 characteristics of relapse (Marshall & Biddle., 2001)
- disappointment
- frustration
- feelings of failure
state 3 strategies to help avoid relapse (Marshall & Biddle., 2001)
- identify triggers that could lead to relapse
- recognise the barriers to success
- reaffirm your goal and commitment to change
the mechanisms of change (self-efficacy and decisional balance) are said to be two things in regards to change. what are these 2 things ?
antecedents and outcomes of change
what are the 3 elements of change ?
- readiness to change (do you have the resources and knowledge to make a lasting change successfully)
- barriers to change
- likelihood of relapse
state what it is meant by the key term - Self-Efficacy
SE is the belief in one’s own capabilities to execute the actions required to produce desired effects (Bandora. 1997;2000)
how can SE be used to promote change ? (Pekmezi et al., 2010)
by raising SE and increasing outcome expectancy and value, we can encourage change
state the 5 ways in which Self-Efficacy can be optimised
- performance accomplishments
- verbal persuasion
- interpretation of the psycho-physiological state
- vicarious experiences
- imaginal experiences
what are the best role models for change (2 things) ?
- ideal if the client can identify and relate to the role model
- the role model should be similar (or less) in fitness capacity than the client
explain, using 3 points, what it is meant by the key term - decisional balance
- people weigh up the pros and cons of exercising
- the balance between the pros and cons of exercising will determine the individuals decision
- helping the client reframe the pros and cons can help shift the balance
what are the 2 different types of ‘processes of change’ with regards to the TTM ?
- experiential
2. behavioural
state what it is meant by the key term - ‘experiential process of change’
strategies challenging the client’s beliefs, emotions, attitudes, and values; most important in the early stages of change
state what it is meant by the key term - ‘behavioural process of change’
behaviours of self or others that support exercise; most important in the mid to latter stages of change
what are the 5 experiential processes of change ?
- conscious raising
- environmental re-evaluation
- self re-evaluation
- social liberation
- dramatic relief
state what it is meant by the key term - conscious raising
improving your knowledge/awareness of the activity and your health
state what it is meant by the key term - environmental re-evaluation
realising the impact of your health on others
state what it is meant by the key term - self re-evaluation
embracing exercise as part of your identity
state what it is meant by the key term - social liberation
realising that society supports healthy behaviours
state what it is meant by the key term - dramatic relief
feeling fear or inspiration due to healthy/unhealthy behaviours
what are the 5 behavioural processes of change ?
- counter conditioning
- helping relations
- reinforcement management
- self-liberation
- stimulus control
state what it is meant by the key term - counter conditioning
substituting healthy behaviours for unhealthy behaviours
state what it is meant by the key term - helping relations
social support from others to encourage change (both direct and indirect)
state what it is meant by the key term - reinforcement management
rewarding or punishing healthy or unhealthy behaviours (Thorndike’s law of Effect)
state what it is meant by the key term - self-liberation
making a commitment (public) to change
state what it is meant by the key term - stimulus control
managing cues for healthy and unhealthy behaviours
do TTM interventions work ? explain using the study done by Spencer et al. 2006 (3 points)
- 25/31 stage-matched exercise interventions motivated participants to higher stages and further exercise
do TTM interventions work ? explain using the study done by Hutchinson et al. 2009
6/7 TTM physical activity interventions has short term success; only 1 demonstrated long term success
do TTM interventions work ? explain using the study done by Romain. 2018 (2 points)
- no difference between interventions targeting the actual SOC vs the interventions that did not across the 33 RCT’s selected for the study
- the mediators of TTM efficiency was the number of theoretical constructs used to tailor the intervention
who came up with project active ?
Dunn et al. 1999
what is project active ?
a trans-theoretical model based on active lifestyle intervention
how was project active carried out ? (4 points)
- 6 month intervention vs exercise control group
- aim to adopt 30 mins MVPA/day (moderate or vigorous activity)
- weekly group meetings with instructor; staged matched strategies and homework assignments
- monthly assessments and feedback
what 3 findings were encountered by Dunn et al 1999 from project active ?
- both groups saw an increase in PA and CV fitness
- both improved their B.P., lipid profiles, cholesterol and body fat
- activity in both groups declined from 6 to 24 months - fitness was maintained in the lifestyle group
state 2 limitations to the TTM study by (Spencer et al., 2006)
- However, most studies limited to white, middle-classed, female populations which limits the generalisability of the findings
- evidence for construct validity is mixed - intervention designees must define key concepts and employ ALL TTM tools, not just stage-matched
state 2 considerations made by (Hutchinson et al., 2009) about TTM interventions
- many TTM interventions fail to accurately represent all aspects of the model
- results show inconsistencies in the development of TTM interventions
state 2 limitations of the TTM model
1) the theory ignores the social context in which behaviour change occurs (Bandura’s social learning theory)
2) arbitrary changes between the stages, with no set criteria to determine whether a person is ready to change or not
