1. MONICA JUAREZ INTERNATIONAL HEALTH TRACK H 571 OCT 23, 2014 Chapter 6: Stages Models for Health Promotion

2. Agenda Introduction Origins of the Transtheoretical Model of Change Assumptions The five stages of TMC Movement across the stages of change Stage matching

3. Introduction Begin where people are and approach the behavior Stage-matched intervention. what is just right for people Ex. Finding the right medication Challenge: find what is “Just Right” for people in terms of behavioral change

4. Two Stage theories for Health Promotion The Transtheorical Model change (TMC) developed by James O. Prachska and colleagues. Precaution Adoption Process Model (PAPM) adopted by Weinstein and Sandman (2002)

5. Transtheoretical Model of Change (TMC): Is a model of intentional behavior change that describes the phases and the mechanism that people go through.  How people change vs. why people change  understanding what happens after people decide to change. “Transtheoretical”  TMC integrates processes and principles of individual-level behavior changes from across major theories of psychotherapy.

6. Stages of Change

8. Precontempletion (PC)

9. Contemplation

10. Preparation

11. Action

12. Maintenance

13. Movement across the Stages

14. Evolutionary not Revolution The TMC supports the idea that the process of behavior changes is “Evolutionary, not revolutionary”  Learn from the experience  Build upon learning  Improve readiness

15. Stage Matching: People can be staged  Ex. Joe and Sally, smoke the same JoeSally Have thought about quitting smoking but have not make any effort to seek professional help Tried repeatedly to quit but not successful ContemplationPreparation

16. Staging Algorithm

17. Comment or question? Critique:  stage-targeted interventions appear to be more likely to induce short- term behavior change  What do you think? Ideas?  Ex. Motivational Interviewing Asking Evocative Questions: open ended questions Using Readiness Rulers Exploring the Decisional Balance Looking Back/Looking Forward Using hypotheticals Key Questions

18. Thank you!