1. STAGE-BASED AND OTHER MODELS OF PHYSICAL ACTIVITY
Moving from thinking to doing

3. Aims
To outline the popular ‘Transtheoretical Model’ approach to physical activity decision-making
Cover the ‘natural history’ model of exercise proposed by Sallis and Hovell (1990)
Outline the relapse prevention model
Describe the lifespan interaction model

4. The Transtheoretical Model of Health Behaviour Change
Core constructs:
Stages of change
Processes of change
Decisional balance (pros and cons)
Self-efficacy

5. The Transtheoretical Model
WHEN
HOW
Precontemplation
Contemplation
Preparation
Action
Maintenance
Self-Efficacy
Decisional Balance
Processes of change

6. Precontemplation
Physically active? NO
Intention to be active? NO

7. Contemplation
Physically active? NO
Intention to be active? YES

8. Preparation Physically active? Yes, but not at criterion level
Intention to be active? YES

9. Action Physically active? YES (less than 6 months)
Intention to be active? YES

10. Maintenance Physically active? YES (more than 6 months)
Intention to be active? YES

11. Prevalence estimates for stages by different levels of physical activity
(Marshall & Biddle, 2001)

12. Prevalence estimates for stages across four countries
(Marshall & Biddle, 2001)

13. Stages are thought to be cyclical
Precontemplation
Contemplation
Preparation
Maintenance
Action

14. Processes of change
"the cognitive, affective, and behavioral strategies and techniques people use as they progress through the different stages of change over time" (Marcus et al., 1992)

15. Processes of change Process Description COGNITIVE / THINKING PROCESSES
Increasing knowledge
Increasing information about oneself and physical activity.
Being aware of risks
Understanding the risks of inactivity and sedentary living.
Caring about consequences to others
Recognising how inactivity might affect others, such as family and co-workers.
Increasing healthy alternatives
Increasing awareness of alternatives for being physically active.
Understanding the benefits
Increasing awareness of the benefits of physical activity.

16. Processes of change BEHAVIOURAL / DOING STRATEGIES
Substituting alternatives
Seeking ways of being physically active when encountering barriers of time etc.
Enlisting social support
Seek support from others for your physical activity efforts.
Rewarding yourself
Praise and reward yourself, in a healthy way, for making successful efforts in physical activity.
Committing yourself
Make plans and commitments for physical activity.
Reminding yourself
Establish reminders and prompts for physical activity, such as diary time slots and making equipment easily available.

17. Pros & cons of exercising
DECISIONAL BALANCE
Pros & cons of exercising
I would be healthier if I exercised (pro)
Other people would respect me more if I exercised (pro)
It is expensive to join a health club (con)
I would probably be sore and uncomfortable if I exercised (con)

18. Differences in pros and cons across stages (Marshall & Biddle, 2001)
Effect Size 2
1.5 1
0.5
Cons
Pros
Precontemplation Preparation Maintenance
Contemplation Action

19. The confidence that you can be active in challenging situations
Self Efficacy
The confidence that you can be active in
challenging situations
Example: I am confident I can be active when I feel I
do not have much time

20. Differences in self-efficacy across stages (Marshall & Biddle, 2001)
Effect Size
2.5 2
1.5 1
0.5
Precontemplation Preparation Maintenance
Contemplation Action

21. TTM: Critique the majority of study designs are cross-sectional
there is a need to standardize and improve the reliability of measurement of stages and related constructs
the role of processes of change for physical activity behaviour remains unclear. The presence of higher-order constructs is not apparent in physical activity
stage-by-process interactions are not evident
(Marshall & Biddle, 2001)

22. A NATURAL HISTIORY MODEL OF EXERCISE

23. MAINTENANCE
SEDENTARY
ADOPTION
RESUMPTION
DROP-
OUT

24. Determinants may differ across phases/stage of the model
Key phases/stages applied to exercise:
Starting exercise
Maintaining exercise
Ceasing exercise
Resuming exercise

25. RELAPSE PREVENTION MODEL

26. effective coping ineffective coping Adequate or increased
self-efficacy
Low
probability
of quitting
High risk
of ceasing
exercise
ineffective
coping
Low self-
efficacy
Negative
attributions
High
probability
of quitting

27. Lifespan Interaction Model
(to be inserted by publisher?)

28. Chapter 6: Conclusions 1
the TTM provides an important advance on static linear models of exercise and physical activity determinants by hypothesising both the ‘how’ and ‘when’ of behaviour change
Measures of stages and processes of change are now available and require validation across more diverse samples
TTM research needs to advance beyond description of predictable cross-sectional differences between stages
meta-analytic evidence broadly supports the model, although the classification of processes of change into two higher-order categories is questioned

29. Chapter 6: Conclusions 2
a natural history model of exercise is a useful framework for identifying key stages in exercise behaviour
more needs to be known about which determinants are important at each of the phases of the model
relapse prevention may depend more on coping strategies than high-risk situations per se
the hybrid HAPA model allows for the distinction between non-intentional, intentional, and action stages of behaviour