Facilitating Behavior Change

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Facilitating Behavior Change

• Applying Prochaskas Transtheoretical Model

Bev Schalk, R.N., M.Ed.
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Objectives

• Discuss Prochaskas Transtheoretical model.
• Describe the stages of change.
• Match typical statements with the stage of change
  they represent.
• Give examples of interventions tailored for each
  stage of change.

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Transtheoretical Model of Change

• People move through distinct stages on the road
  to successful change.
• Actions or interventions are most successful when
  tailored to the individuals particular stage of
  change.
• At each stage, an appropriate approach can
  produce progress towards the next stage.
• A health coach can use the model to assess
  readiness to change, plan and deliver targeted
  interventions and help patients move along the
  continuum towards successful, sustained behavior
  change.

Sources Prochaska, James O. and Wayne F.
Velicera, Behavior Change The Transtheoretical
Model of Health Behavior Change American Journal
of Health Promotion Vol. 12, No. 1, pp. 3848.
Prochaska, James O. and John C. Norcross,
Stages of Change Psychotherapy Vol. 38, No. 4,
pp. 443-448.
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Stages of Change

1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Termination

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Stages of Change
1. PrecontemplationNot intending to take action
in the next six months
I Wont
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2. ContemplationIntending to take action in the
next six months
Stages of Change
I Might
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3. PreparationIntending to act in the next 30
days
Stages of Change
I Will
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4. ActionMade changes for less than six months
Stages of Change
I Am!
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5. MaintenanceMade and sustained changes for
more than six months
Stages of Change
I Have
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Section Review Group Activity
Stages of Change

• Precontemplation ? Contemplation ? Preparation ?
  Action ? Maintenance

Ive signed up for an exercise class. I start
next week. Ive started walking for 30 minutes
each evening with my neighbor. I havent
smoked for a year! I feel so much better. My
grandpa smoked his whole life and lived to be 94
years old. Im not going to quit, either. Ive
been thinking about losing weight but I dont
know where to begin. Ive tried so many diets
before but I always gain the weight back.
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Interventions

• Interventions are most successful when they are
  tailored to the individuals readiness to change.

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Interventions
1. PrecontemplationNot intending to take action
in the next six months
My grandpa smoked his whole life and lived to be
94 years old. Im not going to quit, either.

• Provide information
• Communicate willingness to assist and support
• Help identify discrepancies

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2. ContemplationIntending to take action in the
next six months
Interventions
Ive been thinking about losing weight but I
dont know where to begin. Ive tried so many
diets before but I always gain the weight back.

• Review benefits of lifestyle change
• Provide information and referrals
• Support and encourage

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3. PreparationIntending to act in the next 30
days
Interventions
Ive signed up for an exercise class. I start
next week.

• Identify and address barriers
• Encourage support systems
• Set achievable goals
• Develop action plan
• Help anticipate challenges

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4. ActionMade changes for less than six months
Interventions
Ive started walking for 30 minutes each evening
with my neighbor.

• Review benefits of lifestyle change
• Discuss setbacks or barriers
• Encourage incremental steps
• Reinforce and track progress
• Celebrate accomplishments
• Prepare for challenges

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5. MaintenanceMade and sustained changes for
more than six months
Interventions
I havent smoked for a year! I feel so much
better.

• Provide ongoing monitoring and reinforcement
• Address challenges and relapses
• Review and revise goals
• Identify helpful circumstances or conditions

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Summary

• James Prochaskas Transtheoretical Model of
  Change states that people go through distinct
  stages on the road to successful change.
• The stages that health coaches typically work
  with include
• Precontemplation (I wont)
• Contemplation (I might)
• Preparation (I will)
• Action (I am)
• Maintenance (I have)
• Interventions are most successful when tailored
  to the individuals readiness to change. A health
  coach can help facilitate a persons progress
  through this continuum by recognizing the stage
  of change and providing targeted information,
  assistance and support.

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Questions?

• Bev Schalk, R.N., M.Ed.