Application of the Transtheoretical Model to Health Education for Older Adults

Abstract

The application of theory to practice can be challenging. This article describes the experiences of one organization in applying the Transtheoretical Model (TTM) to a health promotion program for older adults, Health Stages. The concepts of the model, especially stage of change, were successfully used for program planning, curriculum development, and program evaluation. A Programming Grid was developed to guide curriculum development and evaluate if programs were reaching out to people at all stages of readiness to make healthy changes. Other TTM constructs, including self-efficacy, decisional balance, and processes of change were incorporated into the Health Stages curriculum. Evaluation showed that the pilot sites increased their offering of action- and maintenance-oriented programs, filling in the gaps in current programming. Older adults were receptive and interested in the model. The TTM enhanced the program by providing a framework for design and a method for reaching a wider audience of older adults with important health information.

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References

American College of Sports Medicine. (1998). Position stand: Exercise and physical activity for older adults. Medicine and Science in Sports & Exercise, 30, 992-1008.

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.

Burbank, P. M., & Riebe, D. (2002). Promoting exercise and behavior change in older adults: Interventions with the transtheoretical model. New York: Springer.

Everard, K. M., Highstein, G. R., Lach, H. W., Fisher, E. B., & Baum, M. C. (1999). Aerobic, strength, and stretching exercise behavior of older adults. Paper presented at the 52nd meeting of the Gerontological Society of America, San Francisco, CA.

Everard, K. M., Lach, H. W., & Heinrich, B. (2000). The development of Health Stages: A unique university and not-for-profit collaboration to enhance successful aging. Journal of Educational Gerontology, 26, 715-724.

Lorig, K., Stewart, A., Ritter, P., Gonzales, V., Laurent, D., & Lynch, J. (1996). Outcomes for health education. San Francisco: Bull Press.

Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Jr., Bandura, A., Ritter, P., et al. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial. Medical Care, 37(1), 5-14.

Nigg, C. R., Burbank, P. M., Padula, C., Dufresne, R., Rossi, J. S., Velicer, W. F., et al. (1999). Stages of change across ten health risk behaviors for older adults. The Gerontologist, 39, 473-482.

Nigg, C. R., & Riebe, D. (2002). The transtheoretical model: Research review of exercise behavior and older adults. In P. M. Burbank & D. Riebe (Eds.), Promoting exercise and behavior change in older adults: Interventions with the transtheoretical model (pp. 147-180). New York: Springer.

10.

Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.

11.

Prochaska, J. O., DiClemente, C. C., Velicer, W. E., & Rossi, J. S. (1993). Standardized, individualized, interactive and personalized self-help programs for smoking cessation. Health Psychology, 12(5), 399-405.

12.

Prochaska, J. O., Norcross, J. C., & DiClemente, C. C. (1994). Changing for good. New York: Morrow.

13.

Prochaska, J. O., Redding, C. A., & Evers, K. E. (1997). The transtheoretical model and stages of change. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education: Theory, research and practice (pp. 60-84). San Francisco: Jossey-Bass.

14.

Prochaska, J. O., Velicer, W. F., DiClemente, C. C., & Fava, J. L. (1988). Measuring the processes of change: Application to the ces-sation of smoking. Journal of Consulting and Clinical Psychology, 56, 520-528.

15.

Reed, G. R. (1999). Adherence to exercise and the transtheoretical model of behavior change. In S. J. Bull (Ed.), Adherence issues in sport and exercise (pp. 19-46). New York: John Wiley.

16.

Rossi, J. S., Rossi, S. R., Velicer, W. F., & Prochaska, J. O. (1995). To change or not to change: That is the question. In D. B. Allison (Ed.), Handbook of assessment methods for changing eating behavior and weight management (pp. 387-430). Newbury Park, CA: Sage.