Theory to look at if you want to have better health behavior!
Do you want to exercise regularly, quit smoking, cut down sugar, leave crunchy amazing chips, or cultivate some other healthy behavior? TTM is the theory you should be looking at if you haven’t.
For some time I have been struggling with the idea of going to the gym because I always had an excuse to not exercise. And in time I was given the topic Transtheoretical Model(TTM) or stages of change theory to research for a class and this got me interested in drilling down deep and learning theory’s practical applications. The TTM theory suggests that changes in healthy behavior occur in six stages, and that mechanism of change incorporates cognitive and behavioral processes that individuals engage in at different stages. In addition, individuals will weigh the pros and cons of engaging(decisional balance) in an activity and will generally experience self-efficacy as they advance through the stages of activity behavioral change. The framework looks like:-
To explain this model better, let me use an example. Say for example I am obese because of my diet from the last 3 years of a lot of sugary and trans-fat food. I am at this pre-contemplation phase where it doesn’t matter to me if I am obese or not. I haven’t thought about exercising or eating healthy but recently I start to hear from my friends, doctors, and family who make remarks about how I need to change my diet and workout. This hits me and eventually in some months by moving through the three processes of change:- Consciousness-Raising, Dramatic Relief, and Environmental Re-evaluation, I enter a new stage:- Contemplation stage. Additionally, I weigh the pros and cons(decisional balance)of moving from one stage to another. I switch stages and move through processes of change when the pros of starting to thinking about healthy behavior at the pre-contemplation stage are more than cons. Along with decisional balance, I measure my ability to make a change. Unless I feel I am capable of changing and going through the stages of change I won’t do it. Similarly, I move from stages of contemplation to preparation, from preparation to action, and finally from action to management by moving through other processes of change, decisional balance, self-efficacy. In TTM there is a sixth stage called — termination stage or the relapse stage which is used for addictive behaviors like drug abuse, smoking, or obesity, etc. For health behaviors, like actively researching about their own health or, taking recommendations on phishing attacks, there is no need for a termination or relapse stage.
Original research paper by Prochaska and Diclemente suggested that people move from one stage to another through some processes of change. But from the research papers, what became evident was that people don’t necessarily use exactly these processes of change or to move from one stage to another in a linear/cyclic fashion! Basically suggesting that one can have a distinct trajectory of change.
TTM is used as a method to suggest interventions and hence is used mostly by clinics/doctors. Clinics/doctors try to gauge their participants/patients' stage of change and try to push them through to the stages of action and maintenance. Many clinical applications directed to target a specific group of patients can use TTM to push patients forward into managing their own health by knowing their current stage and then using targeted interventions- to get specific how about Fitbit using TTM!!.
There is no theory without limitations and TTM comes with its own set of problems but irrespective of that I personally think TTM can be used well along with other models in a wide variety of fields to direct behavior change- like finance, nutrition, technology, etc. TTM has also been used in learning models to see if a child is in action/ preparation stages to perform better at school and direct interventions like gaming to push them to perform better. Through this article, I am suggesting that teachers/ coaches/ instructors can guide people by actually understanding which stage of change they are in and pushing them through to other stages. Or even people who understand this model can create a plan for themselves. You don’t require an app or software for it. You know yourself better!
I realized that after getting to know TTM I became more cognizant of my behaviors and through a self-directed plan, I could bring myself to go to the gym at least 5 days a week(been 3 weeks now)! In the original papers, it was suggested that people who quit smoking without any therapy, had a pattern and they could make a change to healthy behavior by moving through the stages of change. If you have read till this point, I am sure you are now familiar with this theory so what are you waiting for? I know you can make a change of being better than you are but of course more consciously this time.
I am not an expert on this topic. But please do let me know in the comments if you have some constructive criticism!
