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Transtheoretical Model of Health Behavior Change (TTM) : Niken Nur Widyakusuma, M.SC., Apt

The Transtheoretical Model of Health Behavior Change (TTM) posits that individuals progress through six stages when changing health behaviors: precontemplation, contemplation, preparation, action, maintenance, and termination. For each stage, different intervention strategies are most effective at moving individuals to the next stage and maintaining behavior change long-term. The TTM integrates constructs from other behavior change theories and can be applied to behaviors like smoking cessation, medication adherence, and obesity. It assumes behavior change is a process that unfolds over time through the stages.

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Farmasi Kelas A 2020
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134 views

Transtheoretical Model of Health Behavior Change (TTM) : Niken Nur Widyakusuma, M.SC., Apt

The Transtheoretical Model of Health Behavior Change (TTM) posits that individuals progress through six stages when changing health behaviors: precontemplation, contemplation, preparation, action, maintenance, and termination. For each stage, different intervention strategies are most effective at moving individuals to the next stage and maintaining behavior change long-term. The TTM integrates constructs from other behavior change theories and can be applied to behaviors like smoking cessation, medication adherence, and obesity. It assumes behavior change is a process that unfolds over time through the stages.

Uploaded by

Farmasi Kelas A 2020
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Transtheoretical

Model of Health
Behavior Change
(TTM)
Niken Nur Widyakusuma, M.Sc., Apt.
Reference

Prochaska JO, Velicer WF, 1997, The Transtheoretical Model of Health Behavior Change, Am J Health
Promot,1211:38-48

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Social and Behavioral Theories

▰ Health Belief Model


▰ Integrative Model of Behavioral Prediction
▰ Transtheoretical Model of Behavior Change
▰ Social Cognitive Theory
▰ etc

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Concept

▰ Developed by Prochaska and DiClemente (1970s)


▰ Evolved through studies examining the experiences of smokers who
quit on their own People quit smoking if they were ready to do so
▰ Transtheoretical Model (TTM) focuses on the decision-making of the
individual
▰ People do not change behaviors quickly and decisively
▰ Also called as Stages of Change Model

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▰ Uses a temporal dimension, the stages of change, to integrate
processes and principles of change from different theories of
intervention, include and integrate key constructs from other
theories into a comprehensive theory of change that can be applied
to a variety of behaviors, populations, and settings, hence the name
“transtheoretical”
▰ Other models of behavior change focus exclusively on certain
dimensions of change (e.g. theories focusing mainly on social or
biological influences),

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“ The transtheoretical model posits
that health behavior change
involves progress through six
stages of change:
precontemplation, contemplation,
preparation, action, maintenance,
and termination.
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Termination?

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Stages

Precontemplation
• Do not intend to take action in the foreseeable future
• Unaware that their behavior is problematic/has negative
consequences
• Underestimate the pros of changing behavior
• Emphasis on the cons of changing behavior.

Contemplation
• Intending to start the healthy behavior in the foreseeable future
• Recognize that their behavior may be problematic
• Consider the pros & cons of changing the behavior (equal emphasis
on both)
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Preparation (Determination)
• Ready to take action within the next 30 days
• Start to take small steps toward the behavior change
• Believe changing their behavior can lead to a healthier life.

Action
• People have recently changed their behavior (defined as within the last 6 months)
• Intend to keep moving forward with that behavior change
• Modifying their problem behavior or acquiring new healthy behaviors.

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Maintenance
• Sustained their behavior change for a while (defined as more than 6 months)
• Maintain the behavior change going forward
• Work to prevent relapse to earlier stages.

Termination
• Have no desire to return to their unhealthy behaviors
• Being sure they will not relapse
• Rarely reached (people tend to stay in the maintenance stage)
• Was not part of the original model
• Less often used in application of stages of change for health-related behaviors

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“ For each stage of change, different
intervention strategies are most effective
at moving the person to the next stage of
change and subsequently through the
model to maintenance, the ideal stage of
behavior.

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Cases

• alcohol and substance abuse • mammography screening


• anxiety and panic disorders • medication compliance
• Delinquency • unplanned pregnancy prevention
• eating disorders and obesity • pregnancy and smoking
• high-fat diets • sedentary lifestyles
• AIDS prevention • physicians practicing preventive
medicine.

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Assumptions

▰ Behavior change is a process that unfolds over time through a sequence of


stages. Health population programs need to assist people as they progress over
time.
▰ Stages are both stable and open to change
▰ Change can be motivated by enhancing the understanding of the pros and
diminishing the value of the cons.
▰ The majority of at-risk populations are not prepared for action. Helping people
set realistic goals, like progressing to the next stage, will facilitate the change
process.

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Limitations

▰ The theory ignores the social context in which change occurs, such as SES and
income.
▰ The lines between the stages can be arbitrary with no set criteria of how to
determine a person's stage of change. The questionnaires that have been
developed to assign a person to a stage of change are not always standardized or
validated.
▰ There is no clear sense for how much time is needed for each stage, or how long a
person can remain in a stage.  
▰ The model assumes that individuals make coherent and logical plans in their
decision-making process when this is not always true.

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TTM in
Pharmaceutical
Care?

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