STAGE-BASED AND OTHER
MODELS OF PHYSICAL
ACTIVITY
Moving from thinking to doing
Theories of
Exercise Behaviour
Belief-Attitude
Theories
Competence-Based
Theories
Control-Based
Theories
Stage-Based
Theories
Hybrid
Models
Example:
Theory of
Planned Behaviour
Example:
Self-Efficacy
Theory
Example:
Self-Determination
Theory
Example:
Transtheoretical
Model
Example:
HAPA
Aims
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•
•
•
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
The Transtheoretical Model of
Health Behaviour Change
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•
•
•
•
Core constructs:
Stages of change
Processes of change
Decisional balance (pros and cons)
Self-efficacy
The Transtheoretical Model
HOW
Self-Efficacy
Decisional Balance
Processes of change
WHEN
Precontemplation
Contemplation
Preparation
Action
Maintenance
Precontemplation
• Physically active? NO
• Intention to be active? NO
Contemplation
• Physically active? NO
• Intention to be active? YES
Preparation
• Physically active? Yes, but
not at criterion level
• Intention to be active? YES
Action
• Physically active? YES
(less than 6 months)
• Intention to be active? YES
Maintenance
• Physically active? YES
(more than 6 months)
• Intention to be active? YES
Prevalence estimates for stages by
different levels of physical activity
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Main
Action
Prep
Cont
Pre
3x15m
3x15MVPA
47x30MVPA
None
(Marshall & Biddle, 2001)
Prevalence estimates for stages
across four countries
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Main
Action
Prep
Cont
Pre
Australia
Canada
UK
USA
Total
(Marshall & Biddle, 2001)
Stages are thought to be cyclical
Maintenance
Preparation
Action
Contemplation
Precontemplation
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)
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.
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.
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)
Differences in pros and cons across
Effect Size
stages (Marshall & Biddle, 2001)
2
1.5
1
0.5
Cons
Pros
0
Precontemplation
Contemplation
Preparation
Maintenance
Action
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
Differences in self-efficacy across
stages (Marshall & Biddle, 2001)
Effect Size
2.5
2
1.5
1
0.5
0
Precontemplation
Preparation
Contemplation
Maintenance
Action
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)
A NATURAL HISTIORY
MODEL OF EXERCISE
MAINTENANCE
SEDENTARY
RESUMPTION
ADOPTION
DROPOUT
Determinants may differ across
phases/stage of the model
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•
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Key phases/stages applied to exercise:
Starting exercise
Maintaining exercise
Ceasing exercise
Resuming exercise
RELAPSE PREVENTION
MODEL
Adequate
or increased
self-efficacy
Low
probability
of quitting
High risk
of ceasing
exercise
Low selfefficacy
Negative
attributions
High
probability
of quitting
Lifespan Interaction Model
(to be inserted by publisher?)
Chapter 6: Conclusions 1
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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
Chapter 6: Conclusions 2
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•
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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