Transtheoretical model relationships across multiple health behaviors: A longitudinal analysis

Patricia Holt Castle, University of Rhode Island


Modifiable lifestyle behaviors contribute substantially to the burden of preventable diseases and premature deaths. Such findings support the growing need for health behavior change interventions to promote health, prevent disease, and manage chronic illness. The Transtheoretical Model (TTM) is the most commonly used theory of behavior change. Despite the model's popularity and growing body of evidence, relationships between TTM constructs have primarily been examined using cross-sectional studies, with comparatively limited longitudinal evaluations. The current study utilized meta-analytic techniques pooled across data from eight randomized clinical trials including exercise, stress management, and sun protection behaviors to compare fixed, random, and mixed effect models. Longitudinal theoretical relationships between TTM constructs were examined across multiple health behaviors, with analyses focusing on 12-month Stage transition groups and associated magnitudes of change over time in Pros, Cons and Confidence scales for each behavior. Results suggested patterns consistent with cross-sectional data, with the Pros and Confidence increasing and Cons decreasing as individuals progressed through adjacent Stage transitions. Smaller longitudinal magnitudes of effects were found for Decisional Balance among successful individuals reaching behavior criteria from Precontemplation than had been previously hypothesized based on cross-sectional data. The relationships found between TTM constructs across time and behaviors provide an improved theoretical framework to better guide future health behavior change interventions. ^

Subject Area

Psychology, Behavioral|Health Sciences, Public Health

Recommended Citation

Patricia Holt Castle, "Transtheoretical model relationships across multiple health behaviors: A longitudinal analysis" (2011). Dissertations and Master's Theses (Campus Access). Paper AAI3488408.