The study of college students’ physical exercise behavior phase and process of change based on the Transtheoretical model / 中华疾病控制杂志

Objective To analyze the stage characteristics in the exercise behavior improvement of college students and explore the role of Process in the exercise behavior change based on the transtheoretical model, providing basis for the stage-matched intervention for the exercise behavior of college students. Methods There were 932 students who completed the questionnaires, from 5 universities in Shanxi Province were selected by using a stratified random cluster sampling method. Descriptive analysis was used to describe the exercise behavior of college students. Variance analysis and multivariate Logistic regression model were used to analyze the difference of the process of with stage of change among college students’ physical exercise. Multivariate variance analysis was used to analyze how personal characteristics affect process of change. Results Among all participants, 89.4% students knew the importance of physical exercise, and 29.4% students were satisfied with their physical exercise condition. The distribution of students’ physical exercise stage showed an inverted U-shape with left-side peak, and there was a significant difference between gender( 2=54.657, P<0.001). There were significant stage characteristics in the process of students' exercise behavior, gender had a significant main effects on mutual aid relation(F=7.400, P=0.07)and conscious control (F=7.778, P=0.005), gender and grade had interaction effects on social release (F=3.614, P=0.013). Conclusions The college students' exercise behavior showed the characteristics of “knowing but not to do”, which conformed to the Transtheoretical model. It is essential to develop targeted phased exercise intervention strategies according to the relationship between change of phase and change of procedure.

Psychosocial Factors Related with the Intake of Vegetables and Fruits by Stage of Change of Elementary School Children in Chungnam Province

This study aims at investigating the psychosocial factors that influence on the intake of fruits and vegetables according to stage of change in rural children. Total 256 elementary school children, located in Yeongi-Gun, Chungnam-Do were surveyed from May 14 2007 to May 30 2007. Stage of change on the intake of fruits and vegetables of the students was categorized into three stages: precontemplation (PC), contemplation & preparation (CO&PR) and action (AC). Psychosocial factors consist of decisional balance based on pros and cons, process of change of cognitive and behavioral processes, and self-efficacy. The recognition of cons out of decisional balance showed the highest score in the subjects at the stage of PC and lowest score in those action stage. While, no difference was shown in the score of recognition of pros among the stages. Both levels of cognitive and behavioral process of change showed no difference between two pre-action stages, PC and CO&PR. However, the subjects of action stages got higher scores in more number of the variables in both of cognitive and behavioral process of change compared to those of pre-action stages with more remarkable in results vegetables than in fruits. The results of self-efficacy on fruits and vegetables intake showed that the higher stages of change, the higher the self-efficacy score. From the result, it is suggested that the items and level of psychosocial factors are different according to the stage of change and between fruits and vegetables in rural children.

Influencing Factors of Exercise Behavior Change in Nursing Students / 성인간호학회지

PURPOSE: This study was to predict the stage of exercise behavior change in undergraduate students and to identify the factors affecting exercise behavior change by using the trans theoretical Model. METHOD: The subjects were 193 undergraduate students at K and D university in D city. Data were collected by questionnaire surveys using convenience sampling and analyzed by SPSS 12.0 program. RESULTS: 77.7% of 193 nursing students do not exercise or they exercise irregularly. Exercise self-efficacy score and exercise benefits score were decreased with advancing exercise stage, on the other hand exercise barriers score and the process of exercise behavior change score were increased. In addition to this, the results revealed that stage of exercise behavior was significantly correlated with the process of exercise behavior change, exercise benefits, exercise barriers and exercise self-efficacy. CONCLUSION: These results suggested that the process of exercise behavior change, exercise decisional balance and exercise self-efficacy can be potential affecting factors for the stages of behavior change in university students. Therefore, these findings give useful information for educating nurse to construct nursing service programs focused on the stage of behavior change.

A Study on the Stages of Change of Exercise and Its Related Factors in Patients with Diabetes Mellitus : Application of Transtheoretical Model / 성인간호학회지

PURPOSE: This study was conducted to compare the process of change, decisional balance, and self-efficacy according to the stages of change of exercise on the basis of the Transtheoretical Model in order to investigate factors associated with the change of exercise in adult diabetic patients. METHOD: Data were collected from January to April 2005. The subjects were 160 patients in the G university hospital and public health center in J city. RESULTS: The entire process of change showed the significant difference depending on the stage of change(F=20.007, p=.000). For each process of change, the Consciousness Raising(F=14.602, p=.000), Dramatic Relief(F=7.751, p=.000), Environmental Re-evaluation(F=11.843, p=.000), Self Re-evaluation(F=16.035, p=.000), Social Liberation(F=10.968, p=.000), Counter-conditioning (F=24.090, p=.000), Helping Relationships(F= 7.625, p=.000), Reinforcement Management(F= 16.693, p=.000), Self Liberation(F=11.990, p= .000) and Stimulus Control(F=4.020, p=.002) demonstrated significant differences depending on the stages of change of exercise. For the decisional balance, the Pros showed the significant difference depending on the stage of change(F=14.121, p=.000). For the self efficacy showed significant difference depending on the stage of change(F=17.137, p=.000). CONCLUSION: In order to proceed the stage of change of exercise in patients with Diabetes Mellitus, intensive use of a specific process of change, a stage of change matching is needed.

The Process of Change, Decision Making, Self-efficacy and Perception of Subjective Health by the Stage of Exercise Behavior among Older Adults / 성인간호학회지

PURPOSE: The purpose of this study was to examine the differences of the process of change, decision making, self-efficacy and perception of subjective health according to the stages of exercise behaviors suggested by transtheoretical models among older adults. METHOD: The subjects consisted of 291 older adults. Trained research assistants interviewed the older adults using structured questionnaires. ANOVA analyses with post hoc test were used to examine the mean differences for each stage of exercise behavior using SPSS for windows. RESULT: The subjects were divided into five stages of exercise behavior: 24.4% pre-contemplation, 12.4% contemplation, 17.9% preparation, 12.4% action, 33.0% maintenance stage. There were significant differences in process of change, decision making, self-efficacy and subjective health perception according to the exercise stage of change. 'Self-liberation' and 'stimulus control' were important strategies for intention of exercise, while 'reinforcing management' for the actual practice of exercise. 'Self-efficacy' was an effective strategy to change older adults from pre-contemplation to preparation stage. CONCLUSION: For exercise intervention, older adults should be classified into groups according to their stages of exercise behaviors and provided effective individualized intervention depending on their stage.

Process of Change, Self Efficacy and Decisional Balance Corresponding to Stage of Change in Smoking Cessation in Industrial Workers / 성인간호학회지

PURPOSE: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. METHOD: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). RESULT: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. CONCLUSION: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.

Process of Change, Decisional Balance and Self-Efficacy Corresponding to the Stage of Exercise Behavior in Patients with Type 2 Diabetes Mellitus / 성인간호학회지

PURPOSE:Thisstudy was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior using Transtheoretical Model in patients with type 2 diabetes mellitus. METHOD:The study method was a survey in 100 type 2 DM patients at out-patients clinic of Y medical center from March 19, 2000 to October 30, 2000. RESULT:The results were as follows:The subjects were divided into five stages of exercise behavior ;15.0% in pre-contemplation stage, 33.0% in contemplation stage, 17.0% in preparation stage, 16.0% in action stage and 19.0% in maintenance stage. The subjects in pre-contemplation stage used all processes of change in the least. "Dramatic relief(DR)", "Environmental reevaluation(ER)" and "Self reevaluation(SR)" were identified as main processes ofchangein contemplation stage. "Consciousness raising(CR)", "DR" were used higher than average in preparation stage. "Helpingrelationships(HR)","CR", "ER", "SR", "Social liberation(SL)", "Counter conditioning (CC)", "Reinforcement management(RM)", "Self liberation(SEL)" and "Stimulus control(SC)" were used higher than average in action stage. The subjects in maintenance stage used all process of change the highest except "DR"and "HR". "Cons" score of decisional balance was the highest in pre-contemplation stage, "Pros" score was the highest in action stage and "Self-efficacy" score was the highest in maintenance stage. CONCLUSION: This study can provide the basis of staged matching exercise program using TTM for more effective and useful intervention.

Process of Change Corresponding to the Stage of Change of Exercise in Elderly / 간호학회지

Purpose: This study was performed to identify the factors that change exercise behave. This study will also classify and identify the characteristics of excercise stages to which the elderly belong Also, to identify the processes of change which influence on the changes in exercise performed by the elderly. Methods: Convenient samples of 198 subjects over the age 60 in Seoul Korea(mean age=70) were selected from elderly communities and were all mentally conpetant older adults. The data were collected from April 1,1999 to May 30, 1999. The research instruments were measured the change in exercise (Marcus et al., 1992b), such as Stage of Change measure(Marcus et al,1992a). The data were analyzed by SAS Program. Results: 1. According to the measure of change without missing data, 191 subjects were distributed each stage of change for exercise: 50 subjects (26.1%), 7 subjects (3.6%), 52 subjects (27.2%), 4 subjects (2%), and 78 (40.8%) belonged to the precontemplation stage, the contemplation stage, the preparation stage, the action stage and the maintenace stage. 2. According to the factor analysis, 6 factors of change were identified as appropriate processes of change and were named by the researchers. The names were; 'Supportive helping relationship', 'Self cognitive determination', 'Environmental reinforcement', Consciousness raising', Reinforcement of negative condition and 'Conversion of negative condition'. 3. According to the stage of change, there were significant mean differences in the 'Supportive helping relationship(F=22.04, p=.0001)', 'Self cognitive determination (F=50.87, p=.0001)', 'Reinforcement of negative condition(F=7.84,p=.0006)'. 4. Through the discriminant analysis, it was found that Self cognitive determination is the most influential variable as one of the processes of change which can discrimiate the three stages of change (precontemplation, preparation, and maintenance). Also the next significant variable was Reinforcement of negative condition. Conclusion: The process of the dey change is one of concepts of The transtheoretical model known as strategies and the techniques people use as they go through the different stages of change. Even though this study is cross- sectional not longitudinal study, the finding of this study gives useful information for exercise intervention, by using this strategy of exercise for elderly in different stages of change in exercise.

A Prediction Model for Stage of Change of Exercise In the Korean Elderly: Based on the Transtheoretical Model / 간호학회지

The purpose of this study was to identify causal relationships among variables of transtheoretical model for exercise in the elderly. A predictivel model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 198 old adults over 60 years old in a community setting in Seoul, Korea in April and May,1999. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling (LISREL) 8.0 program was used to find the best fit model which predicts causal relationship of variables. The fit of the hypothetical model to the data was X2=132.85. (df=22, p=.000). GFI=.88, NNFI=.35, NFI=.77, AGFI=.59 which was not favorable but the fit of modified model to the data was X2=46.90. (df=27, p=.01).GFI= .95, NNFI=.91, NFI=.92, AGFI=.87) which was more than moderate. The predictable variables of stage of change for exercise of the Korean elderly were helping relationship, self cognitive determination, conversion of negative condition in process of change and efficacy for exercise . These variables explained 68% of stage of change for exercise of the Korean elderly.

Process of Change Corresponding to the Stage of Change of Exercise in Elderly / 간호학회지

Purpose: This study was performed to identify the factors that change exercise behave. This study will also classify and identify the characteristics of excercise stages to which the elderly belong Also, to identify the processes of change which influence on the changes in exercise performed by the elderly. Methods: Convenient samples of 198 subjects over the age 60 in Seoul Korea(mean age=70) were selected from elderly communities and were all mentally conpetant older adults. The data were collected from April 1,1999 to May 30, 1999. The research instruments were measured the change in exercise (Marcus et al., 1992b), such as Stage of Change measure(Marcus et al,1992a). The data were analyzed by SAS Program. Results: 1. According to the measure of change without missing data, 191 subjects were distributed each stage of change for exercise: 50 subjects (26.1%), 7 subjects (3.6%), 52 subjects (27.2%), 4 subjects (2%), and 78 (40.8%) belonged to the precontemplation stage, the contemplation stage, the preparation stage, the action stage and the maintenace stage. 2. According to the factor analysis, 6 factors of change were identified as appropriate processes of change and were named by the researchers. The names were; 'Supportive helping relationship', 'Self cognitive determination', 'Environmental reinforcement', Consciousness raising', Reinforcement of negative condition and 'Conversion of negative condition'. 3. According to the stage of change, there were significant mean differences in the 'Supportive helping relationship(F=22.04, p=.0001)', 'Self cognitive determination (F=50.87, p=.0001)', 'Reinforcement of negative condition(F=7.84,p=.0006)'. 4. Through the discriminant analysis, it was found that Self cognitive determination is the most influential variable as one of the processes of change which can discrimiate the three stages of change (precontemplation, preparation, and maintenance). Also the next significant variable was Reinforcement of negative condition. Conclusion: The process of the dey change is one of concepts of The transtheoretical model known as strategies and the techniques people use as they go through the different stages of change. Even though this study is cross- sectional not longitudinal study, the finding of this study gives useful information for exercise intervention, by using this strategy of exercise for elderly in different stages of change in exercise.

A Prediction Model for Stage of Change of Exercise In the Korean Elderly: Based on the Transtheoretical Model / 간호학회지

The purpose of this study was to identify causal relationships among variables of transtheoretical model for exercise in the elderly. A predictivel model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 198 old adults over 60 years old in a community setting in Seoul, Korea in April and May,1999. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling (LISREL) 8.0 program was used to find the best fit model which predicts causal relationship of variables. The fit of the hypothetical model to the data was X2=132.85. (df=22, p=.000). GFI=.88, NNFI=.35, NFI=.77, AGFI=.59 which was not favorable but the fit of modified model to the data was X2=46.90. (df=27, p=.01).GFI= .95, NNFI=.91, NFI=.92, AGFI=.87) which was more than moderate. The predictable variables of stage of change for exercise of the Korean elderly were helping relationship, self cognitive determination, conversion of negative condition in process of change and efficacy for exercise . These variables explained 68% of stage of change for exercise of the Korean elderly.