Transtheoretical Model in Sedentary Lifestyle Interventions free essay sample

Despite the social, health, and personal benefits of exercising, many people still choose not to exercise. 60% of the population is inadequately active or completely inactive (2). Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity. Despite many recent technical breakthroughs in healthcare, human behavior remains the largest source of variance in health-related outcomes. Trainers, coaches, and public health employees all want to know how to get through to people who are deemed â€Å"couch potatoes† and don’t seem to have any motivation to change their lifestyle choices. People’s health and well being are robustly affected by lifestyle factors such as smoking, hygiene, diet, and physical activity (4). Even though this population knows exercise is the medicine they desperately need there are several barriers to beginning and maintaining a change in fitness commitment such as lack of social support, inclement weather, disruptions in routine, lack of access to facilities, and dislike of vigorous exercise (2). We will write a custom essay sample on Transtheoretical Model in Sedentary Lifestyle Interventions or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Understanding these underlying issues for resisting change can help to develop intervention programs for populations who are inactive or inadequately inactive according to public health recommendations. Outside of the hospital setting most health care interventions are highly dependent on the patient following their doctors’ orders and buying into the treatment plan. A significant problem is patients not being ready for change and being unable to follow prescribed changes or recommended behaviors over time, thus returning to the doctor time after time for the same issues. The good news is that help for the patient, client, or employee who is not ready for a behavior change is possible through understanding when and what motivational message to use with them. For those patients who are far from integrating a traditional high intensity workout intervention plan into their lives, a moderate-intensity activity plan integrated with the assistance of counseling to integrate this into their daily lives can have significant health benefits and could aid public health efforts to reduce the prevalence of sedentary lifestyles. This means that health care professionals who are counseling their patients about physical activity can provide options beyond traditional fitness center–based recommendations. The question is how does a coach know when and in what way to counsel patients in a manner that will meet them at their level of readiness to change. The transtheoretical model of change argues that individuals progress through stages of change and that movement across the stages is cyclic rather than linear, because many people do not succeed in their efforts at establishing and maintaining lifestyle changes (5). According to this theory at different times a person may be in a different stage of change motivation and therefore different intervention techniques would be more effective to use with them. Utilizing the transtheoretical model, behavior change can be maximized by matching the coach’s motivational message to patients or clients readiness to exercise. When this model is implemented in a health intervention it can be called an individually adapted health behavior change program or a lifestyle change program. In the Journal of American Medical Association, Dunn et al (2), presents a study of comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. The study compared results at 6, 18 and 24 months of a lifestyle based intervention based on the participants readiness of change stage and the structured intervention consisting of a regular workout regiment. The lifestyle change group had no membership to a gym and would meet weekly for group activities and counseling sessions. The population groups in this study were fairly healthy yet sedentary individuals. The results showed very similar results between the two groups. At six months the structured group had a slightly higher peak of physical ability but the lifestyle group had also made significant improvements from the baseline. At 24 months the lifestyle group had stayed close to their peak level of fitness and dropped significantly less than the structured workout group. The novel finding is that this approach is as effective in producing beneficial changes in physical activity, cardiorespiratory fitness, blood pressure, and body composition as the traditional structured approach (2). The results of this study show how a lifestyle based fitness intervention program can have significant results comparable to a structured workout and can even be maintained better over the long term. Most people are not ready to go into change right away. The effectiveness of the lifestyle change intervention based on the transtheoretical model is good news for the population who is not able or ready to adopt and maintain a structured workout program. There is a series of five stages of change in the transtheoretical model that unfolds as a process over time. It is useful for health care workers to be able to diagnose which stage of change a person is in and then be able to tailor a motivational strategy of change for them. If you are working with an individual client, you can begin by asking if he or she engages in exercise in accordance with the American College of Sports Medicine guidelines (an accumulated weekly total of at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise or some equivalent combination) (3). Responses from among the following options will determine his or her stage of change: No, and I do not intend to in the next 6 months; No, but I intend to in the next 6 months; No, but I intend to in the next 30 days; Yes, I have been for less than 6 months; or Yes, I have been for more than 6 months (3). The five stages of the Transtheoretical Model are: one; pre-contemplation (not yet ready for change), two; contemplation (getting ready for change), three; Preparation (ready for change), four; action (actively making change), and five; maintenance (adhering to their behavior changes over time) (5). In pre-contemplation stage (not yet ready), the individual has no realistic thoughts of actually exercising or making behavior changes within the foreseeable future. They have often not been exposed to or don’t realize the weight of the benefits of adopting the behavior. They may also be thinking of all the cons involved with the behavior change. Individuals in this stage will often be defensive, demoralized, or in denial. This stage of lack of readiness to change is not to be confused with a lack of desire to change. The desire is in there and a person in this stage needs to realize the benefits involved for them. Asking the clients â€Å"What’s in it for them? † and â€Å"How will they benefit from exercising regularly? † will help them to build up the benefits in their mind. Moving to the next stage of change happens when the client realizes this change will make them healthier, improve their well-being, help them feel more confidant, make them stronger, and inspire others to be more active. The second stage of the transtheoretical model is contemplation (getting ready) (5). This category of people is intending to change or start exercising new behaviors within the next half year. They have become aware of the benefits involved in their prescribed change but are also acutely aware of the cons and drawbacks of their change. Confidence and commitment must be instilled in this group in order to be able to adopt regular exercise. This can be done by comparing the growing list of pros against the cons on the patients mind. For example you may ask, â€Å"How does finding the time to exercise compare to the time you could be adding to your life by actually exercising? † (3). The third stage of the transtheoretical model is preparation (ready) (5). Participants at this stage are ready to start taking action within the next 30 days. They take small steps that they believe can help them make the healthy behavior a part of their lives. For example, they tell their friends and family that they want to change their behavior. During this stage, participants are encouraged to seek support from friends they trust, tell people about their plan to change the way they act, and think about how they would feel if they behaved in a healthier way. Their number one concern is—when they act, will they fail? They learn that the better prepared they are the more likely they are to keep progressing. The fourth stage of the transtheoretical model is action. Participants at this stage have changed their behavior within the last 6 months, and need to work hard to keep moving ahead. These participants need to learn how to strengthen their commitments to change and to fight urges to slip back. Strategies taught here include substituting activities related to the unhealthy behavior with positive ones, rewarding themselves for taking steps toward changing, and avoiding people and situations that tempt them to behave in unhealthy ways. The fifth stage of the transtheoretical model is maintenance (5). Participants at this stage changed their behavior more than 6 months ago. It is important for people in this stage to be aware of situations that may tempt them to slip back into doing the unhealthy behavior—particularly stressful situations. Participants here learn to seek support from and talk with people they trust, spend time with people who behave in healthy ways, and remember to engage in alternative activities to cope with stress instead of relying on unhealthy behavior. Individually adapted lifestyle behavior change programs to increase physical activity teach behavioral skills to help participants incorporate physical activity into their daily routines. The programs are tailored to each individual’s specific interests, preferences, and readiness for change. These programs teach behavioral skills such as goal-setting and self-monitoring of progress toward those goals, building social support for new behaviors, behavioral reinforcement through self-reward and positive self-talk, structured problem solving to maintain the behavior change and prevention of relapse into sedentary behavior (1). Different strategies of motivation are most effective at different stages of change. Understanding what stage of change a patient is in will cater to the most effective intervention strategy being used on them. This paper reviewed the effectiveness of lifestyle change interventions based on the transtheoretical model and showed it to be as effective as traditional structured workout interventions on sedentary lifestyles. This is good news for the population who has previously been deemed unchangeable couch potatoes. The idea of success can be redefined to accept a change from one level of change to the next. Moving from pre-contemplation to the ready phase is a huge accomplishment that should not be overlooked.