Adoption of Change: A Systematic Review of the Transtheoretical Model

Abstract

Introduction
Sedentary lifestyle is a risk factor for life-altering comorbidities. Though the World Health Organization (WHO) and the Centers
for Disease Control (CDC) have provided guidelines, 80% of Americans do not get the recommended physical activity (PA) dose
per day. Motivation continues to be an important and elusive factor to effect change.
Purpose
Assess the available evidence regarding the application of the transtheoretical model and stages of change theory (TTM-SOC) in
the last 10-years to behavior changes for PA.
Methods
Databases including PSYCInfo, ERIC, CINAHL, EBM, DARE, and OVID, were searched with the following key search terms:
“Lifestyle Changes” OR “Lifestyle” OR “Active Living” OR “Lifestyle Changes” OR “Physical Activity” OR “Actigraphy” OR
“Exercise” OR “Activity Level” AND “Transtheoretical Model” OR “Stages of Change”. Seventy-nine studies fit the inclusion
criteria and were assessed for quality and validity using the PEDrO scale for experimental studies and the specialist unit for review
evidence (SURE) for cohort investigations.
Results
Of the five (5) interventional studies included, none used all four components of the TTM-SOC, namely, stages of change, decisional
balance, processes of change and self-efficacy. Observational studies were assessed with eleven (11) classified as observational
analytical and nineteen (19) as observational descriptive.
Conclusion
None of the investigations assessed the full TTM-SOC. As such, there can be no definitive conclusions with regard to the effectiveness
of stage-matched interventions to promote a change from sedentary lifestyle to adoption of PA. There is a need for more
rigorous research to test the application of TTM-SOC with both physiologic and quantitative measures for PA.