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Are precontemplators less likely to change their dietary behavior? A prospective analysis
Ken Resnicow1, Frances McCarty, Tom Baranowski
1School of Public Health, University of Michagan, Ann Arbor, MI 48109, USA. kresnic@sph.emory.edu
Health Education Research
|December 5, 2003
Summary
African-American adults in the Eat for Life Trial showed that individuals in the precontemplation stage increased fruit and vegetable intake as much as those in the preparation stage. These findings question the predictive validity of the stage of change for intervention response.
Area of Science:
- Behavioral Science
- Public Health Nutrition
- Health Psychology
Background:
- The Transtheoretical Model (TTM) posits that individuals progress through distinct stages of change.
- The stage of change is often used to tailor interventions, assuming those in later stages (e.g., preparation) are more receptive to behavior modification than those in earlier stages (e.g., precontemplation).
- Previous research has largely supported the stage-based approach for predicting health behavior change.
Purpose of the Study:
- To examine the association between baseline stage of change and intervention outcomes in African-American adults.
- To determine if individuals in the precontemplation stage respond differently to an intervention aimed at increasing fruit and vegetable intake compared to those in the preparation stage.
- To assess the validity of the stage of change construct within the Transtheoretical Model as a predictor of intervention response.
Main Methods:
- The Eat for Life Trial utilized a sample of African-American adults attending Black churches.
- Participants completed food-frequency questionnaires to assess fruit and vegetable intake and psychosocial variables at baseline and 1-year follow-up.
- Individuals were classified into stages of change (precontemplation, preparation) based on baseline assessments.
Main Results:
- Individuals initially classified as precontemplators reported an increase in fruit and vegetable intake comparable to those in the preparation stage.
- Post-intervention fruit and vegetable intake was equivalent between precontemplators and those in the preparation stage.
- Changes in psychosocial outcomes were similar or greater among precontemplators compared to those in the preparation stage.
Conclusions:
- The findings challenge the predictive validity of the stage of change construct from the Transtheoretical Model for fruit and vegetable intake.
- Interventions may not need to be strictly tailored by stage of change, as precontemplators demonstrated significant behavioral and psychosocial improvements.
- Further research is needed to validate the stage of change as a predictor of intervention response in diverse populations and health behaviors.