Spiritual_Wellness_Holistic_Health_and_the_Practic

Problem - Based Learning 171
EXHIBIT 17.1 Transtheoretical Model “Stages of Change”
1. PRECONTEMPLATION—not interested in change. May deny a need exists.
2. CONTEMPLATION—recognizes a need. Begins to consider altering behavior.
3. PREPARATION—makes plans. May initiate small changes.
4. ACTION—makes commitment and undertakes action.
5. MAINTENANCE—alterations continue, stabilize and become ingrained.
(1994) “ transtheoretical ” model. This construct, also known as the “ stage of change ”
model, suggests that behavioral alterations follow a continuum that begins with “ precontemplation
” and concludes, as seen in Exhibit 17.1, with “maintenance ” (Robbins,
Powers, & Burgess, 1997).
Additionally, the model demonstrates the ability to reliably apply to diverse habits
including, but not limited to, smoking cessation, weight control and exercise acquisition,
found within the college - aged population (Prochaska, Velicer et al., 1994). Ability
to modify behavior can result from identifying position within the continuum as well
as engaging in activities and experiences that expand knowledge, provide a rationale
for change and explore diverse processes and strategies enabling transition between
various stages (Prochaska, DiClemente et al., 1994; Robbins et al., 1997). This investigation
focused on students initially positioned in “precontemplation ” (stage 1) and
“ contemplation ” (stage 2) and assessed the effectiveness of the multiple instructional
approaches in moving them further along the continuum. Contrary to stages 1 and 2,
stage 3, “ preparation, ” while not demonstrating overt, ongoing commitment to lifestyle
modification frequently included small alterations in existing behavior (Prochaska,
DiClemente et al., 1994) and was eliminated from experimental consideration for that
reason. The instrument utilized for evaluating student “stage ” was a modification of an
algorithm developed by Curry, Kristal, and Bowen (1992) which utilized self - reported
responses to a series of questions designed to determine position within the model
(Exhibit 17.2 and Table 17.1 ). Algorithmic assessment of position within the “ stage of
change ” model has demonstrated acceptable validity and reliability between multiple
samples (Green, Rossi, Reed, Wiley, & Prochaska, 1994).
Additionally, the instrument used in this investigation included questions that
identified the behavior that was the foci of student change efforts. This was undertaken
in order to determine whether behaviors being addressed by the study ’ s samples were
consistent with those reliably evaluated with the stage of change model (Prochaska,
Velicer et al., 1994) and were similar between groups. Student behaviors, subjected to
change efforts, were arbitrarily, numerically coded for statistical evaluation. Statistical
evaluation of group characteristics, between group differences and change over a fifteen -
week academic semester utilized accepted methodologies (Remington & Schork,
1970). Results were considered statistically significant at p 0.050.