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Failure of Post-Action Stages of the Transtheoretical Model to Predict Change in Regular Physical Activity: A Multiethnic Cohort Study

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Predicting variation in meeting recommended levels of physical activity is important for public health evaluation.

Purpose

The purpose of this study is to determine the predictive value of stages of the Transtheoretical Model (TTM) for classifying people who meet the US Healthy People 2010 guideline for regular physical activity.

Methods

A cohort (N = 497) from a random, multiethnic sample of 700 adults living in Hawaii was assessed at 6-month intervals three or more times for 2 years. Latent transition analysis was used to classify people according to TTM stages and separately according to whether they met the guideline. The predictive value of pre- vs. post-action stages was then tested.

Results

Stages were more likely to falsely classify people as meeting the guideline than to falsely classify them as not meeting it. Probabilities of predicting 6-month transitions were about 50% for the stable class of meeting the guideline each time and just 25% for transitions between meeting and not meeting the guideline.

Conclusion

The TTM post-action stages had limited usefulness in this cohort. Further longitudinal study is needed to determine whether TTM stages can accurately classify transitions from physical inactivity to physical activity below recommended levels.

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Acknowledgment

Supported by National Cancer Institute grant RO1 CA109941.

Author information

Authors and Affiliations

  1. Department of Kinesiology, The University of Georgia, Ramsey Center, 330 River Road, Athens, GA, 30602-6554, USA

    Rod K. Dishman Ph.D., Nathaniel J. Thom Ph.D. & Cherie R. Rooks M.S.

  2. University of Illinois—Champaign Urbana, Urbana, IL, USA

    Robert W. Motl Ph.D.

  3. University of Otago, Dunedin, New Zealand

    Caroline Horwath Ph.D.

  4. University of Hawaii-Manoa, Manoa, HI, USA

    Claudio R. Nigg Ph.D.

Authors
  1. Rod K. Dishman Ph.D.
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  2. Nathaniel J. Thom Ph.D.
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  3. Cherie R. Rooks M.S.
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  4. Robert W. Motl Ph.D.
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  5. Caroline Horwath Ph.D.
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  6. Claudio R. Nigg Ph.D.
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Corresponding author

Correspondence to Rod K. Dishman Ph.D..

Appendix 1

Appendix 1

Interview definition of participation in regular physical activity according to TTM stages [25, 26]:

“We will be talking about regular exercise for the next few questions.”

“By regular exercise we mean any planned physical activity—for example, brisk walking, jogging, bicycling, swimming, dancing, tennis, rowing, or lifting weights—which is performed to increase physical fitness. Vigorous activity is hard physical effort that makes you breathe much harder than normal and should be performed 3 or more times per week for 20 or more minutes per session. Moderate activity is moderate physical effort that makes you breathe somewhat harder than normal and should be performed 30 or more minutes a day, 5 or more days per week. Exercise can be vigorous activity or moderate activity.”

“So, according to the definition we just went through,

  • Do you currently engage in regular exercise?

  • Do you intend to engage in regular exercise in the next 6 months?

  • Do you intend to engage in regular exercise in the next 30 days?

  • Have you been exercising regularly for the past six months?”

Interview definition of participation in regular physical activity according to IPAQ [27]:

“I am going to ask you about the time you spent being physically active in the last 7 days. Please answer each question even if you do not consider yourself to be an active person. Think about the activities you do at work, as part of your house and yard work, to get from place to place, and in your spare time for recreation, exercise or sport.”

“Moderate physical activities make you breathe somewhat harder than normal and may include carrying light loads, bicycling at a regular pace, or doubles tennis. Do not include walking. Again, think about only those physical activities that you did for at least 10 minutes at a time. Vigorous activities make you breathe much harder than normal and may include heavy lifting, digging, aerobics, or fast bicycling. Think about only those physical activities that you did for at least 10 minutes at a time.

During the last 7 days, on how many days did you do moderate physical activities?”

How much time in total did you usually spend on one of those days doing moderate physical activities?

“Vigorous activities make you breathe much harder than normal and may include heavy lifting, digging, aerobics, or fast bicycling. Think about only those physical activities that you did for at least 10 minutes at a time.

During the last 7 days, on how many days did you do vigorous physical activities?

How much time in total did you usually spend on one of those days doing vigorous physical activities?”

Interview definition of participation in regular physical activity according to GLTEQ [28]

“How many days in a week do you do moderate activity for at least 30 minutes a day total?”

Moderate activity is activity that doesn’t make you tired, and makes you sweat just a little.

Some examples would be fast walking, slow bicycling, easy swimming, weight lifting, baseball, softball, tennis, volleyball, hula, or dancing.

“How many days in a week do you do strenuous activity for at least 30 minutes a day total?”

“Strenuous activity is activity that makes your heart beat quickly, and makes you sweat. Some examples would be running, jogging, fast bicycling, aerobic dance, roller blading, paddling, fast swimming, soccer, basketball, football or martial arts.”

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Dishman, R.K., Thom, N.J., Rooks, C.R. et al. Failure of Post-Action Stages of the Transtheoretical Model to Predict Change in Regular Physical Activity: A Multiethnic Cohort Study. ann. behav. med. 37, 280–293 (2009). https://doi.org/10.1007/s12160-009-9113-8

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