• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.77-89
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• 2006

Objectives: Recent studies have shown that tailoring to women's individual beliefs and stage of cancer screening adoption increase the probability that cancer screening will ensue. To identify variables associated with cancer screening behavior, many studies for cancer screening have used the Transtheoretical Model(TTM). This study was carried out to identity the cognitive and behavioral factors associated with breast cancer screening by stages of change among women, forties aged. Methods: Building on the TTM constructs, we collected the data to test the association with cognitive and behavioral factors for breast cancer screening by stage of change among women, forties aged (N=232), using the self-reported questionnaire. The stages of change were grouped according to screening participation and intention for breast cancer as precontemplation, contemplation, preparation, action, and maintenance. We found out the association between breast cancer screening and cognitive and behavioral factors, and testified the difference between stages of change by chi-square test, one-way ANOVA, and multiple comparison analysis(Duncan test). Results: Analyses of 232 women showed that participation on mammography was 68.1% within lifetime and 46.1% within last 2 years, and we found out the association with breast cancer screening participation, intention and cognitive-behavioral factors. The stages of change based on participation and intention were different from the decisional balance, the screening attitude, and the self-efficacy(p<0.01). The decisional balance was differ from stages of change because the difference on opinions about pros(positives) and cons(negative) were likely to significant by stages of change(p<0.05, p<0.01). Conclusion: To increase the screening rate for breast cancer, it should be developed the tailored message and recommend guideline. And the tailored message should be designed to increase the pros of breast cancer screening(mammography) and to decrease the cons, and considered the woman's stage of adoption.

• Journal of Nutrition and Health
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• v.36 no.7
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• pp.759-768
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• 2003

This study examined the factors related to stages of dietary behavioral changes among 1449 child bearing aged women (mean age $\pm$ SD = 25.6 $\pm$ 5.3 years) residing in large cities. A self administered questionnaire was used to assess stages of dietary behavioral change, meal balance and regularity, food availability, nutrition knowledge, body mass index, nutrient intake, and psycho-social factors including self efficacy, perceived benefits and barriers, social modeling. Undesirable dietary behaviors (precontemplation and contemplation) were shown among 45.1-57.4% of the participants, among those, 33.4-43.0% were precontemplators. Participants' self efficacy scores associated with dietary changes were higher in specific situations (3.42) as compared to general situations (2.86). Similarly, they appeared to perceive more benefits (3.86) rather than barriers (2.76) by changing their inappropriate eating habits. Perception and accuracy scores of nutrition knowledge were relatively high, indicating 90.9 and 80.1, respectively. In terms of food availability at home, fresh fruits received the highest score, followed by milk and milk products, vegetables, meat, alcoholic beverages and soft drinks. In social modeling assessment, family members, as compared to friends, appeared to have better dietary habits. Stages of dietary behavioral change assessed in terms of meal regularity were associated with nutrient intake, showing higher energy and carbohydrate intakes but lower fat intake among those who belonged to the action and maintenance stage. They also presented higher self efficacy and perceived more benefits and less barriers regarding the change of undesirable eating habits. Fresh meat and vegetables were more available among those maintaining desirable dietary habits. Results of this study presented the significant relations of motivational and reinforcing social factors with stages of dietary behavioral changes and a need for the development of tailored nutrition education program considering these factors for child-bearing aged Korean women.

• Korean Journal of Adult Nursing
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• v.21 no.4
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• pp.391-402
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• 2009

Purpose: This study was conducted to identify predictors of the stage of change for smoking cessation of male university students on the basis of the Transtheoretical model (TTM). Methods: The 388 current smokers or exsmokers who agreed to participate were recruited from three areas in Korea from August 2 to September 5, 2006. Data was analyzed using a SPSS program for descriptive statistics, ANOVA, and multiple logistic regression. Results: Most subjects (76.8%) were current smokers. According to stages of change, there were statistically significant differences in self efficacy, smoking temptation, decisional balance (cons, pros), and processes of change. The predictors of transition from contemplation to preparation were behavioral and experiential processes. The predictors of transition from preparation to action were pros of smoking and experiential process. The predictors of transition from action to maintenance were cons of smoking and behavioral process. Conclusion: Specific nursing interventions based on stages of change need to be developed for smoking cessation of male university students.

• Korean Journal of Health Education and Promotion
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• v.20 no.3
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• pp.171-188
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• 2003

This study, based on stages of behavioral change, was aimed at suggesting strategies for the adoption of moderate drinking habits for community-based health education designed to help rural people. An interview survey was conducted during the period from March 4 to April 5, 2002 by sampling 467 rural people living in 6 villages covered by a public healthcare clinic. The results of this study can be summarized as follows； 1. The perceived non-moderate drinkers were less prepared for behavioral change. 2. The heavier drinking habits were ‘drinking alone’, ‘meals accompanied by drinking’ and ‘drinking twice or more at a time’. The agricultural off-season and the custom of brewing liquor at home were negative environmental factors for moderate drinking. 3. The predisposing factors affecting moderate drinking were recognition of health, expectation of the drinking effect, etiquette encouraging overdrinking and control of drinking. The reinforcing factors were stress from ordinary life and perception of being loved. The enabling factor was accessibility to the public healthcare clinic. 4. Rural residents are less motivated to participate in health education for moderate drinking. Based on the above findings, health education strategies for each stage can be suggested as follows： 1) Pre-contemplation stage： improvement of perception, motivation, sharing of experiences, and reawakening. 2) Contemplation/preparation stag e： measurement of value, departure from the inertia against a change, formation of a habit, and reinforcement of the behavior. 3) Action/maintenance stage： creation of a social atmosphere, encouragement of participation, change of life style, and improvement of environment.

• Research in Community and Public Health Nursing
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• v.18 no.3
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• pp.431-440
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• 2007

Purpose: The purpose of this study was to describe stage distribution of current and former smokers and to analyze significant variables that used by adolescents at each stage using the Transtheoretical Model. Methods: A cross-sectional study was performed with 145 students attended to five high schools in one rural area. The survey instruments included stages and processes of change. decisional balance, self-efficacy, and knowledge related to smoking. Results: Among the participants, 47.6% were in the precontemplation and contemplation stages, 20.7% were in the preparation stage, and the other 31.7% were in the action and maintenance stages. Analysis of variance tests revealed that behavioral processes, pros and cons of smoking, and self-efficacy were significantly associated with the stages of smoking cessation, while among 10 processes of change, self-reevaluation, self-liberation, and reinforcement management were significantly different by the stages. Conclusions: The study results suggest that smoking cessation programs should emphasize behavioral strategies, self-efficacy, and decisional balance to help students adopt and maintain smoking cessation.

• The Journal of the Korea Contents Association
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• v.12 no.11
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• pp.246-257
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• 2012

Objectives : This study was aimed to grasp the stages of change in breast cancer screening of the nurses and general women who were over 20 and under 50 and specify the factors which affected the stages of change in breast cancer screening, based on Precaution Adoption Process Model. Methods : This study was conducted for 158 people who consisted of the nurses and general women who were over 20 and under 50. Results : As a result of examining the factors of cues to action and the belief in cancer screening according to the stages of change in the breast cancer screening of the nurses and general women, there was not a statistically significant difference and the perceived barriers showed a statistically significant difference in the stage of behavioral decision, the fifth stage. Conclusion : It is necessary to approach the individuals with the recommendation of cancer screening through the people around them and differentiated strategies considering the stages of change in cancer screening in order to induce the behavioral change in breast cancer screening, and develop and apply the strategies to enhance the severity perceived on the breast cancer.

• Journal of Korean Public Health Nursing
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• v.26 no.1
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• pp.147-157
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• 2012

Purpose: The purpose of this study was to identify the related factors of change affecting the stages of change for exercise, on the assumption that there are various stages of change in the exercise behavior of women in nursing college. Methods: The subjects were 496 female college students in D city. The research instruments were stages of change for exercise behavior, the process of change, decisional balance, and self-efficacy. The dates were analyzed by descriptive statistics, ANOVA, and stepwise multiple regression using the SPSS 18.0 program. Results: The distribution of the subjects across the stages was: pre-contemplation, 17.7%; contemplation, 58.7%; preparation, 19.0%; action, 2.8%; maintenance, 1.8%. Analysis of variance showed that cognitive process (F=17.26, p<0.01), behavioral process (F=27.05, p<0.01), the pros of decisional-balance (F=7.07, p<0.01), the cons of decision-balance (F=5.82, p<0.01), and self efficacy (F=17.79, p<0.01) were significantly associated with the change of exercise behavior stages. The related factors of change affecting the change of exercise behavior stage were the cons of decision-making, counter conditioning, self re-evaluation, and body mass index, including 28.4% R-square. Conclusion: The transtheoretical model would be applicable to explain the exercise behavior of some women in nursing college. So, this study will be useful information for developing effective exercise behavior programs considering female students' stages of change.

• Korean Journal of Health Education and Promotion
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• v.28 no.3
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• pp.67-82
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• 2011

Objectives: The purpose of this study was to identify the factors influencing the stages of exercise behavior change after adjusting for related covariates. Methods: Participants included 362 of fourth to sixth graders in 3 elementary schools in a metropolitan city in Korea. The data were collected using structured questionnaire included Korean Stages of Change Scale for Exercise. Results: Logistic regression results showed that the motivational factors associated with transition from precontemplation to contemplation were cognitive process of change, self-reevaluation, conscious raising; regarding that from contemplation to preparation, cons of the decisional balance; regarding those from preparation to action, behavioral process, counter-conditioning, stimulus control, which were very similar to the results of previous researches subjected other age groups. But, there was no motivational factors associated with from action to maintenance, and self-efficacy had no influence on forwarding stages of change. Conclusions: TTM would be applicable to explain the exercise behavior of some children in Korea, which suggested that it be useful in developing the programs to improve physical activities of Korean school children.

• Korean Journal of Health Education and Promotion
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• v.19 no.4
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• pp.61-76
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• 2002

The purpose of this study is to identify differences in processes of change, decision making, and self-efficacy by exercise behavioral stages and determine variables significantly affecting the older people's participation in exercises. The subjects of this study included 299 people aged 65 or over who were residents of G and S districts in Busan Metropolitan City. They were selected through purposive quota sampling at colleges and centers for old people and homes in order that they could be evenly distributed over stages of pre-contemplation, contemplation, preparation, action and maintenance. Data were analyzed using descriptive, ANOVA, Logistic Regression. Variables that discriminate between participants and non-participants in exercise include self-reevaluation, reinforcing management, cons and self-efficacy. Thus if variables that discriminate between participant and non-participation in exercise such as self-reevaluation, reinforcing management, cons and self-efficacy are fully considered in designing nursing interventions for inducing old people to become exercise participants, it would provide guidelines for nursing intervention programs as appropriate for the people's exercise stages. The purpose of this study is to identify differences in processes of change, decision making, and self-efficacy by exercise behavioral stages and determine variables significantly affecting the older people's participation in exercises. The subjects of this study included 299 people aged 65 or over who were residents of G and S districts in Busan Metropolitan City. They were selected through purposive quota sampling at colleges and centers for old people and homes in order that they could be evenly distributed over stages of pre-contemplation, contemplation, preparation, action and maintenance. Data were analyzed using descriptive, ANOVA, Logistic Regression. Variables that discriminate between participants and non-participants in exercise include self-reevaluation, reinforcing management, cons and self-efficacy. Thus if variables that discriminate between participation and non-participation in exercise such as self-reevaluation, reinforcing management, cons and self-efficacy are fully considered in designing nursing interventions for inducing old people to become exercise participants, it would provide guidelines for nursing intervention programs as appropriate for the people's exercise stages.

• Korean Journal of Health Education and Promotion
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• v.22 no.1
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• pp.103-115
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• 2005

The Purpose of this study was to identify the process of change, decisional balance and self-efficacy corresponding to the stages of change in exercise behavior based on the Transtheoretical Model(TTM) in obese adolescents. A random sample of 517 obese adolescents was recruited in Pusan. The data were collected from June 15 to 30, 2004. The research instruments were Stages of Change for Exercise Behavior, Process of Change, Decisional Balance, and Self-Efficacy. The data were analyzed by descriptive statistics and ANOVA using SPSS WIN 10.0 program. The results of this study were as follows 1. The subjects were distributed in each stage of exercise behavior: There were 255 subjects($49.3\%$) in the contemplation stage, 131 subjects($25.3\%$) in the preparation stage, 52 subjects($10.1\%$) in the maintenance stage, 41 subjects($7.9\%$) in the action stage, and 38 subjects($7.4\%$) in the precontemplation stage. 2. Analysis of variance showed that cognitive process (F=13.57, p=.000), behavioral process(F=17.23, p=.000), decisional balance pros(F=11.95, p=.000), and self efficacy(F=12.52, p=.000) were significantly associated with the stages of exercise behavior change, but decisional balance cons(F=2.87, p=.023) was not significantly associated with the stages of exercise behavior change. This study can provide useful information for developing effective exercise behavior program considering obese adolescents' stages of change according t'.t the TTM.