• Korean Journal of Adult Nursing
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• v.16 no.1
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• pp.72-81
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• 2004

Purpose: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). Method: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. Result: According to the stage of adoption of mammography, 17.4% of the women were In pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption ($R^{2}=26%$). Conclusion: Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.

• Journal of the Korean Dietetic Association
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• v.21 no.3
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• pp.215-226
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• 2015

The prevalence of obesity is increasing worldwide and has become a serious epidemic health problem. We developed the 'Change 10 Habits' educational program based on obesity treatment and dietary guidelines and examined its effects on customized nutrition education in mildly obese adults. The study was approved by the Institutional Review Board. Study subjects were excluded if they had several major diseases, if had consumed an anti-obesity drug, or if they practiced an obesity-related program within 30 days. The subjects (n=87, $25{\leq}BMI$ <30) were each exposed to the customized nutrition education program with four lessons according to the stage of the transtheoretical model (TTM). The stage-matched program was administered for 12 weeks and was run by a clinical dietitian. Overall, subjects who were in the precontemplation/contemplation stage at baseline made progress in the preparation and action/maintenance stage after 12 weeks (P<0.05). For 'Alcohol is consumed, up to 2 drinks per day', the proportion of subjects who belonged in the action/maintenance stage increased from 34.5% to 49.4% at 12 weeks. In addition, scores of all items significantly increased after the program (P<0.05). 'Chew more than 10 times and eat slowly' score significantly increased from $3.9{\pm}2.4$ to $5.8{\pm}2.3$ (P<0.05). In conclusion, behavioral stage-matched nutrition education using the 'Change 10 Habits' program was effective in improving eating behaviors and enhancing healthy lifestyles in mildly obese adults.

• Journal of Korean Academy of Nursing
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• v.34 no.2
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• pp.362-371
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• 2004

Purpose: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior change based on a Transtheoretical Model in middle aged women. Method: The subjects consisted of 317 women by convenience sampling residing in city B. The collected data were analyzed using one-way ANOVA, Scheffe test, and Discriminant analysis by SPSS/WIN program. Result: The subjects were distributed in each stage of change of exercise behaviors: 53 subjects (16.7%) in the precontemplation stage, 86 subjects (27.1%) in the contemplation stage, 88 subjects (27.8%) in the preparation stage, 51 subjects (16.1%) in the action stage and 39 subjects(12.3%) in the maintenance stage. Analysis of variance showed that consciousness raising (F=24.96, p=.00), environmental reevaluation (F=7.l3, p=.00), self reevaluation (F=19.47, p=.00), dramatic relief (F=15.22, p=.00), social liberation (F=4.26, p=.00), counter conditioning (F=26.44, p=.00), a helping relationship (F=13.l7, p=.00), reinforcement management (F=21.25, p=.00), self liberation (F=27.70, p=.00), stimulus control (F=13.49, p=.00), pros (F=14.40, p=.00) and self-efficacy (F=39.9l, p=.00) were significantly associated with the stages of change of exercise behaviors. Through discriminant analysis, it was found that ‘stimulus control’ was the most influential variable in discriminating the five stages of change. Conclusion: This study can provide the basis of a staged matching exercise program using TTM for more effective and useful intervention.

• 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 Korean Academy of Fundamentals of Nursing
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• v.14 no.2
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• pp.230-238
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• 2007

Purpose: The Transtheoretical Model (TTM) is a theoretical construct explaining stages of health behavior change. The purpose of this study was to describe and analyze the stages of health behavior change and health related quality of life (HRQL), Method: A descriptive survey design was utilized, and, using a questionnaire, which included a series of 5 questions designed to assess stages of health behavior change and HRQL instrument, data were collected from 292 adults. Means, standard deviation, t-test, ANOVA, and SNK test were used to analyze the collected data. Results: Health risk behaviors were lack of stress management(44%), alcohol use (42.5%), poor nutrition (37%), smoking (36.3%), a lack of spirituality (28.8%), poor communication skills (21.9%), Lack of safety(21.6%), lack of fittness (20.1%), violent behavior(12.3%), and drug use(6.8%). There was a significant difference in HRQL according to stage of health behavior change (P=0.001). Conclusion: The results of the study identified the need for individualized nursing interventions that based on the stage of health behavior change. Nursing interventions that focus on the stage of health behavior change would be effective for health promotion for Koreans.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.331-338
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• 2006

Objectives: The goal of this study is to measure women's willingness to pay for cancer screening and to identify those factors associated with this willingness to pay. Methods: A population-based telephone survey was performed on 1,562 women (aged 30 years or over) for 2 weeks (9-23th, July, 2004). Data about sociodemographic characteristics, health behaviors, the intention of the cancer screenings and willingness to pay for cancer screening were collected. 1,400 respondents were included in the analysis. The women's willingness to pay for cancer screening and the factors associated with this willingness to pay were evaluated. Results: The results show that 76% of all respondents have a willingness to pay for cancer screening. Among those who are willing to pay, the average and median amount of money for which the respondents are willing to pay are 126,636 (s.d.: 58,414) and 120,000 won, respectively. As the status of education & the income are higher, the average amount that women are willing to pay becomes much more. The amount of money women are willing to pay is the highest during the 'contemplation' stage. Being willing to payor not is associated with a change of behavior (transtheoretical model), the income, the concern about the cancer risk, the family cancer history, the marital status, the general health exam, age and the place of residence. Income is associated with a greater willingness to pay. Old age was associated with a lower willingness to pay. Conclusions: According to the two-part model, income and TTM are the most important variables associated with the willingness to pay for cancer screening. The cancer screening participation rate is low compared with the willingness to pay for cancer screening. It is thought that we have to consider the participants' behavior that's associated with cancer screening and their willingness to pay in order to organize and manage cancer screening program.

• Korean Journal of Adult Nursing
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• v.14 no.1
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• pp.83-92
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• 2002

Purpose: This study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of exercise behavior using Transtheoretical Model in patients with type 2 diabetes mellitus. Method: The study method was a survey in 100 type 2 DM patients at out-patients clinic of Y medical center from March 19, 2000 to October 30, 2000. Result: The results were as follows: The subjects were divided into five stages of exercise behavior ; 15.0% in pre-contemplation stage, 33.0% in contemplation stage, 17.0% in preparation stage, 16.0% in action stage and 19.0% in maintenance stage. The subjects in pre-contemplation stage used all processes of change in the least. "Dramatic relief(DR)", "Environmental reevaluation(ER)" and "Self reevaluation(SR)" were identified as main processes of change in contemplation stage. "Consciousness raising(CR)", "DR" were used higher than average in preparation stage. Helping relationships(HR)", "CR", "ER", "SR", "Social liberation(SL)", "Counter conditioning (CC)", "Reinforcement management(RM)", "Self iberation(SEL)" and "Stimulus control(SC)" were used higher than average in action stage. The subjects in maintenance stage used all process of change the highest except "DR"and "HR". "Cons" score of decisional balance was the highest in pre-contemplation stage, "Pros" score was the highest in action stage and "Self-efficacy" score was the highest in maintenance stage. Conclusion: This study can provide the basis of staged matching exercise program using TTM for more effective and useful intervention.

• Korean Journal of Adult Nursing
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• v.15 no.3
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• pp.483-492
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• 2003

Purpose: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. Method: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). Result: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. Conclusion: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.188-198
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• 2016

This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.