• 대한간호학회지
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• 제34권2호
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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.

• Journal of Preventive Medicine and Public Health
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• 제57권2호
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• pp.167-175
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• 2024

Objectives: Rural housewives are integral to household management and family care, yet their sedentary lifestyles present significant health risks. This study used the transtheoretical model (TTM) to investigate strategies that encourage and maintain regular exercise habits among rural housewives. Methods: A semi-experimental study was conducted in 2021 with 114 housewives aged 30 to 59 who attended rural health centers in Gorgan, Iran. Participants were randomly assigned to 1 of 2 groups. Data collection involved a validated questionnaire that gathered demographic information and constructs of the TTM. The intervention group participated in a comprehensive educational program, which included four 60-minute sessions. Data were collected again 6 months post-intervention and analyzed using descriptive and inferential statistics in SPSS version 21. Results: The study encompassed women with an average age of 39.75±6.05 years, the majority of whom had educational levels below a diploma, and over 90% were married. We observed strong correlations between the processes of change, self-efficacy, and decisional balance. At the outset, there were no significant differences in demographics or model structures between the 2 groups. However, 6 months post-intervention, the intervention group exhibited statistically significant differences in the mean scores of model structures, stages of change, and body mass index (p<0.05). Conclusions: This study highlights the importance of physical activity training for rural housewives. The findings suggest that the educational intervention, which utilized the TTM, significantly impacted the participants' model structures and their stages of change.

• 대한영양사협회학술지
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• 제21권3호
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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.

• 보건교육건강증진학회지
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• 제24권3호
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• pp.73-86
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• 2007

Objective: The purposes of this study are to understand the characteristics of the participants in a community walking campaign and to analyze the factors related to their participation based on the Transtheoretical Model (TTM). Methods: The study composed of the description of participant characteristics and comparison of them with non-participant characteristics in a walking campaign in K province. The data were collected through a survey of 2,590 participants and 258 non-participants from the same community. The survey instrument included questions about stages of walking and exercise, knowledge and attitude toward walking, and environmental condition for walking. Results: A majority of the walking campaign participants were in the action(24.8%) and maintenance(43.6%) stages of walking and exercise behavior. The non-participant group was split between maintenance(51.6%) and precontemplation (30.6%) stages. Among the participants, effective campaign promotion channels differed by age group while motivation for participation and participation patterns were associated with both age and gender. Favorable physical environment was a significant factor of participating in walking campaign(OR=1.396, CI=1.149-1.696). Although the campaign participants scored higher than the non-participants in most attitude toward walking questions, differences in knowledge scores between two groups were less significant. Conclusion: In conclusion, further social marketing to increase the awareness and to increase the concern of population in the community is needed based on the survey result. Transtheoretical model seems appropriate to apply to the evaluation and the planning the program of the behavior change in the community. Also, more organized and sustainable support in need to maintain the good habit of walking for the participants in walking campaign.

• 지역사회간호학회지
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• 제18권4호
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• pp.611-623
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• 2007

Purpose: To evaluate a reducing alcohol intervention program for workers. Method: The intervention program employed one-group pretest-post-test design with repeated measuring by quasi-experimental study. The program was developed from literature review based on the Transtheoretical Model, and evaluated from April 6 to June 22, 2006. Sixteen white collar male workers participated. At the beginning, the subjects were at the pre-contemplation stage (50%) and contemplation stage (50%). The intervention was applied personally or in group twice a week for 9 weeks. Results: The scores of each stage of change in the post-test increased significantly compared with those in the pretest. The scores of process (cognitive and behavioral) of change in the post-test increased significantly compared with those in the pretest. The score of self-efficacy of change in the post-test increased significantly compared with that in the pretest. The score of pros-cons for drinking in the post-test decreased significantly compared with that in the pretest. The consumption of alcohol a week and a day in the post-test decreased significantly compared with that in the pretest. The levels in ALT, AST, GGT, total cholesterol, triglyceride, B.P. and BMI in the post-test did not decrease significantly compared with those in the pretest, but the level of FBS decreased significantly compared with that in the pretest. Conclusion: The above result informs us that a stage-based reducing alcohol intervention program for workers has the effect of increasing the stages of change, the process of change (cognitive and behavioral) and self-efficacy, and decreasing pros-cons for drinking alcohol consumption and FBS, and it also has a value as an effective means of nursing for workers.

• 한국직업건강간호학회지
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• 제23권4호
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• pp.262-268
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• 2014

Purpose: This study was conducted to identify the differences by the stages of change in exercise behaviors of caregivers based on Transtheoretical Model. Methods: The subjects were consisted of randomly chosen 105 caregivers working in a nursing home. The collected data were analyzed with descriptive statistics, chi-square test, ANOVA and Duncan test using IBM SPSS Statistics 19. Results: The results showed that in the stages of exercise behaviors, there were most participants in contemplation stage with 24.7%, followed by 22.8% in preparation, 21.9% maintenance, 19.0% action and 11.4% pre-contemplation. As for the process of change by the stages of change in exercise behaviors, it showed statistically significant differences in behavioral strategies (F=7.64, p<.001). In decisional balance, pros (F=3.75, p=.007) showed statistical significance, with higher pros in all stages except pre-contemplation. Self-efficacy was also statistically significant (F=6.25, p<.001), especially in the maintenance stage. Conclusion: This study suggested that in order to encourage caregivers to exercise, a strategic intervention to reinforce the process of change, recognition of positive decision-making and promotion of self-efficacy in exercise behaviors should be developed.

• 한국학교ㆍ지역보건교육학회지
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• 제18권2호
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• pp.55-70
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• 2017

Objectives: The purpose of this study was to identify the factors associated with stage of change for drinking cessation among adolescents on the basis of the Transtheoretical Model. Methods: The data was collected from 343 high school students in Kimhae-city, who have experienced any kind of alcohol in their lifetime. For data analysis, descriptive statistics and Logistic regression were performed using the SPSS WIN 18. 0 program. Results: The stage of change was as follows: 24.2% in the precontemplation stage, 8.7% in the contemplation stage, 10.8% in the preparation stage, 39.7% in the action stage and 16.6% in maintenance stage. The predictive factors to move from the precontemplation stage to the contemplation/preparation stage were dramatic relief (OR=1.36, 95% CI:1.13-1.63) and self-efficacy (OR=1.05, 95% CI:1.01-1.09). The predictive factors to move from the contemplation/preparation stage to the action/maintenance stage were female (OR=0.50, 95% CI:0.27-0.94), the number of friend who have drunk (OR=0.84, 95% CI:0.77-0.91) and self-efficacy (OR=1.04, 95% CI: 1.00-1.07). Conclusions: To stop adolescent drinking, this study suggests the intervention program needs to be considered the individual's stage of change of drinking. The intervention program to enhance dramatic relief and self-efficacy is needed to adolescents in the precontemplation stage. It is crucial to develop strategies to raise self-efficacy for adolescents in the contemplation/preparation stage, which also respect their gender and peer groups.

• 경영정보학연구
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• 제19권4호
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• pp.183-209
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• 2017

정보기술이 발전함에 따라 소비자들은 혁신적인 새로운 서비스로의 전환을 보다 빈번하게 고려하게 되었다. 이에 따라 기업에게도 고객의 서비스 전환 행동은 주요 과제 중 하나가 되었다. 이러한 요구에 부응하기 위해 학계에서도 고객의 서비스 전환 행동과 관련한 다양한 연구들이 진행되어 왔다. 그럼에도 불구하고, 쾌락적 서비스(hedonic service)에 대한 고객의 전환 행동을 단계적으로 파악한 연구는 거의 이루어지지 않고 있다. 본 연구는 범이론적 모형(TTM: transtheoretical model)을 기반으로 서비스 전환 행동의 단계를 파악하고, 서비스 제공자 전환 모형(SPSM: service provider switching model)을 기반으로 전환 행동 단계별로 서비스 전환에 영향을 미치는 요인이 어떻게 변화하는지를 파악하고자 한다. 이를 위해 숙박공유경제 서비스에 대한 고객의 전환 행동과 관련한 가설을 제시하고 이를 실증적으로 분석하였다. 분석 결과 서비스 전환 행동 단계에 따라 서비스 전환 행동에 영향을 미치는 요인이 달라짐을 파악하였다. 본 연구는 서비스 전환 행동과 영향 요인이 단계별로 차이가 있음을 밝힘으로써 고객 유지 및 이탈 방지를 위한 가이드라인을 제시할 수 있을 것이다. 또한 고객 유지 역량을 증대시킴으로써 기업성과를 향상시키고자 하는 경영자들에게 실질적인 도움을 줄 수 있을 것이다.

• 농촌의학ㆍ지역보건
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• 제25권1호
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• pp.113-131
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• 2000

이 연구는 일개 군 지역 농촌주민을 대상으로 한 건강증진사업 접근전략 개발을 위하여 흡연, 음주 및 운동에 대한 행태를 단계별로 그 분포를 기술함으로써 향후 건강증진사업의 기획과 평가에 적용 및 효율적이고 효과적인 건강증진사업의 접근전략 개발을 위한 기초자료를 제공하고자 시도되었다. 본 조사의 대상자는 옥천군의 30세 이상 주민 중 남성 384명(43.1%), 여성 508명(56.9%)이었다. 조사는 1999년 8월중 6일간 다단계 추출법으로 선정된 세대별로 구조화된 면담지를 이용한 직접 방문조사를 통하여 이루어졌다. 사용된 설문지는 사회인구학적 조사변수로는 성, 연령, 학력, 직업, 총수입, 결혼상태 등을 포함하였으며, 흡연과 음주 그리고 운동은 행동변화 6단계로 측정하였다. 흡연경력자의 흡연의 행동수정 변화 6단계의 분포는 남자인 경우, 계획전 단계에 50.6%, 계획 단계에 32.5%인데 반해 여자의 경우 계획전 단계 60.6%, 계획 단계 28.8%로 계획전 단계와 계획단계에 집중된 분포 양상이었다. 음주 경력자에서는 남자인 경우 계획전 단계가 72.8%, 계획단계 19.3%였으며, 여자의 경우 계획전 단계 80.3%, 계획단계 15.5%로 계획전 단계의 분포가 집중되어 있었다. 운동의 경우에도 남자가 계획전 단계가 80.6%, 유지단계 1.8%, 완료단계가 10.2%였으며, 여자의 경우 계획전 단계 87.6%, 유지단계 1.2%, 완료단계 5.3%로 계획전 단계에서는 여성이 더 높았으나 준비단계 이상의 긍정적인 단계에서는 남자가 더 많아 성별로 유의한 차이를 보였다. 따라서 성인들에서의 건강증진의 접근전략에서 위험요인별로 각기 다른 단계별 전략이 개발되어야 함을 시사하였다. 또한 특히 흡연, 음주, 운동의 건강증진 전략은 계획전 단계가 일차적으로 목표되어야 한다. 흡연과 음주 그리고 운동의 행동수정 변화 단계간에 유의한 일치도는 없었으나 상관 분석에서는 흡연과 음주, 음주와 운동이 유의한 상관을 다변수 분석에서 운동과 음주, 운동과 흡연간에 유의한 관련성을 보였다. 따라서 행동수정의 단계적 변화론 모형의 건강행태 측정에서 그 타당도가 재확인 되어야하며, 이러한 행동수정의 단계별 변화론의 적용결과는 추후 중재연구의 전향적 추적조사를 통하여 검정되어 건강행위로의 가능한 출입구(gateway)가 밝혀져야 할 것이다.

• 대한간호학회지
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• 제35권7호
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• pp.1285-1294
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• 2005

Purpose: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. Method: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. Result: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with $42.1\%$ in Precontemplation, $24.1\%$ in Contemplation, $9.7\%$ in Preparation, $6.2\%$ in Active, and $17.9\%$ in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained $33.2\%$ of the smoking cessation. Conclusion: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.