• Nutrition Research and Practice
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• 제11권4호
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• pp.319-326
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• 2017

BACKGROUND/OBJECTIVE: Effective weight reduction remains a challenge throughout the world as the prevalence of obesity and its consequences are increasing. This study aimed to determine the effects of an individualized nutrition counseling program (IC) matched with a transtheoretical model (TTM) for overweight and obese subjects. SUBJECTS/METHODS: Fifty overweight and obese subjects aged 19-60 years with a body mass index ${\geq}23kg/m^2$ were enrolled in the weight reduction study. They were randomized into two groups: Intervention group received an IC matched with a TTM; control group received an educational handbook. Body weight (BW), body fat (BF), waist circumference (WC), waist to height ratio (WHtR), stages of change (SOC), processes of change (POC), food intake, and physical activity (PA) were assessed at baseline and at 4, 8, and 12 weeks after program initiation in both groups. All data were analyzed by intention-to-treat, using SPSS software for hypothesis testing. RESULTS: Forty-five female subjects were included in the 12-week trial at Ramkhamhaeng Hospital, Bangkok, Thailand. The results showed significant weight loss ($1.98{\pm}1.75kg$; 3% loss of initial weight) in the intervention group at 12 weeks, compared to a $0.17{\pm}1.67kg$ loss in the control group. There were significant differences between intervention and control groups in BF mass ($-1.68{\pm}1.78$, $-0.04{\pm}1.62kg$); percentage BF ($-1.54{\pm}2.11$, $0.08{\pm}2.05$); WC ($-5.35{\pm}3.84$, $0.13{\pm}3.23cm$); WHtR ($-0.0336{\pm}0.02$, $-0.0004{\pm}0.02$), and energy consumption ($-405.09{\pm}431.31$, $-74.92{\pm}499.54kcal/day$) in the intervention and control groups, respectively. Intragroup SOC was improved in both groups. The POC for the weight management action (WMA) process was significantly different with POC scores increasing by $16.00{\pm}11.73$ and $7.74{\pm}14.97$ in the intervention and the control groups, respectively. PA level did not change in either group. CONCLUSIONS: The IC matched with a TTM resulted in reductions in BW, BF, and WC, thus reducing likely health risks by decreasing energy intake and inducing positive behavior changes while enhancing the WMA process.

• 성인간호학회지
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• 제15권3호
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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.

• 보건교육건강증진학회지
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• 제23권2호
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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.

• 사회복지연구
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• 제49권1호
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• pp.5-28
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• 2018

개인의 건강에 부정적인 영향을 미치고 높은 사회경제적 비용 부담을 초래하는 흡연은 예방이 가능하다는 측면에서 중요한 사회문제로 인식되고 있지만, 성인 흡연자의 금연의도에서 행동으로의 종단적인 변화 패턴을 살펴보는 연구는 매우 제한적이다. 따라서 본 연구는 3~11차의 한국복지패널 자료를 활용하여 한국 성인 흡연자 4,968명의 금연행동의 변화 패턴을 반복측정 잠재계층 모형을 사용하여 확인하였다. 반복측정 잠재계층 분석 결과, 본 연구는 (1) 지속적으로 금연 실행/유지 단계에 있는 집단(33.6%) (2) 금연 숙고/준비 단계에서 금연 실행/유지 단계로 변화하는 집단(14.8%), (3) 지속적으로 숙고/준비 단계에 머무르는 집단(29.6%), (4) 지속적으로 숙고이전 단계에 머무를 집단(22.1%)의 4개의 잠재적 집단을 확인하였다. 또한 다항로지스틱 분석을 통하여 금연행동 변화 패턴과 인구사회학적 요인 및 임상적 특성(우울수준 및 음주행동) 간 연관성을 살펴보았다. 다항로지스틱 회귀분석 결과 높은 우울수준과 음주를 하는 흡연자의 경우 지속적 금연 실행/유지 단계의 집단보다는 지속적 숙고 이전 단계에 속할 가능성이 높은 것으로 나타났다. 본 연구의 결과는 금연을 전혀 고려하지 않고 있는 숙고 이전 단계의 사람들과 지속적으로 숙고/준비 단계에 머무를 사람들에 대한 타켓화된 접근이 필요함을 시사한다.

• 대한간호학회지
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• 제35권8호
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• pp.1443-1450
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• 2005

Purpose. The study was conducted to identify predictors of mammography screening for rural Korean women according to 'Stage of Change' from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study. Methods. A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion's HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed. by Rakowski, et al.(1992). Results. The most frequent stage of mammography adoption was 'contemplation' ($40.5\%$). Predictors of stage of mammography adoption included 'mammogram recommended by health professional' (beta==0.59, t=16.12, p=.000), 'perceived benefits' (beta=0.09, t=2.21, p=.050), 'perceived susceptibility' (beta=0.09, t=1.98, p=.050), and 'perceived barriers' (beta=-0.07, t=-2.05, p=.041). 'Mammogram recommended by health professional' demonstrated the greatest association with having a mammogram. Conclusion. Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.

• 성인간호학회지
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• 제14권1호
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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.

• Journal of Preventive Medicine and Public Health
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• 제39권4호
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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.

• 성인간호학회지
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• 제16권2호
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• pp.191-201
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• 2004

Purpose: Many studies have shown that regular exercise produces positive effects on health. The purpose of this study was to examine the differences of health-related quality of life by stage of exercise and the interaction effect of age, sex and stage of exercise. Method: A total of 1266 participants were interviewed with structured questionnaire. Stage of exercise was assessed with a single item and respondents were classified with respect to exercise intention and behavior. Health-related quality of life was measured with SF-36 Health Survey Questionnaire. Result: Health-related QOL were found to be different by stage of exercise. The subjects who were reached maintenance stage showed significantly higher scores on physical functioning, bodily pain, general health perception, mental health, role limitation due to emotional problems, social functioning, and vitality than those in preparation, contemplation, and precontemplation stage. In addition a significant interaction effect between stage of exercise and age was found on physical functioning, bodily pain, general health perception, mental health, and vitality. Conclusion: Perceived health-related QOL varies with stage of exercise. This finding suggests that health is related to both intention and behavior of exercise. Therefore it is important to consider cognitive-motivational and behavioral stage of change for developing exercise programs.

• 보건교육건강증진학회지
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• 제23권2호
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• pp.11-27
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• 2006

Objectives: This study was conducted to evaluate the effects of a tailored program based on the Transtheoretical Model to smoking cessation in high school girls. Methods: A quasi-experimental research design was used in this study. The participants were 35 industrial high school girls who have been smoking. The girls were allocated to an experimental group(18) and a control group(17) by randomization. For intervention, the experimental group received the group smoking cessation program and individual program which tailored according to the stage of change. A common group smoking cessation program was given to the control group. Data were collected before the program, immediately after and 4 weeks after the program was completed and were analyzed with repeated measure ANOVA. Result: In the experimental group, the daily smoking amount, nicotine dependency and decisional balance(Pros) score were significantly decreased and the self-efficacy score were significantly increased at one month after the intervention in comparison with before and immediately after it. The decisional balance(Cons) and processes of change score of the experimental group were significantly increased at immediately after the intervention and one month after it in comparison with before it, and at one month after it in comparison with immediately after it. A significant difference in the daily smoking amount, urine cotinine, nicotine dependency, decisional balance(Pros, Cons) and processes of change score between the both groups was found after one month of intervention. Conclusions: The tailored smoking cessation program was more effective, compared to the common smoking cessation program on smoking behavior, self-efficacy, decisional balance, processes of change. This program can be used for favorable changes in high school girl's smoking behavior.

• 보건교육건강증진학회지
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• 제19권4호
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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.