• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.250-265
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• 2024

Purpose: This study aimed to develop an app-based self-management program based on the transtheoretical model (TTM) for breast cancer survivors' exercise practice, as well as to investigate the program's effects on the stage of change for exercise, exercise self-efficacy, exercise decisional balance, exercise amount, and body composition. Methods: This non-randomized controlled study included 52 participants (26 in each of the experimental and control groups, respectively). An app-based self-management program based on the TTM was conducted with the experimental group for a 12-week period. The program comprised three components: individual coaching for each stage of change for exercise based on TTM, amount of exercise and body composition monitoring, and online self-help meetings. Results: Compared with the control group, the experimental group had significantly higher stages of change for exercise (p < .001), exercise self-efficacy (p < .001), exercise decisional balance (p = .002), exercise amount (p < .001), and body composition (body weight [p = .006], body mass index [p = .005], and body fat percentage [p = .010]) immediately and four weeks after the intervention. Conclusion: An app-based self-management program based on the TTM improves exercise behaviors in breast cancer survivors and provides physical benefits.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.113-131
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• 2000

Transtheoretical model of change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. The objectives of this study were to describe the distribution of smokers by stage of change of smoking, alcoholic drinking, and exercising in rural residents and to develope health promotion strategies. This study was done in Okchun County of Chungbuk Province. The representative sample were 892 residents over 30 years old. The questionnaires of interview included socio-demographic, the six stage distribution of smoking, alcoholic drinking, and exercising. In male, 50.6% of smokers were in the precontemplation stage, 32.5% in the contemplation. In female, corresponding figures were 60.6% and 28.8%. Precontemplation and contemplation stage of drinker were 72.8%, 19.3% in male and 80.3%, 15.5%. Distribution of exercise were 80.6%, 1.8% in male, 87.6%, 1.2% in female, respectively. The stage distribution of smoker, alcoholic drinker, and exerciser was shift to left of the distribution. And the stage distribution was slightly differ with each health behavior. The stage of change with smoking, drinking and exercising was correlated with each other but not concordant. So interventions in rural residents need to take into account the large proportion of precontemplators repeatedly observed among smoker, drinker, and non-exerciser. And intervention strategies of each risk behavior should be different approach. Result of concordance analysis suggest reconstruct validity of the transtheoretical model in our country due to ethnic and sociocultural difference. This results and theory should be tested in prospective intervention studies for seeking the possible gateway of health behavior.

• Journal of Preventive Medicine and Public Health
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• v.57 no.2
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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.

• Korean Journal of Adult Nursing
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• v.16 no.3
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• pp.421-431
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• 2004

Purpose: The study was performed to investigate the predictors associated transition with each stage of exercise behavior based to the Transtheoretical Model, and to provide basic data for exercise behavior programs for middle aged women. Methods: The subjects consisted of 434 women residing in B city by convenience sampling. The collected data were analyzed with multiple logistic regression using SPSS/WIN program. Results: The predictors of transition from precontemplation to contemplation were consciousness raising(OR=2.095, 95% CI: 1.305-3.363), Reinforcement management(OR= 1.903, 95% CI: 1.107-3.271), Stimulus control (OR=2.176, 95% CI:1.239-3.820), Menstrual status (OR=5.327, 95% CI: 1.110-25.562). The predictors of transition from contemplation to preparation were Helping relationship(OR= 1.671, 95% CI: 1.065-2.662), Pros(OR=2.500, 95% CI: 1.254-4.982), Perceived Health status (OR=.178, 95% CI: .041-.770). The predictor of transition from preparation to action was Stimulus control(OR=1.918, 95% CI: 1.103- 3.336). The predictors of transition from action to maintenance were Consciousness raising(OR= 1.939, 95% CI: 1.031-3.647), Dramatic relief (OR=2.249, 95% CI: 1.025-4.931). Conclusions: Adequate examination on the factors, which can predict the transitional stages of change exercise behaviors among middle aged women, which is presented in this study. The results of this study will become the pillar of exercise intervention program planning and application.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.3
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• pp.391-401
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• 2001

Purpose: The purpose of this study was to identify variables that influence smoking cessation based on the transtheoretical model. Methods: Variables that influence the stages of change in smoking cessation were selected based on transtheoretical model. Data were collected from 176 men aged 30-64 who smoked, Data collection was done in community settings in Seoul and vicinity, Korea between December, 1999 and June, 2000. Data were analyzed by descriptive statistics and logistic analysis using the pc-SAS program. Results: According to the logit model, the influence of significant variables on stage of change for smoking cessation suggest that ; When the scores for Pros in decision making for smoking cessation are high, the possibility that the subjects are in the action, precontemplation and contemplation stage of change will be lower than the possibility that the subjects are in the maintenance stage of change. When the scores of habitual craving in smoking temptation is high, the possibility that the subjects are in the precontemplation and contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of smoking temptation in negative affect situations are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of cognitive process in the process of change are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. Conclusions : The results provide evidence that physical and psychological dependence on smoking are main barriers to smoking cessation. Therefore nursing interventions based on stage that focus on increasing motivation and intention for smoking cessation need to be developed.

• Korean Parent-Child Health Journal
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• v.11 no.1
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• pp.61-72
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• 2008

This study is a descriptive research attempted to examine the exercise practice of junior high school students and figure out their changing process, decision-making balance, and self-efficacy according to the exercise practice so that they can be utilized as fundamental data for developing exercise intervention programs for junior high school students. The study subjects were students from five junior high schools in B City. Total 600 questionnaires were distributed, and 554 responded ones were analyzed. The collected data were analyzed using SPSS/Win 10.0. According to the results of analyzing the subjects with the exercise changing stage tool, exercise non-practice group including the precontemplation stage, contemplation stage, and preparation stage occupies 57.6% while the exercise practice group including the action stage and maintenance stage consists of 42.4%. And according to the results of discriminating analysis setting total 10 factors of transtheoretical model variables as predictive factors to predict each group based on whether they practice exercise or not, it was found out that the subordinate factors of the changing process, consciousness-raising (F=33.98, p=.000), self-cognitive decision (F=21.55, p=.000), contrary condition provision (F=84.67, p=.000), helping relationship (F=28.52, p=.000), reinforced thinking (F=14.15, p=.000), and stimulus control (F=54.64, p=.000), and the subordinate factors of the decision-making balance, beneficial factors (F=15.65, p= .000) and hindering factors (F=8.58, p=.004), and self-efficacy (F=78.60. p=.000) were significant predictive factors and discriminating variables. Based on the research findings above, it will be necessary to develop exercise intervention programs sufficiently reflecting the changing process, decision-making balance, and self-efficacy suitably for the subjects and make strategies to encourage their active participation and exercise maintenance, through verifying transtheoretical model variables according to whether the junior high school students practice exercise or not.

• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.656-668
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• 2018

Purpose: The purpose of this study was to develop and examine the effects of combined exercise program for older adults with sarcopenia based on transtheoretical model (TTM). Methods: A non-equivalent control group with a pretest-posttest design was used. The subjects consisted of 43 older adults with sarcopenia in precontemplation stage, contemplation stage and preparation stage of TTM (experimental group: 22, control group: 21). The developed program consisted of 36 sessions for 12 weeks including combined exercise (60 minutes) and TTM based strategies for enhancing exercise behavior (10 minutes) per session. Data were collected before, immediately after the program between July 31 to October 27, 2017. The data were analyzed using independent t-test, Mann-Whitney U test with SPSS/WIN 18.0. Results: Compared with their counterparts in the control groups, older adults with sarcopenia in the experimental group showed a significantly greater improvement in process of exercise behavior change, pros and cons of decisional balance for exercise behavior, exercise self-efficacy, parameters of muscle, and the level of physical performance. Conclusion: The study findings indicate that this combined exercise program for older adults with sarcopenia based on TTM model was effective and can be recommended as a nursing intervention for older adults with sarcopenia.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.514-514
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• 2005

• 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.36 no.4
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• pp.587-595
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• 2006

Purpose. The purpose of this study was to differentiate the change in exercise behavior into different stages and to investigate differences in the process of change, self efficacy, decisional balances and depression according to the stages of exercise behavior change among middle aged women in Korea by using the transtheoretical Model. Methods. A convenience sample of 434 middle aged women (40-64 years) completed measures of all transtheoretical model constructs involved in exercise behaviors (stages and processes of exercise behaviors change, self efficacy and decisional balance) and depression. The data were analyzed by using the SPSS 10.0 program including descriptive statistics, and one-way ANOVA. Results. The subjects were distributed in each stage of change in exercise behaviors: pre-contemplation (n = 106; 24.4%), contemplation (n = 126; 29%), preparation (n = 88; 20.3%), action (n = 51; 11.8%), and maintenance (n = 63; 14.5%). The processes of change, pros (advantages of behaviors), self-efficacy and depression were significantly differentiated across the stages of exercise behavior change. Cons(disadvantage of behaviors) was not significantly differentiated across the stages of exercise behavior change. Conclusions. Results of this study suggested that discriminating of processes of change, self-efficacy, decisional balance, and depression could provide positive information to people about the stages of change in exercise behavior. Therefore, in designing interventions, the stage of a client's exercise behaviors change needs to be assessed prior to application of intervention programs in order to increase and maintain exercise behavior in middle aged women.