Unit4HealthBehaviorStudyGuide.pdf

PUH 5304, Health Behavior 1

Course Learning Outcomes for Unit IV

Upon completion of this unit, students should be able to:

1. Appraise the theoretical models used to define health behavior principles.
1.1 Identify how the Transtheoretical Model of Change can be used to determine how to proceed

with health behavior change.

2. Evaluate the role of the health educator in health behavior change.
2.1 Discuss the role of a health educator in helping a community reach a particular goal.
2.2 Explain ways health educators use stage matching in health education.

Course/Unit
Learning Outcomes

Learning Activity

1.1
Unit Lesson
Chapter 6
Unit IV Assignment

2.1

Unit Lesson
Chapter 6
Video: Determinants of Health (Segment 1 of 6)
Unit IV Assignment

2.2
Unit Lesson
Chapter 6
Unit IV Assignment

Reading Assignment

Chapter 6: Stage Models for Health Promotion

In to access the following resources, click the links below.

Video Education America (Producer). (2010). Determinants of health. (Segment 1 of 6) [Video file]. Retrieved

from
https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPla
ylists.aspx?wID=273866&xtid=42230

The transcript for this video can be accessed here.

Unit Lesson

In the previous unit, we discussed the idea that there are many things that play a role in a person’s decision-
making process outside of simply their own will to change. We discussed how determinants of health could
affect a person’s readiness to change, and affect his or her ability to change behavior. In this unit, we will
discuss how to identify a person or population’s readiness to change.

Transtheoretical Model of Change

The Transtheoretical model of change (TMC) was developed in the 1970s by James Prochaska and
colleagues and is often referred to as the stages of change model (DiClemente, Salazar, & Crosby, 2019).
One of those colleagues was Ralph DiClemente, which you are sure to see quite often in the public health
field. The model came to be after the two set off to capture experiences of people who were able to quit

UNIT IV STUDY GUIDE

Transtheoretical Model of Change and
Health Educators

https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPlaylists.aspx?wID=273866&xtid=42230

https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=http://fod.infobase.com/PortalPlaylists.aspx?wID=273866&xtid=42230

https://online.columbiasouthern.edu/bbcswebdav/xid-111890317_1

PUH 5304, Health Behavior 2

UNIT x STUDY GUIDE

Title

smoking on their own without of the aid of any quit-smoking aids. The goal was to research why some people
successfully quit smoking cold turkey, while others were unsuccessful (Wu & Chu, 2015). Prochaska and
DiClemente’s research revealed that people were more like to quit smoking without any smoking aids
because they were ready to quit smoking. A person’s decision-making process and the model of intentional
change is the foundation of the TMC. The TMC sits on the premise that a person does not make a change in
their behavior quickly or without making a mindful decision to change behavior. Their research also revealed
that the decision-making process is not linear but rather circular in manner and a person may revisit stages
(Wu & Chu, 2015).

TMC: Stages of Change

There are five stages in the transtheoretical model of change: precontemplation, contemplation, preparation,
action and maintenance as shown below (DiClemente et al., 2019).

 Precontemplation: In this stage, a person is not ready to change. He or she does not have any
intention to begin to change any behavior in the near future. In this stage, the “future” is defined as
the next six months. Example: “I am not ready to start thinking about eating healthy.”

 Contemplation: In this stage, a person is preparing to make a change. Thought has been given to the
pros and cons of making a change, in addition to what it would take to change the behavior. Once a
person looks at the cost and benefit of making a change, he or she may determine that he or she
does not want to put in the effort or he or she is ready to make the leap. A person may remain in this
stage and not change his or her behavior. On the other hand, a person may determine he or she is
ready to make a change and move on to the next stage. Example: “I have decided to start eating
healthy.”

 Preparation: In this stage, a person plans to make a change soon. Soonis considered within the next
30 days. At this point, a person has normally taken some type of noteworthy step toward a behavior
change. Example: “I purchased a healthy eating plan that should help me get started.”

 Action: In this stage, a person is actively changing behavior and has been doing so for up to six
months. Example: “I am eating a healthy diet on a regular basis.”

 Maintenance: In this stage, a person has made the behavior change and has been doing so for more
than six months. Example: “I have been eating a healthy diet for over six months, and it is now part of
my daily routine.”

The stages of change of the TMC are essential; it is important for a health educator to know the different
stages a person may be experiencing in to have a better understanding of how to proceed (Mastellos,
Gunn, Felix, Car, & Majeed, 2014). For instance, if a person were in the contemplation stage, a health

The five stages of the transtheoretical model of change
(Eastnine, n.d.)

PUH 5304, Health Behavior 3

UNIT x STUDY GUIDE

Title

educator would want to start by giving a person information on how not eating a healthy diet could lead to
different health diseases and why eating a healthy diet would be a good choice. In this stage, a health
educator would not want to focus on getting recipes to share because he or she is just not ready to process
and accept that information yet. Utilizing the stages of change will also help a health educator be more
responsible with his or her resources. A health educator would not want to waste any time focusing on things
that would not help a person make a change if they are not ready.

Health Professional Interview

In to take a deeper look at how health educators use models and frameworks like the TMC in their
everyday work, we will be hearing from another health educator in the field to gain some insight on her
experiences. Theresa Frost-Goodrich is a certified health educator with a passion for health and wellness and
has 13 years of experience in public health education and health promotion. She also holds certifications as a
Center for Disease and Prevention (CDC) National Diabetes Prevention Program lifestyle coach and an
American Association of Diabetes Educators (AADE), L2. With a Bachelor of Science in Public Health
Education and Health Promotion from Central Michigan University, Theresa has worked across multiple public
health disciplines from employer wellness to community health. Her experience includes health education
design, strategic planning, program development, grant administration, communication design, and analysis
of wellness and benefits trends. With public health as her core background, she has developed employer-
based wellness program roles at Pitney Bowes Inc., Memorial Sloan-Kettering Cancer Center, and Goldman
Sachs. In her role as diabetes program manager at Beaumont Health, she directed the implementation of
evidence-based programming for the pre-diabetic and diabetic populations in communities of need for
multiple counties in the hospital’s service area. Currently serving as account manager at Asset Health—a
health and wellness consulting, management, and technology firm—Theresa designs innovative employer-
based wellness programs for clients and their employees.

Click here to listen to the interview.
Click here to view the transcript.

Bringing It All Together

In this unit, health educator Theresa Frost-Goodrich discussed how she has used the TMC in her positions as
a workplace health and wellness health educator. The TMC is useful when it comes to behavior change.
Taking the time to understand how to apply the TMC to the goal of behavior change helps a person’s process
of change run smoothly. The TMC allows a health educator to meet a person where they are. The only way to
truly understand what stage a person is in is by listening to him or her to gauge the best way to proceed with
a tailored plan of action.

References

DiClemente, R. J., Salazar, L.F., & Crosby, R.A. (2019). Health behavior theory for public health: Principles,
foundations, and applications (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Eastnine. (n.d.). Side view of man (ID 36053963) [Vector]. Retrieved from https://www.dreamstime.com/stock-

photos-side-view-man-running-image36053963

https://online.columbiasouthern.edu/bbcswebdav/xid-111890332_1

https://online.columbiasouthern.edu/bbcswebdav/xid-111890316_1

PUH 5304, Health Behavior 4

UNIT x STUDY GUIDE

Title

Mastellos, N., Gunn, L. H., Felix, L. M., Car, J., & Majeed, A. (2014). Transtheoretical model stages of change
for dietary and physical exercise modification in weight loss management for overweight and obese
adults. Cochrane Database of Systematic Reviews, 2(2). doi:10.1002/14651858.CD008066.pub3

Wu, Y. K., & Chu, N. F. (2015). Introduction of the transtheoretical model and organizational development

theory in weight management: A narrative review. Obesity Research & Clinical Practice, 9(3), 203–
213. doi:10.1016/j.orcp.2014.12.003

Learning Activities (Nongraded)

Nongraded Learning Activities are provided to aid students in their course of study. You do not have to submit
them. If you have questions, contact your instructor for further guidance and information.

In this unit, we heard from Theresa Frost-Goodrich, a professional in the field of health education. As a
student, consider the importance of hearing from someone already in the field of health. What did you learn?
What could you take away from the interview and apply to your own life?