Transtheoretical Model

Precontemplation

Individuals in the precontemplation stage do not intend to change in the next 6 months. People in this stage may think that their unhealthy behavior is not a real or serious problem for many reasons. They may avoid thinking, reading, or talking about their behavior, and may seem resistant, defensive, and unmotivated.

Contemplation

In the contemplation stage, individuals admit that their behavior is a problem and they are seriously considering change within the next 6 months. They [Page 1044]acknowledge the benefits of change but are keenly aware of the costs, resulting in ambivalence. These individuals often delay acting on their intentions and may remain in this stage for a long time (‘chronic contemplation’).

Preparation

Individuals in the preparation stage intend to change behavior in the next 30 days. They have a specific plan of action that includes small steps forward, such as smoking fewer cigarettes, quitting smoking for 24 hr, enrolling in an online program, or talking to a health professional. Often, they have made recent short-term attempts to change behavior.

Action

Individuals in the action stage must meet a specific and well-established behavioral criterion, such as quitting smoking (rather than cutting down), or eating five or more daily servings of fruits and vegetables (rather than eating more in one serving). Ideally, the criterion reflects expert consensus on how much change is necessary to promote health or reduce disease risk. The action stage lasts for 6 months, since this includes the period of greatest relapse risk.

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