Processes and stages of personal health behavior change

This study investigated Prochaska and DiClemente's (1984) Processes and Stages of Change Model (PSCM) as a model for changing a variety of health-related behaviors. Subjects were primarily undergraduates from two colleges (N = 323) . They were assessed on their general health habits (both positive and negative) and on the processes and stages of change for a specific habit (chosen from a list of positive and negative behaviors). Demographic data collected included age, sex, race, income, and education. MANOVAs using Wilks's Lambda procedure, with appropriate follow-up tests, were performed on the primary data to answer four specific research questions: (a) Across health behaviors what experiential and environmental processes are used most frequently at each stage? (b) Are the frequencies with which the experiential and environmental processes used at each stage significantly different for positive and negative health-related behaviors? (c) Are individuals with an array of good health habits distinguishable from individuals with poor health habits in terms of the experiential and environmental processes used at each stage of change? (d) Are subjects who are unsuccessful at sustaining changes (relapsers) significantly different from those in a maintenance stage relative to the frequency of use of the experiential and environmental processes at each stage? Results related to the first research question indicated that six pivotal processes promoted successful change across the Contemplation, Action, and Maintenance stages. These processes were Self Liberation, Self Reevaluation, Environmental Reevaluation, Interpersonal Control, Stimulus Control, and Substance Use. In general, a combination of experiential and environmental processes were emphasized by subjects in the Action stage. Environmental processes were exclusively emphasized in the Maintenance stage. One primary and one secondary model variation was discovered for subjects attempting to change a variety of behaviors. Different models of self-change were found for subjects changing positive behaviors versus subjects changing negative health behaviors in the analysis related to the second research question. Results related to the third question indicated no difference in use of the processes of change across the stages of change for subjects with good health habits versus subjects with poor health habits. Similarly, results indicated no difference in process use for subjects who maintained changes for six months or more versus subjects who relapsed, the focus of the fourth research question. In all, one primary and three secondary model variations emerged for subjects attempting self-change of health behaviors. Knowledge of these model variations is important for health professionals giving advice on changing health behaviors.