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| == Models of Change == | | == Models of Change == |
| === Trans-theoretical Model === | | === Trans-theoretical Model === |
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| The TTM is a model of behaviour change that was first developed in 1977 by James O. Prochaska to aid smokers cease their negative and addictive behaviours. It has since been used in numerous studies across 12 different problem behaviours such as weight control, high-fat diets and quitting cocaine (Prochaska et al. 1994, Prochaska and DiClemente 1992). It has been used as a method to determine an individual’s readiness to change, progress through change and maintenance of new behaviours (Kidd et al. 2003, Peterson 2009), and has been described as an integrative and comprehensive model which builds upon a broad range of psychotherapy theories (Prochaska and Norcross 2001). The TTM consists of six stages of change and ten processes of change, with self-efficacy and decisional balance being central themes of the model (Prochaska et al. 1998). The TTM recognises change as a process that evolves over time with the individual moving through the series of stages. The time that an individual spends at each stage can be variable but the steps that need to be taken to move from one stage to another are not (ProChange Behaviour systems 2015). It is described as a cyclic change process rather than linear as individuals may progress through stages and then relapse many times before maintaining meaningful change (Noar et al. 2007). The physiotherapist can use the TTM to determine the stage a patient is in and then use the processes of change to facilitate progress through stages and reduce probability of relapse (ProChange Behaviour systems 2015).
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| As described earlier obesity and weight gain is a modern day epidemic and is growing in both the adult and adolescent populations. Problem behaviours such as weight gain and sedentary lifestyles often start in adolescence and repeated over time become habitual and part of an individual’s self-image (Kidd et al. 2002). By targeting at risk adolescent population with specific interventions based on the TTM principles physiotherapist may be able to invoke lifestyle changes that will be carried into adulthood (Prapavessis et al. 2006). The TTM is a model which is being used in clinical practice throughout the world across a broad range of populations including adolescents (Kidd et al. 2002, Woods et al. 2002, Prapavessis et al. 2006). Kidd et al. (2002) described the TTM as an appropriate and valid tool for use with an adolescent population, with several studies employing the model for changing risky behaviours exhibited by adolescents.
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| Stages of change and processes of change
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| The six stages of change of the TTM are described in figure x (Kidd et al. 2002, Peterson 2009, Woods et al. 2002):
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| == Attitudes and Perceptions == | | == Attitudes and Perceptions == |
