Transtheoretical

Transtheoretical model (TTM), also known as the stage of change model, is a framework for studying how people modify health-related behaviors. Developed in the late 1980s by James O. Prochaska and Carlo C. DiClemente, it integrates concepts from several theories to describe the process of intentional change rather than focusing on a single factor.

The model posits that change progresses through a series of stages: precontemplation (not considering change), contemplation (ambivalent but considering change within the next six months), preparation (intending to act soon and planning steps), action (actively engaging in the new behavior), and maintenance (sustaining change over time). Some formulations include termination, a stage in which the former behavior is no longer a temptation. Transitions between stages are not strictly linear and individuals may move back and forth.

Key constructs within TTM include decisional balance (weighing the pros and cons of changing), self-efficacy (confidence in one's ability to change and to resist relapse), and temptation (inclination to revert to the former behavior in high-risk situations). The model also identifies processes of change, a set of experiential and behavioral strategies such as consciousness-raising, self-reevaluation, reinforcement management, helping relationships, stimulus control, and cue exposure, which are used to facilitate progress through stages.

Applications of the transtheoretical model span health promotion, substance abuse treatment, smoking cessation, weight management, and adherence to medical regimens. Criticisms focus on questions about stage discreteness, measurement reliability, and the universality of sequential progression, though meta-analytic reviews report modest but consistent effects in certain contexts.