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Stages of Change Model (Transtheoretical Model)

The Stages of Change Model, also called the Transtheoretical Model, explains an individual's readiness to change their behavior. It describes the process of behavior change as occurring in stages. These stages include:

  • Pre-contemplation: There is no intention of taking action.
  • Contemplation: There are intentions to take action and a plan to do so in the near future.
  • Preparation: There is intention to take action and some steps have been taken.
  • Action: Behavior has been changed for a short period of time.
  • Maintenance: Behavior has been changed and continues to be maintained for the long-term.
  • Termination: There is no desire to return to prior negative behaviors.

Stages of Change Examples

  • High Five for Kids incorporated elements of the Stages of Change Model into a primary care-based obesity management program for overweight children and their caregivers. The program provided caregivers with counseling sessions and resources, with results including lower increases in body mass index and less time spent watching television. Program participants received resources including a booklet and a Smoke-Free Homes Kit, along with a coaching call from a program specialist to supplement the materials.
  • Based on the Stages of Change Model, Smoke-Free Homes: Some Things Are Better Outside is a home-based intervention designed to reduce second-hand smoke exposure by promoting home smoking bans.
  • The Centers for Disease Control and Prevention (CDC) provides a Talking about Fall Prevention with Your Patients fact sheet that describes how to use the Stages of Change Model for fall prevention education.

Considerations for Implementation

The Stages of Change Model describes how an individual or organization integrates new behaviors, goals, and programs at various levels. At each stage, different intervention strategies will help individuals progress to the next stage and through the model. Individuals within a population will likely vary in their readiness to change. In addition, it is important to recognize that movement through this model is cyclical — individuals may progress to the next stage or regress to a previous stage.

The Stages of Change model can be applied to health promotion and disease prevention programs to address a range of health behaviors, populations, and settings. It may be an appropriate model for health promotion and disease prevention programs related to worksite wellness, tobacco use, weight management, medication compliance, addiction, and physical activity, among other health topics.

Resources to Learn More

Stages of Change Theory
Overview of the stages of change or transtheoretical model (TTM) in a health promotion setting: precontemplation, contemplation, preparation, action, and maintenance. Describes examples of each stage, clinical significance of TTM, and offers guidelines for team interventions by health professionals.
Authors(s): Raihan, N., & Cogburn, M.
Date: 3/2022