Stages of Change Theory

Stagesof Change Theory

Stagesof Change Theory


DoesStage of Change Modify the Effectiveness of an EducationalIntervention to Improve Diet among Family Members of HospitalizedCardiovascular Disease Patients?

b).Purpose of the study

Theaim of the study was to assess if effectiveness of a particularintervention to enhance diet against control intervention varies byreadiness to minimize dietary saturated fat founded on theTranstheoretical Model Stage of Change among members of family ofcardiovascular inpatients (Mochari-Greenberger, Terry and Mosca,2010).

c).Variables (dependent &amp independent)

Thedependent variables were the risk factors measurements which includeddemographics, education level, medical and family history among othercharacteristics obtained by a questionnaire at baseline and at 1year. In addition, diet measurements obtained through Block 98 BFFand MEDIFICTS questionnaires. Interventions that were administersincluding special intervention as well as the control interventionsare the independent variables.


Participantswere recruited between January 2005 and June 2007. 501 participantsparticipated in the study. They were English and Spanish dialectsfamily members of patients with cardiovascular disease hospitalizedat New York Presbyterian Hospital. Participants were family members.A family member in this study was defined as a blood relative orpartner or any other person like a son or a daughter living with thepatient or who has cohabited with him/her for at least one year. Themean age of the participants was 48 years, 66 percent being femaleand the minority groups making 36 percent. The average fat intake ofthe participants was 10.7 percent of daily calories at baseline(Mochari-Greenberger, Terry and Mosca, 2010).


Thestudy entails exploring the behavior of family members ofhospitalized patients of cardiovascular disease. There are variousinterventions approaches to minimize calorie and fat accumulationamong family members of these patients.

f).Data collection methods/instruments used

Stagesof change including pre-contemplation, contemplation, action,preparation and maintenance were evaluated by the use of standardizedquestionnaire. Participants diet was evaluated in person byprofessional interviewer assisted questionnaire at baseline and ayear using the BFF (Block 98 Food Frequency Questionnaire) in theFamily Intervention Trial for Heart Health. There were fiveinterviewers who were trained to administer the data collection tool(Block 98 BFF). The questionnaires take between 30 to 40 minutes tocomplete. Questionnaires which were successfully completed werescanned and evaluated by NutritionQuest (Mochari-Greenberger, Terryand Mosca, 2010).

Inaddition, participants were evaluated at baseline and a year usingMEDFICTS questionnaire which represent (meat, eggs, dairy, friedfoods, fat in baked foods convenience foods, fats added at the tableand snacks). This instrument is part of the National CholesterolEducation Program Adult Treatment Panel III stipulations.

TherapeuticLifestyle Change diet training was provided to individualintervention subject designed for baseline stage of change. Analysisof data involved multivariable linear regression. It was used todetermine whether the effect of the intervention was influenced bystage of change.


Inthe randomized control trial, participants’ special intervention inthe contemplation phase at baseline experienced huge saturated fatand cholesterol minimization, as compared to participants in specialintervention in other phases and controls. Special interventionparticipants outside maintenance were more probable to enhanceadherence to a first stage diet, and special intervention respondentswere less probable to revert to lower level of change from baselineto a year compared to controls. The results therefore suggest that astage of change suited educational intervention was appropriate tofoster advantageous diet changes and effectiveness may be influencedby baseline stage of change. Participants in the stage of maintenanceat baseline had lower baseline saturated fat and cholesterolconsumption levels as compared to participants not in this stage.

Controlintervention respondents were highly likely than those in specialintervention to regress backward across stage of change, a factorthat could explain the average rise in dietary cholesterol, saturatedfat, and trans-fat intake recorded at 1 year in participants incontrol intervention in action level at baseline.


Theeffectiveness of an intervention to reduce saturated fat changes withbaseline stage of change among members of the family of hospitalizedpatients with cardiovascular disease. These findings can be ofsignificance to consider when planning research or clinical dietintervention. The study observed all the ethical procedures requiredfor study of humans. Strengths of the study include womenparticipants and ethnic minorities, hence increasing thegeneralizability of the findings. The limitations that could beexperienced in the study were addressed effectively. For exampleself-reported diet habit is subject to bias and could vary by stage.To address this limitation, the employment of highly skilledinterviewers and validated questionnaires reduced the chances of suchbias. The recommendations made for future research are an importantindicator for scholars interested in the subject(Mochari-Greenberger, Terry and Mosca, 2010).


Mochari-Greenberger,Terry and Mosca (2010). Does Stage of Change Modify the Effectivenessof an Educational Intervention to Improve Diet among Family Membersof Hospitalized Cardiovascular Disease Patients? Journalof the American Dietetic Association 110,1027-1035

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