Transtheoretical model

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for three health behaviors that are crucial to effective weight management: healthy eating (i.e., reducing calorie and dietary fat intake), moderate exercise, and managing emotional distress without eating. Up to three tailored reports (one per behavior) were delivered based on assessments conducted at four time points: baseline, 3, 6, and 9 months. All participants were followed up at 6, 12, and 24 months. Multiple Imputation was used to estimate missing data. Generalized Labor Estimating Equations (GLEE) were then used to examine differences between the treatment and comparison groups. At 24 months, those who were in a pre-Action stage for healthy eating at baseline and received treatment were significantly more likely to have reached Action or Maintenance than the comparison group (47.5% vs. 34.3%). The intervention also impacted a related, but untreated behavior: fruit and vegetable consumption. Over 48% of those in the treatment group in a pre-Action stage at baseline progressed to Action or Maintenance for eating at least 5 servings a day of fruit and vegetables as opposed to 39% of the comparison group. Individuals in the treatment group who were in a pre-Action stage for exercise at baseline were also significantly more likely to reach Action or Maintenance (44.9% vs. 38.1%). The treatment also had a significant effect on managing emotional distress without eating, with 49.7% of those in a pre-Action stage at baseline moving to Action or Maintenance versus 30.3% of the comparison group. The groups differed on weight lost at 24 months among those in a pre-Action stage for healthy eating and exercise at baseline. Among those in a pre-Action stage for both healthy eating and exercise at baseline, 30% of those randomized to the treatment group lost 5% or more of their body weight vs. 16.6% in the comparison group. Coaction of behavior change occurred and was much more pronounced in the treatment group with the treatment group losing significantly more than the comparison group. This study demonstrates the ability of TTM-based tailored feedback to improve healthy eating, exercise, managing emotional distress, and weight on a population basis. The treatment produced the highest population impact to date on multiple health risk behaviors.

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effect. Measures that are associated with both health and sustainability were more common. Effects were reported as number of car trips, distance travelled, main mode share etc. Results varied due to greatly differing approaches. In general, car use could be reduced between 6% and 55%, while use of the alternative mode (walking, biking and/or public transport) increased between 11% and 150%. These results indicate a shift to action or maintenance stage, some researchers investigated attitude shifts such as the willingness to change. Attitudes towards using alternative modes improved with approximately 20% to 70%. Many of the intervention studies did not clearly differentiate between the five stages, but categorised participants in pre-action and action stage. This approach makes it difficult to assess the effects per stage. Also, interventions included different processes of change; in many cases these processes are not matched to the recommended stage. It highlights the need to develop a standardised approach for travel intervention design.

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motivators and barriers at the different stages regarding biking, walking and public transport. The motivators identified were e.g. liking to bike/walk, avoiding congestion and improved fitness. Perceived barriers were e.g. personal fitness, time and the weather. This knowledge was used to design interventions that would address attitudes and misconceptions to encourage an increased use of bikes and walking. These interventions aim at changing people's travel behaviour towards more sustainable and more active transport modes. In health-related studies, TTM is used to help people walk or bike more instead of using the car. Most intervention studies aim to reduce car trips for commute to achieve the minimum recommended physical activity levels of 30 minutes per day. Other intervention studies using TTM aim to encourage sustainable behaviour. By reducing single occupied motor vehicle and replacing them with so called

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stage-matched interventions were more effective than non-matched interventions. One reason for this was the greater intensity of stage-matched interventions. Also, the use of stage-based interventions for smoking cessation in mental illness proved to be effective. Further studies, e.g. a randomized controlled trial published in 2009, found no evidence that a TTM based smoking cessation intervention was more effective than a control intervention not tailored to stage of change. The study claims that those not wanting to change (i.e. precontemplators) tend to be responsive to neither stage nor non-stage based interventions. Since stage-based interventions tend to be more intensive they appear to be most effective at targeting contemplators and above rather than pre-contemplators. A 2010 systematic review of

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a mediator of performance on future tasks. In his research Bandura already established that greater levels of perceived self-efficacy leads to greater changes in behavior. Similarly, Ajzen mentions the similarity between the concepts of self-efficacy and perceived behavioral control. This underlines the integrative nature of the transtheoretical model which combines various behavior theories. A change in the level of self-efficacy can predict a lasting change in behavior if there are adequate incentives and skills. The transtheoretical model employs an overall confidence score to assess an individual's self-efficacy. Situational temptations assess how tempted people are to engage in a problem behavior in a certain situation.

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norm) are positively show a gradually increasing relationship to stage of change for bike commuting. As expected, intention or willingness to perform the behaviour increases by stage. Similarly, Bamberg uses various behavior models, including the transtheoretical model, theory of planned behavior and norm-activation model, to build the stage model of self-regulated behavior change (SSBC). Bamberg claims that his model is a solution to criticism raised towards the TTM. Some researchers in travel, dietary, and environmental research have conducted empirical studies, showing that the SSBC might be a future path for TTM-based research.

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period. The intervention's largest effects were observed among patients with moderate or severe depression, and who were in the Precontemplation or Contemplation stage of change at baseline. For example, among patients in the Precontemplation or Contemplation stage, rates of reliable and clinically significant improvement in depression were 40% for treatment and 9% for control. Among patients with mild depression, or who were in the Action or Maintenance stage at baseline, the intervention helped prevent disease progression to Major Depression during the follow-up period.

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the transtheoretical model stages of change (TTM SOC) method is effective in helping obese and overweight people lose weight. There were only five studies in the review, two of which were later dropped due to not being relevant since they did not measure weight. Earlier in a 2009 paper, the TTM was considered to be useful in promoting physical activity. In this study, the algorithms and questionnaires that researchers used to assign people to stages of change lacked standardisation to be compared empirically, or validated.

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prescribed medication regimen at the 18-month follow-up. Additionally, only 15% of those in the intervention group who were already in Action or Maintenance relapsed into poor medication adherence compared to 45% of the controls. Further, participants who were at risk for physical activity and unhealthy diet were given only stage-based guidance. The treatment group doubled the control group in the percentage in Action or Maintenance at 18 months for physical activity (43%) and diet (25%).

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movement through the stages of change is not always linear, a study of smoking cessation conducted in 1996 demonstrated that the probability of forward stage movement is greater than the probability of backward stage movement. Due to the variations in use, implementation and type of research designs, data confirming TTM are ambiguous. More care has to be taken in using a sufficient amount of constructs, trustworthy measures, and longitudinal data.

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alternative interventions including best-in-class action-oriented self-help programs, non-interactive manual-based programs, and other common interventions. Furthermore, these interventions continued to move pre-Action participants to abstinence even after the program ended. For a summary of smoking cessation clinical outcomes, see Velicer, Redding, Sun, & Prochaska, 2007 and Jordan, Evers, Spira, King & Lid, 2013.

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intervention are rarely stage-matched and short cuts are taken by classifying participants in a pre-action stage, which summarises the precontemplation, contemplation and preparation stage, and an action/maintenance stage. More generally, TTM has been criticised within various domains due to the limitations in the research designs. For example, many studies supporting the model have been

504:" of comparative potential gains and losses. Decisional balance measures, the pros and the cons, have become critical constructs in the transtheoretical model. The pros and cons combine to form a decisional "balance sheet" of comparative potential gains and losses. The balance between the pros and cons varies depending on which stage of change the individual is in. 933:

Additionally, the effectiveness of stage-based interventions differs depending on the behavior. A continuous version of the model has been proposed, where each process is first increasingly used, and then decreases in importance, as smokers make progress along some latent dimension. This proposal suggests the use of processes without reference to stages of change.

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commute however showed that stage-matched interventions tended to have slightly more effect than non-stage matched interventions. Since many studies do not use all constructs of the TTM, additional research suggested that the effectiveness of interventions increases the better it is tailored on all core constructs of the TTM in addition to stage of change. In

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significant reductions in stress and depression and an increase in the use of stress management techniques when compared to the control group. Two additional clinical trials of TTM programs by Prochaska et al. and Jordan et al. also found significantly larger proportions of treatment groups effectively managing stress when compared to control groups.

417:, Bartholomew et al. (2006) summarised the processes that they identified in a number of studies; however, their extended list of processes was removed from later editions of the text, perhaps because the list mixes techniques with processes. There are unlimited ways of applying processes. The additional strategies of Bartholomew et al. were: 104:, and Carlo Di Clemente and colleagues developed the transtheoretical model beginning in 1977. It is based on analysis and use of different theories of psychotherapy, hence the name "transtheoretical". Prochaska and colleagues refined the model on the basis of research that they published in peer-reviewed journals and books. 965:

TTM has generally found a greater popularity regarding research on physical activity, due to the increasing problems associated with unhealthy diets and sedentary living, e.g. obesity, cardiovascular problems. A 2011 Cochrane Systematic Review found that there is little evidence to suggest that using

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This core construct is "the situation-specific confidence people have that they can cope with high-risk situations without relapsing to their unhealthy or high risk-habit". The construct is based on Bandura's self-efficacy theory and conceptualizes a person's perceived ability to perform on a task as

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People at this stage do not intend to start the healthy behavior in the near future (within 6 months), and may be unaware of the need to change. People here learn more about healthy behavior: they are encouraged to think about the pros of changing their behavior and to feel emotions about the effects

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In each stage, a patient may have multiple sources that could influence their behavior. These may include: friends, books, and interactions with their healthcare providers. These factors could potentially influence how successful a patient may be in moving through the different stages. This stresses

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found that "stage-based self-help interventions (expert systems and/or tailored materials) and individual counselling were neither more nor less effective than their non-stage-based equivalents". A 2014 Cochrane systematic review concluded that research on the use of TTM stages of change "in weight

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Different outcome measures were used to assess the effectiveness of the intervention. Health-centred intervention studies measured BMI, weight, waist circumference as well as general health. However, only one of three found a significant change in general health, while BMI and other measures had no

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Five-hundred-and-seventy-seven overweight or moderately obese adults (BMI 25-39.9) were recruited nationally, primarily from large employers. Those randomly assigned to the treatment group received a stage-matched multiple behavior change guide and a series of tailored, individualized interventions

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Aveyard, Paul; Lawrence, Terry; Cheng, K. K.; Griffin, Carl; Croghan, Emma; Johnson, Carol (May 2006). "A randomized controlled trial of smoking cessation for pregnant women to test the effect of a transtheoretical model-based intervention on movement in stage and interaction with baseline stage".

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Within the health research domain, a 2005 systematic review of 37 randomized controlled trials claims that "there was limited evidence for the effectiveness of stage-based interventions as a basis for behavior change. Studies with which focused on increasing physical activity levels through active

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Participants were 350 primary care patients experiencing at least mild depression but not involved in treatment or planning to seek treatment for depression in the next 30 days. Patients receiving the TTM intervention experienced significantly greater symptom reduction during the 9-month follow-up

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Over 1,000 members of a New England group practice who were prescribed antihypertensive medication participated in an adherence to antihypertensive medication intervention. The vast majority (73%) of the intervention group who were previously pre-Action were adhering to their prescribed medication

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published in 1999, measures of levels of change did not predict premature discontinuation of therapy. Nevertheless, in 2005 the creators of the TTM stated that it is important "that both therapists and clients agree as to which level they attribute the problem and at which level or levels they are

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People in this stage should be encouraged to seek support from friends they trust, tell people about their plan to change the way they act, and think about how they would feel if they behaved in a healthier way. Their number one concern is: when they act, will they fail? They learn that the better

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behaviour". However, it was also mentioned that stage based interventions are often used and implemented inadequately in practice. Thus, criticism is directed towards the use rather the effectiveness of the model itself. Looking at interventions targeting smoking cessation in pregnancy found that

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The quantitative definition of the stages of change (see below) is perhaps the most well-known feature of the model. However it is also one of the most critiqued, even in the field of smoking cessation, where it was originally formulated. It has been said that such quantitative definition (i.e. a

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Main criticism is raised regarding the "arbitrary dividing lines" that are drawn between the stages. West claimed that a more coherent and distinguishable definition for the stages is needed. Especially the fact that the stages are bound to a specific time interval is perceived to be misleading.

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called the TTM "arguably the dominant model of health behaviour change, having received unprecedented research attention, yet it has simultaneously attracted exceptional criticism", and said "that there is still value in the transtheoretical model but that the way in which it is researched needs

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Due to the use of decisional balance and attitude, travel behaviour researchers have begun to combine the TTM with the TPB. Forward uses the TPB variables to better differentiate the different stages. Especially all TPB variables (attitude, perceived behaviour control, descriptive and subjective

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The evaluation of pros and cons is part of the formation of decisional balance. During the change process, individuals gradually increase the pros and decrease the cons forming a more positive balance towards the target behaviour. Attitudes are one of the core constructs explaining behaviour and

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It is recommended that people in this stage seek support from and talk with people whom they trust, spend time with people who behave in healthy ways, and remember to engage in healthy activities (such as exercise and deep relaxation) to cope with stress instead of relying on unhealthy behavior.

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Within research on prevention of pregnancy and sexually transmitted diseases, a systematic review from 2003 comes to the conclusion that "no strong conclusions" can be drawn about the effectiveness of interventions based on the transtheoretical model. Again this conclusion is reached due to the

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Multiple studies have found individualized interventions tailored on the 14 TTM variables for smoking cessation to effectively recruit and retain pre-Action participants and produce long-term abstinence rates within the range of 22% – 26%. These interventions have also consistently outperformed

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While most of these processes and strategies are associated with health interventions such as stress management, exercise, healthy eating, smoking cessation and other addictive behaviour, some of them are also used in other types of interventions such as travel interventions. Some processes are

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Relapse in the TTM specifically applies to individuals who successfully quit smoking or using drugs or alcohol, only to resume these unhealthy behaviors. Individuals who attempt to quit highly addictive behaviors such as drug, alcohol, and tobacco use are at particularly high risk of a relapse.

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Jordan, P.J., Evers, K.E., Spira, J.L., King, L.A., & Lid, V. (2013). Computerized, tailored interventions improve outcomes and reduce barriers to care. Poster presented at the 17th Annual International meeting and Exposition of the American Telemedicine Association in Austin, TX, May 5–7,

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A national sample of pre-Action adults was provided a stress management intervention. At the 18-month follow-up, a significantly larger proportion of the treatment group (62%) was effectively managing their stress when compared to the control group. The intervention also produced statistically

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Sound decision making requires the consideration of the potential benefits (pros) and costs (cons) associated with a behavior's consequences. TTM research has found the following relationships between the pros, cons, and the stage of change across 48 behaviors and over 100 populations studied.

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People in this stage progress by being taught techniques for keeping up their commitments such as substituting activities related to the unhealthy behavior with positive ones, rewarding themselves for taking steps toward changing, and avoiding people and situations that tempt them to behave in

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data would allow for stronger causal inferences. Another point of criticism is raised in a 2002 review, where the model's stages were characterized as "not mutually exclusive". Furthermore, there was "scant evidence of sequential movement through discrete stages". While research suggests that

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Similar criticism regarding the standardisation as well as consistency in the use of TTM is also raised in a 2017 review on travel interventions. With regard to travel interventions only stages of change and sometimes decisional balance constructs are included. The processes used to build the

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can be reduced considerably. A reduction in the number of cars on our roads solves other problems such as congestion, traffic noise and traffic accidents. By combining health and environment related purposes, the message becomes stronger. Additionally, by emphasising personal health, physical

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research the "existing data are insufficient for drawing conclusions on the benefits of the transtheoretical model" as related to dietary interventions. Again, studies with slightly different design, e.g. using different processes, proved to be effective in predicting the stage transition of

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Members of a large New England health plan and various employer groups who were prescribed a cholesterol lowering medication participated in an adherence to lipid-lowering drugs intervention. More than half of the intervention group (56%) who were previously pre-Action were adhering to their

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The use of TTM in travel behaviour interventions is rather novel. A number of cross-sectional studies investigated the individual constructs of TTM, e.g. stage of change, decisional balance and self-efficacy, with regards to transport mode choice. The cross-sectional studies identified both

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person is in preparation if he intends to change within a month) does not reflect the nature of behaviour change, that it does not have better predictive power than simpler questions (i.e. "do you have plans to change..."), and that it has problems regarding its classification reliability.

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At this stage, participants are intending to start the healthy behavior within the next 6 months. While they are usually now more aware of the pros of changing, their cons are about equal to their Pros. This ambivalence about changing can cause them to keep putting off taking action.

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The following notes summarize major differences between the well-known 1983, 1992, and 1997 versions of the model. Other published versions may contain other differences. For example, Prochaska, Prochaska, and Levesque (2001) do not mention the Termination stage, Self-efficacy, or

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People at this stage are ready to start taking action within the next 30 days. They take small steps that they believe can help them make the healthy behavior a part of their lives. For example, they tell their friends and family that they want to change their behavior.

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This core construct identifies the depth or complexity of presenting problems according to five levels of increasing complexity. Different therapeutic approaches have been recommended for each level as well as for each stage of change. The levels are:

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that assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual. The model is composed of constructs such as: stages of change, processes of change, levels of change,

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Achieving a long-term behavior change often requires ongoing support from family members, a health coach, a physician, or another motivational source. Supportive literature and other resources can also be helpful to avoid a relapse from happening.

527:(TPB) and the stage model of self-regulated change, also emphasise attitude as an important determinant of behaviour. The progression through the different stages of change is reflected in a gradual change in attitude before the individual acts. 333:

To progress through the early stages, people apply cognitive, affective, and evaluative processes. As people move toward Action and Maintenance, they rely more on commitments, counter conditioning, rewards, environmental controls, and support.

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Prochaska, J. O.; Velicer, W. F.; Fava, J. L.; Ruggiero, L.; Laforge, R. G.; Rossi, J. S.; et al. (2001a). "Counselor and stimulus control enhancements of a stage-matched expert system intervention for smokers in a managed care setting".

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Bridle, Christopher; Riemsma, Robert Paul; Pattenden, Jill; Sowden, Amanda J.; Mather, Lisa; Watt, Ian S.; Walker, A. (June 2005). "Systematic review of the effectiveness of health behavior interventions based on the transtheoretical model".

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Prochaska and colleagues state that their research related to the transtheoretical model shows that interventions to change behavior are more effective if they are "stage-matched", that is, "matched to each individual's stage of change".

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People at this stage changed their behavior more than 6 months ago. It is important for people in this stage to be aware of situations that may tempt them to slip back into doing the unhealthy behavior—particularly stressful situations.

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People at this stage have changed their behavior within the last 6 months and need to work hard to keep moving ahead. These participants need to learn how to strengthen their commitments to change and to fight urges to slip back.

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In the 1983 version of the model, "decisional balance" is absent. In the 1992 version of the model, Prochaska et al. mention "decisional balance" but in only one sentence under the "key transtheoretical concept" of "processes of

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the importance to have continuous monitoring and efforts to maintain progress at each stage. TTM helps guide the treatment process at each stage, and may assist the healthcare provider in making an optimal therapeutic decision.

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Hemmingsson, Erik; Uddén, Joanna; Neovius, Martin; Ekelund, Ulf; Rössner, Stephan (June 2009). "Increased physical activity in abdominally obese women through support for changed commuting habits: a randomized clinical trial".

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Prochaska, JO; Redding, CA; Evers, KE. The Transtheoretical Model and Stages of Change. In: Glanz, K; Rimer, BK; Viswanath, K. (eds.) Health Behavior and Health Education. 4th ed. San Francisco: Jossey-Bass; 2008. p. 105.

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One of the most effective steps that others can help with at this stage is to encourage them to become more mindful of their decision making and more conscious of the multiple benefits of changing an unhealthy behavior.

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Evers, K. E.; Prochaska, J. O.; Johnson, J. L.; Mauriello, L. M.; Padula, J. A.; Prochaska, J. M. (2006). "A randomized clinical trial of a population- and transtheoretical model-based stress-management intervention".

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In the 1983 version of the model, "self-efficacy" is absent. In the 1992 version of the model, Prochaska et al. mention "self-efficacy" but in only one sentence under the "key transtheoretical concept" of "stages of

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In the 1983 version of the model, the Termination stage is absent. In the 1992 version of the model, Prochaska et al. showed Termination as the end of their "Spiral Model of the Stages of Change", not as a separate

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Levesque, D. A.; Van Marter, D. F.; Schneider, R. J.; Bauer, M. R.; Goldberg, D. N.; Prochaska, J. O.; Prochaska, J. M. (2011). "Randomized trial of a computer-tailored intervention for patients with depression".

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Company founded by James O. Prochaska. Mission is to enhance the well-being of individuals and organizations through the scientific development and dissemination of Transtheoretical Model-based change management

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West claimed that the model "assumes that individuals typically make coherent and stable plans", when in fact they often do not. However, the model does not require that all people make a plan: for example, the

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urgently to be addressed". Depending on the field of application (e.g. smoking cessation, substance abuse, condom use, diabetes treatment, obesity and travel) somewhat different criticisms have been raised.

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Miller, Kay (29 December 2001). "Revolving resolutions – Year after new year, we vow to lose weight, stop smoking, find love or a better job – only to fail. A few simple strategies could set us straight".

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Dramatic relief (Pay attention to feelings) — feeling fear, anxiety, or worry because of the unhealthy behavior, or feeling inspiration and hope when hearing about how people are able to change to healthy

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Prochaska, James O.; DiClemente, Carlo C.; Velicer, Wayne F.; Rossi, Joseph S. (September 1993). "Standardized, individualized, interactive, and personalized self-help programs for smoking cessation".

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Johnson, S. S.; Driskell, M. M.; Johnson, J. L.; Dyment, S. J.; Prochaska, J. O.; Prochaska, J. M.; et al. (2006a). "Transtheoretical model intervention for adherence to lipid-lowering drugs".

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Patterson, D. A.; Buckingham, S. L. (2010). "Does motivational interviewing stages of change increase treatment retention among persons who are alcohol and other drug dependant and HIV-infected?".

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Johnson, S. S.; Driskell, M. M.; Johnson, J. L.; Prochaska, J. M.; Zwick, W.; Prochaska, J. O. (2006b). "Efficacy of a transtheoretical model-based expert system for antihypertensive adherence".

945:, which uses the TTM, also says: "Don't assume that all clients need a structured method to develop a change plan. Many people can make significant lifestyle changes and initiate recovery from 3226:

Velicer, Wayne F.; Fava, Joseph L.; Prochaska, James O.; Abrams, David B.; Emmons, Karen M.; Pierce, John P. (July 1995). "Distribution of smokers by stage in three representative samples".

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activity or even direct economic impact, people see a direct result from their changed behaviour, while saving the environment is a more general and effects are not directly noticeable.

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adults was assessed in a 2014 systematic review. The results revealed that there is inconclusive evidence regarding the impact of these interventions on sustainable (one year or longer)

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Kirk, A.; MacMillan, F.; Webster, N. (2010). "Application of the Transtheoretical model to physical activity in older adults with Type 2 diabetes and/or cardiovascular disease".

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Prochaska, J. O.; DiClemente, C. C.; Velicer, W. F.; Rossi, J. S. (1993). "Standardized, individualized, interactive, and personalized self-help programs for smoking cessation".

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Armitage, Christopher J.; Povey, Rachel; Arden, Madelynne A. (June 2003). "Evidence for discontinuity patterns across the stages of change: a role for attitudinal ambivalence".

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called it "arguably the dominant model of health behaviour change, having received unprecedented research attention, yet it has simultaneously attracted exceptional criticism".

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Prochaska, J. O., & Norcross, J. C. (2002). Stages of change. In J. C. Norcross (Ed.), Psychotherapy relationships that work (303-313). New York: Oxford University Press.

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inconsistency of use and implementation of the model. This study also confirms that the better stage-matched the intervention the more effect it has to encourage condom use.

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Connors, GJ; Donovan, DM; DiClemente, CC. Substance abuse treatment and the stages of change: selecting and planning interventions. 2nd ed. New York: Guilford Press, 2013.

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Spencer, L.; Adams, T.B.; Malone, S.; Roy, L.; Yost, E. (2006). "Applying the transtheoretical model to exercise: a systematic and comprehensive review of the literature".

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Environmental reevaluation (Notice your effect on others) — realizing how their unhealthy behavior affects others and how they could have more positive effects by changing.

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Contemplation ("getting ready") – "People are beginning to recognize that their behaviour is problematic, and start to look at the pros and cons of their continued actions"

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This construct refers to the temporal dimension of behavioural change. In the transtheoretical model, change is a "process involving progress through a series of stages":

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In addition, the researchers conceptualized "Relapse" (recycling) which is not a stage in itself but rather the "return from Action or Maintenance to an earlier stage".

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Brogan, Mary M.; Prochaska, James O.; Prochaska, Janice M. (1999). "Predicting termination and continuation status in psychotherapy using the transtheoretical model".

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Prochaska, J.O.; Wright, J. A.; Velicer, W.F. (2008). "Evaluating Theories of Health Behavior Change: A hierarchy of Criteria Applied to the Transtheoretical Model".

3971:; Prochaska, Judith J.; Eisendrath, Stuart; Rossi, Joseph S.; Redding, Colleen A.; Rosen, Amy B.; Meisner, Marc; Humfleet, Gary L.; Gorecki, Julie A. (October 2006). 4131: 938: 6729: 1149:

Prochaska, James O.; Butterworth, Susan; Redding, Colleen A.; Burden, Verna; Perrin, Nancy; Leo, Michael; Flaherty-Robb, Marna; Prochaska, Janice M. (March 2008).

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Klöckner, C.A. (2017). "A stage model as an analysis framework for studying voluntary change in food choices: The case of beef consumption reduction in Norway".

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Breitling, Lutz Philipp; Twardella, Dorothee; Raum, Elke; Brenner, Hermann (June 2009). "Situational temptation scores and smoking cessation in general care".

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This core construct "reflects the individual's relative weighing of the pros and cons of changing". Decision making was conceptualized by Janis and Mann as a "

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Skill improvement (Build a supportive environment) – restructuring environments to contain important, obvious and socially supported cues for the new behaviour

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Glanz, K; Rimer, BK; Viswanath, K. (eds.) Health behavior and health education: theory, research, and practice, 4th ed. San Francisco, CA: Jossey-Bass; 2008.

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Precontemplation ("not ready") – "People are not intending to take action in the foreseeable future, and can be unaware that their behaviour is problematic"

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Burbank, PM; Riebe, D. Promoting exercise and behavior change in older adults: interventions with the transtheoretical model. New York: Springer; 2002.

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Aveyard, P; Massey, L; Parsons, A; Manaseki, S; Griffin, C (Feb 2009). "The effect of transtheoretical model based interventions on smoking cessation".

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Forward, S.E. (2014). "Exploring people's willingness to bike using a combination of the theory of planned behavioural and the transtheoretical model".

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duration and frequency, and fruits and vegetables consumption, along with reduced dietary fat intake, based on very low quality scientific evidence.

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Health researchers have extended Prochaska's and DiClemente's 10 original processes of change by an additional 21 processes. In the first edition of

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Reinforcement management (Use rewards) — increasing the rewards that come from positive behavior and reducing those that come from negative behavior.

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Johnson, S. S.; Paiva, A. L.; Cummins, C. O.; Johnson, J. L.; Dyment, S. J.; Wright, J. A.; Prochaska, J. O.; Prochaska, J. M.; Sherman, K. (2008).

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Diniz, I.; Duarte, M.; Peres, K.; de Oliveira, E.; Berndt, A. (2015). "Active commuting by bicycle: Results of an educational intervention study".

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Velicer, Wayne F.; Norman, Gregory J.; Fava, Joseph L.; Prochaska, James O. (July 1999). "Testing 40 predictions from the transtheoretical model".

3039:"Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults" 6739: 481:

Coping skills (Identify difficult situations) – identifying high risk situations; selecting solutions; practicing solutions; coping with relapse

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Prochaska, JO; DiClemente, CC. The transtheoretical approach: crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin; 1984.

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Velicer, W. F.; Redding, C. A.; Sun, X.; Prochaska, J. O. (2007). "Demographic variables, smoking variables, and outcome across five studies".

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In the 1983 version of the model, the processes of change were said to be emphasized in only the Contemplation, Action, and Maintenance stages.

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Confidence that they can make and maintain changes in situations that tempt them to return to their old, unhealthy behavior—the TTM calls this

259:

People here learn about the kind of person they could be if they changed their behavior and learn more from people who behave in healthy ways.

122:

Preparation ("ready") – "People are intending to take action in the immediate future, and may begin taking small steps toward behaviour change"

433:

Self-examination relate to risk (Be aware of your risks) – conducting an assessment of risk perception, e.g. personalisation, impact on others

421:

Risk comparison (Understand the risks) – comparing risks with similar dimensional profiles: dread, control, catastrophic potential and novelty

1941: 472:

Skills enhancement (Adapt your strategies) – restructuring cues and social support; anticipating and circumventing obstacles; modifying goals

3469:

Communication for the Commons: Revisiting Participation and Environment: Proceedings of the 2013 Conference on Communication and Environment

915:, the authors found that "stage based interventions are no more effective than non-stage based interventions or no intervention in changing 436:

Reevaluation of outcomes (Know the outcomes) – emphasising positive outcomes of alternative behaviours and reevaluating outcome expectancies

3564: 3333: 2079: 1939:

Prochaska, JO; Velicer, WF; DiClemente, CC; Fava, J (Aug 1988). "Measuring processes of change: applications to the cessation of smoking".

1203: 394:

Self-liberation (Make a commitment) — believing in one's ability to change and making commitments and re-commitments to act on that belief.

1546: 1201:

Greene, GW; Rossi, SR; Rossi, JS; Velicer, WF; Fava, JL; Prochaska, JO (June 1999). "Dietary applications of the stages of change model".

3379: 442:

Self-efficacy and social support (Get help) – mobilising social support; skills training on coping with emotional disadvantages of change

1302:

Changing for good: the revolutionary program that explains the six stages of change and teaches you how to free yourself from bad habits

5708: 3827:"The effectiveness of community-based cycling promotion: Findings from the cycling connecting communities project in Sydney, Australia" 242:

Precontemplators typically underestimate the pros of changing, overestimate the cons, and often are not aware of making such mistakes.

131:

Termination – "Individuals have zero temptation and they are sure they will not return to their old unhealthy habit as a way of coping"

2294:

Janis, I.L. & Mann, L. (1977) Decision making: a psychological analysis of conflict, choice and commitment. New York: Free Press.

4705:

Prochaska, JO; Norcross, JC. Systems of psychotherapy: a transtheoretical analysis. 9th ed. New York: Oxford University Press, 2018.

4158:

Horowitz, Stephen M. (June 2003). "Applying the transtheoretical model to pregnancy and STD prevention: a review of the literature".

4130:. Treatment improvement protocol (TIP) series. Vol. 35 (2019 ed.). Rockville, MD: U.S. Dept. of Health and Human Services, 4096:

Noël, Yvonnick (June 1999). "Recovering unimodal latent patterns of change by unfolding analysis: application to smoking cessation".

3759: 409:

Stimulus control (Manage your environment) — using reminders and cues that encourage healthy behavior and avoiding places that don't.

262:

Others can influence and help effectively at this stage by encouraging them to work at reducing the cons of changing their behavior.

3878:

Riemsma, Robert Paul; Pattenden, Jill; Bridle, Christopher; Sowden, Amanda J.; Mather, Lisa; Watt, Ian S.; Walker, Anne (May 2003).

125:

Action – "People have made specific overt modifications in modifying their problem behaviour or in acquiring new healthy behaviours"

439:

Perception of benefits (Focus on benefits) – perceiving advantages of the healthy behaviour and disadvantages of the risk behaviour

3724:

Gatersleben, B.; Appleton, K.M. (2007). "Contemplating cycling to work: Attitudes and perceptions in different stages of change".

3181:(2001b). "Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation". 660:

The outcomes of the TTM computerized tailored interventions administered to participants in pre-Action stages are outlined below.

5925: 5741: 5713: 4753: 4061: 1979:

Prochaska, Janice M.; Prochaska, James O.; Levesque, Deborah A. (2001). "A transtheoretical approach to changing organizations".

6744: 5718: 5034: 457:

Persuasion of positive outcomes (Persuade yourself) – promoting new positive outcome expectations and reinforcing existing ones

385:

Self-reevaluation (Create a new self-image) — realizing that the healthy behavior is an important part of who they want to be.

6790: 5776: 5683: 4710: 4699: 4595: 2196: 345:

A growing awareness that the advantages (the "pros") of changing outweigh the disadvantages (the "cons")—the TTM calls this

5766: 3932: 2676: 1628: 899: 85: 4579:

DiClemente, CC. Addiction and change: how addictions develop and addicted people recover. New York: Guilford Press; 2003.

2022:

McConnaughy, EA; Prochaska, JO; Velicer, WF (1983). "Stages of change in psychotherapy: measurement and sample profiles".

1522: 6029: 5723: 5287: 4875: 2452: 728:. However, this approach may produce positive effects in physical activity and dietary habits, such as increased in both 63:

since the stages of change are only one part of the model along with processes of change, levels of change, etc. Several

2983:"Transtheoretical model-based multiple behavior intervention for weight management: Effectiveness on a population basis" 2583:"Specific barriers and drivers in different stages of decision-making about energy efficiency upgrades in private homes" 2369:

Bagozzi, R.P.; Yi, Y. (1989). "The degree of intention formation as a moderator of the attitude-behavior relationship".

1499: 749:

In the treatment of smoke control, TTM focuses on each stage to monitor and to achieve a progression to the next stage.

466:

Coping with barriers (Plan to tackle barriers) – identifying barriers and planning solutions when facing these obstacles

424:

Cumulative risk (Get the overall picture) – processing cumulative probabilities instead of single incident probabilities

6785: 6749: 5977: 4791: 4554:

Velasquez, MM. Group treatment for substance abuse: a stages-of-change therapy manual. New York: Guilford Press; 2001.

4451:

Martin, R.; Velicer, WF; Fava, JL. (1996). "Latent transition analysis to the stages of change for smoking cessation".

1868: 1315: 1122: 2674:

Ajzen, I (2002). "Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior".

6034: 6007: 6002: 5781: 5307: 4890: 4584: 4570: 4559: 4548: 4537: 3977: 2748: 2299: 1694: 1399: 1355: 1264: 2450:

Bamberg, S (2013). "Changing environmentally harmful behaviors: A stage model of self-regulated behavioral change".

378:(Get the facts) — increasing awareness via information, education, and personal feedback about the healthy behavior. 6130: 3523: 2332:

Hall, K.L.; Rossi, J. S. (2008). "Meta-analysis Examination of the sting and weak principals across 48 behaviors".

1430: 128:

Maintenance – "People have been able to sustain action for at least six months and are working to prevent relapse"

6754: 6698: 5424: 5052: 5029: 4408: 6775: 6254: 5879: 5698: 5648: 5460: 5357: 5118: 5019: 4932: 3790: 3658: 3615: 454:

Trying out new behaviour (Try it) – changing something about oneself and gaining experience with that behaviour

3329:"'Walk in to work out': A randomised controlled trial of a self help intervention to promote active commuting" 2117:

Velicer, WF; Prochaska, JO; Rossi, JS; Snow, MG (Jan 1992). "Assessing outcome in smoking cessation studies".

1896:; Rakowski, William; Fiore, Christine; Harlow, Lisa L.; Redding, Colleen A.; Rosenbloom, Dena (January 1994). 1571: 6795: 6375: 6244: 5967: 5891: 5531: 5302: 3407: 3228: 3139: 2987: 2334: 1155: 621: 330:

The 10 processes of change are "covert and overt activities that people use to progress through the stages".

3461: 6703: 6316: 6203: 6024: 6014: 5396: 5123: 4024: 3462:"Promoting sustainable transportation across campus communities using the transtheoretical model of change" 3460:

Mundorf, Norbert; Redding, Colleen A.; Fu, Tat; Paiva, Andrea; Brick, Leslie; Prochaska, James O. (2015) .

1594: 1466: 929:

loss interventions is limited by risk of bias and imprecision, not allowing firm conclusions to be drawn".

478:

Self-rewards for success (Reward yourself) – feeling good about progress; reiterating positive consequences

147: 427:

Qualitative and quantitative risks (Consider different factors) – processing different expressions of risk

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Social liberation (Notice public support) — realizing that society is supportive of the healthy behavior.

32: 3973:"Treatment for cigarette smoking among depressed mental health outpatients: a randomized clinical trial" 6325: 5997: 5613: 5538: 5443: 4979: 1386:

Changing to thrive: using the stages of change to overcome the top threats to your health and happiness

1307: 1151:"Initial efficacy of MI, TTM tailoring and HRI's with multiple behaviors for employee health promotion" 524: 101: 6780: 6380: 6363: 6150: 5735: 5730: 5598: 5297: 5004: 4962: 4926: 4833: 4309: 3301:

Standardized, individualized, interactive, and personalized self-help programs for smoking cessation.

1554: 1483: 600: 554: 36: 4543:

Miller, WR; Heather, N. (eds.). Treating addictive behaviors. 2nd ed. New York: Plenum Press; 1998.

475:

Dealing with barriers (Accept setbacks) – understanding that setbacks are normal and can be overcome

6249: 6064: 5987: 5573: 5272: 4984: 4880: 3695:

Rose, G.; Marfurt, H. (2007). "Travel behaviour change impacts of a major ride to work day event".

881: 576: 501: 495: 151: 3880:"Systematic review of the effectiveness of stage based interventions to promote smoking cessation" 6358: 6140: 6079: 5844: 5771: 5603: 2785: 2587: 2024: 1114: 3037:

Mastellos, Nikolaos; Gunn, Laura H.; Felix, Lambert M.; Car, Josip; Majeed, Azeem (2014-02-05).

6800: 6688: 6289: 6158: 6135: 5911: 5867: 5839: 5342: 4828: 4739: 4654:"Using the Stages of change model to help clients through the 12-steps of Alcoholics Anonymous" 2119: 1599: 946: 925: 2244:"Transtheoretical Model of Change during Travel Behavior Interventions: An Integrative Review" 1860: 1854: 451:

Focus on important factors (Prioritise) – incorporating personal factors of highest importance

6390: 6239: 6193: 6046: 5962: 5824: 5608: 5143: 5044: 4937: 4786: 4098: 4059:

Cahill, K; Lancaster, T; Green, N (2010). "Stage-based interventions for smoking cessation".

3654:"Promoting active transport in a workplace setting: Evaluation of a pilot study in Australia" 971: 861: 640:, a spectrum from physiological microcontext to environmental macrocontext: "The horizontal, 586: 375: 3422:

Crawford, F.; Mutrie, N.; Hanlon, P. (2001). "Employee attitudes towards active commuting".

1523:"Health plans use a variety of strategies to identify and ensure compliance among diabetics" 1383: 19: 6668: 6503: 6428: 6294: 6229: 5799: 5583: 5448: 5414: 5362: 5187: 5182: 5128: 5084: 4974: 4912: 4801: 4796: 2639: 582: 1626:

Armitage, Christopher J. (2009-05-01). "Is there utility in the transtheoretical model?".

8: 6400: 6311: 6188: 6059: 5809: 5804: 5578: 5377: 5367: 5202: 4811: 4453: 4243: 3183: 2708: 1805: 1504: 1347: 1033:

In the 1983 version of the model, Relapse is considered one of the five stages of change.

708:

The effectiveness of the use of this model in weight management interventions (including

610: 400: 3073: 3038: 403:(Use substitutes) — substituting healthy ways of acting and thinking for unhealthy ways. 397:

Helping relationships (Get support) — finding people who are supportive of their change.

6528: 6343: 6234: 6163: 5431: 5014: 4863: 4678: 4653: 4640: 4433: 4380: 4353: 4334: 4219: 4183: 3999: 3972: 3855: 3826: 3807: 3586: 3559: 3439: 3355: 3328: 3208: 3009: 2982: 2963: 2902: 2865: 2689: 2611: 2582: 2563: 2538: 2425: 2388: 2272: 2243: 2004: 1767: 1674: 1576: 1435: 1379: 1291: 1177: 1150: 1102: 975: 97: 45: 6473: 4489:

Stages and processes of self-change of smoking: toward an integrative model of change.

3906: 3879: 3380:"Cycle commuting and perceptions of barriers: stages of change, gender and occupation" 3327:

Mutrie, N.; Carney, C.; Blamey, A.; Crawford, F.; Aitchison, T.; Whitelaw, A. (2002).

3196: 2721: 1216: 448:

Tailoring on time horizons (Set the time frame) – incorporating personal time horizons

6673: 6643: 6603: 6483: 6271: 6198: 6115: 6019: 5593: 5588: 5516: 5465: 5239: 5219: 5207: 5167: 5138: 5106: 5024: 4917: 4885: 4781: 4706: 4695: 4683: 4615: 4591: 4580: 4566: 4555: 4544: 4533: 4470: 4466: 4425: 4385: 4371: 4358: 4326: 4293: 4262: 4257: 4238: 4175: 4135: 4078: 4041: 4004: 3949: 3911: 3860: 3811: 3677: 3634: 3591: 3540: 3499: 3443: 3360: 3282: 3245: 3200: 3156: 3115: 3078: 3060: 3014: 2967: 2955: 2919: 2882: 2832: 2765: 2725: 2656: 2616: 2555: 2429: 2421: 2351: 2295: 2277: 2192: 2173: 2136: 2096: 1996: 1958: 1874: 1864: 1824: 1819: 1800: 1759: 1700: 1690: 1653: 1645: 1558: 1487: 1405: 1395: 1384: 1361: 1351: 1321: 1311: 1300: 1270: 1260: 1220: 1182: 1128: 1118: 988: 958: 921: 908: 713: 592: 572: 4644: 4437: 4223: 4187: 4037: 3212: 2008: 1771: 430:

Positive framing (Think positively) – focusing on success instead of failure framing

6678: 6648: 6518: 6320: 6299: 6279: 6105: 5758: 5511: 5470: 5282: 5257: 5069: 4999: 4843: 4673: 4665: 4632: 4611: 4462: 4417: 4375: 4367: 4338: 4318: 4289: 4252: 4211: 4167: 4107: 4074: 4070: 4033: 3994: 3986: 3941: 3901: 3893: 3850: 3840: 3799: 3768: 3735: 3706: 3667: 3624: 3581: 3573: 3532: 3491: 3435: 3431: 3402: 3394: 3350: 3342: 3274: 3237: 3192: 3148: 3107: 3068: 3055: 3050: 3004: 2996: 2947: 2911: 2874: 2824: 2794: 2757: 2717: 2685: 2648: 2637:

Bandura, A (1977). "Self-efficacy: toward a unifying theory of behavioral change".

2606: 2596: 2567: 2547: 2518: 2488: 2461: 2417: 2380: 2343: 2267: 2257: 2165: 2128: 2088: 2033: 1988: 1950: 1914: 1834: 1814: 1751: 1686: 1678: 1637: 1339: 1295: 1252: 1212: 1172: 1164: 1106: 865: 709: 562: 558: 1801:"Time for a change: putting the Transtheoretical (Stages of Change) Model to rest" 523:

behaviour change in various research domains. Other behaviour models, such as the

6693: 6623: 6608: 6563: 6413: 6368: 6125: 6069: 5819: 5521: 5324: 5317: 5252: 5192: 5074: 5064: 4994: 4967: 4952: 4907: 4897: 4848: 4515: 4495: 4406:

Littell, Julia H.; Girvin, Heather (April 2002). "Stages of change: a critique".

4215: 3773: 3754: 3307: 1892:

Prochaska, James O.; Velicer, Wayne F.; Rossi, Joseph S.; Goldstein, Michael G.;

1838: 1248: 614: 486:

recommended in a specific stage, while others can be used in one or more stages.

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Rissel, C.E.; New, C.; Wen, L.M.; Merom, D.; Bauman, A.E.; Garrard, J. (2010).

3278: 3111: 2828: 2652: 2522: 2169: 2132: 1954: 1850: 1530: 1464:

Stettner, Morey (19 December 2005). "A methodical way to change bad behavior".

1426: 993: 606: 143: 64: 4669: 4636: 4111: 3897: 3739: 3710: 3398: 1992: 1918: 1755: 1256: 6769: 6683: 6568: 6548: 6533: 6523: 6488: 6458: 6304: 6213: 6110: 6100: 5934: 5814: 5693: 5501: 5475: 5352: 5312: 5277: 5267: 5247: 4989: 4947: 4922: 4870: 4858: 4853: 4762: 4322: 3990: 3577: 3064: 2601: 1704: 1649: 1641: 1476:"Why it's hard to change unhealthy behavior – and why you should keep trying" 1409: 1365: 1274: 460:

Modelling (Build scenarios) – showing models to overcome barriers effectively

41: 4354:"Physical activity and food environments: solutions to the obesity epidemic" 3945: 3755:"Propensity for Voluntary Travel Behavior Changes: An Experimental Analysis" 3672: 3653: 3629: 3610: 1878: 1325: 1132: 6708: 6653: 6628: 6588: 6573: 6538: 6498: 6468: 6463: 6453: 6385: 6120: 5834: 5262: 5111: 5101: 5079: 5009: 4902: 4816: 4687: 4429: 4389: 4330: 4266: 4179: 4139: 4082: 4045: 4008: 3953: 3915: 3864: 3681: 3638: 3611:"Bicycling to university: Evaluation of a bicycle-sharing program in spain" 3595: 3544: 3503: 3495: 3364: 3286: 3241: 3204: 3160: 3152: 3082: 3018: 2959: 2923: 2915: 2886: 2878: 2836: 2769: 2729: 2620: 2559: 2355: 2281: 2262: 2000: 1828: 1763: 1657: 1562: 1491: 1455: 1224: 1186: 596: 359:

Strategies that can help them make and maintain change—the TTM calls these

4474: 3845: 3471:. International Environmental Communication Association. pp. 427–438. 3346: 3249: 3119: 2177: 2140: 2100: 1962: 6638: 6613: 6543: 6508: 6423: 6348: 6095: 6074: 5829: 5526: 5224: 5133: 5096: 3968: 3178: 2660: 1893: 1113:. Oxford series in clinical psychology (2nd ed.). Oxford; New York: 869: 725: 3536: 2072:"Decisional balance measure for assessing and predicting smoking status" 716:

interventions, or both, and also combined with other interventions) for

322: 6598: 6513: 6408: 5455: 5177: 2392: 2070:

Velicer, WF; DiClemente, CC; Prochaska, JO; Brandenburg, N (May 1985).

2054: 717: 146:

suggested that the stages of change are analogues of the stages of the

80: 60: 3788:

Cooper, C (2007). "Successfully changing individual travel behavior".

2215:

Bartholomew, L.K.K., Parcel, G.S.S., Kok, G., Gottlieb, N.H.H., 2006.

962:

intention to exercise in relation to treating patients with diabetes.

678:

regimen at the 12-month follow-up when compared to the control group.

445:

Decision making perspective (Decide) – focusing on making the decision

6558: 6493: 6478: 6208: 5553: 5372: 4942: 4823: 2798: 2761: 2069: 2037: 512:

The cons of changing outweigh the pros in the Precontemplation stage.

4509:

In search of how people change. Applications to addictive behaviors.

3803: 3560:"Promoting walking to school: Results of a quasi-experimental trial" 2384: 2217:

Planning Health Promotion Programs: An Intervention Mapping Approach

6284: 5957: 5419: 5172: 4806: 4776: 3832:

International Journal of Behavioral Nutrition and Physical Activity

3609:

Molina-García, J.; Castillo, I.; Queralt, A.; Sallis, J.F. (2013).

1391: 1105:; DiClemente, Carlo C. (2005). "The transtheoretical approach". In 943:

Enhancing Motivation for Change in Substance Use Disorder Treatment

729: 648:

of an intervention, rather than the latter's focus on intervention

568: 4498:

J Consult Clin Psychol 1983 Jun;51(3):390–5. Accessed 2009 Mar 18.

3608: 1898:"Stages of change and decisional balance for 12 problem behaviors" 1014:

In the 1983 version of the model, the Preparation stage is absent.

5091: 2249:

International Journal of Environmental Research and Public Health

1148: 916: 877: 721: 469:

Goal setting (Set goals) – setting specific and incremental goals

276:

prepared they are, the more likely they are to keep progressing.

5903: 4731: 2936: 2862: 625:

willing to target as they work to change the problem behavior".

5386: 3377: 3095: 2153: 873: 744: 644:

dimension resembles TTM's Levels of Change, but emphasizes the

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Health Psychol 1993 Sep;12(5):399–405. Accessed 2009 March 18.

2811: 2311: 1938: 1891: 1547:"Why behavior change is hard – and why you should keep trying" 1245:

Systems of psychotherapy: dialectical tensions and integration

51:

The transtheoretical model is also known by the abbreviation "

5548: 3177:

Prochaska, J. O.; Velicer, W. F.; Fava, J. L.; Rossi, J. S.;

3135: 2899: 2745: 4200: 4127:

Enhancing motivation for change in substance abuse treatment

4021: 3877: 3378:

van Bekkum, J.E.; Williams, J.M.; Graham Morris, P. (2011).

1344:

Changeology: 5 steps to realizing your goals and resolutions

5674:

Committee on the Environment, Public Health and Food Safety

5480: 4724: 3966: 3928: 3752: 3481: 2021: 1290: 672: 4481: 3326: 3262: 3225: 3176: 2980: 2705: 1978: 23:

Stages of change, according to the transtheoretical model.

4132:

Substance Abuse and Mental Health Services Administration

3884: 2116: 1735:

Prochaska, James O.; Velicer, Wayne F. (September 1997).

162: 6730:

Association for Applied Psychophysiology and Biofeedback

4518:

Am Psychol 1992 Sep;47(9):1102–14. Accessed 2009 Mar 16.

3557: 2782: 2057:

Cognit Ther Res 1985;9(2):181–200. Accessed 2009 Mar 22.

3558:

McKee, R.; Mutrie, N.; Crawford, F.; Green, B. (2007).

3424:

International Journal of Health Promotion and Education

3299:

Prochaska, JO; DiClemente, CC; Velicer, WF; Rossi, JS.

2055:

Self-efficacy and the stages of self-change of smoking.

1200: 632:, adopted many ideas from the TTM, but in place of the 4601: 3753:

Meloni, I.; Sanjust, B.; Sottile, E.; Cherchi (2013).

2315: 1737:"The transtheoretical model of health behavior change" 1338: 4306: 3459: 3036: 1683:

Systems of psychotherapy: a transtheoretical analysis

83:

have discussed the model. In 2009, an article in the

4501: 4279: 4058: 3421: 2848: 2846: 2409:

Organizational Behavior and Human Decision Processes

1974: 1972: 1286: 1284: 681: 4622: 3727:

Transportation Research Part A: Policy and Practice

3723: 3698:

Transportation Research Part A: Policy and Practice

3652:Wen, L.M.; Orr, N.; Bindon, J.; Rissel, C. (2005). 2786:

Psychotherapy: Theory, Research, Practice, Training

2406:Ajzen, I (1991). "The theory of planned behavior". 2049: 2047: 1101: 6735:Association for Behavioral and Cognitive Therapies 4651: 3651: 2478: 2319: 1833:See also the responses to West in the same issue: 1730: 1728: 1726: 1724: 1722: 1720: 1718: 1716: 1714: 1378: 1299: 4658:Journal of Social Work Practice in the Addictions 4450: 3824: 3408:20.500.11820/04647e05-7246-4c69-b80a-0d610f43a385 2843: 1969: 1673: 1281: 6767: 6725:Association for the Advancement of Psychotherapy 3032: 3030: 3028: 2741: 2739: 2241: 2044: 1734: 1669: 1667: 1422:Examples of articles in the news media include: 1144: 1142: 6740:Association for Behavior Analysis International 1859:(5th ed.). New York: Free Press. pp. 1711: 1097: 1095: 1093: 1091: 1089: 1087: 1085: 1083: 1081: 1079: 518:The pros outweigh the cons in the Action stage. 515:The pros surpass the cons in the middle stages. 2701: 2699: 2025:Psychotherapy: Theory, Research & Practice 1342:; Loberg, Kristin; Norcross, Jonathon (2012). 636:construct, Fromme proposed a construct called 341:In general, for people to progress they need: 92: 5919: 4747: 4507:Prochaska, JO; DiClemente, CC; Norcross, JC. 4405: 3172: 3170: 3131: 3129: 3025: 2736: 2580: 2325: 2184: 2112: 2110: 2053:DiClemente, CC; Prochaska, JO; Gibertini, M. 1942:Journal of Consulting and Clinical Psychology 1664: 1139: 3565:Journal of Epidemiology and Community Health 3334:Journal of Epidemiology and Community Health 2080:Journal of Personality and Social Psychology 1794: 1792: 1790: 1788: 1238: 1236: 1234: 1204:Journal of the American Dietetic Association 1076: 745:Example for TTM application on smoke control 4351: 3694: 2696: 5926: 5912: 5709:Centers for Disease Control and Prevention 4754: 4740: 4652:Patterson, D. A.; Nochajski, T.H. (2010). 4239:"Moving beyond the transtheoretical model" 3167: 3126: 2107: 2065: 2063: 1981:Administration and Policy in Mental Health 1621: 1619: 1500:"Understanding change: expect a few bumps" 5669:Centre for Disease Prevention and Control 5659:Center for Disease Control and Prevention 4677: 4379: 4256: 4236: 3998: 3905: 3854: 3844: 3772: 3760:Procedia - Social and Behavioral Sciences 3671: 3628: 3585: 3406: 3354: 3072: 3054: 3008: 2610: 2600: 2368: 2331: 2288: 2271: 2261: 2242:Friman, M.; Huck, J.; Olsson, L. (2017). 1818: 1785: 1685:(8th ed.). Australia; Stamford, CT: 1231: 1176: 605:Long-term intrapersonal conflicts: e.g., 4157: 2535: 1625: 1463: 690: 673:Adherence to antihypertensive medication 628:Psychologist Donald Fromme, in his book 321: 161: 157: 18: 5714:Health departments in the United States 4625:Journal of HIV/AIDS and Social Services 4062:Cochrane Database of Systematic Reviews 3484:Journal of Physical Activity and Health 3043:Cochrane Database of Systematic Reviews 2636: 2508: 2449: 2060: 1616: 1572:"Overcoming your psychological inertia" 1569: 1520: 1425: 655: 581:Current interpersonal conflicts: e.g., 142:Communication theorist and sociologist 6768: 6745:European Association for Psychotherapy 5719:Council on Education for Public Health 4401: 4399: 3787: 3515: 3513: 3455: 3453: 3322: 3320: 3318: 3316: 2237: 2235: 2233: 2231: 2229: 2227: 2225: 1849: 1451: 1242: 567:Current maladaptive cognitions: e.g., 317: 239:of their negative behavior on others. 5907: 5777:Professional degrees of public health 5684:Ministry of Health and Family Welfare 4735: 4153: 4151: 4149: 2673: 2632: 2630: 2511:European Review of Applied Psychology 2504: 2502: 2445: 2443: 2441: 2439: 2405: 2219:. 1st ed. San Francisco: Jossey-Bass. 2211: 2209: 2207: 2205: 1431:"New addiction approach gets results" 1111:Handbook of psychotherapy integration 489: 5874: 5767:Bachelor of Science in Public Health 4160:American Journal of Health Promotion 4095: 3933:British Journal of Health Psychology 2940:American Journal of Health Promotion 2677:Journal of Applied Social Psychology 2316:Norcross, Loberg & Norcross 2012 1798: 1744:American Journal of Health Promotion 1629:British Journal of Health Psychology 1521:Carbine, Michael E. (6 March 2009). 900:British Journal of Health Psychology 735: 699: 663: 553:Symptom/situational problems: e.g., 86:British Journal of Health Psychology 6030:Mindfulness-based cognitive therapy 5886: 5035:Workers' right to access the toilet 4876:Human right to water and sanitation 4396: 3510: 3450: 3313: 2453:Journal of Environmental Psychology 2222: 543: 107: 13: 6750:Society for Psychotherapy Research 5978:Transference focused psychotherapy 4525: 4146: 2690:10.1111/j.1559-1816.2002.tb00236.x 2627: 2581:Klöckner, C.A.; Nayum, A. (2016). 2499: 2436: 2202: 1592: 924:studies under the auspices of the 854: 415:Planning Health Promotion Programs 59:", although this latter term is a 14: 6812: 6035:Rational emotive behavior therapy 6008:Functional analytic psychotherapy 6003:Acceptance and commitment therapy 5933: 5308:Commercial determinants of health 4761: 4725:Pro-Change Behavior Systems, Inc. 4718: 3978:American Journal of Public Health 2749:Psychology of Addictive Behaviors 1570:Gropper, Michael (23 June 2015). 806:not ready to quit or demoralized 682:Adherence to lipid-lowering drugs 5885: 5873: 5862: 5861: 4891:National public health institute 4616:10.1111/j.1464-0597.2008.00345.x 4372:10.1111/j.1468-0009.2009.00550.x 4294:10.1016/j.psychsport.2010.03.001 4282:Psychology of Sport and Exercise 4258:10.1111/j.1360-0443.2006.01404.x 3524:International Journal of Obesity 1820:10.1111/j.1360-0443.2005.01139.x 591:Family/systems conflicts: e.g., 534: 6755:World Council for Psychotherapy 5288:Open-source healthcare software 5030:Sociology of health and illness 4487:Prochaska, JO; DiClemente, CC. 4444: 4345: 4300: 4273: 4230: 4194: 4118: 4089: 4052: 4038:10.1016/j.socscimed.2008.10.036 4015: 3960: 3922: 3871: 3818: 3781: 3746: 3717: 3688: 3645: 3602: 3551: 3475: 3415: 3371: 3293: 3256: 3219: 3089: 2974: 2930: 2893: 2856: 2805: 2776: 2667: 2574: 2529: 2472: 2399: 2362: 2304: 2147: 2015: 1932: 1885: 1843: 1382:; Prochaska, Janice M. (2016). 1298:; DiClemente, Carlo C. (1994). 1109:; Goldfried, Marvin R. (eds.). 1055: 1045: 1036: 1027: 1017: 1008: 5649:Caribbean Public Health Agency 5461:Sexually transmitted infection 5358:Statistical hypothesis testing 5119:Occupational safety and health 5020:Sexual and reproductive health 4933:Occupational safety and health 4075:10.1002/14651858.CD004492.pub4 3791:Transportation Research Record 3659:Health Promotion International 3616:Health Promotion International 3436:10.1080/14635240.2001.10806142 3056:10.1002/14651858.cd008066.pub3 2320:Prochaska & Prochaska 2016 1593:Wu, Fiona (21 February 2020). 1486:. January 2007. pp. 4–5. 1416: 1372: 1332: 1193: 1: 5968:Mentalization-based treatment 5303:Social determinants of health 4352:Sallis, JF; Glanz, K (2009). 4025:Social Science & Medicine 3197:10.1016/s0306-4603(00)00151-9 2722:10.1016/s0306-4603(98)00100-2 1595:"Get psyched: starting fresh" 1217:10.1016/S0002-8223(99)00164-9 1069: 892: 844:temptation, stress, distress 622:psychotherapy discontinuation 55:" and sometimes by the term " 37:integrative theory of therapy 16:Integrative theory of therapy 6791:Psychotherapeutical theories 6025:Dialectical behavior therapy 6015:Cognitive behavioral therapy 5363:Analysis of variance (ANOVA) 5124:Human factors and ergonomics 4467:10.1016/0306-4603(95)00037-2 4216:10.1080/08870440512331333997 3774:10.1016/j.sbspro.2013.10.592 2422:10.1016/0749-5978(91)90020-t 1839:10.1111/add.2005.100.issue-8 1799:West, Robert (August 2005). 1557:. March 2012. pp. 4–5. 1553:. Vol. 19, no. 7. 1551:Harvard Women's Health Watch 1482:. Vol. 14, no. 5. 1480:Harvard Women's Health Watch 949:without formal assistance". 913:randomized controlled trials 7: 6055:Emotionally focused therapy 5544:Good manufacturing practice 5348:Randomized controlled trial 4422:10.1177/0145445502026002006 3001:10.1016/j.ypmed.2007.09.010 2952:10.4278/ajhp.090123-quan-27 2552:10.1016/j.appet.2016.11.002 2493:10.1080/0887044031000066553 2466:10.1016/j.jenvp.2013.01.002 2372:Social Psychology Quarterly 2348:10.1016/j.ypmed.2007.11.006 2093:10.1037/0022-3514.48.5.1279 1527:AIS's Health Business Daily 1169:10.1016/j.ypmed.2007.11.007 982: 911:, published in 2003, of 23 897:In 2009, an article in the 148:innovation adoption process 93:History and core constructs 79:(2016)—and articles in the 10: 6817: 6326:Systematic desensitization 6255:Practitioner–scholar model 5998:Clinical behavior analysis 5614:Theory of planned behavior 5539:Good agricultural practice 5444:Public health surveillance 5336:epidemiological statistics 4980:Public health intervention 4237:Prochaska, JO (Jun 2006). 4172:10.4278/0890-1171-17.5.304 3279:10.1037/0278-6133.26.3.278 3112:10.1037/0278-6133.12.5.399 2829:10.1037/0278-6133.25.4.521 2653:10.1037/0033-295x.84.2.191 2523:10.1016/j.erap.2014.04.002 2170:10.1037/0278-6133.12.5.399 2133:10.1037/0033-2909.111.1.23 1955:10.1037/0022-006X.56.4.520 1308:William Morrow and Company 1306:(1st ed.). New York: 1243:Fromme, Donald K. (2011). 620:In one empirical study of 525:theory of planned behavior 493: 102:University of Rhode Island 6786:Integrative psychotherapy 6717: 6441: 6399: 6336: 6270: 6263: 6222: 6181: 6149: 6088: 6045: 5986: 5948: 5941: 5857: 5792: 5751: 5736:World Toilet Organization 5731:World Health Organization 5638: 5627: 5564: 5489: 5405: 5333: 5298:Public health informatics 5238: 5043: 5005:Right to rest and leisure 4834:Globalization and disease 4769: 4670:10.1080/15332561003730262 4637:10.1080/15381500903584346 4310:Health Promotion Practice 4112:10.1037/1082-989X.4.2.173 3898:10.1136/bmj.326.7400.1175 3740:10.1016/j.tra.2006.09.002 3711:10.1016/j.tra.2006.10.001 3399:10.1108/09654281111180472 1919:10.1037/0278-6133.13.1.39 1756:10.4278/0890-1171-12.1.38 1555:Harvard Health Publishing 1484:Harvard Health Publishing 1467:Investor's Business Daily 1257:10.1007/978-1-4419-7308-5 838:doctor, nurse, friend... 835:doctor, nurse, friend... 825: 802: 779: 601:structural family therapy 555:motivational interviewing 233:Stage 1: Precontemplation 6337:Other individual therapy 5782:Schools of public health 5574:Diffusion of innovations 5273:Health impact assessment 4985:Public health laboratory 4881:Management of depression 4323:10.1177/1524839905278900 3991:10.2105/AJPH.2005.080382 3578:10.1136/jech.2006.048181 2602:10.3389/fpsyg.2016.01362 1856:Diffusion of innovations 1642:10.1348/135910708X368991 999: 882:greenhouse gas emissions 832:Book, newspaper, friend 829:Book, newspaper, friend 803:Action and intervention 630:Systems of Psychotherapy 577:rational emotive therapy 502:decisional balance sheet 496:Decisional balance sheet 152:diffusion of innovations 6359:Cognitive restructuring 6080:Person-centered therapy 5845:Social hygiene movement 5772:Doctor of Public Health 5604:Social cognitive theory 5406:Infectious and epidemic 5188:Fecal–oral transmission 4204:Psychology & Health 3946:10.1348/135910705X52534 2588:Frontiers in Psychology 2481:Psychology & Health 1993:10.1023/A:1011155212811 1115:Oxford University Press 6290:Contingency management 6169:Transtheoretical model 6159:Eclectic psychotherapy 6136:Transactional analysis 5840:Germ theory of disease 5619:Transtheoretical model 3496:10.1123/jpah.2013-0215 3242:10.1006/pmed.1995.1065 3153:10.1006/pmed.2000.0767 2916:10.1089/dis.2006.9.102 2879:10.1089/dis.2006.9.291 2263:10.3390/ijerph14060581 2120:Psychological Bulletin 1600:The Vanderbilt Hustler 1580:. p. Features, 25 926:Cochrane Collaboration 327: 250:Stage 2: Contemplation 167: 29:transtheoretical model 24: 6776:Behavior modification 6240:Common factors theory 6204:Residential treatment 5724:Public Health Service 5609:Social norms approach 5599:PRECEDE–PROCEED model 5045:Preventive healthcare 4938:Pharmaceutical policy 4787:Chief Medical Officer 4409:Behavior Modification 4099:Psychological Methods 3846:10.1186/1479-5868-7-8 3673:10.1093/heapro/dah602 3630:10.1093/heapro/dat045 3347:10.1136/jech.56.6.407 2312:Prochaska et al. 1994 862:sustainable transport 815:take action and quit 786:in the next 6 months 691:Depression prevention 587:interpersonal therapy 376:Consciousness-raising 325: 214:in the next 6 months 165: 158:Details of each stage 150:in Rogers' theory of 22: 6796:Psychological models 6669:Lorna Smith Benjamin 6504:Harry Stack Sullivan 6429:Sensitivity training 6230:Clinical formulation 5800:Sara Josephine Baker 5699:Public Health Agency 5584:Health communication 5449:Disease surveillance 5415:Asymptomatic carrier 5397:Statistical software 5085:Preventive nutrition 4913:Medical anthropology 4802:Environmental health 2640:Psychological Review 1429:(1 September 1993). 1348:Simon & Schuster 1117:. pp. 147–171. 656:Outcomes of programs 294:Stage 5: Maintenance 266:Stage 3: Preparation 6401:Group psychotherapy 6312:Counterconditioning 6189:Brief psychotherapy 6060:Existential therapy 5810:Carl Rogers Darnall 5805:Samuel Jay Crumbine 5579:Health belief model 5432:Notifiable diseases 5368:Regression analysis 5203:Waterborne diseases 4792:Cultural competence 4454:Addictive Behaviors 3892:(7400): 1175–1177. 3537:10.1038/ijo.2009.77 3229:Preventive Medicine 3184:Addictive Behaviors 3140:Preventive Medicine 2988:Preventive Medicine 2709:Addictive Behaviors 2335:Preventive Medicine 1675:Prochaska, James O. 1505:The Washington Post 1390:. Center City, MN: 1380:Prochaska, James O. 1292:Prochaska, James O. 1156:Preventive Medicine 1103:Prochaska, James O. 783:more than 6 months 611:existential therapy 401:Counterconditioning 369:processes of change 361:processes of change 326:Processes of change 318:Processes of change 211:more than 6 months 6529:Milton H. Erickson 6364:Emotion regulation 6344:Autogenic training 6235:Clinical pluralism 6164:Multimodal therapy 5963:Analytical therapy 5408:disease prevention 5343:Case–control study 5015:Security of person 4864:Health care reform 4604:Applied Psychology 4514:2008-07-23 at the 4494:2011-06-06 at the 3306:2011-06-06 at the 2903:Disease Management 2866:Disease Management 2318:, pp. 76–78; 1851:Rogers, Everett M. 1577:The Jerusalem Post 1436:The New York Times 1251:. pp. 34–36. 976:longitudinal study 795:at least 6 months 789:in the next month 490:Decisional balance 347:decisional balance 328: 223:at least 6 months 217:in the next month 168: 98:James O. Prochaska 77:Changing to Thrive 46:decisional balance 25: 6763: 6762: 6689:William R. Miller 6674:Marsha M. Linehan 6644:Jean Baker Miller 6604:Salvador Minuchin 6484:Ludwig Binswanger 6437: 6436: 6272:Behaviour therapy 6199:Online counseling 6177: 6176: 6116:Narrative therapy 6020:Cognitive therapy 5901: 5900: 5853: 5852: 5763:Higher education 5594:Positive deviance 5589:Health psychology 5565:Health behavioral 5492:safety management 5466:Social distancing 5240:Population health 5220:Smoking cessation 5168:Pharmacovigilance 5139:Injury prevention 5107:Infection control 5025:Social psychology 4975:Prisoners' rights 4918:Medical sociology 4886:Public health law 4782:Biological hazard 4711:978-0-1908-8041-5 4700:978-1-4625-0804-4 4596:978-0-7879-9614-7 4359:Milbank Quarterly 3985:(10): 1808–1814. 3967:Hall, Sharon M.; 3940:(Pt 2): 263–278. 3266:Health Psychology 3099:Health Psychology 2816:Health Psychology 2322:, pp. 35–37. 2197:978-0-7879-9614-7 2157:Health Psychology 1906:Health Psychology 1679:Norcross, John C. 1636:(Pt 2): 195–210. 1340:Norcross, John C. 1296:Norcross, John C. 1107:Norcross, John C. 989:Change management 922:smoking cessation 909:systematic review 848: 847: 773:Can Relapse to an 758:Precontemplation 736:Smoking cessation 714:physical activity 700:Weight management 664:Stress management 593:strategic therapy 573:cognitive therapy 282:(current action) 230: 229: 69:Changing for Good 6808: 6781:Health promotion 6679:Vittorio Guidano 6649:Otto F. Kernberg 6519:Donald Winnicott 6376:Free association 6321:Exposure therapy 6300:Stimulus control 6280:Aversion therapy 6268: 6267: 6131:Systemic therapy 6106:Feminist therapy 5958:Adlerian therapy 5946: 5945: 5928: 5921: 5914: 5905: 5904: 5889: 5888: 5877: 5876: 5865: 5864: 5759:Health education 5636: 5635: 5490:Food hygiene and 5471:Tropical disease 5283:Infant mortality 5258:Community health 5134:Controlled Drugs 5070:Health promotion 5000:Right to housing 4844:Health economics 4756: 4749: 4742: 4733: 4732: 4691: 4681: 4648: 4619: 4519: 4505: 4499: 4485: 4479: 4478: 4448: 4442: 4441: 4403: 4394: 4393: 4383: 4349: 4343: 4342: 4304: 4298: 4297: 4277: 4271: 4270: 4260: 4234: 4228: 4227: 4198: 4192: 4191: 4155: 4144: 4143: 4122: 4116: 4115: 4093: 4087: 4086: 4069:(11): CD004492. 4056: 4050: 4049: 4019: 4013: 4012: 4002: 3964: 3958: 3957: 3926: 3920: 3919: 3909: 3875: 3869: 3868: 3858: 3848: 3822: 3816: 3815: 3785: 3779: 3778: 3776: 3750: 3744: 3743: 3721: 3715: 3714: 3692: 3686: 3685: 3675: 3649: 3643: 3642: 3632: 3606: 3600: 3599: 3589: 3555: 3549: 3548: 3517: 3508: 3507: 3479: 3473: 3472: 3466: 3457: 3448: 3447: 3419: 3413: 3412: 3410: 3387:Health Education 3384: 3375: 3369: 3368: 3358: 3324: 3311: 3297: 3291: 3290: 3260: 3254: 3253: 3223: 3217: 3216: 3174: 3165: 3164: 3133: 3124: 3123: 3093: 3087: 3086: 3076: 3058: 3034: 3023: 3022: 3012: 2978: 2972: 2971: 2934: 2928: 2927: 2897: 2891: 2890: 2860: 2854: 2850: 2841: 2840: 2809: 2803: 2802: 2799:10.1037/h0087773 2780: 2774: 2773: 2762:10.1037/a0015715 2743: 2734: 2733: 2703: 2694: 2693: 2671: 2665: 2664: 2634: 2625: 2624: 2614: 2604: 2578: 2572: 2571: 2533: 2527: 2526: 2506: 2497: 2496: 2476: 2470: 2469: 2447: 2434: 2433: 2403: 2397: 2396: 2366: 2360: 2359: 2329: 2323: 2308: 2302: 2292: 2286: 2285: 2275: 2265: 2239: 2220: 2213: 2200: 2188: 2182: 2181: 2151: 2145: 2144: 2114: 2105: 2104: 2076: 2067: 2058: 2051: 2042: 2041: 2038:10.1037/h0090198 2019: 2013: 2012: 1976: 1967: 1966: 1936: 1930: 1929: 1927: 1921:. Archived from 1902: 1889: 1883: 1882: 1847: 1841: 1832: 1822: 1813:(8): 1036–1039. 1796: 1783: 1782: 1780: 1774:. Archived from 1741: 1732: 1709: 1708: 1687:Cengage Learning 1671: 1662: 1661: 1623: 1614: 1611: 1609: 1607: 1589: 1587: 1585: 1566: 1542: 1540: 1538: 1529:. Archived from 1517: 1515: 1513: 1508:. 2 January 2007 1495: 1471: 1460: 1448: 1446: 1444: 1420: 1414: 1413: 1389: 1376: 1370: 1369: 1336: 1330: 1329: 1305: 1288: 1279: 1278: 1240: 1229: 1228: 1197: 1191: 1190: 1180: 1146: 1137: 1136: 1099: 1063: 1059: 1053: 1049: 1043: 1040: 1034: 1031: 1025: 1021: 1015: 1012: 866:public transport 752: 751: 642:contextual focus 638:contextual focus 634:levels of change 563:exposure therapy 559:behavior therapy 544:Levels of change 290:unhealthy ways. 252:(getting ready) 177:Precontemplation 170: 169: 166:Stages of change 108:Stages of change 57:stages of change 6816: 6815: 6811: 6810: 6809: 6807: 6806: 6805: 6766: 6765: 6764: 6759: 6713: 6694:Steven C. Hayes 6624:Paul Watzlawick 6609:Paul Watzlawick 6564:Virginia Axline 6474:Sándor Ferenczi 6433: 6414:Couples therapy 6395: 6369:Affect labeling 6332: 6317:Desensitization 6259: 6245:Discontinuation 6218: 6173: 6145: 6126:Reality therapy 6084: 6070:Gestalt therapy 6041: 5989: 5982: 5937: 5932: 5902: 5897: 5849: 5820:Margaret Sanger 5788: 5747: 5631: 5629: 5623: 5566: 5560: 5532:Safety scandals 5491: 5485: 5407: 5401: 5335: 5329: 5325:Social medicine 5318:Race and health 5253:Child mortality 5234: 5193:Open defecation 5075:Human nutrition 5065:Family planning 5053:Behavior change 5039: 4995:Right to health 4908:Maternal health 4898:Health politics 4849:Health literacy 4765: 4760: 4721: 4716: 4528: 4526:Further reading 4523: 4522: 4516:Wayback Machine 4506: 4502: 4496:Wayback Machine 4486: 4482: 4449: 4445: 4404: 4397: 4350: 4346: 4305: 4301: 4278: 4274: 4235: 4231: 4199: 4195: 4156: 4147: 4124: 4123: 4119: 4094: 4090: 4057: 4053: 4020: 4016: 3969:Tsoh, Janice Y. 3965: 3961: 3927: 3923: 3876: 3872: 3823: 3819: 3804:10.3141/2021-11 3786: 3782: 3751: 3747: 3722: 3718: 3693: 3689: 3650: 3646: 3607: 3603: 3556: 3552: 3518: 3511: 3480: 3476: 3464: 3458: 3451: 3420: 3416: 3382: 3376: 3372: 3325: 3314: 3308:Wayback Machine 3298: 3294: 3261: 3257: 3224: 3220: 3175: 3168: 3134: 3127: 3094: 3090: 3049:(2): CD008066. 3035: 3026: 2979: 2975: 2935: 2931: 2898: 2894: 2861: 2857: 2851: 2844: 2810: 2806: 2781: 2777: 2744: 2737: 2704: 2697: 2672: 2668: 2635: 2628: 2579: 2575: 2534: 2530: 2507: 2500: 2477: 2473: 2448: 2437: 2404: 2400: 2385:10.2307/2786991 2367: 2363: 2330: 2326: 2309: 2305: 2293: 2289: 2240: 2223: 2214: 2203: 2189: 2185: 2152: 2148: 2115: 2108: 2074: 2068: 2061: 2052: 2045: 2020: 2016: 1977: 1970: 1937: 1933: 1925: 1900: 1894:Marcus, Bess H. 1890: 1886: 1871: 1848: 1844: 1797: 1786: 1778: 1739: 1733: 1712: 1697: 1672: 1665: 1624: 1617: 1605: 1603: 1583: 1581: 1545: 1536: 1534: 1511: 1509: 1498: 1474: 1442: 1440: 1427:Goleman, Daniel 1421: 1417: 1402: 1377: 1373: 1358: 1337: 1333: 1318: 1289: 1282: 1267: 1249:Springer-Verlag 1241: 1232: 1198: 1194: 1147: 1140: 1125: 1100: 1077: 1072: 1067: 1066: 1060: 1056: 1050: 1046: 1041: 1037: 1032: 1028: 1022: 1018: 1013: 1009: 1002: 985: 972:cross-sectional 895: 857: 855:Travel research 841:friend, family 826:Related source 812:intend to quit 774: 747: 738: 702: 693: 684: 675: 666: 658: 615:Gestalt therapy 546: 537: 498: 492: 320: 280:Stage 4: Action 160: 110: 95: 65:self-help books 33:behavior change 17: 12: 11: 5: 6814: 6804: 6803: 6798: 6793: 6788: 6783: 6778: 6761: 6760: 6758: 6757: 6752: 6747: 6742: 6737: 6732: 6727: 6721: 6719: 6715: 6714: 6712: 6711: 6706: 6701: 6696: 6691: 6686: 6681: 6676: 6671: 6666: 6664:Arnold Lazarus 6661: 6659:Irvin D. Yalom 6656: 6651: 6646: 6641: 6636: 6634:Eugene Gendlin 6631: 6626: 6621: 6619:Ogden Lindsley 6616: 6611: 6606: 6601: 6596: 6594:Virginia Satir 6591: 6586: 6584:James Bugental 6581: 6579:Silvano Arieti 6576: 6571: 6566: 6561: 6556: 6551: 6546: 6541: 6536: 6531: 6526: 6521: 6516: 6511: 6506: 6501: 6496: 6491: 6486: 6481: 6476: 6471: 6466: 6461: 6456: 6451: 6449:Philippe Pinel 6445: 6443: 6439: 6438: 6435: 6434: 6432: 6431: 6426: 6421: 6419:Family therapy 6416: 6411: 6405: 6403: 6397: 6396: 6394: 6393: 6388: 6383: 6378: 6373: 6372: 6371: 6361: 6356: 6354:Clean language 6351: 6346: 6340: 6338: 6334: 6333: 6331: 6330: 6329: 6328: 6314: 6309: 6308: 6307: 6302: 6297: 6287: 6282: 6276: 6274: 6265: 6261: 6260: 6258: 6257: 6252: 6247: 6242: 6237: 6232: 6226: 6224: 6220: 6219: 6217: 6216: 6214:Support groups 6211: 6206: 6201: 6196: 6191: 6185: 6183: 6179: 6178: 6175: 6174: 6172: 6171: 6166: 6161: 6155: 6153: 6147: 6146: 6144: 6143: 6138: 6133: 6128: 6123: 6118: 6113: 6108: 6103: 6098: 6092: 6090: 6086: 6085: 6083: 6082: 6077: 6072: 6067: 6062: 6057: 6051: 6049: 6043: 6042: 6040: 6039: 6038: 6037: 6032: 6027: 6022: 6012: 6011: 6010: 6005: 5994: 5992: 5988:Cognitive and 5984: 5983: 5981: 5980: 5975: 5973:Psychoanalysis 5970: 5965: 5960: 5954: 5952: 5943: 5939: 5938: 5931: 5930: 5923: 5916: 5908: 5899: 5898: 5896: 5895: 5883: 5871: 5858: 5855: 5854: 5851: 5850: 5848: 5847: 5842: 5837: 5832: 5827: 5822: 5817: 5812: 5807: 5802: 5796: 5794: 5790: 5789: 5787: 5786: 5785: 5784: 5779: 5774: 5769: 5761: 5755: 5753: 5749: 5748: 5746: 5745: 5738: 5733: 5728: 5727: 5726: 5721: 5716: 5711: 5703: 5702: 5701: 5696: 5688: 5687: 5686: 5678: 5677: 5676: 5671: 5663: 5662: 5661: 5653: 5652: 5651: 5642: 5640: 5633: 5628:Organizations, 5625: 5624: 5622: 5621: 5616: 5611: 5606: 5601: 5596: 5591: 5586: 5581: 5576: 5570: 5568: 5562: 5561: 5559: 5558: 5557: 5556: 5551: 5541: 5536: 5535: 5534: 5529: 5524: 5519: 5514: 5509: 5504: 5495: 5493: 5487: 5486: 5484: 5483: 5478: 5473: 5468: 5463: 5458: 5453: 5452: 5451: 5441: 5440: 5439: 5429: 5428: 5427: 5417: 5411: 5409: 5403: 5402: 5400: 5399: 5394: 5393: 5392: 5384: 5375: 5370: 5365: 5355: 5350: 5345: 5339: 5337: 5334:Biological and 5331: 5330: 5328: 5327: 5322: 5321: 5320: 5315: 5310: 5300: 5295: 5293:Multimorbidity 5290: 5285: 5280: 5275: 5270: 5265: 5260: 5255: 5250: 5244: 5242: 5236: 5235: 5233: 5232: 5230:Vector control 5227: 5222: 5217: 5215:School hygiene 5212: 5211: 5210: 5205: 5200: 5198:Sanitary sewer 5195: 5190: 5185: 5175: 5170: 5165: 5164: 5163: 5156:Patient safety 5153: 5152: 5151: 5146: 5141: 5136: 5131: 5126: 5116: 5115: 5114: 5109: 5104: 5099: 5089: 5088: 5087: 5082: 5072: 5067: 5062: 5061: 5060: 5049: 5047: 5041: 5040: 5038: 5037: 5032: 5027: 5022: 5017: 5012: 5007: 5002: 4997: 4992: 4987: 4982: 4977: 4972: 4971: 4970: 4965: 4960: 4955: 4950: 4940: 4935: 4930: 4920: 4915: 4910: 4905: 4900: 4895: 4894: 4893: 4888: 4878: 4873: 4868: 4867: 4866: 4861: 4851: 4846: 4841: 4839:Harm reduction 4836: 4831: 4826: 4821: 4820: 4819: 4814: 4804: 4799: 4794: 4789: 4784: 4779: 4773: 4771: 4767: 4766: 4759: 4758: 4751: 4744: 4736: 4730: 4729: 4720: 4719:External links 4717: 4715: 4714: 4703: 4692: 4664:(2): 224–227. 4649: 4620: 4610:(4): 561–588. 4599: 4588: 4577: 4574: 4563: 4552: 4541: 4529: 4527: 4524: 4521: 4520: 4500: 4480: 4443: 4416:(2): 223–273. 4395: 4344: 4317:(4): 428–443. 4299: 4288:(4): 320–324. 4272: 4229: 4210:(3): 283–301. 4193: 4166:(5): 304–328. 4145: 4117: 4106:(2): 173–191. 4088: 4051: 4032:(3): 397–403. 4014: 3959: 3921: 3870: 3817: 3780: 3745: 3734:(4): 302–312. 3716: 3705:(4): 351–364. 3687: 3666:(2): 123–133. 3644: 3623:(2): 350–358. 3601: 3572:(9): 818–823. 3550: 3531:(6): 645–652. 3509: 3490:(6): 801–807. 3474: 3449: 3414: 3393:(6): 476–497. 3370: 3341:(6): 407–412. 3312: 3292: 3273:(3): 278–287. 3255: 3236:(4): 401–411. 3218: 3191:(4): 583–602. 3166: 3125: 3106:(5): 399–405. 3088: 3024: 2995:(3): 238–246. 2973: 2929: 2910:(2): 102–114. 2892: 2873:(5): 291–301. 2855: 2842: 2823:(4): 521–529. 2804: 2793:(2): 105–113. 2775: 2756:(2): 362–367. 2735: 2716:(4): 455–469. 2695: 2684:(4): 665–683. 2666: 2647:(2): 191–216. 2626: 2573: 2528: 2517:(3): 151–159. 2498: 2487:(3): 373–386. 2471: 2435: 2416:(2): 179–211. 2398: 2379:(4): 266–279. 2361: 2342:(3): 266–274. 2324: 2303: 2287: 2256:(6): 581–596. 2221: 2201: 2183: 2164:(5): 399–405. 2146: 2106: 2087:(5): 1279–89. 2059: 2043: 2032:(3): 368–375. 2014: 1987:(4): 247–261. 1968: 1931: 1928:on 2011-06-06. 1884: 1870:978-0743222099 1869: 1842: 1784: 1781:on 2010-06-02. 1710: 1695: 1663: 1615: 1613: 1612: 1590: 1567: 1543: 1518: 1496: 1472: 1470:. p. A11. 1461: 1449: 1415: 1400: 1371: 1356: 1331: 1317:978-0688112639 1316: 1280: 1265: 1230: 1192: 1163:(3): 226–231. 1138: 1124:978-0195165791 1123: 1074: 1073: 1071: 1068: 1065: 1064: 1054: 1044: 1035: 1026: 1016: 1006: 1003: 1001: 998: 997: 996: 994:Decision cycle 991: 984: 981: 894: 891: 856: 853: 846: 845: 842: 839: 836: 833: 830: 827: 823: 822: 821:back to smoke 819: 816: 813: 810: 807: 804: 800: 799: 796: 793: 790: 787: 784: 781: 780:Standard time 777: 776: 775:earlier stage 771: 768: 765: 762: 761:Contemplation 759: 756: 746: 743: 737: 734: 701: 698: 692: 689: 683: 680: 674: 671: 665: 662: 657: 654: 618: 617: 607:psychoanalytic 603: 589: 579: 565: 545: 542: 536: 533: 520: 519: 516: 513: 494:Main article: 491: 488: 483: 482: 479: 476: 473: 470: 467: 464: 461: 458: 455: 452: 449: 446: 443: 440: 437: 434: 431: 428: 425: 422: 411: 410: 407: 404: 398: 395: 392: 389: 386: 383: 379: 365: 364: 357: 350: 319: 316: 228: 227: 224: 221: 218: 215: 212: 209: 208:Standard time 205: 204: 199: 194: 189: 184: 179: 174: 159: 156: 144:Everett Rogers 133: 132: 129: 126: 123: 120: 117: 109: 106: 94: 91: 15: 9: 6: 4: 3: 2: 6813: 6802: 6801:Public health 6799: 6797: 6794: 6792: 6789: 6787: 6784: 6782: 6779: 6777: 6774: 6773: 6771: 6756: 6753: 6751: 6748: 6746: 6743: 6741: 6738: 6736: 6733: 6731: 6728: 6726: 6723: 6722: 6720: 6716: 6710: 6707: 6705: 6704:Jeffrey Young 6702: 6700: 6699:Michael White 6697: 6695: 6692: 6690: 6687: 6685: 6684:Les Greenberg 6682: 6680: 6677: 6675: 6672: 6670: 6667: 6665: 6662: 6660: 6657: 6655: 6652: 6650: 6647: 6645: 6642: 6640: 6637: 6635: 6632: 6630: 6627: 6625: 6622: 6620: 6617: 6615: 6612: 6610: 6607: 6605: 6602: 6600: 6597: 6595: 6592: 6590: 6587: 6585: 6582: 6580: 6577: 6575: 6572: 6570: 6569:Carl Whitaker 6567: 6565: 6562: 6560: 6557: 6555: 6552: 6550: 6549:Viktor Frankl 6547: 6545: 6542: 6540: 6537: 6535: 6534:Jacques Lacan 6532: 6530: 6527: 6525: 6524:Wilhelm Reich 6522: 6520: 6517: 6515: 6512: 6510: 6507: 6505: 6502: 6500: 6497: 6495: 6492: 6490: 6489:Melanie Klein 6487: 6485: 6482: 6480: 6477: 6475: 6472: 6470: 6467: 6465: 6462: 6460: 6459:Sigmund Freud 6457: 6455: 6452: 6450: 6447: 6446: 6444: 6440: 6430: 6427: 6425: 6422: 6420: 6417: 6415: 6412: 6410: 6407: 6406: 6404: 6402: 6398: 6392: 6389: 6387: 6384: 6382: 6379: 6377: 6374: 6370: 6367: 6366: 6365: 6362: 6360: 6357: 6355: 6352: 6350: 6347: 6345: 6342: 6341: 6339: 6335: 6327: 6324: 6323: 6322: 6318: 6315: 6313: 6310: 6306: 6305:Token economy 6303: 6301: 6298: 6296: 6293: 6292: 6291: 6288: 6286: 6283: 6281: 6278: 6277: 6275: 6273: 6269: 6266: 6262: 6256: 6253: 6251: 6248: 6246: 6243: 6241: 6238: 6236: 6233: 6231: 6228: 6227: 6225: 6221: 6215: 6212: 6210: 6207: 6205: 6202: 6200: 6197: 6195: 6192: 6190: 6187: 6186: 6184: 6180: 6170: 6167: 6165: 6162: 6160: 6157: 6156: 6154: 6152: 6148: 6142: 6139: 6137: 6134: 6132: 6129: 6127: 6124: 6122: 6119: 6117: 6114: 6112: 6111:Music therapy 6109: 6107: 6104: 6102: 6101:Dance therapy 6099: 6097: 6094: 6093: 6091: 6087: 6081: 6078: 6076: 6073: 6071: 6068: 6066: 6063: 6061: 6058: 6056: 6053: 6052: 6050: 6048: 6044: 6036: 6033: 6031: 6028: 6026: 6023: 6021: 6018: 6017: 6016: 6013: 6009: 6006: 6004: 6001: 6000: 5999: 5996: 5995: 5993: 5991: 5985: 5979: 5976: 5974: 5971: 5969: 5966: 5964: 5961: 5959: 5956: 5955: 5953: 5951: 5950:Psychodynamic 5947: 5944: 5940: 5936: 5935:Psychotherapy 5929: 5924: 5922: 5917: 5915: 5910: 5909: 5906: 5894: 5893: 5884: 5882: 5881: 5872: 5870: 5869: 5860: 5859: 5856: 5846: 5843: 5841: 5838: 5836: 5833: 5831: 5828: 5826: 5823: 5821: 5818: 5816: 5815:Joseph Lister 5813: 5811: 5808: 5806: 5803: 5801: 5798: 5797: 5795: 5791: 5783: 5780: 5778: 5775: 5773: 5770: 5768: 5765: 5764: 5762: 5760: 5757: 5756: 5754: 5750: 5743: 5739: 5737: 5734: 5732: 5729: 5725: 5722: 5720: 5717: 5715: 5712: 5710: 5707: 5706: 5704: 5700: 5697: 5695: 5694:Health Canada 5692: 5691: 5689: 5685: 5682: 5681: 5679: 5675: 5672: 5670: 5667: 5666: 5664: 5660: 5657: 5656: 5654: 5650: 5647: 5646: 5644: 5643: 5641: 5639:Organizations 5637: 5634: 5626: 5620: 5617: 5615: 5612: 5610: 5607: 5605: 5602: 5600: 5597: 5595: 5592: 5590: 5587: 5585: 5582: 5580: 5577: 5575: 5572: 5571: 5569: 5563: 5555: 5552: 5550: 5547: 5546: 5545: 5542: 5540: 5537: 5533: 5530: 5528: 5525: 5523: 5520: 5518: 5515: 5513: 5510: 5508: 5505: 5503: 5500: 5499: 5497: 5496: 5494: 5488: 5482: 5479: 5477: 5476:Vaccine trial 5474: 5472: 5469: 5467: 5464: 5462: 5459: 5457: 5454: 5450: 5447: 5446: 5445: 5442: 5438: 5435: 5434: 5433: 5430: 5426: 5423: 5422: 5421: 5418: 5416: 5413: 5412: 5410: 5404: 5398: 5395: 5391: 5389: 5385: 5383: 5381: 5376: 5374: 5371: 5369: 5366: 5364: 5361: 5360: 5359: 5356: 5354: 5353:Relative risk 5351: 5349: 5346: 5344: 5341: 5340: 5338: 5332: 5326: 5323: 5319: 5316: 5314: 5313:Health equity 5311: 5309: 5306: 5305: 5304: 5301: 5299: 5296: 5294: 5291: 5289: 5286: 5284: 5281: 5279: 5278:Health system 5276: 5274: 5271: 5269: 5268:Global health 5266: 5264: 5261: 5259: 5256: 5254: 5251: 5249: 5248:Biostatistics 5246: 5245: 5243: 5241: 5237: 5231: 5228: 5226: 5223: 5221: 5218: 5216: 5213: 5209: 5206: 5204: 5201: 5199: 5196: 5194: 5191: 5189: 5186: 5184: 5181: 5180: 5179: 5176: 5174: 5171: 5169: 5166: 5162: 5159: 5158: 5157: 5154: 5150: 5147: 5145: 5142: 5140: 5137: 5135: 5132: 5130: 5127: 5125: 5122: 5121: 5120: 5117: 5113: 5110: 5108: 5105: 5103: 5100: 5098: 5095: 5094: 5093: 5090: 5086: 5083: 5081: 5078: 5077: 5076: 5073: 5071: 5068: 5066: 5063: 5059: 5056: 5055: 5054: 5051: 5050: 5048: 5046: 5042: 5036: 5033: 5031: 5028: 5026: 5023: 5021: 5018: 5016: 5013: 5011: 5008: 5006: 5003: 5001: 4998: 4996: 4993: 4991: 4990:Right to food 4988: 4986: 4983: 4981: 4978: 4976: 4973: 4969: 4966: 4964: 4961: 4959: 4956: 4954: 4951: 4949: 4946: 4945: 4944: 4941: 4939: 4936: 4934: 4931: 4928: 4924: 4923:Mental health 4921: 4919: 4916: 4914: 4911: 4909: 4906: 4904: 4901: 4899: 4896: 4892: 4889: 4887: 4884: 4883: 4882: 4879: 4877: 4874: 4872: 4871:Housing First 4869: 4865: 4862: 4860: 4859:Health system 4857: 4856: 4855: 4854:Health policy 4852: 4850: 4847: 4845: 4842: 4840: 4837: 4835: 4832: 4830: 4827: 4825: 4822: 4818: 4815: 4813: 4810: 4809: 4808: 4805: 4803: 4800: 4798: 4795: 4793: 4790: 4788: 4785: 4783: 4780: 4778: 4775: 4774: 4772: 4768: 4764: 4763:Public health 4757: 4752: 4750: 4745: 4743: 4738: 4737: 4734: 4726: 4723: 4722: 4712: 4708: 4704: 4701: 4697: 4693: 4689: 4685: 4680: 4675: 4671: 4667: 4663: 4659: 4655: 4650: 4646: 4642: 4638: 4634: 4630: 4626: 4621: 4617: 4613: 4609: 4605: 4600: 4597: 4593: 4589: 4586: 4585:1-57230-057-4 4582: 4578: 4575: 4572: 4571:0-8261-1502-0 4568: 4564: 4561: 4560:1-57230-625-4 4557: 4553: 4550: 4549:0-306-45852-7 4546: 4542: 4539: 4538:0-87094-438-X 4535: 4531: 4530: 4517: 4513: 4510: 4504: 4497: 4493: 4490: 4484: 4476: 4472: 4468: 4464: 4460: 4456: 4455: 4447: 4439: 4435: 4431: 4427: 4423: 4419: 4415: 4411: 4410: 4402: 4400: 4391: 4387: 4382: 4377: 4373: 4369: 4366:(1): 123–54. 4365: 4361: 4360: 4355: 4348: 4340: 4336: 4332: 4328: 4324: 4320: 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