The effect of transtheoretical model-based individual counseling, training, and a 6-month follow-up on smoking cessation in adult women: a randomized controlled trial*

Abstract

Background/aim: This study was conducted to determine the effect of transtheoretical model (TTM)-based individual counseling, training, and a 6-month follow-up on smoking cessation in adult women. Materials and methods:We carried out this randomized controlled trial in Konya, Turkey. Female subjects were randomly assigned into groups in a 1:1 ratio using block randomization, block size 3 × 3, divided by stages (precontemplation, contemplation, and preparation) and age (20-29, 30-39, and 40-49 years). The study was completed with 77 women (an intervention group containing 38 participants and a control group of 39 participants). The intervention group was interviewed 5 times (baseline and 1, 1.5, 2, and 6 months). Counseling and training were given to the intervention group at the first 3 interviews. The TTM scales were assessed for both groups at baseline and at 2 and 6 months.Results: In the 6-month follow-up, the rate of smoking cessation and the rate of progress were higher in the intervention group than in the control group. All the TTM variables had differences except the cognitive processes in the intervention group over time. Analysis of variance related to time × groups indicated that all variables had significantly changed except the cognitive processes and the pros of change. Conclusion:Results suggest that the TTM may be useful in understanding the stages individuals are at and in deciding on the appropriate treatment for smoking cessation.

Validation of Health Behavior and Stages of Change Questionnaire

“…Some authors have generated questionnaires9,13 or established criteria6,11,12 for the location of subjects in each of the stages of change. However, there was no questionnaire that would integrate the five health behaviors that the HBSCQ proposed.…”

“…The same trend was observed while analyzing the concordance for each of the health behaviors, thus ensuring content validity aimed at both the TTM and the recommendations of health in Mexico. The questionnaire offers health professionals in Mexico the option to apply a fast, simple, and innovative screening test, to identify persons who may benefit from interventions to promote health behaviors, and at the same time they can count on intervention strategies delimited to the stage of change 6,8–11,23…”

“…The aim of HBSCQ is to be a reliable method to identify individuals who may benefit from interventions based on the stage of change, using the strategies that the same model and other authors have proposed 6,9,10,13. Future work must show the utility of HBSCQ.…”

“…These stages are pre-contemplation, contemplation, preparation, action, maintenance, relapse, and termination 4. The model has been used widely, showing its effectiveness in behaviors such as quitting smoking,5,6 alcohol intake,7 eating habits,8 physical activity,9,10 and use of screening tests 11,12. To evaluate the stages of change, these studies are supported by criteria constructed from proposed definitions,6,11,12 self-report questionnaires,9,13,14 or evaluating various groups of behaviours 15…”

“…The questionnaires and criteria that have been used to evaluate smoking, alcoholism, and physical activity from the TTM are applied to diverse populations. Furthermore, the approach of studying each behavior separately predominates 6,9,13,14. Few studies have associated health behaviors, TTM, and the use of screening tests for cancer prevention 11,12.…”