The Transtheoretical Model in Weight Management: Validation of the Processes of Change Questionnaire

Abstract

Objective: The processes of change implied in weight management remain unclear. The present study aimed to identify these processes by validating a questionnaire designed to assess processes of change (the P-Weight) in line with the transtheoretical model. The relationship of processes of change with stages of change and other external variables is also examined. Methods: Participants were 723 people from community and clinical settings in Barcelona. Their mean age was 32.07 (SD = 14.55) years; most of them were women (75.0%), and their mean BMI was 26.47 (SD = 8.52) kg/m². They all completed the P-Weight and the stages of change questionnaire (S-Weight), both applied to weight management, as well as two subscales from the Eating Disorders Inventory-2 and Eating Attitudes Test-40 questionnaires about the concern with dieting. Results: A 34-item version of the P-Weight was obtained by means of a refinement process. The principal components analysis applied to half of the sample identified four processes of change. A confirmatory factor analysis was then carried out with the other half of the sample, revealing that the model of four freely correlated first-order factors showed the best fit (GFI = 0.988, AGFI = 0.986, NFI = 0.986, and SRMR = 0.0559). Corrected item-total correlations (0.322–0.865) and Cronbach’s alpha coefficients (0.781–0.960) were adequate. The relationship between the P-Weight and the S-Weight and the concern with dieting measures from other questionnaires supported the validity of the scale. Conclusion: The study identified processes of change involved in weight management and reports the adequate psychometric properties of the P-Weight. It also reveals the relationship between processes and stages of change and other external variables.

Evidence That a Very Brief Psychological Intervention Boosts Weight Loss in a Weight Loss Program

“…However, published factor analyses of items used to assess the processes of change have yielded between four and twelve factors. To ensure adequate coverage, Prochaska, Norcross, Fowler, Follick, and Abrams' (1994) twelve factor model was adopted with reference to published factor analytic work elsewhere (Andrés, Saldaña, & Gómez-Benito, 2011;Cancer Prevention Center, 2011;Rossi, Rossi, Rossi-DelPrete, Prochaska, Banspach, & Carleton, 1994). The processes were:…”

The transtheoretical model is an effective for weight management intervention: A randomized controlled trial

“…Intervention studies with multiple behaviors show greater compliance with body weight control than using a single behavior-based approach. 5,7,10,13 Among the most evaluated behaviors are portion control, changes in dietary fat, fruit, and vegetable intake, and physical activity. These behaviors are key markers for weight loss.…”

“…7,9 Actions based on these dimensions can help to understand the behavioral change and, therefore, are used to assess the patients' motivation and intervention design. 7,10 Although TTM is widely used to treat various health behaviors, there is little evidence of its effectiveness to induce weight loss. 911 Most evidence is produced in high-income countries and shows a reduction of weight, body mass index, and percentage of body fat, 7,12 in addition to an increase in physical activity and an improvement in cholesterol levels and glycemia.…”

Validation of the Questionnaire “Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity” (CEHAF)

“…Several instruments for health-related issues have been developed worldwide based on the TTM, showing adequate psychometric properties (Andrés, Saldaña, & Gómez-Benito, 2011;Blaney et al, 2012;Henry, Smith, & Ahmad, 2013;Kushida & Murayama, 2012;Sarbandi, Niknami, Hidarnia, Hajizadeh, & Montazeri, 2013;Vereecken et al, 2009). In Mexico, literature suggests that just a few surveys and questionnaires based on the TTM have been created or adapted, from which most involve just PA and are directed to an adult population (Esparza del Villara et al, 2013;Villalobos et al, 2012).…”