Results of a transtheoretical model-based alcohol, tobacco and other drug intervention in middle schools.

Background: Early use of alcohol, tobacco, and other drugs threatens the physical and mental well-being of students and continued use negatively affects many areas of development. An internet-based, tailored intervention based on the Transtheoretical Model of Behavior Change was delivered to middle school students to reduce alcohol, tobacco, and other drug use. This internet-based approach requires very little faculty and staff time, which is efficient given curricular demands.

Proactive health consumerism: an important new tool for worksite health promotion.

Consumerism in health care has taken on the form of a major innovation among employers and health plans. Yet many of our efforts to enhance the skills and attitudes that enable consumerism have met with limited success. Proactive Health Consumerism is proposed as an approach that utilizes many of the hard-won lessons from health promotion research.

Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis.

Background: The increasing prevalence of overweight and obesity underscores the need for evidence-based, easily disseminable interventions for weight management that can be delivered on a population basis. The Transtheoretical Model (TTM) offers a promising theoretical framework for multiple behavior weight management interventions.

Methods: Overweight or obese adults (BMI 25-39.

Randomized trial of stage-based interventions for informed Medicare choices.

A randomized trial involving 1,351 new Medicare enrollees was conducted to assess the efficacy of a transtheoretical model (TTM) based manual and multimedia expert system program that delivered guidance and feedback matched to individual stage of readiness to compare Medicare health plans. At 6 months post-intervention, compared to enrollees in the control group, those receiving the manual plus expert system intervention or the manual alone exhibited greater increases in Medicare knowledge. The TTM-based interventions also increased use of and satisfaction with traditional Medicare education materials among most enrollees.

Stage of change for making an informed decision about Medicare health plans.

Objective: To assess the applicability of the transtheoretical model of change (TTM) to informed choice in the Medicare population.

Data Sources/study Setting: Two hundred and thirty-nine new Medicare enrollees randomly selected from the Center for Medicare and Medicaid Services' October 2001 Initial Enrollee File, a repository of data for persons who are going to turn 65 and become entitled to enroll in Medicare in the next 3 months.

Study Design: Study participants completed TTM measures of stage of change, decisional balance, and self-efficacy for informed choice, as well as measures of Medicare knowledge, perceived knowledge, and information seeking.

Prevention profiles: Understanding youth who do not use substances.

This study replicates innovative profiles of prevention among students not using substances but who may be at different risks for acquisition. Using the Transtheoretical Model constructs of Decisional Balance and Temptations, cluster analyses were performed on four independent samples of students (n=1240) in the USA, England and Israel. For each sample, the same four distinct profiles emerged.

Online health behavior and disease management programs: are we ready for them? Are they ready for us?

Advancing the science and practice of health promotion and disease management on the Internet requires a systematic program of research examining the population impact of such programs. With impact described as the combination of effectiveness and participation, such research needs to include the examination of the quality and effectiveness of programs that are available to the general public, as well as descriptive and predictive knowledge about population readiness to participate in such programs. There have been few studies examining the quality of interactive health behavior change (HBC) programs on the Internet, and even fewer investigations of the effectiveness of such programs.

Assessing stage of change and informed decision making for Internet participation in health promotion and disease management.

The Internet is a potentially powerful source of low- or no-cost programs through which individuals can be guided in changing their behavior to improve health. Using the Transtheoretical Model and survey methodology, the authors sought to produce reliable and valid instruments for assessing "stage of change" and "informed decision making," and to generate cross-sectional and longitudinal stage-of-change data for a sample of Internet users, as they apply to Internet use for health promotion and disease management. They found that only 24.

Strengths and weaknesses of health behavior change programs on the internet.

Full reviews were conducted on 37 public websites on health behavior change for disease prevention and management. All had at least four of five of the `5A's for effective health behavior change treatment on the Internet' (advise, assess, assist, anticipatory guidance and arrange follow-up) that are assumed to be minimum criteria for a program to have the potential for producing behavior change. The strength of these 37 programs included: rationales provided for assessments; privacy and confidentiality protections; some form of feedback provided; and some form of interactivity.

Development of review criteria to evaluate health behavior change websites.

A growing number of major health care organizations, such as the American Heart Association and the Mayo Clinic, are investing considerable resources in developing and marketing Internet-based programs for health promotion and disease management. These programs have the potential to provide some of the best-tailored interventions in behavior change science at relatively low costs. This report discusses review criteria developed in order to conduct a systematic evaluation of Internet programs for preventive behaviors (alcohol, diet, exercise and smoking) and disease management (pediatric asthma, depression and diabetes.