Temporal Sequencing of Physical Activity Change Constructs within the Transtheoretical Model.

Objective: Studies support the Transtheoretical Model's (TTM) ability to describe behavior change processes and guide interventions; however, the temporal sequencing of constructs is less understood. This cohort study tested five sequences to identify TTM construct changes related to physical activity.

Methods: A random sample provided baseline data (=689; 63% female; ()=47(17); 37% white), with 401 participants providing 24-month data, at six-month intervals.

Results: Structural equation models revealed processes to cognitions to stage (=29313.093, =29514.883, =0.999, =0.006, SRMR=0.026); processes to stage to cognitions (=27788.651, =27973.268, =0.978, =0.024, SRMR=0.038), self-efficacy/temptations to processes to decisional balance to stage (=13914.771, =14031.169, =0.981, =0.018, SRMR=0.034), and stage to processes to cognitions (=22048.324, =22212.986, =0.976, =0.026, SRMR=0.029) all fit well. However, cognitions to processes to stage did not fit the data well (=10353.555, =10444.179, =0.937, =0.038, SRMR=0.035).

Conclusions: Integrating results revealed a cyclical model so that intervention efforts should focus on processes to change cognitions related to barrier self-efficacy and decisional balance, which then lead to change in stage and then renew focus on the processes.