Syftet med denna studie är att undersöka hur individer tagit sig ut ett drogmissbruk och hur de håller sig nyktra. För att uppnå detta har det genomförts kvalitativa intervjuer med personer som själva identifierar sig som nyktra narkomaner. Den insamlade empirin har analyserats med hjälp av den transteoretiska modellen som utgår ifrån att förändring sker stegvis och genom processer. Resultatet visar att individen upplever negativa konsekvenser av droganvändningen och ofta når en personlig botten innan hen bestämmer sig för att sluta. Förändringsprocessen sker bland annat genom att individen får ett andligt uppvaknande. För att kunna bibehålla nykterheten visar studien att relationen till Gud och anhöriga är viktig. Att hitta en ny mening i livet där man hjälper andra människor är också av stor betydelse. / This study examines how individuals have emerged out of substance abuse and how they stay sober. To achieve this we have done qualitative interviews with sober drug addicts. The collected empirical data has been analyzed using the Transtheoretical Model (TTM) that assumes that change occurs gradually and through processes. The result shows that the individual experience negative consequences of the drug abuse and often reaches a personal rock bottom before he or she choose to terminate.  The process of change partly occurs through a spiritual awakening. To maintain the sobriety our study also shows that the relationship to God and relatives are important. Finding a new purpose in life where you help other people is also significant.

Clinical research suggests that adolescent offenders often do not view their criminal behaviors as problematic and, therefore, are not motivated for treatment. Although customarily defined as a static characteristic, the transtheoretical model (TTM) proposes treatment amenability is dynamic and can be achieved through tailored interventions that motivate individuals for treatment. The current study examines the predictive validity of TTM measures for adolescent offenders at a maximum security correctional facility. In particular, the Stages of Change Scale (SOCS) and Decisional Balance for Adolescent Offenders (DBS-AO) were compared with a more traditional assessment tool utilized in evaluating treatment amenability of juvenile offenders (i.e., Risk-Sophistication-Treatment Inventory; RSTI). One hundred adolescent offenders from the Gainesville State School completed two waves of data collection with a 3-month time interval. Information was collected on offenders' treatment progress between waves. Consistent with TTM research, predictors of treatment progress included low scores on the Cons scale on the DBS-AO and on the Precontemplation scale on the SOCS. Participants in the most advanced levels of treatment also scored high on the Sophistication-Maturity scale on the RSTI and the Impression Management scale on the Paulhus Deception Scale.

Regular physical activity is associated with improved physiological and psychological wellbeing, by reducing the risk of chronic illnesses such as cardiovascular disease, cancer, obesity, diabetes, osteoporosis and depression. There is a common perception that physical activity levels in the population are declining, and one of the biggest changes affecting this is occupational based activity. Since adults spend on average over 50% of their waking hours at work, work sites have the potential to be an important setting for health promotion initiatives. Cognitions and behaviours are key causal factors behind many of today s most widespread health problems and illnesses. The stage of change model has been highlighted as having intuitive appeal because it considers the dynamic nature of attitudes and behaviour change. This thesis is concerned with the application of the stage of change model to an occupational health intervention promoting physical activity. Several research studies were undertaken to explore the experiences of employees with workplace health initiatives and investigate the strategies and practices used by occupational health to promote healthy behaviours. These research studies highlighted the barriers and facilitators to successful health interventions and contributed towards the design, development and implementation of an activity promotion intervention. Additional research was also conducted to develop information materials based on the stage of change model. The stage approach was simplified and intervention materials were classified based on whether employees were thinking about making a change or not thinking about making a change to their activity levels. In order to test the materials, a twelve month intervention was implemented in ten work sites across the UK that were allocated to one of three groups. Two groups received information materials and one group received no information during the intervention period (control group). The difference between the two groups who received information was that one group received standard activity promotion information (standard group) and the second group received tailored information based on their stage of change construct (staged group). Participants in the staged intervention group demonstrated significant decreases in body mass index, fat percentage, waist circumference, blood pressure and resting heart rate following the twelve month intervention. In contrast, reductions were identified for the standard intervention group for waist circumference and diastolic blood pressure. Finally, there were no long-term significant improvements identified for the control group. However, group comparisons revealed there were no significant differences between the intervention conditions. The intervention also recorded self-reported psychological outcomes, which demonstrated variations throughout the intervention period for all groups. The potential reasons for these inconsistent outcomes are discussed. A process evaluation following the intervention demonstrated employees valued the health screenings and identified issues relating to knowledge, behaviour change and health implications that were important outputs of the intervention. Based on these findings, the research concludes there is scope to make physical activity interventions in the workplace more effective by applying the stage of change approach. Using the process of simplifying the stages and focusing on whether employees want to change their behaviours or not allows occupational health to deliver information that could be more meaningful and have a significant impact on behaviour change. By understanding employees readiness to change their activity behaviours and targeting information based on their beliefs, attitudes and intentions to change may produce significant improvements in health outcome measures compared to standard information. The results also suggest there is potential for this type of tailored intervention to be extended to other occupational health issues.

Parent and child readiness to change have been identified as emerging areas informing pediatric obesity interventions. The purpose of this study was to increase understanding of child and parent readiness to change in obese youth by examining how these constructs are related to demographic variables, as well as to psychosocial functioning, in a sample of obese youth presenting for weight- management treatment. A secondary aim was to examine consistency between parent and child readiness to change. Two hundred twenty-eight 7- to 17-year-old children and their parents participated during the child’s initial assessment at a multidisciplinary weight-management clinic. Demographic variables included in analyses were child Body Mass Index, parent Body Mass Index, child age, child gender, child race, and family income. Children completed measures of quality of life, depression, social anxiety, internalizing and externalizing symptoms, and readiness to change. Parents completed assessments of children’s quality of life, children’s internalizing and externalizing symptoms, and parents’ own readiness to change. The child’s Body Mass Index was significantly related to both parent and child readiness to change. There was also a significant positive relation between child readiness to change and the child’s own report of social anxiety symptoms, as well as a curvilinear relation with internalizing symptoms, such as depression. In addition to the child’s Body Mass Index, parent readiness to change was positively related to the child’s age and was higher in African American parents than in European American parents. Race moderated the relation between parent readiness to change and health-related quality of life, internalizing symptoms, and externalizing problems. Parents and children were discordant in their ratings of readiness to change, with parents tending to report higher levels; the child’s Body Mass Index moderated the relation between parent and child report of readiness to change. Clinical implications and future directions are discussed.

The purpose of this study was to investigate to what extent university students are regularly physically active, what motives and barriers they perceive towards exercise and the relationship between motivational profile, self-efficacy and exercise behaviors. A questionnaire including the instruments Physical Activity Stages of Change, BARSE, BREQ-2 and Exercise Adherence Questionnaire was distributed at a university in southern Sweden. The respondents (n = 251) were Men (n = 104) and Women (n = 147). For analysis and processing of the gathered data SPSS was used with One-Way ANOVA, Pearson's r and Regression Analysis. The study showed that 70 percent of the students were regularly physically active. The most common motives for exercise were to improve health and increase physical strength whilst the most frequent barriers were lack of motivation and lack of energy/fatigue. The results also revealed positive correlations between identified regulation, intrinsic regulation, barrier self-efficacy and physical activity.

This study aimed to verify the propositions regarding the application procedures indicated in the cinematherapy literature. Moreover it was also aimed to frame the rationale of cinematherapy on a theoretical basis by integrating the procedures of cinematherapy intervention technique into Transtheoretical Model (Prochaska &amp / Norcross, 2003) and to discover the mechanisms that the applications function through. Finally, it was also aimed to apply cinematherapy intervention technique to the domain of relationship problems. For this study, university students who were in an on-going relationship and were in need of professional help due to their relationship problems were included. Content analyses were conducted for reaching the aims of the study. According to these results, in viewing stage the four-stage process was not attained by all participants, while all stages, except catharsis, were reached in one movie during discussion stage. These results suggest that viewing alone does not induce change, but discussions lead to attaining the stages that would expected to induce change. Moreover, the results revealed that during movie discussions a three-phase process was followed / namely identification, awareness, and solution. Based on the results, it could be assumed that the first phase functions through projection processes / whereas the second phase functions through metaphors and the final stage functions as the projections resolved by using metaphors. Furthermore, according to the outcome monitoring results two participants were grouped in &ldquo / meaningful outcome&rdquo / category, three participants were grouped in &ldquo / ambivalent outcome&rdquo / category, and one participant was grouped in &ldquo / negative outcome&rdquo / category. The results were discussed in accordance with the Transtheoretical Model.

Communication concerning the care one wishes to receive at the end of life (EOL) is central to ensuring that wishes are honored. Many studies have examined doctor-patient or doctor-family EOL communication. However, relatively few studies have focused on the occurrence of EOL care discussions among family members. This is an important topic, as research suggests that advance directives (ADs) are ineffective if patients have not involved surrogate decision-makers, most of whom are family members. This study examined EOL care discussions among family members. It used quantitative and qualitative data from a diverse sample of older adults from West Central Florida collected for the purpose of this examination. The quantitative and qualitative data were analyzed separately and together. This study employed the Transtheoretical Model, which proposes that individuals are in varying behavioral “stages of change” and that bringing about a behavioral change requires understanding their particular stage and adapting interventions appropriately. Statistical analysis of the quantitative data (N=364) using multinomial logistic regression showed that participants were in distinct stages that were associated with several factors, including family involvement with health care decision-making and communications with doctors. Racial and ethnic differences were not found in controlled analysis, though Hispanics were less likely to be in more advanced EOL care discussion stages in unadjusted analyses. Several themes were found in qualitative analysis of focus groups (n=36) drawn from the larger sample. Findings suggested that those who engaged in family EOL care discussions were more careful planners overall, more accepting of death, and able to manage complex family dynamics. They also had greater knowledge of EOL matters, largely related to knowledge of loved ones EOL wishes. The quantitative-qualitative (mixed-methods) study reinforced the role of family relationships in general in whether EOL care discussions occurred. It also highlighted the role of being proactive and having EOL care knowledge. All three studies – the quantitative, qualitative, and mixed methods showed the potential for doctors and other health professionals to help families with EOL care discussions and ACP overall.

Because of the expense associated with hospital admissions, the use of observation status has grown. One of the most consistently measured outcomes in observation is the patient length of stay (LOS). Research supports the positive impact that nurse practitioners (NP) have on LOS when added to other service lines that could be applied to observation. Banner Desert Medical Center (BDMC) is currently attempting to decrease their observation LOS. Adding acute care nurse practitioners (ACNP) to the care delivery model is a potential intervention. The purpose of this project was to develop an executive summary to inform staff of current evidence that supports the addition of ACNPs to observation. Then, via a survey, the project aimed to determine the level of staff support by identifying the Transtheoretical Model of Change (TTM) Stage of Change and to recommend appropriate stage-matched interventions for staff based on TTM processes of change. The 10 Likert scale survey questions were adapted from two validated TTM surveys. The final question asked for the pros and cons of the intervention to determine the Decisional Balance (DB). The registered nurse (RN) cohort demonstrated consistently strong support for the proposed intervention with an average mean response of 6.57 on affirmative questions and a correspondingly low average mean of 2.2 on negative questions. When compared to the RN cohort, the physician cohort had lower mean responses with an average of 4.29 on every affirmative, a higher average mean response of 3.85 on the negatively worded questions. The DB for RNs was 19 pros to two cons. The DB for physicians was eight cons to three pros. These finding reflect that nurses are in the Preparation Stage of Change and are ready to move forward with adding ACNPs. An appropriate stage-matched intervention for registered nurses would be the development of change teams. In contrast, the physician cohort is in the Precontemplation stage and is not ready to proceed with adding ACNPs. Appropriate stage-matched interventions for physicians would include facilitating consciousness-raising activities such as an open forum to communicating information about the proposed change and to explore concerns and questions regarding the intervention.

A review of literature indicates limited effort to understand and explain employees' acclimation to, and adoption of, new behaviors required by organization change initiatives. Psychological theories of individual behavior change have, in restricted instances, been applied into organizational environments. The transtheoretical model of change (TTM) offers a comprehensive explanation of behavior change uniting multiple theories of individual change. TTM describes change as a series of stages that individual progress through before arriving at the decision to implement a change in behavior. Movement through the stages is facilitated by processes which increase the probability of a behavior change effort's success. The present research investigated the potential applicability of TTM for explaining individual level change within a new context, specifically, an organizational environment. To examine if individual change in the context of an organization occurs in the fashion described by TTM, measures of core TTM constructs were delivered to employees in a water department of a city in the American southwest. The water department was immersed in an organization change initiative necessitating individual behavior change by its employees. Results of TTM core construct measures and their relationships with each other and the stages of change were examined. Initial findings are indicative of TTM's potential applicability as a description of behavior change within an organizational context. Implications of these findings, potential applications, imitations of the current research, and recommendations for future research are discussed.

The online delivery of higher education courses and programs continues to expand across academic disciplines at colleges and universities. This expansion of online education has been precipitated by, among other things, (a) the rise in personal computer ownership, (b) the ease of access to the Internet, (c) the availability and continuous improvement in technology for the delivery of online courses, and (d) the increase in demand for online courses by both traditional and nontraditional students. However, the proliferation of online education has not been enthusiastically supported by all constituents of higher education. Specifically, some faculty members remain resistant to the shift to online course delivery. This article applies the Transtheoretical Model of Change to the process of gaining faculty support for, and involvement in, online learning. After briefly reviewing current issues in online education and making a case for its adoption, we describe sources of faculty resistance and offer recommendations for interventions that may be applied to transforming faculty resistance to support and eventually to active participation.