Peterson, Janice (Jan)

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Peterson
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Janice (Jan)
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Family Practice Nursing
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    Using the Transtheoretical Model in Primary Care Weight management: Tipping the Decisional Balance Scale for Exercise
    (2009-01-01) Peterson, Janice (Jan) M
    Changing or modifying a behavior that is addictive or potentially harmful is difficult for most people. The Transtheoretical Model (TM) (Prochaska, Norcross, & DiClemente, 1994) incorporates a compilation of previous theories, providing a framework for the stages of progression when deciding to change a problematic behavior. The stages include: Precontemplation, Contemplation, Preparation, Action, Maintenance, and Termination. Other constructs of the model, some adapted from previous models, include the Decisional Balance (Janis & Mann, 1977), Self-efficacy (Bandura, 1977) and the Processes of Change (Prochaska, Norcross, & DiClemente, 1994, Velicer, Prochaska, Fava, Norman, & Redding, 1998). Traditionally, examining the stages of change was in the domain of psychology; more recently it has been adapted for use in the primary care arena for various chronic conditions (Boudreaux, et al.,2003, Jimmy & Martin, 2005) as well as the basis for new models in primary care (Katz, 2001). One such chronic condition, leading to other co-morbidities and a factor in early death (LaViest, 2005), is overweight and/or obesity which leads to the challenge of weight management. Overweight patients desire direction with weight management issues (Potter, Vu, & Croughan-Minihane, 2001) yet primary care providers often express an inability to assist with meaningful treatment options other than eat less and move more (Bardia, Holton, Slezsak, & Thompson, 2007). The utility of the TM makes it well suited for use when tailoring healthy lifestyle information for patients during brief visits in primary care. Nurse Practitioners (NP) are trained to coach, teach, and support patients (Hayes & Kalmakis, 2007). Using the TM as a basis to determine the patient’s readiness to change and the construct of Decisional Balance, NPs, through coaching strategies, can be available to assist patients with behavior change.