Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul-Aug;52(4):485-498.
doi: 10.1080/00273171.2017.1309518. Epub 2017 Apr 20.

Intervention Effects on Stage of Change Membership and Transitions among Adolescent Energy Balance Behaviors

Leslie A Brick  1   2   3   4 , Colleen A Redding  3   4 , Andrea L Paiva  3   4 , Lisa L Harlow  4 , Wayne F Velicer  3   4
Affiliations

Intervention Effects on Stage of Change Membership and Transitions among Adolescent Energy Balance Behaviors

Leslie A Brick et al. Multivariate Behav Res. 2017 Jul-Aug.

Abstract

The transition from childhood to adolescence is a crucial period for the development of healthy behaviors to be sustained later in life. With obesity a leading public health problem, the promotion of healthy behaviors has the potential to make a huge impact. The current study evaluated Stage of Change progression in a large (N = 4158) computer-delivered, Transtheoretical Model-tailored intervention focusing on physical activity and fruit and vegetable consumption (FV). Markov models were used to explore stage transitions and patterns of discrete change from sixth to ninth grade. Nested model comparisons examined the consistency of these patterns across time and intervention condition. Major findings supported models in which participants were free to transition forward and backward to any of the stages, but higher probabilities were observed for remaining in the same stage or for transitioning one or two stages forward. Participants in the intervention group had higher probabilities of transitioning toward Maintenance, with more change occurring relative to the comparison group during transitions from grades six to eight but not for grades eight to nine.

Keywords: Energy balance; Markov model; behavioral intervention; stage of change; stage transition model.

PubMed Disclaimer

Conflict of interest statement

Article Information

Conflict of Interest Disclosures: Each author signed a form for disclosure of potential conflicts of interest. No authors reported any financial or other conflicts of interest in relation to the work described.

Figures

Figure 1.
Figure 1.
Summary of findings for transition matrices across grade transitions and intervention condition for physical activity and fruit and vegetable consumption. Note: transition (tau) matrices were equivalent (≈) or non-equivalent (≠) across time or intervention condition. These findings informed the parsimonious model for each behavior.
Figure 2.
Figure 2.
Physical Activity stage movement from grades six to nine for intervention condition. Note: PC = precontemplation; C = contemplation; PR = creparation; A = action; M = maintenance; solid arrows indicate forward stage movement, dashed arrows indicate backwards stage movement; values inside circles represent staying in that stage; smaller values in italics reflect the differences from comparison intervention parameter estimates (note that the transition from 8th-9th grade were constrained to equal)..
Figure 3.
Figure 3.
Fruit and Vegetable stage movement from grades six to nine for intervention condition. Note: PC = precontemplation; C = pontemplation; PR = preparation; A = action; M = aaintenance; solid arrows indicate forward stage movement, dashed arrows indicate backwards stage movement; values inside circles represent staying in that stage; smaller values in italics reflect differences from comparison intervention parameter estimates (note that the transition from 8th-9th grade were constrained to equal).
See this image and copyright information in PMC

References

    1. U.S. Department of Health and Human Services. (2001). The Surgeon General’s call to action to prevent and decrease overweight and obesity. U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD. Available from: U.S. GPO, Washington. - PubMed
    1. Akaike H (1973). Information theory and an extension of the maximum likelihood principle. In Petrov BN and Csaki F (Eds.), Second international symposium on information theory (pp. 267 281). Budapest: Academiai Kiado.
    1. Cleveland MJ, Lanza ST, Ray AE, Turrisi R, & Mallett KM (2012). Transitions in first-year college student drinking behaviors: Does drinking latent class membership moderate the effects of parent- and peer-based intervention components? Psychology of Addictive Behaviors, 26, 440–450. - PMC - PubMed
    1. Collins LM, & Lanza ST (2010). Latent class and latent transition analysis: With applications in the social, behavioral, and health sciences (Vol. 718): John Wiley & Sons.
    1. De Bourdeaudhuij I, Maes L, De Henauw S, De Vriendt T, Moreno LA, Kersting M, . . . Sjöstrom M (2010). Evaluation of a computer-tailored physical activity intervention in adolescents in six european countries: The activ-o-meter in the helena intervention study. Journal of Adolescent Health, 46(5), 458–466. - PubMed