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Applying the Stages of Change Theory to Promote Weight Loss

Applying the Stages of Change Theory to Promote Weight Loss. William Nixon Cleveland State University. What is the Stages of Change Theory?. Assesses an individuals readiness to participate in a new healthier behavior First theory to consider readiness 1

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Applying the Stages of Change Theory to Promote Weight Loss

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  1. Applying the Stages of Change Theory to Promote Weight Loss William Nixon Cleveland State University

  2. What is the Stages of Change Theory? • Assesses an individuals readiness to participate in a new healthier behavior • First theory to consider readiness1 • Provides strategies and processes to act on this change • Goal is to reach action or maintenance stage

  3. What does the literature say? • Promising strategy to promote healthy lifestyles2 • Reduction of fat consumption • Increase in the consumption of fruits and vegetables • Increases in physical activity • Weight loss

  4. What does the literature say? • Positive impact on populations demonstrating poor eating habits • Reduction of caloric intake • Reduction in consumption of high fat foods • Decrease in body weight and BMI • Facilitates greater understanding of an individual’s behavior3 • Allows the development of effective interventions tailored to the individual's readiness to change • i.e. Understand current stage  Develop strategies  Work towards goals

  5. What does the literature say? • Assesses the individual's readiness to change a behavior • Participants less likely to use SOC theory components in earlier stages4 • Precontemplation • Contemplation • Preparation • More likely to use SOC theory components in late stages • Action • Maintenance

  6. Participant Information Demographics Health Behaviors Weight Loss Increase physical activity Improve eating habits • Female • 59 years old • Married • 2 children • 26 years old • 31 years old • Works as a secretary

  7. Overview Plan of Action Strengths/Weaknesses Strengths Clearly defined stages to track progression Easy application Weaknesses Short time period of project Difficult to advance stages because of time constraints • Assess the participant’s readiness to change • Personal interview • Ongoing discussion • Develop goals • Create interventions • Specific to achieving the developed goals

  8. Meeting 1 • “I noticed shortly after the death of my mother 1 year ago that I began to neglect myself. I ate whatever I wanted, I quit exercising, I became a little depressed because the burden of my mom’s health status. I always had time for everyone else around me but I never made time for myself (eating properly, exercising). That all needs to change. I am ready to make a change. I have to. For my own good, my own health. I have to be comfortable telling others no and telling myself yes.” • Preparation Stage • Some behavior changes reported, but not consistently

  9. Meeting 1 Baseline Measurements5,6 Long Term Goals Learn to track daily food consumption Nutrition Education Perform aerobic exercise 30 minutes/day, 3 days/week Elliptical Bicycling Weight loss 2-3 pounds per week Weekly weigh in’s • PAR-Q • Weight= 230 pounds • Height= 5’9’’ • BMI=34 • Resting Heart Rate= 85 BPM • BP=138/88 • 3 minute step test = 112 • “Average”

  10. Meeting 2 Progress From Previous Meeting Goals Log food consumption 5 out of 7 days this upcoming week on weight watchers Ride bike or elliptical for 20 minutes at least 3 days this week. Complete a weigh in at the end of the week • Joined ”Weight Watchers” Program • Has online food tracking to log “points.” • Identified baseline for amount of “points” to be consumed per day • Did not weigh in this week

  11. Meeting 2 Intervention • Discussed healthy food “swap” options to facilitate staying within points7 • Self-reflection on performance thus far

  12. Meeting 3 Progress From Previous Meeting Goals Continue to log food consumption Ride bike for 25 minutes, 2 days Elliptical for 15 minutes, 1 day Complete a weigh in at the end of the week • Logged food consumption the past 7/7 days! • Stayed under weight watcher “points” • Rode bike for 20 minutes, 2 days • Elliptical 7 minutes, 1 day • Reported ellipticalwas difficult • Weigh in= ↓ 3.5 pounds

  13. Meeting 3 Intervention • Discussed the advantages of food prep8,9 • Saves money • Saves time • Helps with weight control • Eat healthier • Consume less fat • Reduces stress about eating • Associated with lower consumption of processed foods10 • Self-reflection on performance thus far

  14. Meeting 4 Progress From Previous Meeting Goals Ride Bike 30 minutes, 2 days Ride Elliptical 30 minutes, 1 day Complete food prep for lunch 5 days this week Complete a weigh in at the end of the week • Logged Food consumption 7/7 days • Rode Bike 25 minutes, 2 days • Rode Elliptical 15 minutes, 1 day • Weigh in= ↓ 4.2 pounds • Total= ↓ 7.7 pounds

  15. Meeting 4 Intervention • Education on portion control • My Plate11 • Reminders to find a healthy eating style

  16. Meeting 5 Progress From Previous Meeting Maintenance Tips Log food intake Portion Control Food Prep Stick to exercise plan Self-Reflect Treat yourself (once in a while) Have Fun! • Biked 30 minutes, 2 days • Elliptical 30 minutes, 1 day • Completed food prep 5 days • Weigh in= ↓ 3.1 pounds • Total= ↓ 10.8 pounds

  17. Meeting 5 Follow-up Measurements Initial Goals Learn to track daily food consumption Nutrition Education ✔ Perform aerobic exercise 30 minutes/day, 3 days/week ✔ Weight loss ✔ • Weight= 219 pounds • Height= 5’9’’ • BMI=32.3 • Resting Heart Rate= 83 BPM • BP=135/88 • 3 minute step test = 104 • “ Above Average”

  18. So Now What?? • How can we use this in our future PT practice? • Knowledge • Experience • Empowerment • Modifications • Teach portion control first • Narrow down the focus of goals i.e. increase physical activity or improve eating habits • They coincide but could have been more effective to isolate and master individually

  19. References • Barley E, Lawson V. Using health psychology to help patients: theories of behaviour change. British Journal Of Nursing [serial online]. September 8, 2016;25(16):924-927. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed July 13, 2017. • Bedeschi L, Santos L, Souza Lopes A, et al. Interventions directed at eating habits and physical activity using the Transtheoretical Model: a systematic review. NutricionHospitalaria [serial online]. September 2016;33(5):1194-1204. Available from: Academic Search Complete, Ipswich, MA. Accessed July 11, 2017. • Menezes M, Mingoti S, Cardoso C, Mendonça R, Lopes A. Intervention based on Transtheoretical Model promotes anthropometric and nutritional improvements — A randomized controlled trial. Eating Behaviors [serial online]. April 2015;17:37-44. Available from: Academic Search Complete, Ipswich, MA. Accessed July 11, 2017. • Han H, Pettee Gabriel K, IIIKohl H. Application of the transtheoretical model to sedentary behaviors and its association with physical activity status. Plos ONE [serial online]. April 27, 2017;12(4):1-13. Available from: Academic Search Complete, Ipswich, MA. Accessed July 11, 2017. • Bohannon R, Bubela D, Ying-Chih W, Magasi S, Gershon R. Six-minute walk test vs three-minute step test for measuring functional endurance. Journal Of Strength & Conditioning Research (Lippincott Williams & Wilkins) [serial online]. November 2015;29(11):3240-3244. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed July 13, 2017.

  20. References • Anderson J. The 3-minute step test: A DIY fitness assessment. Spark people website. http://www.sparkpeople.com/resource/fitness_articles.asp?id=1115. June 24, 2008. Accessed June 5, 2017. • Stirling C. Making healthy food swaps. SR nutrition website. http://www.srnutrition.co.uk/2014/03/making-healthy-food-swaps. Accessed July 1, 2017. • Harvard school of public health. The nutrition source. Harvard website. https://www.hsph.harvard.edu/nutritionsource/2017/03/20/meal-prep-planning/. March 20, 2017. Accessed June 20, 2017. • Lachat C, Nago E, Verstraeten R, Roberfroid D, Van Camp J, Kolsteren P. Eating out of home and its association with dietary intake: a systematic review of the evidence. Obesity Reviews [serial online]. April 2012;13(4):329-346. Available from: Academic Search Complete, Ipswich, MA. Accessed June14, 2017. • Chak Leung Lam M, Adams J. Association between home food preparation skills and behaviour, and consumption of ultra-processed foods: Cross-sectional analysis of the UK National Diet and nutrition survey. International Journal Of Behavioral Nutrition & Physical Activity [serial online]. May 23, 2017;14:1-7. Available from: Academic Search Complete, Ipswich, MA. Accessed July 1, 2017. • United States Department of Agriculture. My plate. USDA website. https://www.choosemyplate.gov/MyPlate. April 19, 2017. Accessed July 7, 2017.

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