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High Impact Tools for Health Promotion

High Impact Tools for Health Promotion. James O. Prochaska, Ph.D. Director and Professor Cancer Prevention Research Center University of Rhode Island Founder Pro-Change Behavior Systems, L.L.C. The Stages of Change:. Maintenance Action Preparation Contemplation

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High Impact Tools for Health Promotion

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  1. High Impact Tools for Health Promotion James O. Prochaska, Ph.D. Director and Professor Cancer Prevention Research Center University of Rhode Island Founder Pro-Change Behavior Systems, L.L.C.

  2. The Stages of Change: Maintenance Action Preparation Contemplation Precontemplation

  3. Intervention Issues 1. Recruitment 2. Retention 3. Progress 4. Process 5. Outcomes

  4. Percent of Smokers by Stage Across Three Different Samples Sample Precont. Cont. Prep. N Rhode Island 42.1 40.3 17.6 4,144 4 Worksites 41.1 38.7 20.1 4,785 California 37.3 46.7 16.0 9,534

  5. T Scores PC C A M

  6. Stage Transitions

  7. Pros and Cons of Arranging Follow-up Appointments T Scores Stage

  8. Stages by Processes PRECONTEMPLATION CONTEMPLATION PREPARATION CONSCIOUSNESS RAISING DRAMATIC RELIEF ENVIRONMENTAL REEVALUATION SELF REEVALUATION

  9. Stages by Processes PREPARATION ACTION MAINTENANCE SELF LIBERATION REINFORCEMENT MANAGEMENT HELPING RELATIONSHIPS COUNTERCONDITIONING STIMULUS CONTROL

  10. Treatment Groups 1. Action-oriented Manuals 2. Stage-Matched Manuals 3. Stage-Matched Computers & Manuals 4. Counselors & Stage-Matched Computers

  11. Percentage Assessment Periods

  12. Computer vs. Counseling Percentage Baseline 6 months 12 months 18 months Assessment Periods

  13. Proactive vs. Reactive Recruitment Percentage Baseline 6 months 12 months 18 months Assessment Periods

  14. Percentage in Action/Maintenance 2 significant (p < .001) at 6, 12, & 18 months Pre-Action at Baseline Only

  15. Smoking Point PrevalenceHome % in Action and Maintenance

  16. Diet Point Prevalence(all subjects - PO1 School Adult Sample) % in Action and Maintenance

  17. Sun Point PrevalenceHome % in Action and Maintenance

  18. Diabetes Self Management Outcomes: Percent in Action or Maintenance at 12 Months Treatment Assessment I. Smoking: A. Canada 26 % 15 % B. Hawaii 15.9 % 25.9 % II. Diet 40.6 % 31.8 % A. Canada B. Hawaii 24.1 % 11.5 % III. SMBG A. Canada 38% 25 % B. Hawaii 28 % 18%

  19. Impact of Stage-Matched Programs • Efficacy X Participation = Impact • Individual/Clinic: • 30% X 5% = 1.5% • Public Health/Community: • 6% X 75% = 4.5% • Stage-Matched Proactive: • 20% X 75% = 15%

  20. Population Health Paradigms

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