Assessing motivation and readiness to change for weight management and control: an in-depth evaluation of three sets of instruments

Martina Ceccarini, Maria Borrello, Giada Pietrabissa, Gian Mauro Manzoni, Gianluca Castelnuovo, Martina Ceccarini, Maria Borrello, Giada Pietrabissa, Gian Mauro Manzoni, Gianluca Castelnuovo

Abstract

It is highly recommended to promptly assess motivation and readiness to change (RTC) in individuals who wish to achieve significant lifestyle behavior changes in order to improve their health, overall quality of life, and well-being. In particular, motivation should be assessed for those who face the difficult task to maintain weight, which implies a double challenge: weight loss initially and its management subsequently. In fact, weight-control may be as problematic as smoking or drugs-taking cessation, since they all share the commonality of being highly refractory to change. This paper will examine three well-established tools following the Transtheoretical Model, specifically assessing RTC in weight management: the University of Rhode Island Change Assessment Scale, the S-Weight and the P-Weight and the Decisional Balance Inventory. Though their strengths and weaknesses may appear to be rather homogeneous and similar, the S-Weight and P-Weight are more efficient in assessing RTC in weight management and control. Assessing motivation and RTC may be a crucial step in promptly identifying psychological obstacles or resistance toward weight-management in overweight or obese hospitalized individuals, and it may contribute to provide a more effective weight-control treatment intervention.

Keywords: Transtheoretical Model; assessment; motivation; obesity; overweight; readiness to change; weight-management.

References

    1. Ames G. E., Heckman M. G., Grothe K. B., Clark M. M. (2012). Eating self-efficacy: development of a short-form WEL. Eat. Behav. 13 375–378 10.1016/j.eatbeh.2012.03.013
    1. Andrés A., Saldaña C., Gómez-Benito J. (2009). Establishing the stages and processes of change for weight loss by consensus of experts. Obesity 17 1717–1723 10.1038/oby.2009.100
    1. Andrés A., Saldaña C., Gómez-Benito J. (2011). The Transtheoretical model in weight management: validation of the processes of change questionnaire. Obes Facts 4 433–442 10.1159/000335135
    1. Bautista-Castaño I., Molina-Cabrillana J., Montoya-Alonso J. A., Serra-Majem L. (2004). Variables predictive of adherence to diet and physical activity recommendations in the treatment of obesity and overweight, in a group of Spanish subjects. Int. J. Obes. 28 697–705 10.1038/sj.ijo.0802602
    1. Blanchard K. A., Morgenstern J., Morgan T. J., Labouvie E., Bux D. A. (2003). Motivational subtypes and continuous measures of readiness for change: concurrent and predictive validity. Psychol. Addic. Behav. 17 56–65 10.1037/0893-164X.17.1.56
    1. Britt E., Hudson S. M., Blampied N. M. (2004). Motivational interviewing in health settings: a review. Patient Educ. Couns. 53 147–155 10.1016/S0738-3991(03)00141-1
    1. Carney M. M., Kivlahan D. R. (1995). Motivational subtypes among veterans seeking substance abuse treatment: profiles based on stages of change. Psychol. Addic. Behav. 9 1135–1142 10.1037/0893-164X.9.2.135
    1. Castelnuovo G., Manzoni G. M., Cuzziol P., Cesa G. L., Tuzzi C., Villa V., et al. (2010). TECNOB: study design of a randomized controlled trial of a multidisciplinary telecare intervention for obese patients with type-2 diabetes. BMC Public Health 10:204 10.1186/1471-2458-10-204
    1. Di Clemente C. C. (2005). Conceptual models and applied research: the ongoing contribution of the transtheoretical model. J. Addict. Nurs. 16 5–12 10.1080/10884600590917147
    1. Di Clemente C. C., Hughes S. O. (1990). Stages of change profiles in alcoholism treatment. J. Subst. Abuse 2 217–235 10.1016/S0899-3289(05)80057-4
    1. Di Clemente C. C., Prochaska J. O. (1982). Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addict. Behav. 7 133–144 10.1016/0306-4603(82)90038-7
    1. Di Clemente C. C., Prochaska J. O. (1985). “Processes and stages of self-change: coping and competence in smoking behavior change,” in Coping and Substance Abuse eds Shiffman S., Wills T. (San Diego: Academic Press) 319–343.
    1. Di Clemente C. C., Prochaska J. O., Fairhurst S. K., Velicer W. F., Velasquez M. M., Rossi J. S. (1991). The processes of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J. Consult. Clin. Psychol. 59 295–304 10.1037/0022-006X.59.2.295
    1. Di Clemente C. C., Schlundt D., Gemmell L. (2004). Readiness and stages of change in addiction treatment. Am. J. Addict. 13 103–119 10.1080/10550490490435777
    1. Dozois D. J., Westra H. A., Collins K. A., Fung T. S., Garry J. K. (2004). Stages of change in anxiety: psychometric properties of the University of Rhode Island Change Assessment (URICA) scale. Behav. Res. Ther. 42 711–729 10.1016/S0005-7967(03)00193-1
    1. Greene G. W., Rossi S. R. (1998). Stages of change for reducing dietary fat over 18 months. J. Am. Diet. Assoc. 98 529–534 10.1016/S0002-8223(98)00120-5
    1. Greene G. W., Rossi S. R., Rossi J. S., Velicer W. F., Fava J. S., Prochaska J. O. (1999). Dietary applications of the stages of change model. J. Am. Diet. Assoc. 99 673–678 10.1016/S0002-8223(99)00164-9
    1. Henderson M. J., Saules K. K., Galen L. W. (2004). The predictive validity of the University of Rhode Island change assessment questionnaire in a heroin-addicted polysubstance abuse sample. Psychol. Addict. Behav. 18 106–112 10.1037/0893-164X.18.2.106
    1. Horwath C. C. (1999). Applying the transtheoretical model to eating behaviour change: challenges and opportunities. Nutr. Res. Rev. 12 281–317 10.1079/095442299108728965
    1. Janis I. L., Mann L. (1977). Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment. New York, NY: Macmillan.
    1. Johnson S. S., Paiva A. L., Cummins C. O., Johnson J. L., Dyment S. J., Wright J. A., et al. (2008). Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis. Prev. Med. 46 238–246 10.1016/j.ypmed.2007.09.010
    1. Jordan P. J., Nigg C. R. (2002). “Applying the Transtheoretical Model: tailoring interventions to stages of change,” in Promoting Exercise and Behavior Change in Older Adults: Interventions with the Transtheoretical Model eds Burbank P. M., Riebe D. (New York, NY: Springer) 181–207.
    1. Levesque C. S., Williams G. C., Elliot D., Pickering M. A., Bodenhamer B., Finley P. J. (2007). Validating the theoretical structure of the treatment self-regulation questionnaire (TSRQ) across three different health behaviors. Health Educ. Res. 22 691–702 10.1093/her/cyl148
    1. Marshall S. J., Biddle S. J. H. (2001). The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. Ann. Behav. Med. 23 229–246 10.1207/S15324796ABM2304_2
    1. McConnaughy E. A., Di Clemente C. C., Prochaska J. O., Velicer W. F. (1989). Stages of change in psychotherapy: a follow-up report. Psychotherapy 26 494–503 10.1037/h0085468
    1. McConnaughy E. A., Prochaska J. O., Velicer W. F. (1983). Stages of change in psychotherapy: measurement and sample profiles. Psychother. Theory Res. Prac. 20 368–375 10.1037/h0090198
    1. Miller W. R., Rollnick S. (1991). Motivational Interviewing: Preparing People to Change. Addictive Behaviour. New York, NY: Guilford Press.
    1. Norcross J. C., Krebs P. M., Prochaska J. O. (2011). Stages of change. J. Clin. Psych. 67 143–154 10.1002/jclp.20758
    1. O’Connell D., Velicer W. F. (1988). A decisional balance measure for weight loss. Int. J. Addict. 23 729–750.
    1. Palmeira A. L., Teixeira P. J., Branco T. L., Martins S. S., Minderico C. S., Barata J. T., et al. (2007). Predicting short-term weight loss using four leading health behavior change theories. Int. J. Behav. Nutr. Phys. Act. 4 14 10.1186/1479-5868-4-14
    1. Pantalon M. V., Nich C., Frankforter T., Carroll K. M. (2002). University of rhode island change assessment. the URICA as a measure of motivation to change among treatment-seeking individuals with concurrent alcohol and cocaine problems. Psychol. Addict. Behav. 16 299–307 10.1037/0893-164X.16.4.299
    1. Pietrabissa G., Manzoni G. M., Corti S., Vegliante N., Molinari E., Castelnuovo G. (2012). Addressing motivation in globesity treatment: a new challenge for clinical psychology. Front. Psychol. 3:317 10.3389/fpsyg.2012.00317
    1. Prochaska J. O., Di Clemente C. C. (1982). Transtheoretical therapy: toward a more integrative model of change. Psychother. Theory Res. Prac. 19 276–288 10.1037/h0088437
    1. Prochaska J. O., Di Clemente C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. J. Consult. Clin. Psychol. 51 390–395 10.1037/0022-006X.51.3.390
    1. Prochaska J. O., Di Clemente C. C. (1984). The Transtheoretical Approach: Crossing the Traditional Boundaries of Therapy. Malabar: Krieger.
    1. Prochaska J. O., Di Clemente C. C. (1985). “Common processes of self-change in smoking, weight control, and psychological distress,” in Coping and Substance Abuse eds Shiffman S., Wills T. (San Diego, Academic Press) 345–363.
    1. Prochaska J. O., Di Clemente C. C. (1986). “Toward a comprehensive model of change,” in Treating Addictive Behaviors: Processes of Change eds Miller W. R., Heather N. (New York, NY: Plenum) 3–27 10.1007/978-1-4613-2191-0_1
    1. Prochaska J. O., Di Clemente C. C., Norcross J. C. (1992a). In search of how people change: applications to addictive behaviors. Am. Psychol. 47 1102–1114 10.1037/0003-066X.47.9.1102
    1. Prochaska J. O., Norcross J. C., Folwer J. L., Follick M. J., Abrams D. B. (1992b). Attendance and outcome in a work-site weight control program: Processes and stages of change as process and predictor variables. Addict. Behav. 17 35–45 10.1016/0306-4603(92)90051-V
    1. Prochaska J. O., Norcross J. C. (2006). Systems of Psychotherapy: A Transtheoretical Analysis, 6th Edn. Pacific Grove, CA: Brooks-Cole.
    1. Prochaska J. O., Spring B., Nigg C. R. (2008). Multiple health behavior change research: an introduction and overview. Prev. Med. 46 181–188 10.1016/j.ypmed.2008.02.001
    1. Prochaska J. O., Velicer W. F. (1997). The transtheoretical model of health behavior change. Am. J. Health Promot. 12 38–48 10.4278/0890-1171-12.1.38
    1. Prochaska J. O., Velicer W. F., Rossi J. S., Goldstein M. G., Marcus B., Rakowski W., et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychol. 13 39–46 10.1037/0278-6133.13.1.39
    1. Redding C. A., Rossi J. S., Rossi S. R., Velicer W. F., Prochaska J. O. (2000). Health Behavior Models. Int. EJ. of Health Educ. 3 180–193.
    1. Resnicow K., Davis R. E., Zhang G., Konkel J., Strecher V. J., Shaikh A. R., et al. (2008). Tailoring a fruit and vegetable intervention on novel motivational constructs: results of a randomized study. Ann. Behav. Med. 35 159–169 10.1007/s12160-008-9028-9
    1. Rossi J. S., Rossi S. R., Velicer W. F., Prochaska J. O. (1995). “Motivational readiness to control weight,” in Handbook of Assessment Methods for Eating Behaviors and Weight-Related Problems: Measures, Theory, and Research ed. Allison D. B. (Thousand Oaks, CA: Sage) 387–430.
    1. Rossi S. R., Greene G. W., Rossi J. S., Plummer B. A., Benisovich S. V., Keller S., et al. (2001). Validation of decisional balance and temptation measures for dietary fat reduction in a large school-based population of adolescents. Eat. Behav. 2 1–18 10.1016/S1471-0153(00)00019-2
    1. Ryan R. M., Deci E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am. Psychol. 55 68–78 10.1037/0003-066X.55.1.68
    1. Ryan R. M., Lynch M. F., Vansteenkiste M., Deci E. L. (2011). Motivation and autonomy in counseling, psychotherapy, and behavior change: A Look at Theory and Practice. Counse. Psychol. 39 193–260 10.1177/0011000009359313
    1. Salvini A., Faccio E., Mininni G., Romaioli D., Cipolletta S., Castelnuovo G. (2012). Change in and through psychotherapy: a dialogical analysis single-case study of a patient with bulimia nervosa. Front. Psychol. 3:546 10.3389/fpsyg.2012.00546
    1. Steptoe A., Kerry S., Rink E., Hilton S. (2001). The impact of behavioural counseling on stage of change in the fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. Am. J. Public Health 91 265–269 10.2105/AJPH.91.2.265
    1. Toft U. N., Kristoffersen L. H., Aadahl M., von Huth Smith L., Pisinger C., Jørgensen T. (2007). Diet and exercise intervention in a general population mediators of participation and adherence. Eur. J. Public Health 17 455–463 10.1093/eurpub/ckl262
    1. Tremblay A., Sánchez M. (2012). “Environmental toxins as triggers for obesity,” in Food and Addiction, a Comprehensive Handbook eds Brownell K. D., Gold M. S. (New York, NY: Oxford University).
    1. Velicer W. F., Hughes S. L., Fava J. L., Prochaska J. O., Di Clemente C. C. (1995). An empirical typology of subjects within stages of change. Addict. Behav. 20 299–320 10.1016/0306-4603(94)00069-B
    1. Wadden T. A., Brownell K. D., Foster G. D. (2002). Obesity: responding to the global epidemic. J. Consult. Clin. Psychol. 70 510–525 10.1037/0022-006X.70.3.510
    1. World Health Organization [WHO]. (2014). Obesity and Overweight. Fact Sheet N 311 Geneva: World Health Organization.
    1. Willoughby F. W., Edens J. F. (1996). Construct validity and predictive utility of the stages of change scale for alcoholics. J. Subst. Abuse 8 275–291 10.1016/S0899-3289(96)90152-2
    1. Wilson G. T., Schlam T. R. (2004). The transtheoretical model and motivational interviewing in the treatment of eating and weight disorders. Cli. Psych. Rev. 24 361–378 10.1016/j.cpr.2004.03.003

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