Assess readiness to take action
Personal readiness
You can assess personal readiness to change and how people adapt to change using a model which has been used widely across various areas of health promotion called the Transtheoretical Model [1]. Evidence suggests that behaviour change occurs in a cycle involving a pattern of adoption, maintenance, relapse, and re-adoption over time, rather than in a series of linear steps.
Transtheoretical Model
| Stage | Characteristics | What can be done to encourage change |
| Pre-contemplation | - Don't recognise any problem exists
- Have no intention of changing their
behaviour
| - Explain and personalize the risk
- Encourage re-evaluation of their current behaviour
- Clarify that any decision to change rests with them
- Aim to gently move these people from "NO!" to "I'll think about it"
|
| Contemplation | - Generally ambivalent about any behaviour change
- "Sitting on the fence"
- Not considering changing any time soon
| - Acknowledge they are in control
- Clarify benefits that could be gained from adopting falls prevention strategies and behaviours
- Encourage further self-exploration
- Leave the door open for further progress at a later stage
|
| Preparation | - Have recognised the need for change and are "getting ready" to make the required changes
- May have already "tested the waters"
- Thinking about how they can make the personal and environmental changes necessary to accomplish the new behaviours
| - Praise them for making a positive choice
- Prioritise the most important elements of the change process
- Provide support
- Encourage small, individual steps in the right direction.
|
| Action | - Actually doing the things necessary to imbed the required changes into their daily practice and lives
- Dealing with new ways of doing things
| - Need to be re-assured that they are doing well and making positive progress
- May feel a sense of loss about old habits so reinforce the long term benefits of the changes made and the improvements that will start to accumulate.
|
| Maintenance | | - Need follow up and support to continue the new behaviours
- Reinforce the rewards
- Warn about the possibility of re-lapse.
|
| Relapse | - Resumes old patterns of behaviour
| - Help to identify "triggers"
- Reassure relapse is perfectly normal
- Reassess motivation for change
- Plan stronger coping mechanisms.
|
Owen and Lee (1984) use a similar model to summarise their model of personal behaviour change:
- awareness of the problem and a need to change
- motivation to make a change
- skill development to prepare for the change
- initial adoption of the new behaviour, and
- maintenance of the new behaviour and integration into the lifestyle.
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