caa a22 4500 388070706 CHVBK 20180307125148.0 cr unu---uuuuu 161130e199912 xx s 000 0 eng 10.1079/095442299108728965 doi S0954422499000128 pii (NATIONALLICENCE)cambridge-10.1079/095442299108728965 Horwath Caroline C. E-mail: caroline.horwath@stonebow.otago.ac.nz Applying the transtheoretical model to eating behaviour change: challenges and opportunities [Elektronische Daten] [Caroline C. Horwath] This review provides a rigorous investigation of the question of whether the transtheoretical model (TTM) (or stages of change model) is applicable to eating behaviour change. The TTM is currently the most popular of a number of stage theories being used to examine health behaviour change. Stage theories specify an ordered set of ‘stages of readiness to change' into which people can be classified and identify the factors that can facilitate movement from one stage to the next. If eating behaviour change follows a stage process, then nutritionists could identify the predominant stage or stages in a population and focus resources on those issues most likely to move people to the next stage (e.g. from no intention of changing, to thinking about changing). In addressing this question, the review draws on the defining characteristics of stage theories as clarified by Weinstein et al. (1998), provides an in-depth coverage of methodological considerations, and a detailed summary table of dietary studies applying the TTM. Specific recommendations are made for improving the accuracy of dietary stage classifications. Among the key conclusions are: (1) dietary studies using the TTM have been hampered by a focus on nutritional outcomes such as dietary fat reduction, rather than clearly understood food behaviours (e.g. five servings of fruit and vegetables per day); (2) accurate stage classification systems are possible for food-based goals, but major misclassification problems occur with nutrient-based goals; (3) observation of an association between stage and dietary intake is not sufficient to demonstrate the validity of the model for dietary behaviour; (4) there is a need for valid questionnaires to measure all aspects of the TTM, and more research on the whole model, particularly the ‘processes of change', rather than on single constructs such as ‘stage' (5) cross-sectional studies generally support the predicted patterns of between-stage differences in decisional balance, self-efficacy, and processes of change; (6) studies which test the key hypothesis that different factors are important in distinguishing different stages are rare, as are prospective studies and stage-matched interventions. Only such studies can conclusively determine whether the TTM is applicable to eating behaviour. Since the ultimate test of the TTM will be the effectiveness of stage-matched dietary interventions, the review ends by exploring the requirements for such studies. Copyright © CABI Publishing 1999 Transtheoretical model nationallicence Stage theories nationallicence Behaviour change nationallicence Food choice nationallicence Nutrition Research Reviews Cambridge University Press 12/2(1999-12), 281-317 0954-4224 12:2<281 1999 12 NRR https://doi.org/10.1079/095442299108728965 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1079/095442299108728965 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Horwath Caroline C. E-mail: caroline.horwath@stonebow.otago.ac.nz NATIONALLICENCE 773 0- Nutrition Research Reviews Cambridge University Press 12/2(1999-12), 281-317 0954-4224 12:2<281 1999 12 NRR CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge