The thresholds of change model: an approach to analyzing stages of change data

Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine
D HedekerK A Weeks

Abstract

Stage models are prominent in research describing health behavior change. Since stage models often propose that different factors have varying influences on membership in the different stage, statistical methods that can estimate the thresholds that separate the stages and the relative value of variables in influencing these thresholds are useful. This article describes use of a "thresholds of change" model for analyzing the thresholds separating stages and specifically for examining the effects of explanatory variables on these thresholds using a generalization of an ordinal logistic (or probit) regression model. Data from a skin cancer prevention study (N=3,185) in which participants were grouped into three stages for sunscreen use (precontemplation, contemplation, and action) are used to illustrate the Thresholds of Change Model. For this example, two thresholds exist: a contemplation (between precontemplation and contemplation) and an action threshold (between contemplation and action). Variables examined include gender, skin type, perceived susceptibility to sunburn, worry about skin cancer, and sun protection self-efficacy. We examine models that assume that the effects of these variables are the same across thresholds, a...Continue Reading

References

Jan 1, 1996·Addictive Behaviors·R A MartinJ L Fava
Mar 1, 1996·Computer Methods and Programs in Biomedicine·D Hedeker, R D Gibbons
Dec 1, 1996·Addiction·D Hedeker, R J Mermelstein

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Citations

Aug 20, 2003·Psychological Methods·Frank RijmenPeter Kuppens
Jul 1, 2011·Health Education Research·Sarah J DurkinMatthew J Spittal
Mar 12, 2010·American Journal of Health Behavior·Hyunyi ChoKari M Wilson
Sep 28, 2013·Journal of Behavioral Medicine·Marc T Kiviniemi, Erin M Ellis
May 20, 2003·Addiction·Lan LiangRichard Clayton
Jul 1, 2006·Preventive Medicine·Gitte C KloekJohan P Mackenbach
Jun 19, 2014·Prevention Science : the Official Journal of the Society for Prevention Research·Donald Hedeker
Oct 1, 2016·American Journal of Public Health·Z Harry Piotrowski, Donald Hedeker
Apr 19, 2002·Behavior Modification·Julia H Littell, Heather Girvin
Feb 25, 2009·Journal of Health Psychology·Steven Prentice-DunnRobert J Cramer
Apr 20, 2004·Health Education & Behavior : the Official Publication of the Society for Public Health Education·Gitte C KloekJohan P Mackenbach
Feb 8, 2006·The Pediatric Infectious Disease Journal·Nesri PadayatchiRazia Bobat
Nov 16, 2021·Prevention Science : the Official Journal of the Society for Prevention Research·Andrew S Fullerton, Kathryn Freeman Anderson

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