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  • Writer's pictureBarbara J. Mayfield, MS, RDN, LD, FAND

How does behavior change happen? Can the process be easily understood?

The word change with a process bar below

Does behavior change progress in a linear fashion?

Does behavior change occur at a steady pace?

Does behavior change always move in a forward direction?

The answer to all three questions is NO, at least not usually. Behavior change is not linear, steady, or always moving forward. It stops and starts, falls back into negative behaviors, as well as goes in divergent directions.

To help ourselves and others change behaviors successfully, we need to understand the process of behavior change.

Let's continue our series covering the concepts from Chapter 12 in Communicating Nutrition: The Authoritative Guide and learn more about the behavior change theories that describe how behavior change happens.

How can we understand the process of changing behaviors?

Utilizing behavior change theories that focus on the process of behavior change can help us understand the steps or stages people progress through when changing behaviors.

The basic steps or stages begin with an absence of any awareness of the need to change, followed by gaining that awareness and knowledge, forming an intention and preparing for change, and finally performing and maintaining a new behavior.

In the diagram below these are represented by the circles labeled Preintention, Intention, and Action. The five stages illustrate the Stages of Change or the Transtheoretical Model.

Illustration of the Stages of Change model
Source: “Use Behavior Change Theories to Create Effective Communication” by Carol Byrd-Bredbenner and Virginia Stage, Communicating Nutrition: The Authoritative Guide, Chapter 12, Page 179, ©2020

How does the Stages of Change Model help describe behavior change?

Behavior change, whether it occurs gradually or rapidly, follows predictable stages of change. The first stage, which is called precontemplation, is when a person doesn’t practice the behavior. The authors of Chapter 12 state this is because they are unaware, disengaged, or discouraged.

The next stage, called contemplation, is when a person begins to think about the behavior change. They may start learning about it and gathering information and the opinions of others. They are weighing the pros and cons of adopting the behavior.

The preparation stage occurs when people decide to change their behavior and form an intention to act. They make plans for change, continue to gather information and build their self-confidence in adopting the new behavior.

The action stage describes the initial 6-month period of adopting the new behavior. During this stage, knowledge, positive attitudes, and self-confidence all increase, strengthening the behavior.

The maintenance stage indicates the behavior has been practiced for at least 6 months and is considered sustainable for long-term practice. However, these behaviors can be terminated sending the individual back to an earlier stage.

A similar model to Stages of Change is called the Precaution-Adoption Model.

How does the Precaution-Adoption Model describe behavior change?

This model also describes three basic steps in the process of behavior change: Preintention, Intention, and Action. However, unlike the Stages of Change, this model does not specify time frames for taking action or for maintenance.

Another significant difference is in how the concept of preintention is described. This model separates those who are unaware of the issue from those who are aware but unengaged and from those who are engaged but undecided. It also includes a stage in which the individual decides not to act.

Illustration of the Precaution Adoption Process Model
Source: “Use Behavior Change Theories to Create Effective Communication” by Carol Byrd-Bredbenner and Virginia Stage, Communicating Nutrition: The Authoritative Guide, Chapter 12, Page 181, ©2020

How can we use these behavior change models in practice?

These models help us determine how best to communicate about a health behavior with an audience. By assessing which stage someone is in allows the communicator to tailor the communication to their needs.

For those in the preintention stage, communicators must build awareness of the need to change, and provide information about the benefits of adopting a particular behavior.

For those in the intention stage, communicators must provide easily implemented action steps and build the audience’s self-confidence for making the change.

For those in the action and maintenance stages, communicators must provide additional strategies for maintaining the behavior and offer plenty of ongoing encouragement and support.   

The goal is to move people from not thinking about a behavior (precontemplation), to thinking about it (contemplation), to preparing to act (preparation), to taking action (action), and finally making the behavior a lifelong habit (maintenance).

Now that we agree that utilizing behavior change theories in practice is essential and that understanding the stages in which behavior change progresses is key, in our next post, we will explore the various factors that influence behavior change.

“To improve is to change; to be perfect is to change often.” ~ Winston Churchill

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