TTM(Transtheoretical Model (One Pager)

Behavior modicationBehavior change NCD (non communicable disease 1979Healthy People50% 5 107 (US Dept. of Health, 1979

418 173.5Mokdad. 2004)

TTM (Transtheoretical Model) ProchaskaDiClemente(1982)transtheoretical)

Prochaska

1. stage of change)

Tadao Okada, MD, MPH @ Primary Care Institute Japan of last updated on 2014/07/28ver 1.11 4

(Prochaska 1997)

2. (process of change) 3. decisional balance) I. L. Janis & L. Mann

4. (self-ecacy)A. Bandura

condence vstemptation

Outcome Expectancy () Ecacy Expectancy ()

3

1

Prochaska, DiClemente, Velicer, & Rossi1993, Rossi1994 0.74(Noar. 54, 2007) TTM

1

precontemplation

6

contemplation

6

preparation

1

action

6

maintainance

6

termination 100%

relapse

Tadao Okada, MD, MPH @ Primary Care Institute Japan of last updated on 2014/07/28ver 1.12 4

2

1 2 3 4

Conviction-condence model, Keller & White, 1997)

4686

experiential

consciousness raising

XX

dramatic relief

environmental revaluation

self-revaluation

social liberation

behavioral

self-liberation

2

counterconditioning

helping relationship

contingency/reinforcement management

stimulus control

Tadao Okada, MD, MPH @ Primary Care Institute Japan of last updated on 2014/07/28ver 1.13 4

!5A, 5R, 2008) 5AR

, 2002)

LEARN (Berlin, 1983) Listen with sympathy and understanding to the patient's perception of the problem / Explain your perceptions of the problem / Acknowledge and discuss the dierences and similarities / Recommend treatment / Negotiate agreement (motivational interviewing) US Department of Health, Education, and Welfare. Healthy people: the surgeon generals report on health promotion and disease prevention. Washington DC: US Government Printing Oce; 1979. Mokdad. et al. Actual causes of death in the United States, 2000.JAMA. 2004;291:1238-1245. Prochaska, J. O., & DiClemente, C. C (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research and Practice, 20, 161-173. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am. J Health Promot 1997;12(1):38-48 . . J. Natl. Inst. Public Health. 58(1), 2009 Patricia M. Burbank, Deborah Riebe. ed. Promoting Exercise and Behavior Change in Older Adults: Interventions With the Transtheoretical Model. Springer Publish Company, Inc, NY, 2002 . Book House HD,Ltd.,Tokyo Y http://blogs.yahoo.co.jp/uechihiroaki/13312460.html . (TTM) . . 9 2010, 77-88 : ,,82(2),135-141,2000. Bandura A. Self-ecacy: toward a unifying theory of behavior change. Psychol Rev 1977;84:191-215. Janis lL, Mann L. Decision Making: A Psychological Analysis of Conict, Choice and Commitment. New York: Free Press, 1977 Noar, S.M., Benac, C.N., and Harris, M.S. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychological Bulletin, 4, 673-693, 2007 . [] http://www.igaku-shoin.co.jp/paperDetail.do?id=PA02874_07 . 2002 e-[]http://www.e-healthnet.mhlw.go.jp/information/ Keller VF, et al. Choices and changes : a new model for inuencing patient health behavior. J Clin Outcomes Manag. 1997 ; 46 : 33-6. U.S. Dept. of Health and Human Services Public Health Service. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. May, 2008 Berlin EA, Fowkes WC. A teaching framework for cross- cultural health care. The Western journal of medicine. 1983;139(6):934-8. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health. Theory at a Glance A Guide For Health Promotion Practice (Second Edition) . 2005.

Ask about tobacco use.

Relevance

Advise to quit.

Risks

Assess willingness to make a quit attempt.

Rewards

Assist in quit attempt. R

Roadblocks

Arrange followup.

Repetition

Tadao Okada, MD, MPH @ Primary Care Institute Japan of last updated on 2014/07/28ver 1.14 4