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This version was published on October 1, 2006
Health Promotion Practice, Vol. 7, No. 4, 428-443 (2006)
DOI: 10.1177/1524839905278900

Applying the Transtheoretical Model to Exercise: A Systematic and Comprehensive Review of the Literature

Leslie Spencer, PhD, CHES

Rowan University in Glassboro, New Jersey

Troy B. Adams, PhD

Arizona State University in Mesa, Arizona

Sarah Malone, BA, CHES

ElderCare Companies in Point Pleasant Beach, New Jersey

Lindsey Roy, BA, CHES

Explosive Training Center for Pursuit of Excellence, Inc., in Kelowna, British Columbia, Canada

Elizabeth Yost, BS

Arizona State University in Mesa, Arizona

Three questions guided a literature review of the transtheoretical model (TTM) as applied to exercise to address the evidence for stage-matched interventions, the description of priority populations, and the identification of valid TTM measurement tools. One-hundredand-fifty studies were reviewed. Results indicate preliminary support for the use of stage-matched exercise interventions. Most studies have focused on White, middle-class, female populations, limiting the generalizability of their findings. Valid and reliable measures exist for stage of change, decisional balance, processes of change, self-efficacy, and temptations to not exercise; however, more research is needed to refine these measures. Evidence for the construct validity of the TTM as applied to exercise is mixed. When designing and implementing TTM-based exercise interventions, practitioners and policy makers are encouraged to clearly define the term exercise, choose a valid and reliable staging tool, and employ all TTM constructs and not just stage membership.

Key Words: transtheoretical model • stage of change • exercise • fitness


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