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NCHPAD - Building Healthy Inclusive Communities

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Stages of Change


By Amy Rauworth, NCHPAD Director of Policy and Public Affairs

Fitness in January inevitably relates to New Year's resolutions and all of the vows to lose weight and be more active. In theory, these vows are truly what you want, but in practice you will often find any excuse to skip your visit to the gym. Many individuals with disabilities have additional barriers that they must address that go beyond the more general excuses of "not enough time" or "exercise is boring." This month I will address a model/theory to determine where you are in your readiness to change, and how to make this year the year you break the cycle and really make these resolutions count!

Speaking of theory, are you ready to get a little deeper and contemplate where you are in the Transtheoretical Model? Stay with me here...I promise no test questions will follow, but you just might get at the core of where you are, and how you can address your motivational needs to be successful in adopting healthy behavior changes in the New Year.

The Transtheoretical Model is used in health psychology to evaluate an individual's readiness to adopt a new healthy behavior. It outlines five stages of behavior change, as well as processes to move through these stages. Your answers to the questions below can help determine your readiness to change your behavior.

  • How much you are currently exercising?
  • Do you intend to exercise?
  • How much control do you have over exercising?
  • Is exercise enjoyable?

The Five Stages of Change

For every health behavior, people fall into one of these stages based on their readiness to change:

Precontemplation: You are not yet intending to take action in the foreseeable future (i.e. in the next 6 months).
Contemplation: You are intending to take action in the next 6 months.
Preparation: You are intending to take action in the immediate future (i.e. in the next month).
Action: You have already made specific modifications in your lifestyle within the past 6 months.
Maintenance: You are working to prevent relapse. Maintenance is a stage estimated to last from 6 months to about 5 years.

Making the "Stages of Change" Work for You

Although, the Transtheoretical Model can be used for any health behavior change, you can use it to help you become a regular exerciser in the New Year.

Once you determine the stage that you are in, your goal becomes "to continually move forward toward Maintenance". It is important to realize that many people will, at some point, fall back into an earlier stage. Instead of being frustrated by this, recognize what is happening and have a plan in place to overcome the obstacle that set you back so that you can get back up, dust yourself off, and continue to move forward again.

Figuring Out Your Current Stage

*Exercise refers specifically to a structured program or activity geared toward achieving or maintaining physical fitness.

What Stage Are You In?

Using the definition of "exercise" above, determine which of the following statements most closely matches you right now?

  1. I am not considering starting to exercise within the foreseeable future.
  2. I am planning to start exercising within the next 6 months.
  3. I am planning to start exercising in the immediate future.
  4. I am currently exercising and have been doing so for less than 6 months.
  5. I am currently exercising and have been doing so for over 6 months.

Corresponding stages:
1. = Precontemplation
2. = Contemplation
3. = Preparation
4. = Action
5. = Maintenance

Moving To the Next Stage

(Processes of Change)

Now that you have figured out in what stage you are starting, it's time to move forward. The following are examples of processes you can use to help you move into that next stage.

  • Learn more about exercise and how you can be active.
  • Surround yourself with people who support your new active lifestyle.
  • Remove things from your environment that tempt you to be less active or eat less healthy.
  • Determine activities that you enjoy doing instead of watching television (or other sedentary behaviors).
  • Reward yourself for a job well done.
  • Continually recommit to your decision to be more active.
  • Take note of how exercise makes you feel healthier and remind yourself of these things.

Here are some motivational quotes that can certainly be related to physical activity and improved health. Find your favorite and write it on an index card that is strategically placed around your home.

Unless you try to do something beyond what you have already mastered, you will never grow.
-Ralph Waldo Emerson

Perseverance is not a long race; it is many short races, one after another.
-Walter Elliott

"You don't have to change that much for it to make a great deal of difference. A few simple disciplines can have a major impact on how your life works out in the next 90 days, let alone in the next 12 months or next 3 years."
-Jim Rohn

"You've got to get up every morning with determination if you're going to go to bed with satisfaction."
-George Horace Lorimer

Look at a day when you are supremely satisfied at the end. It's not a day when you lounge around doing nothing, it's when you've had everything to do and you've done it!
-Margaret Thatcher


Additional NCHPAD Resources:

A Proactive Approach to Inclusive Fitness: (http://www.nchpad.org/1246/5927/A~Proactive~Approach~to~Inclusive~Fitness)

How to Choose a Personal Trainer: (http://www.nchpad.org/fitt/fact_sheet.php?sheet=384 )

Choosing a Fitness Center: (http://www.nchpad.org/exercise/fact_sheet.php?sheet=359&view=all )

Using a Fitness Center Does Not Have to be an Exercise in Frustration: Tips for People with Mobility and Visual Disabilities:
( http://www.nchpad.org/programming/fact_sheet.php?sheet=812§ion=3123)


For comments and feedback, please feel free to contact Amy Rauworth at amyr@lakeshore.org


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