Temporal sequencing of physical activity change constructs within the transtheoretical model

Objective: Studies support the Transtheoretical Model's (TTM) ability to describe behavior change processes and guide interventions; however, the temporal sequencing of constructs is less understood. This cohort study tested five sequences to identify TTM construct changes related to physical activity. Methods: A random sample provided baseline data (n = 689; 63% female; M-age (SD) = 47(17); 37% white), with 401 participants providing 24-month data, at six-month intervals. Results: Structural equation models revealed processes to cognitions to stage (AIC = 29313.093, BIC = 29514.883, CFI = 0.999, RMSEA = 0.006, SRMR = 0.026); processes to stage to cognitions (AIC = 27788.651, BIC = 27973.268, CFI = 0.978, RMSEA = 0.024, SRMR = 0.038), self-efficacy/temptations to processes to decisional balance to stage (MC = 13914.771, BIC = 14031.169, CFI = 0.981, RMSEA = 0.018, SRMR = 0.034), and stage to processes to cognitions (AIC = 22048.324, BIC = 22212.986, CFI = 0.976, RMSEA = 0.026, SRMR = 0.029) all fit well. However, cognitions to processes to stage did not fit the data well (MC = 10353.555, BIC = 10444.179, CFI = 0.937, RMSEA = 0.038, SRMR = 0.035). Conclusions: Integrating results revealed a cyclical model so that intervention efforts should focus on processes to change cognitions related to barrier self-efficacy and decisional balance, which then lead to change in stage and then renew focus on the processes.