Applying the Transtheoretical Model of Behavioral Change to Establish Physical Activity Habits

Colin G. Pennington


The Transtheoretical Model is an integrative model of behavior change developed in response to increasing theoretical diversity within psychotherapy. Since its conception, the model has been applied to a variety of behavior change contexts such as substance abuse, diet, and exercise.  PURPOSE: to review and summarize the literature relative to applications of the Transtheoretical Model in exercise interventions, and to provide considerations for health professionals while using the Transtheoretical Model in their practice. METHODS: The components of the Transtheoretical Model of behavior change are parsed and analyzed to review their function and role in the model. In addition, the model is reviewed to determine the effectiveness of applying the Transtheoretical Model in conjunction to interventions aimed at increasing physical activity behavior. RESULTS: In general, results support the application of Transtheoretical Model for physical activity behavioral change, but not unconditionally. Beyond highlighting results of studies applying the Transtheoretical Model, implications and considerations for interventions using the models are also detailed.  CONCLUSION: When acknowledging the multidimensional nature of the model, it is important to demonstrate a good understanding of how the various dimensions relate to one another and recognize how these relationships will influence intervention development.

Full Text:



Adams, J., & White, M. (2003). Are activity promotion interventions based on the Transtheoretical Model effective? A critical review. British Journal of Sports Medicine, 37, 106-114.

Adams, J., & White, M. (2005). Why don’t stage-based activity promotion interventions work? Health Education Research, 20, 237-243.

Biddle, S. J. H., & Mutrie, N. (2008). Psychology of physical activity: Determinants, well-being and interventions (2nd ed.). London: Routledge.

Bock, B. C., Marcus, B. H., Pinto, B. M., & Forsyth, L. H. (2001). Maintenance of physical activity following an individualized motivationally tailored intervention. Annals of Behavioral Medicine, 23(2), 79-87.

Bridle, C., Riemsma, R. P., Pattenden, J., Sowden, A. J., Mather, L., Watt, I. S., & Walker, A. (2005). Systematic review of the effectiveness of health behavior interventions based on the transtheoretical model. Psychology and Health, 20(3), 283-301.

Cardinal, B. J., Engels, H. J., & Zhu, W. (1998). Application of the transtheoretical model of behavior change to preadolescents’ physical activity and exercise behavior. Pediatric Exercise Science, 10(1), 69-80.

Cox, K. L., Burke, V., Gorely, T. J., Beilin, L. J., & Puddey, I. B. (2003). Controlled comparison of retention and adherence in home-vs center-initiated exercise interventions in women ages 40–65 years: the SWEAT study (Sedentary Women Exercise Adherence Trial). Preventive Medicine, 36(1), 17-29.

Dallow, C. B., & Anderson, J. (2003). Using self-efficacy and a transtheoretical model to develop a physical activity intervention for obese women. American Journal of Health Promotion, 17(6), 373-381.

Dunn, A. L., Marcus, B. H., Kampert, J. B., Garcia, M. E., Kohl, H. W., & Blair, S. N. (1999). Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. Journal of the American Medical Association, 281, 327-334.

Fahrenwald, N. L., & Walker, S. N. (2003). Application of the Transtheoretical Model of behavior change to the physical activity behavior of WIC mothers. Public Health Nursing, 20(4), 307-317.

Graham-Clarke, P., & Oldenburg, B. (1994). The effectiveness of a general-practice-based physical activity intervention on patient physical activity status. Behaviour Change, 11(3), 132-144.

Hilton, S., Doherty, S., Kendrick, T., Kerry, S., Rink, E., & Steptoe, A. (1999). Promotion of healthy behaviour among adults at increased risk of coronary heart disease in general practice: methodology and baseline data from the Change of Heart study. Health Education Journal, 58(1), 3-16.

Hutchison, A. J., Breckon, J. D., & Johnston, L. H. (2009). Physical activity behavior change interventions based on the transtheoretical model: a systematic review. Health Education and Behavior, 36(5), 829-845.

Kim, C., Hwang, A., & Yoo, J. (2004). The impact of a stage matched intervention to promote exercise behavior in participants with Type 2 diabetes. International Journal of Nursing Studies, 41, 833-841.

Marcus, B. H., Bock, B. C., Pinto, B. M., Forsyth, L. A. H., Roberts, M. B., & Traficante, R. M. (1998). Efficacy of an individualized, motivationally-tailored physical activity intervention. Annals of Behavioral Medicine, 20(3), 174-180.

Marcus, B. H., Rakowski, W., & Rossi, J. S. (1992). Assessing motivational readiness and decision making for exercise. Health Psychology, 11(4), 257-261.

Marshall, S. J., & Biddle, S. J. (2001). The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. Annals of Behavioral Medicine, 23(4), 229-246.

Nelson, L., Guess, W., Olson, T., Buckwalter, J., Evans, M., & Morris, M. (2011). Heart rates of elementary physical education students during the dancing classrooms program. Research Quarterly for Exercise and Sport, 82(2), 256-263.

Nutbeam, D., & Harris, E. (2004). Theory in a nutshell. A practical guide to health promotion theories. Sydney, Australia: McGraw-Hill.

Plotnikoff, R. C., Hotz, S. B., Birkett, N. J., & Courneya, K. S. (2001). Exercise and the transtheoretical model: a longitudinal test of a population sample. Preventive Medicine, 33(5), 441-452.

Prochaska, J. (1979). Systems of psychotherapy: A transtheoretical analysis. Homewood, IL: Dorsey.

Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 5, 390-395.

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.

Roberts, C. K., & Barnard, R. J. (2005). The effects of exercise and diet on chronic disease. Journal of Applied Physiology, 98, 3-30.

Steptoe, A., Day, S., Doherty, S., Rink, E., Kerry, S., Kendrick, T., & Hilton, S. (1999). Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial Commentary: Treatment allocation by the method of minimisation. British Journal of Sports Medicine, 319(7215), 943-948.

Steptoe, A., Kerry, S., Rink, E., & Hilton, S. (2001). The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. American Journal of Public Health, 91(2), 265.

U.S. Department of Health and Human Services. (2010). 2010 Physical Activity Guidelines for Americans. Washington DC: Author. Retrieved from

Velicer, W. F., Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Smoking cessation and stress management: Applications of the Transtheoretical Model of behavior change. Homeostasis, 38, 216-233.

World Health Organization Technology Report, 2003. Diet, nutrition, and the prevention of chronic diseases. Ser 916: i–viii, 1–149.



  • There are currently no refbacks.

Copyright (c) 2021 Journal of Leisure and Recreation Patterns