Transtheoretical Model of Change Guided-Motivational Behavioral Intervention

Guide to Effective Programs
for Children and Youth

Transtheoretical Model of Change Guided-Motivational Behavioral Intervention

OVERVIEW

This experimental evaluation uses a motivational behavioral intervention (MBI) based on a Transtheoretical Model of Change (TTM) framework to encourage young women to get sexually transmitted infection screenings and checkups in response to high-risk sexual behavior. The intervention was evaluated with sexually active women between the ages of 16 and 22.5 who were patients at a community-based urban clinic that provided free reproductive healthcare. Although the intervention was both theory-based and delivered using motivational interviewing, results showed no significant difference for number or reason for checkups or consistent condom use between the MBI treatment and standard care control groups.

Description of the Program

Target Population: Sexually active women

TTM-guided motivational behavioral intervention aims to encourage sexually active women to get sexually transmitted infection (STI) checkups in response to high-risk sexual behavior. TTM has been used to help understand how individuals can adopt or maintain healthy behaviors for a wide variety of health protective behaviors and therefore was used as a framework for this intervention. The motivational-behavioral intervention is based on the constructs from the TTM and motivational interviewing to promote client-initiated screening for chlamydia (CT) and gonorrhea (GC). The intervention intends to increase motivation for screenings for those in preaction of Stages of Change (before engaging in certain behaviors) and support maintenance in those already seeking STI screening for other behaviors. The MBI consists of an individual 30 to 50 minute intervention plus a 15 minute booster intervention 6 months later tailored to her Stages of Change level for target behaviors with a trained Bachelors- or Masters-level health educator.

EVALUATIon of the Program

Chacko, M.R., Wiemann, C.M., Kozinetz, C.A., von Sternberg, K., Velasquez, M.M., Smith, P.B., & DiClemente, R. (2010). Efficacy of motivational behavioral intervention to promote chlamydia and gonorrhea screening in young women: A randomized controlled trial. Journal of Adolescent Health 46, 152-161.

Evaluated population: Participants were 376 sexually active, non-pregnant and not trying to conceive, English-speaking women with a mean age of 18.5 years. All women were patients at a community-based urban clinic that provided free reproductive health care to women and were predominantly minorities.

Approach: Of a total of 950 women approached in a clinic waiting area by research staff, 376 of them met eligibility requirements and gave informed consent. Participants were randomly assigned to study conditions: intervention plus standard care (MBI) or standard care only (SC). Women in the MBI group received intervention and follow-ups by health educators at baseline, 2 weeks and 6 months later. Both MBI and SC groups received standard care by clinic staff. Baseline and 6- and 12-month questionnaires were administered to participants in both groups, and visits to the clinic between scheduled study-related visits were monitored (participants were asked to fill out questionnaire to identify reason for visit). Measured outcomes included client-initiated clinic visits for STI checkups in response to seven high-risk sexual behaviors, consistent condom use, number of CT and GC episodes, and movement along the stages of change.

Results: There were no group differences at baseline, 6-, or 12-month assessments for distribution of stage of change across the seven risk behaviors. There were no difference in mean scores between the processes of change for the two groups at baseline except for dramatic relief, which was significantly more likely to be endorsed by the MBI group than the SC group but this was not predictive of STI-related clinic visits. There were no significant differences between the number of clinic visits and reason for visit between the MBI and SC groups. Likewise, no significant differences were found between the two groups at 6- and 12-month assessments in regards to consistent condom use during the previous three months or number of episodes of CT and GC cervical infection.

SOURCES FOR MORE INFORMATION

References:

KEYWORDS: Adolescents (12-17), Youth (16+), Young Adults (19-24), Communtiy-Based, Female Only, African American, Clinic-Based, Condom Use and Contraception, STD/HIV/AIDS

Program information last updated on 10/21/11