Introduction
Theories and models that examine the human behavior originates from all disciplines of social sciences. Disciplinary scope helps in identifying the various types of behavior, how these behaviors are categorized, and methods in which it can be used to examine. Thus a comprehensive study and understanding of the theories and models are paramount. Attempts to separate the major aspects that cause and control behavior originates from the field of psychology and sociology. However, anthropology can be applied to comprehend issues relating to the habits, rituals, and political power and institutional arrangements. This article presents a review of the Trans-theoretical model and the Health Belief Model of behavior and behavioral change, describes the widely used model, summarizes certain shared elements, and also cross-cutting themes as used in managing obesity.
Comparison Between the TTM and HBM
Transtheoretical model is referred to as the stages of change (Jake Morris, 2012) was developed by Prochaska and DiClemente in the 1970s. The model developed through examining smokers whom some quit on their own while some required further medication. And the system noted that people stopped smoking when they are ready to do so (LaMorte, 2019). Therefore, this system formed its basis on decision making. It explains an individual readiness to change their behavior, and therefore, it describes the stages under which a change can be made possible. The time in which an individual stays in a given stage is variable, but the tasks are not. At each stage, certain processes are emphasized to reduce resistance, facilitate progress, and prevent lapse, and such includes personal decision, personal efficiency, and processes of change (Pro-change, 2018).
Pre-contemplation is an entry point targeting individuals without a foreseeable future to drop their habits. They are usually measured for six months (Pro-change, 2018). The majority of the people are in constant trials to change and are classified as resistant, unmotivated, or are not ready. The contemplation stage is individuals getting prepared and there is an intention in six months. The pros and cons of changing are known at this stage, characterized by procrastination or chronic contemplation. Preparation is a stage for people ready for behavioral change, and there is a high likelihood of tasking the steps. Here there is also a history of some actions. Action is where an individual has made modifications over their lifestyle in the last six months. Finally, the maintenance is where an individual has made specific overt modifications and are working to prevent relapse (Pro-change, 2018).
However, it is worth to note the limitations of this model when applying in public health which includes the following; (1) the theory assumes the social context in which change occurs such as SES and income, (2) the lines between the stages are arbitrary and there no criteria that determine stage f change, (3) there is no method of measuring the duration in which someone can stay in a given stage, and (4) this model assumes that an individual makes logical and rational decisions before committing to change which is not always true.
The Health Belief Model is a model guided by an individual cognitive and asserts that behavioral change is based on the number of beliefs about a perceived threat to one's well-being, effectiveness, and results of a particular behavior (Jake Morris, 2012). Readiness to action is based on the belief of susceptibility of a specific threat, and adversity of such consequences. Moreover, the benefits that accrue from changing a certain behavior is weighed against the expense of consequences that result from the behavior.
For an individual to change their behavior, the following must feature in their perceptions; perceived susceptibility, perceived severity, perceived benefits, and perceived barriers (Olender, 2019). Furthermore, there are several limitations of this model including; (1) the model does not take into account the person's attitudes, and beliefs that dictate the acceptance of health factor, (2) does not take into account habitual behaviors that may inform decision-making action, (3) does not take into account the environmental or economic factors that may discourage or promote the recommended engagement, and (4) assumes that everyone can access the equal amounts of information on the health issues (LaMorte, 2019).
Diagnosis of Obesity
Obesity is a chronic and multifactorial health problem and is the highest cause of morbidity and also premature mortality globally. Statistically, over a billion people around the globe are considered overweight, and over half a billion are obese (Wirtz, 2004). Moreover, it is associated with a high range of weight of an individual concerning the height and is linked with poor health effects. Its diagnosis is founded on the cutoff points of individuals' body mass index (BMI) (Obesity, 2019).
Behavioral measures for working with obese patients and families within the basic context requires a multifactorial model for adopting treatment (C.P. Kelley, 2017).
Conclusion
Basing on the tables above, the HBM model is more superior in terms of obese treatment. It is more comprehensive. Furthermore, the threats that come as a result of obesity, such as type 2 diabetes, coronary heart disease, some types of cancer, i.e., breast cancer and bowel cancer, and stroke (NHS, 2019) are enough to compel an obese person to make behavioral adjustments. As opposed to TTM, which is best applied for situations concerning habitual lifestyles. Therefore, HBM is strongly recommended for obesity.
References
al, N. M. (2014). Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database of Systematic Reviews.
C.P. Kelley, G. S. (2017). Behavioral Modification for the Management of Obesity. US National Library of Medicine National Institutes of Health.
Jake Morris, M. M. (2012). Theories and models of behavior and behavior change. Forest Research, 23.
Kazemi, . 2.-M. (2017). 2016 Iranian Journal of Nursing and Midwifery Research | Published by Wolters Kluwer - Medknow 595Health beliefs and stages of changes to improve behaviors among obese and overweight women undergoing preconception care. Iranian journal of nursing and midwifery research, 599.
LaMorte, W. W. (2019, 09 9). Behavioral Change Models. Retrieved from The Transtheoretical Model (Stages of Change): http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html
NHS. (2019, 05 16). NHS. Retrieved from Overview Obesity: https://www.nhs.uk/conditions/obesity/
Obesity. (2019). Health/Obesity. America's Children and the Environment, 17.
Olender, E. B. (2019, 01, 14). BEHAVIORAL PSYCHOLOGY. Retrieved from Health Belief Model: https://www.verywellmind.com/health-belief-model-3132721
Pro-change. (2018). Pro-change behavior system, inc. Retrieved from The Transtheoretical Model: https://www.prochange.com/transtheoretical-model-of-behavior-change
Wirtz, V. J. (2004). Background Paper 6.18 Obesity. Priority Medicines for Europe and the World "A Public Health Approach to Innovation," 38.
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