Is There Something Beyond Stages of Change in the Transtheoretical Model? The State of Art for Physical Activity Ahmed Jérôme Romain Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada Johan Caudroit University of Lyon 1 Marie Hokayem Lebanese University Paquito Bernard Université du Québec a` Montréal and University Institute of Mental Health at Montréal, Montreal, Quebec, Canada Over the past 30 years, there has been a growing interest in the application of the transtheoretical model (TTM) in the domain of physical activity (PA). Even though this model has been widely used to implement PA interventions, most of these interventions have not used all of the TTM’s theoretical constructs. Indeed, several studies focused exclusively on the stages of change although this construct is only descriptive. Thus, in the present review, we wanted to encourage researchers to go beyond stages of change when they use the TTM. To do so, we aimed to provide an overview of the TTM, its constructs and to present on one hand, longitudinal studies examining the association between PA and TTM constructs and, on the other hand, summarising the efficacy of TTM-based interventions as to present future TTM challenges. Public Significance Statement Theory-based interventions, including those based on the transtheoretical model, showed their efficacy in physical activity promotion. However, although the transtheoretical model proposes key regulatory components (namely, processes of change, self-efficacy, decisional balance, and temptation) to implement interventions, most of research remains focused on the stages of change. It should be reiterated that stages of change are a construct, not a theory, and therefore should not be used to tailor physical activity interventions. The key regulatory components of the transtheoretical model should be used to individualize counseling to physical activity. Moreover, the specific role of the processes of change in health education towards a more physically active lifestyle represents a future area of research. Keywords: physical activity, transtheoretical model, stages of change, processes of change, mediators of change Supplemental materials: http://dx.doi.org/10.1037/cbs0000093.supp As recently evidenced, the world actually faces an increasing prevalence of physical inactivity (Andersen, Mota, & Di Pietro, 2016), which partly explains the ever-rising worldwide prevalence of major noncommunicable diseases (Sallis et al., 2016). This physical inactivity epidemic constitutes an economic burden to the international health care systems of up to US$53.8 billion in 2013 (Ding et al., 2016). Thus, there is a pressing urgency to promote physical activity (PA) by implementing interventions that take into account the reasons favouring its adoption. In this context, theory-based interventions constitute an interesting option, not only because they are assumed to be better than
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model of health behavior at the intrapersonal level