Health Behavior Research and Training Institute, The University of Texas at Austin.
Department of Psychology, University of Maryland, Baltimore County.
Psychol Addict Behav. 2018 Nov;32(7):749-758. doi: 10.1037/adb0000417.
Using data from Project CHOICES, a randomized controlled trial to test an intervention to prevent alcohol-exposed pregnancies, this study examined process of change profiles composed of Transtheoretical Model of Change (TTM) constructs for alcohol. The primary purpose was to identify a profile of TTM variables associated with reduced drinking. Participants (n = 570) were women at risk of an alcohol-exposed pregnancy recruited from high risk settings. Profile analyses compared end-of-treatment (i.e., 3 months postintake) TTM construct mean profiles for women who reduced drinking to below NIAAA-defined risk levels1 (changers) with women who continued to drink at risk levels (nonchangers) at the 9-month follow-up. TTM construct profiles included experiential and behavioral processes of change, pros and cons for change, confidence to reduce drinking, and temptation to drink above risk levels. Results revealed a parallelism effect or interaction (p < .001) in the end-of-treatment TTM construct profiles for the changers versus the nonchangers at the 9-month follow-up. Changers reported greater pros (p < .001) and lower cons for change (p = .012), greater confidence (p = .030), lower temptation (p < .001) and greater use of the experiential (p < .001) and behavioral processes of change (p < .001). A larger percentage of the women from the CHOICES intervention were in the end-of-treatment profile of the changers (48%) compared with the control condition (39%; p = .042). Interventions can potentially be enhanced by clinicians' understanding what successful change "looks like" for specific clients in terms of their process use, decisional balance, and self-efficacy, allowing for tailored interventions targeted to each client's specific strengths and deficits. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
利用 CHOICES 项目的数据，这是一项旨在测试预防酒精暴露妊娠干预措施的随机对照试验，本研究考察了由变化过程理论（TTM）构建的变化过程的概况，该理论用于研究酒精。主要目的是确定与减少饮酒量相关的 TTM 变量概况。参与者（n = 570）是从高风险环境中招募的有酒精暴露妊娠风险的女性。分析比较了治疗结束时（即摄入后 3 个月）的 TTM 结构变化概况，用于比较减少饮酒量至低于国家酒精滥用与酒精中毒研究所定义的风险水平 1（变化者）的女性和在 9 个月随访时仍处于风险水平饮酒的女性（不变者）。TTM 结构概况包括体验和行为变化过程、改变的利弊、减少饮酒的信心和饮酒超过风险水平的诱惑。结果显示，在治疗结束时，与 9 个月随访时的不变者相比，变化者的 TTM 结构变化概况存在平行效应或相互作用（p <.001）。变化者报告说，他们有更多的优点（p <.001）和更少的缺点（p =.012）来改变，更多的信心（p =.030），更低的诱惑（p <.001）和更多地使用体验（p <.001）和行为变化过程（p <.001）。与对照组（39%；p =.042）相比，CHOICES 干预组中有更多的女性处于治疗结束时的变化者概况（48%）。了解成功变化的“样子”，即特定客户在使用过程、决策平衡和自我效能方面的变化，从而为每个客户的特定优势和劣势提供有针对性的干预措施，这可能会增强干预措施的效果。（PsycINFO 数据库记录（c）2018 APA，保留所有权利）。
