Transtheoretical Model-based Interventions are Effective in Promoting Healthy Behaviors Related to Modifiable Risk Factors of Noncommunicable Diseases: A Systematic Review

Abstract

Introduction: Noncommunicable diseases (NCDs) such as heart diseases, type II diabetes mellitus, cancers, and stroke represent significant public health challenges globally. Modifiable risk factors, including insufficient physical activity (PA), overweight or obesity, and smoking, contribute significantly to the prevalence of these diseases. The transtheoretical model (TTM) offers a structured approach to behavior change, identifying stages of readiness and change processes. This systematic review (SR) aims to evaluate the effectiveness of TTM-based interventions in promoting healthy behaviors to mitigate these risk factors. Methods: This systematic review addresses the PICO question: In adults aged 18 years and older with modifiable risk behaviors related to NCDs, how effective are TTM-based interventions compared to standard care in increasing physical activity levels (PAL), reducing weight or body mass index, improving dietary habits, and promoting smoking cessation (SC)? A comprehensive search of predetermined databases was conducted using nine research strings, adhering to strict inclusion and exclusion criteria. A six-stage process was employed to select studies for inclusion, followed by data extraction and narrative synthesis to identify relevant patterns, trends, and associations. Results: Of the 259 articles retrieved, eight met the inclusion criteria. Baseline assessments determined participants’ readiness for change. TTM-based interventions included feedback or counseling sessions, feedback materials, and reports delivered in-person, online, and by telephone. Follow-up durations varied from 2 weeks to 2 years. Five out of six studies supported the effectiveness of TTM-based interventions in enhancing PAL. Four out of five studies demonstrated their efficacy in weight management and improving dietary habits. However, only two out of five studies confirmed their effectiveness in SC. Discussion: The findings indicate that TTM-based interventions are promising for improving PAL and, to a lesser extent, for managing weight and promoting healthy dietary behaviors. The limited effectiveness observed in SC interventions suggest a need for further research and possibly tailored strategies within this context. Conclusion: TTM-based interventions effectively promote PA and weight management, with moderate success in improving dietary habits. However, their effectiveness in SC remains inconclusive, highlighting the necessity for further investigation and potential refinement of intervention strategies.

Keywords

• noncommunicable diseases (NCDs)
• transtheoretical model (TTM)
• behavior change
• physical activity levels (PAL)
• weight management
• smoking cessation