Stage of change versus an integrated psychosocial theory as a basis for developing effective behaviour change interventions

According to the Stages of Change (SOC) model, behavioural change involves a process of movement from precontemplation (no intention to change), to contemplation (some intention to change, but no behaviour), to preparation (intention to change and early inconsistent behavioural attempts to change), to action (consistent behavioural performance for less than six months) and finally, to maintenance (consistent behavioural performance for six months or more). Moreover, it is argued that cognitive (e.g. attitude change) and action oriented (e.g. changing self-efficacy) strategies are differentially effective at different stages. In contrast, most other behavioural prediction and change models suggest that both cognitive and action oriented approaches are necessary to move people from precontemplation to contemplation (i.e. to develop intentions). This paper tests this and other differences between these two theoretical approaches. Among other findings, our data indicate that a combination of cognitive and action strategies may be the most effective way to target individuals who have no intention to change their behaviour.