Download PDF
J Am Acad Audiol 2018; 29(06): 548-560
DOI: 10.3766/jaaa.16122
Review
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Application of Transtheoretical (Stages of Change) Model in Studying Attitudes and Behaviors of Adults with Hearing Loss: A Descriptive Review

Vinaya Manchaiah
*   Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
†   The Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
‡   Audiology India, Mysore, Karnataka, India
§   Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
,
Barbara Michiels Hernandez
**   Department of Health and Kinesiology, Lamar University, Beaumont, TX
,
Douglas L. Beck
*   Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
††   Oticon Inc, Somerset, New Jersey, NJ
‡‡   Department of Communication Disorders, State University of New York at Buffalo
› Author Affiliations
Further Information

Publication History

Publication Date:
29 May 2020 (online)

   Permissions and Reprints

Abstract

Background:

Health Behavior Change (HBC) refers to facilitating changes to habits and/or behaviors related to health. There are a number of models/theories of HBC, which provide a structured framework to better understand the HBCs of individuals. The Transtheoretical Model (TTM, aka “the Stages of Change” model) is an integrative model used to conceptualize the process of intentional behavior change and is applied to a variety of behaviors, populations, and settings. In the last few years, use of TTM by the profession of audiology has been increasing.

Purpose:

This descriptive literature review was aimed at identifying and presenting a summary of research studies, which use TTM to study the attitudes and behaviors of adults with hearing loss.

Research Design:

A literature review was conducted.

Study Sample:

This review included 13 empirical studies.

Data Collection and Analysis:

A literature review was conducted using the EBSCOhost and included the databases Cumulative Index to Nursing and Allied Health, MEDLINE, and PsycINFO.

Results:

The review suggests TTM is useful in studying the attitudes and behaviors of adults with hearing loss. There are positive associations between stages of change and help-seeking, intervention uptake, and hearing rehabilitation outcome (i.e., benefit and satisfaction). However, associations with intervention decisions and intervention use were not evident. It appears help-seeking, intervention uptake, and successful outcomes are usually displayed in people in the later stages of change as those with greater hearing loss are often in the later stages of change.

Conclusions:

Understanding the readiness toward help-seeking and uptake of intervention in people with hearing loss based on TTM may help clinicians develop more focused management strategies. However, additional longitudinal and interventional studies are needed to further test the predictive validity of the stages of change model.

Key Words

attitudes - belief - health behavior - hearing loss - help-seeking - outcome - rehabilitation - stages of change - transtheoretical model.
 

  • REFERENCES

  • Ajzen I. 1991; The theory of planned behavior. Org Behav Hum 50: 179-211
    Google Scholar
  • Armitage CJ. 2009; Is there utility in the transtheoretical model?. Br J Health Psychol 14 Pt 2 195-210
    CrossrefPubMedGoogle Scholar
  • Armitage CJ, Povey R, Arden MA. 2003; Evidence for discontinuity patterns across the stages of change: a role for attitudinal ambivalence. Psychol Health 18: 373-386
    CrossrefGoogle Scholar
  • Babeu LA, Kricos PB, Lesner SA. 2004; Application of the stages-of-change model in audiology. J Acad Rehab Audiol 37: 41-56
    Google Scholar
  • Bandura A. 1986. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall;
    Google Scholar
  • Clark J. 2010; The geometry of patient motivation: circles, lines and boxes. Audiol Today 22: 32-40
    Google Scholar
  • Cox RM, Alexander GC. 1999; Measuring satisfaction with amplification in daily life: the SADL scale. Ear Hear 20 (04) 306-320
    CrossrefPubMedGoogle Scholar
  • Cox RM, Alexander GC. 2002; The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version. Int J Audiol 41 (01) 30-35
    CrossrefPubMedGoogle Scholar
  • Day H, Jutai J. 1996; Measuring the psychosocial impact of assistive devices: the PIADS. Can J Rehabil 9: 159-168
    Google Scholar
  • Ekberg K, Grenness C, Hickson L. 2016; Application of the transtheoretical model of behaviour change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments. Int J Audiol 55 (Suppl 3) S42-S51
    CrossrefPubMedGoogle Scholar
  • Ferguson M, Maidment D, Russell N, Gregory M, Nicholson R. 2016; a Motivational engagement in first-time hearing aid users: A feasibility study. Int J Audiol 55 (Suppl 3) S23-S33
    CrossrefPubMedGoogle Scholar
  • Ferguson MA, Woolley A, Munro KJ. 2016; b The impact of self-efficacy, expectations, and readiness on hearing aid outcomes. Int J Audiol 55 (Suppl 3) S34-S41
    CrossrefPubMedGoogle Scholar
  • Fishbein M, Ajzen I. 1975. Belief, Attitude, Intention and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley;
    Google Scholar
  • Gatehouse S. 1999; Glasgow hearing aid benefit profile: derivation and validation of a client-centred outcome measure for hearing aid services. J Am Acad Audiol 10: 80-103
    Google Scholar
  • Hall KL, Rossi JS. 2008; Meta-analytic examination of the strong and weak principles across 48 health behaviors. Prev Med 46 (03) 266-274
    CrossrefPubMedGoogle Scholar
  • Hernandez BLM. 2011. Foundation Concepts of Global Community Health Promotion and Education. Sudbury, MA: Jones and Bartlett Learning;
    Google Scholar
  • Herzog TA, Blagg CO. 2007; Are most precontemplators contemplating smoking cessation? Assessing the validity of the stages of change. Health Psychol 26 (02) 222-231
    CrossrefPubMedGoogle Scholar
  • Hong O, Chin DL, Kerr MJ, Ronis DL. 2012; Stages of change in hearing-protection behavior, cognition, and hearing status. Am J Health Behav 36 (06) 811-822
    CrossrefPubMedGoogle Scholar
  • Ida Institute 2009 Motivation Tools: The line, Box and Circle. http://idainstitute.com/fileadmin/user_upload/documents/Motivational_Tools_final_nov13.pdf . Accessed July 4, 2016
    PubMedGoogle Scholar
  • Ingo E, Brännström KJ, Andersson G, Lunner T, Laplante-Lévesque A. 2016; Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening. Int J Audiol 55 (Suppl 3) S52-S58
    CrossrefPubMedGoogle Scholar
  • Janz NK, Becker MH. 1984; The health belief model: a decade later. Health Educ Q 11 (01) 1-47
    CrossrefPubMedGoogle Scholar
  • Kaldo V, Richards J, Andersson G. 2006; Tinnitus stages of change questionnaire: psychometric development and validation. Psychol Health Med 11 (04) 483-497
    CrossrefPubMedGoogle Scholar
  • Laplante-Lévesque A, Brännström KJ, Ingo E, Andersson G, Lunner T. 2015; Stages of change in adults who have failed an online hearing screening. Ear Hear 36 (01) 92-101
    CrossrefPubMedGoogle Scholar
  • Laplante-Lévesque A, Hickson L, Worrall L. 2011; Predictors of rehabilitation intervention decisions in adults with acquired hearing impairment. J Speech Lang Hear Res 54 (05) 1385-1399
    CrossrefPubMedGoogle Scholar
  • Laplante-Lévesque A, Hickson L, Worrall L. 2012; What makes adults with hearing impairment take up hearing AIDS or communication programs and achieve successful outcomes?. Ear Hear 33 (01) 79-93
    CrossrefPubMedGoogle Scholar
  • Laplante-Lévesque A, Hickson L, Worrall L. 2013; Stages of change in adults with acquired hearing impairment seeking help for the first time: application of the transtheoretical model in audiologic rehabilitation. Ear Hear 34 (04) 447-457
    CrossrefPubMedGoogle Scholar
  • Manchaiah VK. 2012; Health behavior change in hearing healthcare: a discussion paper. Audiology Res 2 (01) e4
    Google Scholar
  • Manchaiah V, Rönnberg J, Andersson G, Lunner T. 2015; Stages of change profiles among adults experiencing hearing difficulties who have not taken any action: a cross-sectional study. PLoS One 10 (06) e0129107
    CrossrefPubMedGoogle Scholar
  • Manchaiah VKC, Stephens D, Meredith R. 2011; The patient journey of adults with hearing impairment: the patients’ view. Clin Otolarynol 6: 227-234
    Google Scholar
  • McConnaughy EA, Prochaska JO, Velicer WF. 1983; Stages of change in psychotherapy:measurement and sample profiles. Psychol Psychother 20: 368-375
    Google Scholar
  • Meister H, Walger M, Brehmer D, von Wedel U-C, von Wedel H. 2008; The relationship between pre-fitting expectations and willingness to use hearing aids. Int J Audiol 47 (04) 153-159
    CrossrefPubMedGoogle Scholar
  • Milstein D, Weinstein BE. 2002; Effects of information sharing on follow-up after hearing screening for older adults. J Acad Rehab Audiol 35: 43-58
    Google Scholar
  • Nigg CR, Allegrante JP, Ory M. 2002; Theory-comparison and multiple-behavior research: common themes advancing health behavior research. Health Educ Res 17 (05) 670-679
    CrossrefPubMedGoogle Scholar
  • Noar SM, Zimmerman RS. 2005; Health behavior theory and cumulative knowledge regarding health behaviors: are we moving in the right direction?. Health Educ Res 20 (03) 275-290
    CrossrefPubMedGoogle Scholar
  • Noh S, Gagné JP, Kaspar V. 1994. Models of health behaviors and compliance: applications to audiological rehabilitation research. In: Gagné JP, Tye-Murray N. Research in Audiological Rehabilitation: Current Trends and Future Directions. Gainesville, FL: J Acad Rehabil Audiol Monograph Supplement 27; 375-389
    Google Scholar
  • Or KL. 2008 Development of a model of consumer health information technology acceptance of patient with chronic illness. ProQuest LLC database. (3348754). (Ph.D), University of Wisconsin-Madison, Ann Arbor, MI
    PubMedGoogle Scholar
  • Prochaska J, Velicer W, Rossi J, Goldstein M, Marcus B, Rakowski W. 1994; Stages of change and decisional balance for 12 problem behaviors. Health Psychology 13 (01) 39-46
    CrossrefPubMedGoogle Scholar
  • Prochaska JO, DiClemente CC. 1983; Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 51 (03) 390-395
    CrossrefPubMedGoogle Scholar
  • Prochaska JO, DiClemente CC, Norcross JC. 1992; In search of how people change. Applications to addictive behaviors. Am Psychol 47 (09) 1102-1114
    CrossrefPubMedGoogle Scholar
  • Prochaska JO, Diclemente CC. 2005. The transtheoretical approach. In: Norcross JC, Goldfried MR. Handbook of Psychotherapy Integration. New York: Oxford University Press, Inc.; 147-171
    CrossrefGoogle Scholar
  • Prochaska JO, Johnson S, Lee P. 2009. The transtheoretical model of behavior change. In: Shumaker SA, Ockene JK, Riekert KA. The Handbook of Health Behavior Change. 3rd ed. New York, NY: Springer; 59-83
    Google Scholar
  • Prochaska JO, Velicer WF. 1997; The transtheoretical model of health behavior change. Am J Health Promot 12 (01) 38-48
    CrossrefPubMedGoogle Scholar
  • Raymond 3rd DM, Lusk SL. 2006; Staging workers’ use of hearing protection devices: application of the transtheoretical model. AAOHN J 54 (04) 165-172
    CrossrefPubMedGoogle Scholar
  • Rogers RW. 1975; A protection motivation theory of fear appeals and attitude change. J Psychol 91 (01) 93-114
    Google Scholar
  • Rollnick S, Mason P, Butler C. 1999. Health Behavior Change: A Guide to Practitioners. London: Churchill Livingstone;
    Google Scholar
  • Rothpletz AM, Moore AN, Preminger JE. 2016; Acceptance of internet-based hearing healthcare among adults who fail a hearing screening. Int J Audiol 55 (09) 483-490
    CrossrefPubMedGoogle Scholar
  • Ryan RM, Deci EL. 2000; Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 55 (01) 68-78
    CrossrefPubMedGoogle Scholar
  • Saunders GH, Frederick MT, Silverman SC, Nielsen C, Laplante-Lévesque A. 2016; a Description of adults seeking hearing help for the first time according to two health behavior change approaches: transtheoretical model (stages of change) and health belief model. Ear Hear 37 (03) 324-333
    CrossrefPubMedGoogle Scholar
  • Saunders GH, Frederick MT, Silverman SC, Nielsen C, Laplante-Lévesque A. 2016; b Health behavior theories as predictors of hearing-aid uptake and outcomes. Int J Audiol 55 (Suppl 3) S59-S68
    PubMedGoogle Scholar
  • Saunders GH, Frederick MT, Silverman S, Papesh M. 2013; Application of the health belief model: development of the hearing beliefs questionnaire (HBQ) and its associations with hearing health behaviors. Int J Audiol 52 (08) 558-567
    CrossrefPubMedGoogle Scholar
  • Stephens D, Kramer SE. 2009. Living with hearing difficulties: The process of enablement. Chichester: Wiley-Blackwell;
    Google Scholar
  • Sutton S. 2001; Back to the drawing board? A review of applications of the transtheoretical model to substance use. Addiction 96 (01) 175-186
    CrossrefPubMedGoogle Scholar
  • Tønnesen H. 2012. Engage in the Process of Change; Facts and Methods. Copenhagen: World Health Organization;
    Google Scholar
  • Ventry IM, Weinstein BE. 1982; The hearing handicap inventory for the elderly: a new tool. Ear Hear 3 (03) 128-134
    CrossrefPubMedGoogle Scholar
  • Weinstein BE. 2012. Geriatric Audiology. New York: Thieme Medical Publishers, Inc.;
    Google Scholar
  • West R. 2005; Time for a change: putting the Transtheoretical (Stages of Change) Model to rest. Addiction 100 (08) 1036-1039
    CrossrefPubMedGoogle Scholar
  • West RL, Smith SL. 2007; Development of a hearing aid self-efficacy questionnaire. Int J Audiol 46 (12) 759-771
    CrossrefPubMedGoogle Scholar
  • Zhao F, Manchaiah V, St Claire L, Danermark B, Jones L, Brandreth M, Krishna R, Goodwin R. 2015; Exploring the influence of culture on hearing help-seeking and hearing-aid uptake. Int J Audiol 54 (07) 435-443
    CrossrefPubMedGoogle Scholar