Measuring Stage of Change for Exercise

This project continues the development and refinement of the URICA-E2, an instrument to measure stage of change for regular exercise based on the Transtheoretical Model of Behavior Change. In Study One, the URICA-E2, which is a proportionate measure of stage of change, was analyzed using Principal Component Analysis and refined into a 24-item instrument capturing not five, but six components of change: Precontemplation-Non Believer (PCN), Precontemplation-Believer (PCB), Contemplation (C), Preparation (P), Action (A), and Maintenance (M). The standardized scale scores from the URICA-E2 were clustered and seven profiles were found. They duplicated the six components and added a seventh which was tentatively named Ambivalent (ABV). In Study Two, a series of models were tested using Confirmatory Factor Analysis in order to better understand the relationship between the stage constructs. Nine models were tested: two types of simplex, four types of circumplex, and three types of punctuated equilibrium. A circumplex model where the strongest relationships were found among the stages which are adjacent, alternate, and opposite was found to nearly mimic the exercise data. This supports the very common experience of people frequently relapsing and frequently restarting regular exercise. Study Three sought confirmation of the URICA-E2 by validating it against two short form staging algorithms, the Decisional Balance instrument, the Confidence instrument, and a measure of hours of exercise. The Single Question Algorithm was found to outperform the other algorithms. The profiles of the URICA-E2 demonstrated the classic crossover of pros with cons around the Preparation stage. Confidence was seen to rise across the profiles. In conclusion, it was found that the URICA-E2 is a multipurpose tool, well worth the effort required to use it. What other instrument could give you stages of change, profiles, and show a circumplex to be the best way to describe the relationship between the stages? For situations that demand a shorter staging instrument, the Single Question Algorithm has proved to be an instrument of choice. It has the advantage of simplicity, ease of administration, and it performs as well as, if not better than, its five question counterpart