CAUSAL RELATIONSHIPS OF PROCESSES OF CHANGE AND DECISIONAL BALANCE - STAGE-SPECIFIC MODELS FOR SMOKING

This study, a secondary analysis of prospective data of smokers, teste d whether the causal relationships between the processes of change and decisional balance of the transtheoretical model of change (TTM) are stage-specific. It was expected that for smokers in the contemplation stage, higher levels of experiential processing cause the cons of smok ing to become more important and the pros of smoking to become less im portant. In other words, the level of experiential process use was exp ected to causally influence decisional balance (pros minus cons) for p eople in the contemplation stage. For ex-smokers in the action stage, when the cons outweigh the pros (cons become more important while pros become less important), they should increase their behavioral process use: decisional balance was expected to causally influence use of beh avioral processes. Cross-lagged panels were analyzed using structural equation modeling. Results indicate that experiential process use has causal predominance over decisional balance for smokers in the contemp lation stage. For those in the action stage, however, neither decision al balance nor behavioral process had apparent causal predominance. Me an-level invariance indicates that the contemplation and action stages are different. Further analysis investigated smokers who progressed f rom contemplation to either preparation or action or from preparation to action. For these smokers who had progressed toward action, decisio nal balance did causally influence use of behavioral processes. This e vidence provides support for the use of the ?TM as the basis for plann ing interventions that target specific stage-dependent causal mechanis ms. (C) 1998 Elsevier Science Ltd.