The status of evidence and outcomes in Stages of Change research

The Stages of Change model has become a prominent feature within health pro motion and most of the literature associated with the model portrays it as being 'effective', Based on an extensive review of the literature, this pap er suggests that contrary to this view there exist a relative paucity of su fficiently strong supportive evidence. The paper describes the features of the existing evidence base, and highlights problems in relation to various aspects of design and execution. Two wider issues relating to the core natu re of the model and the evidence associated with it are identified as impor tant and discussed. Two main conclusions are drawn. First, better quality q uantitative outcome studies are needed. These should be complemented with s ignificant qualitative case studies with a focus on practitioner and organi zational utilization of the model, Second, the disproportionate popularity of the model may be skewing the practical and conceptual nature of health p romotion. Stages of Change activities are seen to equate to 'health promoti on' at the expense of other activities and approaches.