- This was a cross-cultural comparative study that examined college
students' physical activity behavior in both the United States and the Republic of
China on the basis of the full Transtheoretical Model (TTM) of behavior change.
Although current investigations do support TTM as a powerful model of physical
activity behavior change, there remains a need for examining other variables and
constructs relative to those proposed in TTM. From a health promotion planning
or intervention perspective, the integration of some of the PRECEDE and
PROCEED (PRE) constructs might provide unique insight into physical activity
A total of 1,132 participants were recruited into this study, with 531 coming
from Taiwan and 601 coming from the U.S. In spite of similar recruitment
techniques, demographical data indicated that the participants from Taiwan were
older and had lower BMIs than those in the United States. They also spent more
time sifting in comparison to their American counterparts.
The scales and subscales used in this study were completed in the
participants' native language (i.e., Chinese or English). Prior to their use in this
study, all of the questionnaires were translated into Chinese using a multiple-step
methodology, including back translation, and they were found to have reasonable
internal consistency. Results showed that the best predictive model for the stages of physical
activity behavior change was based on concomitants coming from both TTM and
PRE together. Specifically, the variables that contributed the most to the
participants' stage of change for physical activity classification in a stepwise
analysis, in order of entry, were the behavioral processes of change,
predisposing, nationality, cognitive processes of change, and gender. The overall
classification accuracy was 49%. Other than the maintenance stage (66%-68%
classification accuracy), this study found that the preparation stage (65.5%-
70.4% classification accuracy) was especially reliably predicted, which suggests
that preparation stage might be less transitory than previous thought.
Furthermore, the concurrent validity of the stage of change measure used
in this study was significantly related to the International Physical Activity
Questionnaire (IPAQ). This is the first application of IPAQ in Taiwan and the
results of the present study support its continued use as a physical activity
measure within a new country.
As nationality was a key concomitant of stage of change classification, the
present study suggests there may be a need for more non-Eurocentric research
with TTM before concluding that behavior change strategies and techniques
hypothesized in the model (e.g., behavioral and cognitive processes of change
decisional balance, and self-efficacy) are fully generalizable in physical activity
behavior change interventions using mixed culture samples. Likewise, there may
be some unique contributions to such interventions by incorporating constructs
from a broader health promotion planning or intervention model.