Working with parents/carers at different stages of change
What if someone isn’t ready to change? When setting goals with parents it is important to consider how ready the parent is to change and to set goals that are aligned with their current attitudes and behaviours. For example, if a parent has not even considered changing their physical activity behaviours, setting an action plan with them to go running three times a week will have little effect.
Stages of change model
A model that is helpful for understanding how ready parents are to change is the Transtheoretical Model for Health Behaviour Change (often referred to as “stages of change”).
The stages of change model suggests there are five stages of change:
- Pre-contemplation – not thinking about change
- Contemplation – thinking about change but not yet done anything about it
- Preparation – made some concrete step towards change but not yet where you’d like to be
- Action – engaging in the desired behaviour but been doing so for less than 6 months
- Maintenance – the desired behaviour has been maintained for longer than 6 months.
You can identify a parent’s stage of change by asking open questions about their physical activity and dietary behaviours, how long they have been doing these things and - in cases where change might be beneficial - have they considered changing any of these behaviours? Identifying what stage of change someone is at means you will be able to talk to parents at this level rather than, for example pushing someone into action while they are still at the pre-contemplation stage.
Movement between the five stages is not linear, at any point someone might “relapse” to a previous stage. It is important if someone relapses to encourage them not to be too hard on themselves and acknowledge that relapse is common. Help the individual to identify the benefits they and their family have already achieved from their behaviour change and set a plan to move on.
The ideas below outline how you might work differently with parents at different stages of change.
Below is a short quiz to help you evaluate your learning from this module. You may take the quiz as many times as you like.
Behaviour change techniques
Start the quiz
1. Why is it important to use behaviour change techniques?
a) Education and information alone do not change behaviour
b) People’s behaviours have an impact on their health and well being
c) It is difficult to change our own behaviour and behaviour in other people
d) All of the above
2. What is a behaviour change technique?
a) A strategy that helps an individual change their behaviour
b) A way of telling someone to change their behaviour
c) Something you do that forces someone else’s behaviour to change
d) All of the above
3. If an individual sets a goal to reduce their portion sizes so that they can lose weight, which is their outcome and which is their process goal?
a) Both are outcome goals
b) Both are process goals
c) Losing weight is the outcome goal, reducing portion sizes is the process goal
d) Reducing portion sizes is the outcome goal, losing weight is the process goal
4. Why might you use a “bubble task” with parents?
a) To help give a parent ideas if they do not know what they would like to change
b) To tell a parent what they need to change
c) To help give some focus for a parent who wants to change everything at once
d) a & c only
5. Which behaviour change technique involves setting a detailed and specific behavioural plan?
c) Action planning
d) Environmental re-structuring
6. If you are helping a parent to set an action plan, which of the following would be most likely to result in action?
a) Eat cucumber sticks for snacks on Monday, Wednesday and Friday and carrots with hummus as a snack on Tuesday and Thursday
b) Increase vegetable intake
c) Eat more cucumbers and carrots
d) Replace unhealthy snacks with cucumber sticks or carrots with hummus
7. What are the benefits of self-monitoring when trying to change behaviours?
a) Helping parents see in black and white what their current behaviour is like
b) Helping parents feel a sense of achievement as they “tick” off their progress
c) Providing an account to help you review progress with the parent at the next meeting
d) All of the above
8. Imagine you are working with a parent in the pre-contemplation stage of change who has a pre-school child who is physically inactive. Which of the following action plans would be most appropriate?
a) Be active for an hour every day
b) Reduce TV viewing to 2 hours a day
c) Read an information leaflet about why it is important for pre-school children to be physically active (and the dangers of physical inactivity)
d) Read an information leaflet about how to change physical activity behaviours
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