Relationship of Stages of Change to Attendance in a Diabetes Prevention Program

Abstract

PURPOSE: To determine whether preintervention stage-of-change measures are indicative of subsequent attendance at diabetes prevention intervention sessions. DESIGN: Cross-sectional. SETTING: Local community. SUBJECTS: Seventy-five adult American Indian women participated. MEASURES: Attendance, stage-of-change questions for seven diabetes prevention behaviors, and mean stage-of-change score to reflect the combined stages of change for all behaviors. ANALYSIS: Univariate analyses for stage-of-change distribution and Fisher's exact test and prevalence ratios for the association between attendance and stage of change. RESULTS: Participants' readiness for change at baseline was distributed across all stages of change. The most common stage was preparation. There was a significant relationship between the mean stage-of-change scores and attendance. Participants with lower mean stage-of-change scores (mean +/- SE, 3.03 +/- 0.13) were less likely to attend all 5 sessions than those with higher mean stage-of-change scores (mean +/- SE, 3.38 +/- 0.10) (p = .04). Participants in the action category (preparation, action, and maintenance stages) before the intervention were 6.7 (95% confidence interval, 1.0-44.1; p < .01) times more likely to be high attenders than those in the preaction category (precontemplation and contemplation stages) before the intervention. CONCLUSIONS: Findings from this study suggest that stage of change may be a good predictor of attendance at diabetes prevention intervention sessions and have implications for intervention design and assessment. The mean stage-of-change score may be a more stable estimate of stage of change.

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