Applying the Transtheoretical Model of Behavior Change (TTM)

Applying the Transtheoretical Model of Behavior Change (TTM):
Patient Health Behavior Assessment Paper
NU361
Students will write a 5 page academic paper in APA format that addresses one of the health behavior issues that was identified while interviewing their “volunteer patient”. For example, while obtaining your patient’s health history you may have discovered that they are a smoker, do not get enough sleep, have poor eating habits, are a diabetic who does not monitor their blood sugar, or perhaps they have a sedentary lifestyle. These are all behaviors that may affect your patient’s health and well-being. In order to affect a healthy change you will apply Prochaska & DiClemente’s Transtheoretical Model of Behavior Change (TTM) to your “volunteer patient” as a health promotion activity. The goal is to identify the stage of the TTM the patient is in, and design an evidence-based nursing intervention to assist the patient in changing this behavior, which will allow them to the next stage of the Transtheoretical Model.
For additional information regarding how the Model can be applied to your patient and how to write the paper please you may wish to listen to the lecture in the course Module.
NOTE: The maximum paper length is 5 pages; any text over 5 pages will not be considered for grading.
An APA paper includes the proper setup, a title page, an abstract, the body of 5 pages of writing, and a reference list. Please use APA headings to separate the different topics in the body of the paper will help to organize your data (see APA manual or Purdue Owl website for use of headings, PERRLA software will help you do these automatically).
Be prepared to submit the assignment to Turnitin (the anti-plagiarism tool described previously in NU360. PLEASE NOTE: DO NOT SUBMIT YOUR PAPER WITH YOUR NAME ANYWHERE ON THE ACTUAL PAPER INCLUDING THE TITLE PAGE WHEN YOU POST IT TO TURNITIN.
PLEASE NOTE: This paper cannot be rewritten after grading/submission. Papers with multiple grammatical errors or structural/flow issues will not be read/graded (these papers will be returned without corrections with a grade of zero and will not be allowed a second opportunity for submission). ***If you have difficulty, writing papers you are highly encouraged to consult with the Writing House Online Tutors (they can assist with set-up, grammar, sentence flow, and APA formatting. They will not assist with content). The corrected paper should be saved for your WPE portfolio with your WPE certificate (should you receive one). Please be sure to save the paper and certificate in 3 different, safe places as these cannot be reproduced once the course closes.
PLEASE SEE NEXT 2 PAGES FOR PAPER OUTLINE/FORMAT
Please follow the outline below when constructing your paper:
Paper outline:
1. Introduction:
Please do not use the word “Introduction” as a Level 1 APA heading it is assumed that the first paragraph is the introduction in an APA paper):
Describe the intent (or purpose) of the paper, identifying the focus of the behavior to be changed and introduce the TTM to your reader. Remember to identify a behavior and not a symptom or condition. (For example, with the condition of obesity, the related behavior might be eating large portions, poor food choices, lack of planning, lack of exercise, etc. However, “weight loss” is not a behavior; it is a symptom. Select ONE behavior to focus on –though you may need to identify that other, related behaviors exist that contribute to the condition). Introduce the patient (according to HIPAA—do not use the “patient’s” full name or relation to you. Use the initials or the first name only). The expected outcome (thesis statement) should be clearly stated as a measurable objective. This section should be one paragraph.
2. Health History:
Summarize the “patient’s” health history. You should not repeat the
entire patient history, rather analyze the history, discuss only the relevant facts from the patient and family histories that pertain to the behavior you are addressing, and identify at least two actual or potential health risks. This should only take one paragraph.
3. Rationale:
Provide the rationale for the chosen behavioral health risk factor your “patient” needs to change to promote health in his/her life (be sure to link this to your thesis statement). Provide current, scientific evidence from the peer-reviewed literature as to why the risk factor is important to address in relation to health promotion (you should use a minimum of 3 peer-reviewed references for this section that should be no more than 3-5 years old). This is similar to a literature review, use citations to back up your rationales. You must use references other than the course textbook (this shows strength of research effort). Also, do not use “lay person” websites such as Mayoclinic.com or WebMD. Please use only professional websites such as CDC.gov, NIH.gov or other peer-reviewed websites if you intend to use web-based references. This section should be one-to-two paragraphs.
4. Overview of the TTM:
a. Review the stages of TTM. Articles included in the course sessions may be used to write this portion of the paper. However, you may not use the textbooks from the course in this section of the paper. This is a brief discussion of the 5 stages based on their temporal dimensions.
b. Describe how the TTM works. Briefly discuss motivation and readiness for change (discuss the three outcome measures), identify the ten processes of change and state how the patient looks at the pros and cons of changing their behavior (combining the processes with the outcome measures). Remember, this is still a discussion about the theory behind the model, not as it relates specifically to your patient.
c. Describe how TTM is used in practice. Relate the stages, processes of change, and decision-making aspects of TTM (decisional balance/temptation/self-efficacy) to your patient. Identify which stage your patient is in and which of the processes and outcomes are operating in your patient’s health belief system. Next, identify one appropriate nursing intervention that may assist your patient to progress to the next stage of the Transtheoretical Model while improving their health outcomes. State what nurse’s role would be in guiding/coaching the patient through this intervention (remember, in the TTM the patient who makes the change, not the nurse). Be sure to consider culturally competent care when designing your interventions. Identify at least one barrier that may be affecting your patient’s progress. Support your intervention with evidence with at least 2 articles from the peer-reviewed literature (e.g., identify how applying one of the processes of change may motivate the patient to move to the next stage, or, identify at least one barrier that may prevent this progression).
5. Conclusion:
Please do not use the word “Conclusion” as a Level 1 APA heading it is assumed that the last paragraph is the conclusion in an APA paper):
This should be a conclusion of your paper, not a conclusion of your patient (the conclusion about the patient should be in the previous section). The conclusion of the paper re-iterates what was discussed in the paper and its relevance to nursing practice. This should also tie-in the items discussed in the introduction.

The patient is a 39 year old Hispanic male.  He is lives with his wife and three children.  He owns 2 business of auto tinting and works Monday to Saturday 8am to 6pm.  He reports frequent migraine headaches, fatigue and stress.  He has moderate seasonal allergies which are well control with Allegra and Flonase.  He also takes Excedrin for migraines with good relieve.  Patient has almost daily difficulty sleeping due to bilateral lower legs pain, restless leg syndrome.  Patient has a family history of aneurism, his maternal aunts has multiple surgeries to remove them and his maternal grandmother die of aneurism.  Patient mother has hypertension.  His sister has hypothyroidism, his paternal grandfather is diabetic, and his father is pre diabetic and has high cholesterol.  Patient is not aware of other family history.  He did mention his maternal grandfather had some type of gastrointestinal disease and had surgery where he had an ostomy for a few months but he can’t recall what it is.  Patient reports he used to very active and to exercise about 5 -6 times a week.  Patient notice he has lost weight, he states “muscle weight” and has a belly now and feels sluggish.  He has been contemplating to on starting to go to the gym but does not have the motivation.  He states he knows he needs to go but just feel very tired every day to go.  Patient is overall healthy, reports he has a good nutrition but could eat healthier.