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Prochaska and DiClementes model examines the process of behavioral change by dividing it into stages. It is based on the understanding that people do not change behaviors rapidly but rather progress through the change gradually and dynamically (Summers, 2016). The model has been used in various studies to assess the development of behavioral change of individuals who shift to different regimens, adopt healthier practices, or struggle with addictions. One of the major challenges of applying the model is cultural differences. It can be argued that the models stages of change are not an adequate framework for some cultures, communities, or ethnicities. To address the argument, it is necessary to overview the model and the cases of applying it to culturally diverse individuals.
The model includes five stages: pre-contemplative, contemplative, preparation, action, and maintenance. First, a person does not acknowledge a problem or a need to change behaviors. Then, a person gains the intention to change but does not have a plan on how to do so. After that, a person starts thinking of ways to change his or her behaviors. The next stage is implementing the planned change, although it may be done inconsistently. Finally, a person demonstrates the determination to change by committing to the plan and maintaining changed practices (Summers, 2016). In its core, the model does not imply cultural differences, as it appeals to psychological characteristics that are found in human beings in general.
Charkazi, Shahnazi, Ghourchaei, and Mirkarimi (2012) conducted a study among more than 500 Iranian male students whose native language is Persian to assess their smoking behaviors according to the Prochaska and DiClementes model. Although the questionnaire originally developed in English was translated into Persian, the researchers did not indicate cultural differences as a possible limitation of their study. They did, however, argue that cultural differences may affect the development of the process of change, but the framework itself, i.e. the five stages described above, was not deemed inappropriate in the given research.
Amoyal et al. (2013) used the model to assess blood donation behavioral change in Black adults. The authors suggested that the results of applying the model may be misleading if it is applied in a culture-blind manner. Therefore, to ensure that the process of change in a given situation is understood correctly and more profoundly, it is necessary to develop a culturally tailored framework. The key element of it is individual feedback that is based on each individuals combination of responses on questions regarding stage of change, pros and cons, self-efficacy, and [process of change] (Amoyal et al., 2013, p. 1289). Similarly, Charkazi et al. (2012) dedicated much effort to validate the accuracy of the questionnaires translations by involving linguistics specialists and native speakers.
Any classification, including dividing gradual and dynamic processes into stages, is, in a sense, simplification. It helps systematize phenomena, but there is a risk of missing things that do not fit into the framework. Prochaska and DiClementes model describes the process of behavioral change in stages, which makes it convenient to observe how people change behaviors. However, to be more accurate, scholars who apply it should consider cultural differences by adjusting to certain individuals backgrounds and encouraging participants to provide feedback that is necessary for improving the model in a given study.
References
Amoyal, N. R., Robbins, M. L., Paiva, A. L., Burditt, C., Kessler, D., & Shaz, B. H. (2013). Measuring the processes of change for increasing blood donation in Black adults. Transfusion, 53(6), 1280-1290.
Charkazi, A., Shahnazi, H., Ghourchaei, A. B., & Mirkarimi, K. (2012). Smoking behaviors in Iranian male students: An application of transtheoretical model. Journal of Education and Health Promotion, 1(1), 22-26.
Summers, N. (2016). Fundamentals of case management practice: Skills for the human services (5th ed.). Boston, MA: Cengage Learning.
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