Stages of change, decisional balance, and self-efficacy across four health behaviors in a worksite environment

Purpose. This study examined differences in decisional balance and self-efficacy scores across the five stages of change and across four health behaviors (exercise, protection from sun exposure, smoking, and dietary fat consumption), and explored the relationship between the frequency of subjects at each stage across four health behaviors. Design, Data for this study were collected as part of a health behavior survey of employees. Setting The study was conducted in a municipal government worksite in Arizona. Subjects. A total of 393 employees completed the survey. The sample was predominantly white (84.9%) and male (64.4%), with an average age of 42.2 years and a median annual household income of between $40,000 and $59,999. Measures. Previously validated questions to measure stages of change, decisional balance, and self-efficacy were administered, along with questions about demographic variables. Results. Significant differences were found for decisional balance and self-efficacy scores across the five stages of change, but they were not significantly different between the four health behaviors. A minority of subjects (18.6%) were in the same stage of change for all four health behaviors. Conclusions. This study provides preliminary evidence that there is considerable stage specificity across multiple health behaviors. Because employees at each stage of change possess differences in terms of their pros, cons, and self-efficacy, wellness programs need to focus on stage-specific interventions.