Are precontemplators less likely to change their dietary behavior? A prospective analysis

The association between baseline stage of change and intervention outcomes is examined in a sample of African-American adults who participated in the Eat for Life Trial, a study to increase fruit and vegetable (F & V) intake conducted through Black churches. We explore whether precontemplators responded differently over time than those in the preparation stage, a group assumed to be more likely to change their behavior. Stage of change, F & V intake (by food-frequency questionnaires) and psychosocial variables were assessed at baseline and 1-year follow-up. Individuals initially classified as precontemplators reported an increase in F & V intake as large as those in the preparation stage and precontemplators' post-test intake was equivalent to those in preparation. Precontemplators' change in psychosocial outcomes was also as large or larger than those in the preparation stage. At least with regard to F & V, these findings raise questions regarding the validity of stage of change, one element of the Transtheoretical Model, as a predictor of future behavior and intervention response.