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Transl Behav Med. 2012 Dec;2(4):384-391. Epub 2012 May 31.

The predictive validity and effects of using the transtheoretical model to increase the physical activity of healthcare workers in a public hospital in South Africa.

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The Department of Social and Behavioural Health Sciences, School of Public Health, University of Limpopo (MEDUNSA Campus), Pretoria, South Africa ; P.O. Box 1018, Medunsa, Garankuwa 0204, Akasia, Pretoria, South Africa.


There have been studies conducted on the effectiveness of the transtheoretical model (TTM) in improving the level of physical activity at worksites worldwide, but no such studies have been conducted in South Africa. The aim of this study was to determine the predictive validity and effects of using the Transtheoretical Model to increase the physical activity of healthcare workers in a public hospital in South Africa. A quasi-experimental design in the form of a single-group, pretest-posttest model was used to examine the possible relationship between an exposure to interventions, attitude, knowledge, and an increased level of physical activity. Two hundred hospital staff members (medical and nonmedical staff) were randomly selected for participation in the study. The following variables were measured: TTM stages of physical activity, knowledge and attitudes, fitness level, body mass index, and level of exposure to the intervention. The interventions designed were based on the concept of progressing stages of physical activity in TTM stage sequences: (1) pamphlets about physical activity and health, (2) posters, fun runs, and sports day, and (3) a second set of posters, a daily radio program, and aerobic classes. Post-intervention, participants had significantly increased their stages of physical activity, attitudes, and knowledge compared with their pre-tests. Mean scores of TTM (3.70) and knowledge (3.65) were significantly (pā€‰<ā€‰0.05) greater at post-test. Overall accuracies of TTM at pre-test correctly predicted TTM at post-test by an average of 66.9%. The use of TTM to identify the stage of physical activity of healthcare workers has enabled the researcher to design intervention programs specific to the stage of exercise behavior of hospital staff. The predictors (TTM1), exposure levels, knowledge, attitudes, and processes of change have significant contributions to the outcome (TTM2).

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