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Liberty University HLTH 419 Article Review: Article and...

Liberty University HLTH 419 Article Review: Article and Instructions Attached

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HLTH 419 A RTICLE R EVIEW I NSTRUCTIONS You will be required to submit a paper analyzing an article provided in the Reading & Study folder of Module/Week 6. The article is a collection of brief commentaries about the Stages of Change model (also known as the Transtheoretical Model). Your paper should be 2–4 pages, double spaced (not including the title page and reference page). This assignment is due by 11:59 p.m. (ET) on Monday of Module/Week 6. After reading the article, write a synopsis that includes the following 4 components. Each section should begin with the heading that is provided below in bold type : 1. Thesis Outline the main thesis, objective, or “opinion” of the article. 2. Rationale Select at least 2 authors from the article and provide an explanation of their perceptions of the Stages of Change model. You must also provide supporting rationale to explain the authors’ perceptions. 3. Response Provide a clear explanation of your response to the commentaries. (Do not just agree or disagree. Please state why you feel specific findings were or were not legitimate.) 4. Strengths Outline 2–3 strengths of the model. You must also reference a professional journal article which support these findings and observations.
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© 2005 Society for the Study of Addiction doi:10.1111/j.1360-0443.2005.01171.x Addiction, 100 , 1040–1050 Blackwel Science, Ltd Oxford, UK ADDAddiction 0965-2140© 2005 Society for the Study of Addiction 100 Original Article Commentary Commentary Commentaries WHEN POPULARITY OUTSTRIPS THE EVIDENCE: COMMENT ON WEST (2005) Robert West (2005) has taken the bold step of asserting that the Transtheoretical Model (TTM) is so Fawed that it should be discarded. Whether one agrees with West’s conclusion or not, his editorial should stimulate long- overdue debate about the TTM. A sharp divide of opinion about the TTM has surfaced in recent years. On one side the model enjoys substantial popularity in the form of a voluminous research litera- ture and a large following among clinicians. On the other side there is discontent among many scholars (e.g. Sutton 2001) who have closely scrutinized the scienti±c rigor of the model. There can be no questioning the popular suc- cess of the TTM: it is established fact. But the scienti±c merit of the model can be questioned, and West has fur- thered the debate with his provocative editorial. Consis- tent with West, this commentary will focus on smoking as the model addiction because smoking has been the pri- mary focus of the TTM. The TTM became popular because it brought atten- tion to the intuitive notion that some smokers are more ready to quit than others. ²or this, the originators of the TTM deserve credit, though as West and others (e.g. Bandura 1998) have pointed out, the observation that some smokers are riper for change than others is a con- ±rmation of the obvious. As a scienti±c model, however, the TTM got off to an inauspicious start. The lynchpin of the TTM is, of course, the stages of change. Thus it would seem essential to take great care in formulating how the stages were to be conceptualized and measured. However, there has never been a peer-reviewed account of the developmental research that led to the creation of the stages of change algorithm. In fact, it is not clear that any systematic developmental research took place at all, and the consequences of this omission plague the model to the present time. Instead, the authors of the TTM essentially decreed that readiness to quit smoking should be mea- sured using the stages of change. ²or the most part, the addictions research community then adopted the stages of change, with few questions asked. There would be little consequence to the omission of developmental data on the stages of change if the stages had subsequently been proved to be valid and effective. However, as West (2005) and others (e.g. Etter & Sutton 2002) point out, this is not the case. The stage of change algorithm is a magpie collection of questionnaire items that do not cohere particularly well. Two of the question- naire items rely on arbitrary timeframes and binary yes- no response options. One need not be an expert in questionnaire development to detect potential problems with this instrument. After a time the stages of change became something analogous to a ‘brand name.’ Virtually all addictions researchers became familiar with the stages of change model, and it became common to include the stages as a basic sample characteristic in studies. A pattern emerged in the TTM literature whereby success was declared on behalf of the TTM regardless of research outcomes. Exu- berant interpretations of modest results became com- monplace. Grandiose conclusions were extrapolated from unremarkable ±ndings. The popularity of the TTM had come to outstrip the scienti±c evidence. The popularity of the TTM came at the cost of reduced scienti±c and clinical progress. Alternative models of motivation to quit smoking were not pursued because the TTM had ‘cornered the market’ on the topic. Research on tailored interventions for smoking cessation became dominated by the TTM, which diverted resources and attention that could have been devoted to more promis- ing methods of tailoring. Twenty years after the introduction of the TTM, West (2005) has concluded that the TTM should be discarded, and this commentator concurs. However, the larger topic of motivation to quit should not be abandoned. Rather, researchers should renew efforts to understand and mea- sure motivation to quit smoking. West has done precisely this by introducing his new model of behavior change. There’s much to be learned from the case of the TTM.
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