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...39.7 million Americans (13.2 percent) will be 65 years old and over, and by 2030, up to 20 percent of the U.S. population will be over age 65 (U.S. Census Bureau, 2000a; U.S. Census Bureau, 2000b). Along with this redistribution of the U.S. population, concerns related to aging may increase, including those related to the health and well-being of the older generation (Rogers, 1999).
For example, the U.S. Department of Agriculture reported that Americans" diets need to improve, including those of the elderly (Basiotis, Carlson, Gerrior, Juan, Lino, 2002). Although aging is not itself a cause of malnutrition, related risk factors can affect older adults' nutritional intake, contribute to malnutrition (Wellman, Weddle, Kranz, & Brain, 1997), and be "multiple and synergistic" (American Dietetic Association [ADA], 2000). Other factors that may contribute to the dietary status of the members of this growing older population are the types of nutrition messages they receive and their readiness to change diet-related behaviors.
Background
A 1996 report by the American Dietetic Association discussed the increased challenges of competing with conflicting nutrition messages that consumers receive from a variety of sources. The public needs science-based information that not only educates, but also encourages the adoption of more healthful nutrition-related behaviors. An update of this Association's report notes that research is needed to develop and test cost-effective methods for evaluating the efficacy of nutrition education programs. For effective behavior change, nutrition education programs must be based on the target audience's needs, behaviors, motivations, and desires. And the gap between knowledge of nutrition and actual healthful eating practices must be narrowed by providing nutrition information in a usable form to consumers (ADA, 1996).
In the 1970s, Prochaska and colleagues began studying how people make changes. Their efforts led to the development of the Transtheoretical Model, of which the Stages of Change is a construct (Prochaska, Norcross, & DiClemente, 1994). Prochaska, attempting to bring together the components of the major psychotherapy theories regarding how people acquire successful behavior change, found that the many theories could be summarized by principles called the "processes of change." He was especially interested in how "self-changers" progress along a continuum of change--from Precontemplation to Contemplation, Preparation, Action, Maintenance, and Termination--without therapy or a professional program (box 1).
Box 1--Basic definitions of the Stages of Change Construct of the Transtheoretical Model and operational definitions used in this study Basic definition Operational definition Precontemplation No intention of changing Participant consumed fewer than 3 to behavior and does not see a need 4 servings of fruits (vegetables) to change. each day and did not say he or size was seriously thinking about eating more servings of fiuits (vegetables) during the next 6 months. Contemplation Acknowledges need to change Participant consumed,fewer than 3 to behavior and begins to think 4 servings offuits (vegetables) seriously about doing so during each clay and said he or she was the next 6 months or so. seriously thinking about eating more servings offruits (vegetables) during the next 6 months. Preparation Plans to take action during the Participant consumed fewer than 3 to next month to change a behavior. 4 servings of fiuits (vegetables) each day and was planning to eat more servings offuits (vegetables) during the next 30 days. Action Takes action to change behavior Participant consumed 3 to 4 or more but action has lasted for 6 servings offuits (vegetables) each months or less. day and has been consuming this amount of fruits (vegetables) for 6 months or less. Maintenance Has been practicing a changed Participant consumed 3 to 4 or more behavior for more than 6 months. servings of fruits (vegetables) each day and has been consuming this amount of fruits (vegetables) for more than 6 months. Termination Has reached ultimate goal of behavior change, with no concern for relapse. Note: Stages of change definitions are by Prochaska, Norcross, and DiClemente (1994).
According to this construct, successful change...
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