Before implementing the intervention, the experimental
group participants are assessed for their
stages of change and they undergo their first faceto-
face MI with a cardiovascular clinical nurse
specialist trained in the behavioral intervention.
The TTM expert system assessment69 involves a
series of 3 computer reports generated at 0, 3, and
9 months for each of 3 behaviors (healthy eating,
physical activity, and stress management). The 3- to
5-page report (for each behavior) is divided into
5 sections: The first section focuses on the stage of
change and readiness to change behavior. The second
section addresses pros and cons of changing, with
feedback when necessary about underevaluating the
pros of changing and/or overevaluating the cons.
The third section provides feedback on the participants’
use of change processes relevant to their stage
of change. Participants are compared normatively on
each change process with the most successful selfchangers.
For the 2 follow-up assessments, they are also compared to their prior assessment. The fourth
section offers feedback on how to enhance selfefficacy
in the most tempting situations. The last
section consists of strategies for taking small steps to
progress to the next stage. The expert system reports
facilitate the match between the intervention strategies
used and the participants’ stage of change.