Action is the stage in which people
have made specific overt modifications
in their life styles within the
past 6 months. Since action is observable,
behavior change often has been
equated with action. But in the transtheoretical
model, action is only one
of six stages. Not all modifications of
behavior count as action in this model.
People must attain a criterion that
scientists and professionals agree is
sufficient to reduce risks for disease.
In smoking, for example, the field
used to count reduction in the number
of cigarettes as action, or switching
to low tar and nicotine cigarettes.
Now, the consensus is clear--only total
abstinence counts. In the diet
area, there is a consensus that less
than 30% of calories should be consumed
from fat. But there are those
who believe that this guideline needs
to be lowered to 25% or even 20%.
Maintenance is the stage in which
people are working to prevent relapse
but they do not apply change
processes as frequently as do people
in action. They are less tempted to
relapse and increasingly more confident
that they can continue their
changes. Based on temptation and
self-efficacy data, we estimated that
maintenance lasts from 6 months to
about 5 years. While this estimate
may seem somewhat pessimistic, longitudinal
data in the 1990 Surgeon
General’s report gave some support
to this temporal estimate. 4 After 12
months of continuous abstinence,
the percentage of individuals who returned
to regular smoking was 43%.
It was not until 5 years of continuous
abstinence that the risk for relap