The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57253

Erin Kobetz, MPH¹, Katherine E. Vatalaro², Alexis Moore, MPH³, and Jo Anne L. Earp, ScD¹. (1) Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill, CB #7440, Chapel Hill, NC 27599, 919-966-4371, kobetz@email.unc.edu, (2) UNC Lineberger Comprehensive Cancer Center, CB #7295, Chapel Hill, NC 27599, (3) North Carolina Breast Cancer Screening Program, UNC Lineberger Comprehensive Cancer Center, CB# 7295, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7295

The Transtheoretical Model (TTM), or Stages of Change, is a commonly applied theoretical perspective for understanding mammography behaviors (Rakowski, 1993; Richards, 1998) and improving the effectiveness of one-on-one counseling (Prochaska et al., 2002). The North Carolina Breast Cancer Screening Program (NC-BCSP) developed a training curriculum to incorporate TTM into the advising practices of lay health advisors (LHAs). The Transtheoretical model helped “natural helper” LHAs understand that women in their rural North Carolina communities were likely in different stages for mammography screening and hence required different, tailored messages about mammography. NC-BCSP believes that by combining an understanding of TTM with LHAs’ natural helping abilities we potentially increased the effectiveness of LHA advising. Principles of participatory learning and adult education guided the development of the NC-BCSP TTM curriculum. The curriculum used a set of three characters (Susie Stop; Yasmin Yield; Greta Go) to teach LHAs a simplified version of the Stages of Change model. LHAs were also taught the concept of decisional balance and a set of stage-appropriate advising strategies. Each strategy bears a label (Witness; Light the Way; Praise) designed for compatibility with the LHAs’ spiritual orientation and many church-based outreach activities. Our limited evaluation of this curriculum suggests it is a useful tool for training LHAs, even those unfamiliar with conceptual abstractions that comprise most behavior change models. Our TTM curriculum serves as an example of a health behavior theory successfully operationalized outside the walls of academia for use in the field by lay people.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to:
• 1. Identify three ways the Transtheoretical Model was modified for use by lay health advisors.
• 2. Articulate two reasons why the Transtheoretical Model was incorporated into the lay health advisor training.
• 3. Apply the concept of operationalizing health behavior theories into the implementation phase of interventions.

Keywords: Public Health Curriculum, Community Health Advisor

Related Web page: bcsp.med.unc.edu

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.