Nouvelles applications du modèle transthéorique : la pratique d’une activité physique régulière

RésuméDe nombreuses études ont montré les effets bénéfiques de l’exercice physique au niveau physiologique et psychologique. Cependant, les mécanismes de l’adoption et du maintien d’une pratique physique régulière restent mal connus, d’où les difficultés rencontrées dans la mise en œuvre d’interventions efficaces à court et long termes. Le modèle transthéorique, mis au point par Prochaska et DiClemente, permet de mieux comprendre les différents mécanismes du changement intentionnel de comportement. Ce modèle postule que les différentes stratégies d’intervention devraient être adaptées au stade de changement d’un individu. L’objectif de cet article est de présenter ce modèle avec ses différentes composantes et la façon dont elles s’articulent à travers le continuum de la motivation au changement. Les nouvelles applications, dont notamment l’activité physique régulière et les méthodes d’interventions, seront ensuite passées en revue. Enfin, des perspectives et orientations futures de recherche seront présentées.

Numerous studies have shown the beneficial effects of physical exercise on physiological and psychological dimensions. However, the mechanisms for adopting and maintaining regular physical practice remain little known, hence the difficulties encountered in the elaboration of effective interventions in the short and long term. The transtheoretical model, developed by Prochaska and DiClemente, provides a better understanding of the different mechanisms of intentional behavior change. This model, developed from a comparative analysis of all major psychotherapeutic theories, distinguishes 10 processes of change, which corresponds to the covert and overt activities that individuals use to modify their behavior. Moreover, the different processes of change are hypothesized to correspond to specific stages of change. Theses stages of change (precontemplation, contemplation, preparation, action, and maintenance) correspond to the temporal and motivational aspect of change. Other concepts, such as self-efficacy and decisional balance, are used to facilitate the progression through the stages of change. The objective of this article is to present the concepts of the transtheoretical model applied to physical exercise, to review the effectiveness of interventions tailored to the stages of change on physical activity levels. Finally, we address the perspectives and future directions of research. Interventions based on the components of the transtheoretical model generally prove more effective than traditional “action-oriented” interventions to promote the practice of physical activity for diabetics, elderly, sedentary adults and teenagers, etc. However, it seems that repeated interventions are more effective than brief ones when it comes to achieving results in the long term. We propose that research take into account all the components of the model (stages of change, processes of change, self-efficacy, and decisional balance) in order to meet the specific requirements of each stage and thus obtain a larger effect. Despite of its initial developed in the field of addiction, the transtheoretical model is much more complex and its new applications are numerous and promising. The model has been particularly promising in the study of the mechanisms related to behavior change, as well as in the development of interventions to encourage healthy behaviors and especially the practice of regular physical activity among sedentary individuals. In terms of research directions, it would be interesting to integrate and explore the mechanisms of action of other potential processes of change that emerge from new empirically based therapies, such as the enlargement produced by the specific work on positive emotions in positive psychotherapy, increasing the capacity to be attentive and conscious of the present moment used in mindfulness based therapies etc. Future research should allow us to answer questions about the evaluation, implementation, and evolution of the model.