Determinants of forward stage transitions: a Delphi study.

Insight into stage transition determinants is necessary to develop and evaluate stage-tailored health-promoting interventions. A three-round Delphi study among stages of change researchers was conducted to make an inventory of opinions and examine agreement on determinants of forward transitions between Transtheoretical stages of change. In the first round, 10 experts completed an electronic questionnaire with open-ended questions about potential determinants for each stage transition. In the second round, a structured electronic questionnaire based on the first round results was sent to authors of scientific papers on stages of change, published between 1995 and May 2002. In the third round, participants were presented feedback about the second round and were asked to re-rate their answers based on the information provided. Results showed that participants agreed on various transition determinants, but that determinants were not always stage-specific, e.g. control-related issues and social support were identified as determinants of all transitions from contemplation to maintenance. The results further showed lower consensus about determinants of earlier stage transitions than about determinants of later stage transitions. The Delphi study identified hypotheses worthy of further examination in longitudinal observational and experimental studies.