A decisional balance measure and the stages of change model for weight loss.

Two studies were conducted to explore the cognitive and motivational aspects related to progression through the stages of intentional change in weight loss and control. Study I developed a Decisional Balance Measure for comparison of the positive and negative aspects of a decision to try to lose weight. Based on principal components analysis, item analysis, and coefficient alpha, 20 items were retained, 10 for each of two orthogonal scales labeled Pros and Cons. These two components accounted for 50% of the total variance. In Study II, the Pro, Con, and Pro-Con difference scores were compared across groups representing four stages in the change process: Precontemplation, Contemplation, Action, and Maintenance. External validity for the Decisional Balance Measure was provided by significant ANOVAs for the Pro and the Pro-Con scale scores, with the Action group showing the greatest imbalance of Pros over Cons. The combination of the decisional balance and stages of change models appears to offer a powerful tool for relating two important elements in an integrated theory of how change occurs naturally, and how it could be enhanced through planned treatment.