Title: Transtheoretical model as a framework for promoting cardiovascular health through behaviour change: a systematic review
Abstract: Introduction: Cardiovascular disease (CVD) remains the single leading cause of death around the globe. The Transtheoretical model (TTM) is a successful framework for guiding behaviour change programmes for several health behaviours, yet there are limited reviews on how TTM has been used to facilitate behaviour change associated with reduced CVD. Therefore, the aims of this systematic review are to determine (i) how TTM has been used in promoting physical activity, fruit and vegetable consumption, and smoking cessation and (ii) gaps in knowledge in the use of stage-based model to improve physical activity, intake of fruit and vegetables, and smoking cessation. Materials and Methods: The approach to this systematic review was informed by current recommendations known as Preferred Reporting Items for Systematic Reviews and Meta-analysis Approach (PRISMA). Results: Constructs of TTM were used in the design of studies, facilitation of health behaviour change, monitoring of change in the movement of the participants across the change continuum, and evaluation of the effectiveness of health behaviour programmes. TTM was incorporated with other models, including Health Belief Model (HBM), social-ecological model, and social cognitive theory to facilitate behaviour change. There were limited studies that used all the four constructs of TTM to promote health behaviour change. Conclusion: TTM is a promising tool for designing, facilitating, monitoring, and evaluating behaviour change associated with reduced cardiovascular disease (CVD). TTM may be incorporated with other models, including HBM, social-ecological model, and social cognitive theory to facilitate behaviour change.