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Table 1 Representation of the various stages of change in the behavior of patients

From: Feasibility and acceptance of exercise recommendations (10,000 steps a day) within routine German health check (Check-Up 35/GOÄ29)—study protocol

Stage (modified TTM)

Patient

GP

Principle (modified MI)

Non-intent (pre-contemplation)

Does not feel the need to change and/or has not (yet) thought about possible change

Provision of information about the “10,000 step study” with the aim of encouraging a willingness to change

1

The creation of intent (contemplation)

Is undecided and ambivalent towards change

Talking about the “pros” (greater quality of life through exercise) and “cons” (not enough time) of old and new behaviors; dealing flexibly with resistance; strengthening of self-efficacy

2; 3; 4

Preparation

Is increasingly willing to change; plans are made

Encouraging a feeling of optimism about the ability to exercise in day-to-day life

4

Action

Acts!

Encouragement (by viewing the exercise diaries) and appreciation of changes

1; 4

Maintenance

“Saves” the new behavior

Encouragement and appreciation of changes by medical staff

1; 4

Termination

Always behaves in the new way

Encouragement and appreciation of changes within the framework of the final checkup

1; 4

  1. The various stages of change in the behavior of patients and their accompaniment by GPs and participating medical staff during the study based on the use of the motivational interview (MI) [24] and the Transtheoretical Model (TTM) developed by Prochaska and DiClemente [18]