Pre-Contemplation Stage

Adolescents in the Pre-Contemplation Stage are likely not yet thinking about or intending to initiate healthy behaviors in the near future. These individuals usually are not aware of the risks associated with their behavior (i.e., risks of unhealthy eating and of sedentary behaviors). Sometimes adolescents in this stage may have previous unsuccessful attempts at changing their behaviors and thus may have become discouraged. The following tools can be used during an encounter with an adolescent to help them progress towards the action stage. According to the time allotted, one or several of these tools may be used at one time. Typically, the adolescent will need at least one week to process and apply the content before another tool is attempted.

Contemplation Stage

Adolescents enter the Contemplation Stage when they gain awareness of a desire to change their behavior. They are likely not actively engaged in any behavior change; however, are typically thinking of initiating change within the next six months. Adolescents in this stage may be engaging in unhealthy behaviors (i.e., poor nutrition choices and little physical activity). This can be attributed to the adolescent focusing more on the cons of behavior change than on the pros. Tools in this stage help the adolescent identify his or her cons and then to develop responses, or “comebacks” for each of those cons. Furthermore, adolescents in this stage are encouraged to ask questions about their health and look for answers to those questions. Tools in this stage also challenge the adolescent to consider how their self-image relates to their health.

Preparation Stage

Adolescents in the Preparation Stage are preparing to begin making specific changes and typically plan to implement those changes within the next month. It is possible that adolescents in this stage may have tried to change their behaviors (i.e., eating healthier and exercising more frequently), but were unsuccessful. Some may have started to again experiment with small changes, such as sampling unfamiliar fruits or vegetables or cutting back on drinking soda. You may find that the adolescent may have a plan for changing their behavior (i.e., plan to joint a sports team to get more physical activity), but may not be entirely committed to the plan. Tools in this stage help the adolescent weigh the pros and cons of changing their behavior. Helping the adolescent identify both the pros and the cons of behavior change is a way to help the adolescent progress towards taking action to change

Action Stage

In the Action Stage adolescents would have begun making specific modifications to their lifestyle – such as exercising regularly, controlling intake of sugary drinks, etc. The goal during this stage is to ensure that the adolescent is taking sufficient action to reduce risks associated with their weight status. Tools in this stage can be used to help the adolescent to re-evaluate their environment in such a way that healthy alternatives are more likely to be selected. Counter conditioning or learning new behaviors as substitutes for unhealthy behaviors is also a target during this stage. Tools are also provided to assist the adolescent with goal setting, contracting, and self confidence.

Maintenance Stage

Adolescents in the Maintenance Stage are working towards building and then maintaining a pattern of the new behaviors they have adopted. Adolescents in this stage are working towards not only maintaining new behaviors, but making those an integral part of their lifestyle. During this stage “relapse” is possible – meaning that the adolescent may experience a period of time when he/she returns to engaging in previous, unhealthy, habits. Tools in this stage can be used to help the adolescent develop a plan for avoiding and dealing with relapse (or “setbacks”). During this stage adolescents are also encouraged to identify healthy helping relationships where they can receive support. A tool to help adolescents manage stress is also included.