Taking the Transtheoretical Model Into the Field: A Curriculum for Lay Health Advisors

Erin Kobetz, Katherine Vatalaro, Alexis Moore, jo Anne Earp

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


The transtheoretical model (TTM) is a commonly applied theoretical perspective for understanding mammography behaviors and improving the effectiveness of one-on-one counseling. The North Carolina Breast Cancer Screening Program (NC-BCSP) developed a training curriculum to incorporate TTM into the advising practices of lay health advisors (LHAs). The TTM helped "natural helper" LHAs understand that women in their rural North Carolina communities were likely to be in different stages for mammography screening and hence required different messages. NC-BCSP staff believed that by combining an understanding of TTM with LHAs' natural helping abilities we potentially increased the effectiveness of LHA advising. Our limited evaluation, based on LHA feedback, suggests the curriculum is a useful training tool, even for those unfamiliar with behavior change models. Our TTM curriculum serves as an example of a health behavior theory successfully operationalized outside academia for use in the field by lay people.

Original languageEnglish (US)
Pages (from-to)329-337
Number of pages9
JournalHealth promotion practice
Issue number3
StatePublished - Jul 2005
Externally publishedYes


  • breast cancer screening
  • curriculum development
  • lay health advisors
  • mammography
  • transtheoretical model

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)


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