Process of change, self-efficacy, decisional balance, and stage of change of physical activity in children: A meta-analysis

Research findings on the application of the transtheoretical model (TTM) to physical activity in children and adolescents have been inconsistent, indicating that the relationships between structural elements in the TTM are unclear. We conducted a database search to collect TTM-based cross-sectional studies and used a meta-analysis to explore the relationships between processes of change (POC), self-efficacy (SEI), decisional balance (DBL), and stages of change in children and adolescents. Meta-analysis results of 16 articles showed that physical activity stage changes in children and adolescents were associated with POC, SEI, and DBL, and that POC, SEI, and DBL had distinct stage characteristics. Thus, POC, SEI, and DBL differ in the extent to which they play a role in adjacent stage transitions in the physical activity of children and adolescents. We recommend that stage-matched intervention strategies be developed based on key elements of adjacent stage transitions.