Directions: For this assignment, answer the following questions based on the case study,
�Applying Exercise State of Change to a Low-Income Underserved Population�.
Use complete sentences when answering each question. Answers to each question
should be more than one sentence in length. 1) What was the behavior change
theory that was used for this study? Why was this theory selected? Do you think it
was the best choice for this study design? How was this model measured? (4 points)
2) Who was the target population for this study? Why was this population group
selected? (4 points)
3) Propose how social disparities may have been a factor in the study results. (4 pts) 4) How
can this study be used for future research on behavioral change within this
population group? (4 points) 5) What are some limitations to this study? Will these
limitations affect the applicability of the transtheoretical model to other low-income
populations? (4 points)
A Case Study on the State of Change of a Low-income Population
The theory used in this particular research is the trans-theoretical theory. The theory of
decision balance and self-efficacy are integrated into the trans-theoretical model. The trans-
theoretical model describes change as a process that occurs in five stages. Cardiovascular and
diabetes are examples of conditions that require behavior change through physical exercise
(Carmack, Boudreaux, Jeffries, Scarinci, & Brantley, 2003).
This theory was selected because pro and cons of behavior change and evaluation of self-
efficacy have not been investigated among the low income earners. The theory was the most
appropriate option for this research study since the application of the trans-theoretical model
STATE OF CHANGE OF A LOW-INCOME POPULATION 2
translates into a behavioral change in undertaking physical exercises among the low income
earners (Carmack et al., 2003).
The trans-theoretical model that integrates self-efficacy and decision balance theories is
measured by assessing the change of behavior from one stage to another of the trans-theoretical
The target population of the study is composed of the low socio-economic population
seeking care from public primary care centers. The study population chosen for this study was
selected since no prior study had been done to validate the applicability of the trans-theoretical
model among the low-income population. Also, medical conditions attributed to lack of physical
exercises, for example, hypertension, are more prevalent among the low socio-economic
populations. Therefore, the validations of the appropriateness of the trans-theoretical behavioral
change model regarding the physical exercises will be useful in implementing physical exercises
among the individuals in the low socio economic status class (Carmack et al., 2003).
The data of this study show that failure to participate in physical exercises is prevalent
among the low income and less educated populations in society. Lack of education is associated
with lack of knowledge and awareness of the importance of physical exercises on physical health
such as medical conditions, for instance, diabetes mellitus and psychological health, such as
relief from depression. The results of the study indicate that the association between cons and
pros as aspects of decision balance are not consistent with the change of behavior through the
five stages of the trans-theoretical model. The population in the low economic class requires
different motivators to participate in physical exercises, for example, economic incentives.
STATE OF CHANGE OF A LOW-INCOME POPULATION 3
Similarly, the barriers against the change of behavior are different among individuals in the low
socio-economic class (Carmack et al., 2003).
The results are appropriate for application in the future study. The results of the study
apply to future research. The study results indicate that sedentary life is shared among the low
socio-economic class. Further, some of the individuals in this population group underwent the
five normal stages of the trans-theoretical model. Therefore, the theory may be applied in future
studies in this population group. However, according to the study results, some pros and cons do
not show the consistency of the results compared to studies in other studies. This study,
therefore, informs future studies to modify the motivators and barriers used in the future study
(Carmack et al., 2003).
The study did not record the level of education of the study participants. The study relied
on data from other studies. The demographics of the study populations might have changed
between the time of the previous studies and the current study. Therefore, the results of this study
may not apply to future studies where study participants’ level of education has been specially
determined (Carmack et al., 2003).