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?
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 study aims at validating the Transtheoretical theory for exercise behavior, validate
the designs of decisional balance and self-efficiency for exercise in a low income, poorly
educated primary care sample. This study did integrate many theories in developing its
conclusions touching on the sample behavior. The Transtheoretical model put together the
decision balance and self-efficiency models to come up with the results of the study (Maruf et
CASE STUDY 2
al., 2014). The determination of the cognitive process basing on the change of state from one to
another was done using the decision balance theory. Besides, self-efficiency touched on
establishing whether a patient was in a position to do certain behavior or not. This model got
chosen as it was comprehensive as in it described the sample cognitive competencies. It is thus
agreed to note that the theory best suited for the construct got blended in the study. The model
employed questionnaires to develop applicable measures like self-efficiency, exercise change,
and decision balance.
Patients who attended primary care clinics and were above eighteen years old were the
target population for this study. People who have a low income are expected to make different
decisions concerning their health, education, and their social life as compared to the middle and
high-income earners. This group was selected because it was in line with the objective of the
study which was to find elements of decision balance and self-efficacy among the poorly
educated and low-income earners. Low-income earners of any population would always have
challenges in getting good health care and would look for cheaper treatment methods. Anyone
obviously would expect primary health care clinics to be the most preferred by the poor
population since they are inexpensive and affordable.
It is clear from the study that economic differences are big in the society. The study
showed that two percent of the entire specimen size were over the low-income range.
Furthermore, the questionnaire got designed to determine the level of change with respect to
steady exercise which the correspondents preferred. Social differences were clear in the
CASE STUDY 3
demographics relevant to this study. An example was education, which in some way
determines if one has health insurance cover or not.
Two models which can be employed to realize the conduct choices in a target group
were involved in this study. In light of this, this study can be used in future to develop a
hypothesis (Posavac, 2015. Considering that the study predated to 1996, it is usable in future
for generating deductive statistics like variance which might have happened due to an alteration
of variables such as education. It may, therefore, get used for comparing two different periods.
The study encountered an array of limitations. The study got extended for just one year
which clearly is not sufficient to come up with inferences and generate trends (Yin, 2013). The
study also assumed that people who earn low income prefer going to communal primary care
hospitals. The questionnaire should have also blended the incomes of the population targeted.
The limitations mentioned above are very significant to a level that can greatly affect the ability
of application of this model to other low-income populations.
Maruf, F. A., Ibikunle, P. O., & Raji, N. O. (2014). Relationships between transtheoretical
model stages of change, decisional balance, self-efficacy, and physical activity level
among Nigerian market vendors. American Journal of Health Promotion, 28(5), e118-
CASE STUDY 4
Posavac, E. (2015). Program evaluation: Methods and case studies. Routledge.
Yin, R. K. (2013). Case study research: Design and methods. Sage publications.