Initial development and validity evidence for the processes of change in Psychological Skills Training Questionnaire

Highlights

• We developed and tested a measure to examine the POC in sport psychology.

• Factorial and construct validity was established for the PCPSTQ.

• This is the first known study to empirically examine the POC in a sport context.

Abstract

Objectives

The purpose of this study was to create and provide validity evidence for the Processes of Change in Psychological Skills Training Questionnaire (PCPSTQ).

Design

The current study used a cross-sectional research design.

Methods

Five hundred fifty nine NCAA Division I, professional, and Olympic level athletes participated in the current study. To create the PCPSTQ, an initial pool of 114 items was generated by the research team. After a content validity process, 65 items were retained for analysis. Exploratory structural equation modeling was used as an analytic strategy to identify the most appropriate factor structure for the PCPSTQ. Decisions about the most appropriate model were made using multiple fit indices. To examine the construct validity of the PCPSTQ, a series of one-way ANOVAs were conducted to examine differences in processes of change use across stage of change.

Results

In the current study, validity evidence provided support for a 7-factor process of change measure (χ² = 325.84, p < .001; Comparative Fit Index = .971; Tucker Lewis Index = .945; Root Mean Square Error of Approximation = .037; Standard Root Mean Square Residual = .020). Results also supported the construct validity of the scale as a significant difference in process of change use across stage of change was reported for all seven processes.

Conclusions

Results of the current study support the factor structure and construct validity of the PCPSTQ. It appears that the processes of behavior change reported across multiple behavior change domains might also be viable for sport psychology professionals.

Introduction

Over the past several decades competitive sport has evolved and embraced a more scientific approach to actualizing athletic potential. In addition to a traditional staff of technical coaches, a host of other individuals (e.g., strength & conditioning coaches, athletic trainers, physical therapists, physicians, nutritionists, chiropractors, technical specialists, sport psychologists) serve as support staff for sport teams from the high school to the professional ranks. These support staff work both within the sport organization (i.e., hired by the organization) and outside of the sport organization (i.e., hired by the individual athlete), and serve to facilitate the improvement of physical and psychological performance, rehabilitation, and health of athletes. Related to psychological performance, sport psychologists design and implement psychological skills training (PST) interventions that often target goal setting, intensity regulation, imagery, and cognitive training. Despite empirical data highlighting the efficacy of PST interventions for improved sport performance (Hatzigeorgiadis, Zourbanos, Galanis, & Theodorakis, 2011; Meyers, Whelan, & Murphy, 1996), research and professional practice knowledge indicate that many athletes remain resistant to adopting and maintaining a PST routine (Anderson, 2005, Martin, 2005, Massey et al., 2011). Researchers have examined the stigma associated with – and the perceived effectiveness of – sport psychology services as possible explanations for athletes not engaging in PST routines (e.g., Gould, Murphy, Tammen, & May, 1991; Martin, 2005), yet little is known regarding an athletes' readiness or willingness to change their mental approach to sport.

Readiness to change has received considerable attention in the mental health (Miller & Rollnick, 2002) and health promotion (Pinto et al., 2011) literature, yet neither the construct nor its measurement has been well-established in sport psychology research. Resistance to PST routines remains a notable concern within sport psychology, therefore it is reasonable to examine readiness for change, as a similar approach has been successfully implemented in other behavior change professions (e.g., counseling, exercise promotion). Consistent with other professions, it has been suggested that the Transtheoretical Model of Behavior Change (TTM; Prochaska, 1979) is a viable framework to inform sport psychology consultation; however, psychometrically sound measures must first be developed before advancing this line of research (Keeler and Watson, 2011, Leffingwell et al., 2001). To date, no measure exists to examine the processes of change identified by the TTM in a sport psychology setting. As knowledge of how an athlete changes their behavior is necessary for effective interventions, a valid and reliable tool is needed to aid the assessment process. Specifically, by examining process of change use, in conjunction with other TTM data (i.e., stage of change), sport psychology practitioners can develop targeted goals and intervention strategies based on an individual's readiness for change that will enhance the effectiveness of psychological interventions in sport. Therefore the purpose of the current investigation was to develop and provide validity evidence for the Processes of Change in Sport Questionnaire (PCPSTQ).

The TTM is based on the premise that an individual progresses through a sequence of hierarchical stages as he or she intentionally tries to modify a problematic behavior (e.g., cessation from smoking; Everson, Taylor, & Ussher, 2010), or adopt a positive behavior (e.g., adherence to a PST routine; Leffingwell et al., 2001). The five stages represent various points in the change process: precontemplation (no intent to change behavior), contemplation (considering changing behavior in the next six months), preparation (planning to change behavior in the next 30 days), action (currently engaging in a new, more adaptive behavior), and maintenance (engaging in a new, more adaptive behavior for a period longer than six months). Each stage represents a varying degree of readiness for change, and at each stage decisional balance, self-efficacy, and processes of change help mediate transitions to a different stage (Prochaska and DiClemente, 1982, Prochaska et al., 1992).

Decisional balance represents a set of perceived benefits (i.e., pros) and costs (i.e., cons) associated with a behavior change. Previous TTM research (Prochaska et al., 1994) suggests that perceived gains involved in changing or maintaining one's behaviors (e.g., a decrease in stress as a result of learning new coping techniques) must outweigh perceived losses associated with change (e.g., loss of free time due to practice devoted to meditation) before an individual decides that action towards a new behavior is warranted. Concurrently, as individuals progress towards a permanent change in behavior, self-efficacy, or a person's confidence in their ability to change, increases with the largest increase in self-efficacy thought to take place after action occurs (Sarkin, Johnson, Prochaska, & Prochaska, 2001).

The processes of change are a set of 10 cognitive and behavioral strategies used to help individuals progress through the various stages of behavior change. Conceptually, these processes are divided into two higher order factors – experiential processes and behavioral processes (see Table 1). Although originally conceptualized to describe the change process in behavioral cessation (O'Connor et al., 1996, Prochaska et al., 1988, Pruitt et al., 2010), other researchers have applied the processes of change to the adoption of a positive behavior – namely physical activity and exercise promotion (e.g., Geller et al., 2012, Marcus et al., 1992, Marshall and Biddle, 2001, Paxton et al., 2008).

In examining the relationship between the use of processes of change and an individual's stage of change for exercise behavior, Marshall and Biddle (2001) conducted a meta-analysis and reported that the largest effect size for the self-reported use of all processes took place between precontemplation and contemplation, with the second largest effect reported for the transition from preparation to action. Given an over reliance on cross-sectional studies included in the Marshall and Biddle meta-analysis, Lowther, Mutrie, and Scott (2007) conducted a longitudinal analysis examining use of processes of change across stage transition in the exercise domain. These authors reported: (a) the use of the behavioral processes were most predictive of stage transition from contemplation to preparation; (b) both behavioral and experiential processes were predictive of transition from contemplation to action; (c) the transition from preparation to action was mediated by an increase in self-liberation; (d) the transition from action to maintenance was mediated by an increase in social liberation, counter-conditioning, helping relationships, and self-liberation; and (e) regression from maintenance was predicted by decreased use in the behavioral processes.

The successful implementation of the TTM in a range of behavior change fields, and in particular to the adoption of a positive behavior (e.g., exercise and physical activity), prompts the consideration of the application of the TTM to another positive behavior: adoption of a PST routine designed to increase sport performance. Prior research has begun to support TTM constructs in a sport psychology context. For example, Grove, Norton, Van Raalte, and Brewer (1999) demonstrated that youth baseball players were more likely to be in action or maintenance stages of change after a six week PST intervention when compared to those receiving physical training interventions. Leffingwell et al. (2001) developed stage of change, decisional balance, and self-efficacy questionnaires and reported theoretically consistent relationships of decisional balance and self-efficacy across stage of change, as well as predictive validity for their stage of change measure (i.e., those in contemplation and action were more likely to consult with a sport psychologist than those in precontemplation). Additionally, Keeler and Watson (2011) showed support for stage of change and self-efficacy constructs in a sample of women rugby players, and Massey et al. (2011) reported that athletes without access to sport psychology services were primarily in the precontemplation stage of change (i.e., 66% of athletes in precontemplation). Despite this initial evidence to support the TTM in sport psychology, no measure exists to examine the processes of change in sport psychology settings, thereby making it impossible to evaluate the utility of the TTM in this context. As such, the purpose of the current study was to develop and provide validity evidence for the PCPSTQ.