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Table 3 (abstract A86). The six phases of change adapted to prevention/treatment of childhood overweight / obesity: thoughts and actions adequate to the family’s stage of motivation. Modified from Prochaska, Di Clemente [8]

From: 74th Congress of the Italian Society of Pediatrics

Phase Patient and family position Patient and family actions Therapists actions
Pre-contemplation They don’t think or accept there is a problem. They are not interested in moving more and eating better in the following 6 months. Provide information that increases awareness without judging or blaming.
Contemplation Ambivalence towards change. They have not decided whether to move more and eat better in the following 6 months. Ask the pros and cons and reinforce the reasons for change.
Determination They have decided and are making an action plan. They are planning to move more and eat better in the following 30 days. Help them find acceptable, easy and effective strategies.
Action They are implementing the treatment plan. They have recently started moving more and eating better (< 6 months). Help them monitor change, evaluate efficacy of strategies, support themselves, and face their barriers.
Maintenance They have already realized their plan for some time. They have become more active and they eat better (> 6 months). Help them monitor change, evaluate efficacy of strategies, support themselves, and face their barriers.
Relapse They are no longer interested in the treatment plan. They abandoned the plan and resumed previous behaviors Support them in reducing demoralization, learning from mistakes and restarting the process of change.