Decisional balance and stage of change in relation to weight loss, exercise and dietary fat reduction among Pacific Islands people

It has been postulated that changes in lifestyle follow five 'stages of change', which reflect a 'decisional balance' between the advantages and disadvantages of making such a change. We have assessed this model among Pacific Islands people in New Zealand. We questioned 105 Pacific Islands volunteers to identify their decisional balance for their reduction in dietary fat intake (DFI), weight control (WC) and the adoption of regular exercise habits (REH). Answers were used to develop a closed questionnaire, which was completed by a second group of 195 Pacific Islands volunteers. The major reported advantages were good health (45%) and increased physical attractiveness (41%) for WC; disease prevention (70%) for DFI; and increased fitness (71%) for REH. The major reported disadvantages were losing too much weight (40%) for WC; eating fatty foods was enjoyable (50%) for DFI; and the time required (47%) for REH. Major differences in responses were found by age, sex, Islands group and educational status. The derived decisional balance questions related to the stage of change with advantages outweighing disadvantages for those in the maintenance/action phases and the converse for those in the precontemplative phase. The use of this model will be helpful in evaluating long-term programs aimed at the primary prevention of non-insulin-dependent diabetes through lifestyle change.