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The transtheoretical model defines behavior change as progression through five stages: precontemplation (not ready), contemplation (getting ready), preparation (readiness), action, and maintenance. Decisional balance (i.e., the relative weight of the pros and cons of making a change) is assumed to mediate stage progression. As one progresses through the stages, the model predicts that the balance of pros increases while that of cons decreases. Previous studies have confirmed this; these results may be attributed to differing response patterns to each item of the decisional balance measure across the stages. This study examines the relationship between decisional balance and the stages of change related to effective stress management behavior (i.e., any healthy activity to manage stress) using a decisional balance measure based on item response theory. The participants were 447 male and 602 female college students. A six-item scale of decisional balance was developed. The balance of pros was significantly higher in later stages such as action and maintenance stages relative to earlier stages such as precontemplation and contemplation stages, while the opposite held for the cons. These results provide strong evidence that the correspondence between decisional balance and the stage of change can be applied to stress management behavior.

Evaluation of Decisional Balance in Change of Effective Stress Management Behavior among Chinese University Participants Using Item Response Theory