Humans are wired to strive for positive change in their lives. The change itself doesn’t always come naturally, though.

Healthy behavior change is hard work. It requires consistent effort and practical tools to be successful. It’s also necessary to have trained support and small milestones that can be celebrated throughout the process to keep people motivated.

Dive Deeper: Behavior Change: The Path Towards Health Transformation

When people fall short of making lasting change, it’s often because they’re attempting to make very big changes all at once. However, if the focus is, instead, on taking small, positive steps over time, lasting behavior change is more likely to be achieved. 

This is where trained Vera Whole Health coaches make a difference. Vera health coaches use proven methods to offer consistent support and guidance toward making these important, small changes. Think of these as small wins that build toward larger success.

In the advanced primary care model from Vera, health coaches embedded in care teams incorporate the Transtheoretical Model (TTM) to help people navigate the path toward positive change. This model is a blueprint for effecting self-change in health behaviors and, in turn, translates into better population outcomes. 

Let’s take a closer look at this method and how it helps people achieve positive outcomes. 


TTM explained

TTM was developed by Dr. James Prochaska. It’s a model based on 25 years of research measuring behavior change. The behaviors studied included smoking cessation, exercise adoption, eating a low-fat diet, and mammography use. 

TTM outlines five stages that a person must move through before effective, lasting change occurs. Health coaches with this training utilize these five stages to understand how and when behaviors can be changed. The stages also provide insight as to why people may struggle or give up altogether while pursuing their goal.  

The five stages of change are both predictable and recognizable. They include:

  1. Precontemplation: At this stage, people are not considering any action to change their behavior. In some cases, they may not even be aware that their current behavior is unhealthy or that they need to change. Typically, individuals are in the precontemplation stage for at least six months before they take action.
  2. Contemplation: As people begin to acknowledge that they need to change their behavior, they move into the contemplation stage. In contemplation, they start weighing the pros and cons of changing their behavior but find that the pros are equally balanced with the cons. At this point, people are usually planning to change their behavior within the next six months.
  3. Preparation: In the preparation stage, an individual intends to take action very soon, typically within a month. They may have already taken some action, like reading about nutrition, talking to a health coach, or joining a fitness program. At this point, people are ready for goals that include specific actions.
  4. Action: When someone reaches the action stage, they have made definite adjustments to improve their health. For example, a person who has successfully changed their diet or integrated a new exercise regimen into their routine is in the action stage.
  5. Maintenance: In maintenance, participants are actively sticking to the behavior changes they committed to in their action stage and are working to prevent relapse into earlier stages. Depending on the goal, the maintenance stage can last anywhere from a few months to a few years.

Examples of positive change with TTM:

Health coaches see firsthand how using TTM changes peoples’ lives. Take Vera patient Elizabeth, a lifelong runner, for example. When a car accident forced her to stop her favorite fitness activity, she thought she’d never be able to run again. 

Elizabeth had regularly used the onsite clinic for her annual evaluation screening, but she’d never met with a health coach. Then, at her most recent screening, she began to wonder what a health coach could offer. Was it possible that a health coach could help her run again? She decided to give it a try. 

Elizabeth began meeting with a health coach, and together they set goals to help her run again. She also began seeing a physical therapist in conjunction with her coaching sessions. Within two months, Elizabeth ran for the first time in 10 years. 


Says Elizabeth: “This experience has changed my life. I’m so glad I asked what a health coach could do for me. For many years, it’s like I’d won the lottery, but never cashed in my tickets. There were so many free resources I had, but never used. I recommend health coaching and all of Vera’s resources to anybody.” 

Vera patients like Elizabeth find that once they begin achieving goals they never thought possible, other areas of challenge in their lives begin to open up as well. Through working with health coaches who take the time to listen without judgement and to understand where they are in the TTM, patients find it is not only possible, but highly probable that change will become a reality.  

And, when these positive changes come to fruition for even a small group of people, it has a ripple effect across entire populations. This is of great benefit to employers: healthier employees not only cost less, but they help to create a vibrant and robust culture that attracts talent and boosts productivity.

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