Predictors of Physical Activity Behavior Transitions in Children and Adolescents: A Systematic Review Based on a Transtheoretical Model

BACKGROUND: The transtheoretical model (TTM) views individual behavioral change as a nonlinear, dynamic process, which is consistent with the complex nature of physical activity (PA) in children and adolescents. However, within this theoretical framework, the elements that facilitate the behavioral change in PA in children and adolescents need to be further explored. OBJECTIVE: A systematic review of research related to TTM-based exploration of the elements of behavioral change in PA in children and adolescents, an analysis of the strengths and weaknesses in practice, and an outlook for future research. MATERIALS AND METHODS: After computer searches of the CNKI, Wan-Fang, VIP, WOS, PubMed, and EBSCO databases, two researchers independently screened articles, extracted information, and evaluated the quality of the articles. RESULTS: A total of 25 articles (26 studies) of medium- to high-quality were included in the systematic review. The meta-analysis included 30,106 children and adolescents aged 11.24 to 17.7 years. The counter-conditioning and self-liberation of the process of change, self-efficacy and decisional balance are key elements that facilitate the transition of the PA stage in children and adolescents. Extramodel psychological variables such as exercise motivation play a moderate to large role in the PA stage transition. In addition, VPA is an important discriminator of PA stage transition in children and adolescents. CONCLUSION: It is recommended that interventions be designed according to the key elements of behavioral change in order to better facilitate the PA stage transition of children and adolescents.