by Dean Witherspoon   Dean's profile on LinkedIn  

You've probably experienced the frustration of attending a presentation or class where the first half covers things you already know before you get to the new material. If so, you know how valuable the triage principle can be.


In medicine, triage is a system designed to produce the greatest benefit from limited treatment resources. In wellness, a triage system focuses resources — so those who need the most help get it, and those who need less receive less. The stages of change model outlined by Prochaska and DeClemente in the early '80s offers a framework for health promotion triage by identifying stages of readiness:

  • Precontemplation, where the individual is unaware or in denial of a health problem
  • Contemplation, where the person begins to recognize there's a problem and is considering a change
  • Preparation, where the individual accepts there's a problem and decides it's time to take action
  • Action, where the person has just made a behavior change
  • Lapse/relapse, where the individual experiences temporary or permanent return to the original state
  • Maintenance, where the person sustains a behavior change for a long time despite occasional setbacks.

To help you determine the stage of readiness, consider a series of questions when you first meet new participants:

  • What do you want to happen?
  • How will you know when you've achieved it?
  • What are you willing to do or give up to accomplish it?
  • When do you want it to happen
  • What's preventing you from achieving it?

People in precontemplation and contemplation won't have concrete ideas when asked these questions. Those in the preparation or action stage will, and can benefit from further examination that asks:

  • What are the advantages of attaining this goal?
  • What are the disadvantages?
  • How will you monitor your progress?
  • How will you reward yourself along the way?

The point of this or any other model is that people are at different degrees of change in all areas of their life, and a one-size-fits-all approach isn't productive. It may, in fact, cause a person to regress if the size you choose is too far from their needs. Once you've identified their stage, you can tailor (triage) your services to individual needs so you're not wasting the participant's time or yours.

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