Application of the Multi-Theory Model to Determine Predictors of Initiating and Sustaining Stress Management Behaviors in Undergraduate College Students

Background: Undergraduate college students face stress and concomitant mental health issues that can be mitigated by proper stress management behavior. Purpose: This article examines the multi-theory model (MTM) of health behavior as a predictor of change in the primary outcomes of initiation and sustenance of relaxation-seeking behavior in undergraduate college students for the purposes of stress mitigation. The two main research hypotheses tested were that (a) participatory dialogue, behavioral confidence, and change in physical environment have statistically significant effects on initiation of behavioral change, and (b) emotional transformation, practice for change, and change in social environment have statistically significant effects on sustenance of behavioral change, after controlling for other variables. Methods: The study employed a cross-sectional design to examine the effects of the aforementioned MTM constructs on the two primary outcomes noted. Data were collected via a validated 54-item instrument administered as an online survey to undergraduate college students at a major public university in the southern United States. Results: A total of 235 students responded to the survey, of which 115 met the inclusion criteria. In a hierarchical multivariate regression, behavioral confidence and change in physical environment were significant predictors of initiation of behavioral change, along with perceived stress. The full model explained 51.0% of the variance in initiation of relaxation-seeking behavior for stress mitigation and management (R² = 0.510, p < .001). For sustenance of behavioral change, both emotional transformation and practice for change were significant predictors. A regression model with these constructs explained 57.6% of the variance in this outcome (R² = 0.576, p < .001). Conclusions: Based on the findings of this study, stress management interventions at undergraduate institutions need to address behavioral confidence, changes in physical environment, emotional transformation, and practice for change in order to effectively support students' stress management.