Table 1.

Measurements characteristics.

Measure name	Validation study	No. of items	Tool characteristics	Advantages	Disadvantages
S-Weight and P-Weight	Andrés et al. (2011), “The Transtheoretical Model (TTM) in Weight Management: validation of the Processes of Change Questionnaire”, Obes Facts; 4:433–442 Andrés et al. (2009), “Establishing the stages and processes of change for weight loss by consensus of experts,” Obesity; 17:1717–1723.	S-Weight: five items, P-Weight: 34 items	Self-report measures assessing the stages and the processes of change. The S-Weight has five mutually exclusive items each representing the five stages of change (SOC; Precontemplation, Contemplation, Preparation, Action and Maintenance) in weight-management. The P-Weight has 34 items measuring four processes of change: emotional re-evaluation (EmR), Weight Management Actions (WMA), Environmental Restructuring (EnR) and Weight Consequences Evaluation (WCE). Responses on a 5-point Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Item distribution is uneven: 13 items score for EmR, seven items score for WMA, nine items score for WCE, and five items score for EnR. Subscales scores are calculated by summing up scores obtained on items belonging to the same subscale. Each subscale score should be transformed onto a scale from 0 to 100 (a minimum score of 0 = no use of that process, a maximum score of 100 = full-use of the process). A higher use of a process is represented by scores above 50, while a lower use of a process by scores blow 50.	The S-Weight and the P-Weight questionnaires assess the relationship between stages and processes of change in weight-management. The S-Weight is able to detect five SOC (including the Preparation phase). The four-factor structure of the P-weight has been supported by principal component analysis (PCA) and confirmatory factor analysis (CFA). The P-Weight has good internal consistency (Cronbach’s alpha coefficients from 0.781 to 0.938 for the different subscales). The total scale has excellent internal consistency (total Cronbach’s alpha is 0.960) and adequate item-total correlations (Cronbach’s alpha from 0.322 to 0.865). It has satisfactory convergent validity with the other scales measuring concern with dieting (‘drive for thinness’ subscale of the EDI-3 and the ‘diet’ subscale of the EAT-40). The S-Weight and the P-Weight have been validated in both non-clinical (556 University students) and clinical samples (overweight and obese patients enrolled in a hospital-based weight-management program). Simple and short Likert-scale scoring; trained personnel are not required for administration for both tests. Scoring of both S-Weight and P-Weight can be carried out by hand, in around 15 min.	Subscales scores should be transformed onto a scale from 0 to 100 in order to be comparable with one another. To obtain the processes of change scores (from the P-Weight), across the SOC (from the S-Weight), more complex data analytic processes are needed, and the use of a statistical software is advisable. Unknown test–retest reliability. Clinical cut-offs of the P-Weight subscales are unknown.
University of Rhode Island Change Assessment Scale (URICA)	McConnaughy et al. (1983). SOC in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research, and Practice, 20, 368–375. McConnaughy et al. (1989). SOC in psychotherapy: a follow-up report. Psychotherapy, 26, 494–503.	32 items	Self-report measure assessing SOC on four subscales: Precontemplation, Contemplation, Action, and Maintenance. Responses on a 5-point Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Item distribution is perfectly even: eight items for each of the four subscales. Subscales score range from a minimum of 1 to a maximum of 40. A continuous readiness to change (RTC) score is calculated by summing up scores on Contemplation, Action and Maintenance subscales and by subtracting the Precontemplation score. The total score ranges from a minimum of 1 to a maximum of 160. Scores below 80 reveal a total low readiness, while a high RTC is represented by a total score above 80.	Widely studied measure of RTC designed for an adult target population. It can be applied on a wide range of different problems (addictions, smoking cessation, and weight-control). Mainly useful for assessing patients in psychotherapy reporting on their specific problem in treatment. The four-factor structure of the test has been supported by principal component analysis (PCA) and structural equation modeling. In the clinical setting, the four subscales scores can be used to define behavior modifications according to the individual’s specific SOC. It has good internal consistency even in follow-up studies (coefficient alphas from 0.79 to 0.89 across subscales). Good construct validity is supported by factor and cluster analyses. It has good predictive validity, in foreseeing treatment attendance and weight-loss. Very easy to administer, it takes short time for completion and scoring (can be carried out by any staff by hand) and it does not require trained personnel.	It evaluates RTC on four SOC leaving out the Preparation one. It does not consider the processes of change. Weak test–retest reliability. Unclear structure and internal consistency on weight-control samples. The total score or the mean scale score may require cluster analysis and standardized scoring in large sample sizes. Clinical cut-offs in weight-management are unknown. Changes in pre–post design studies do not consider subscale shifts (into Action and Maintenance). Cluster profiling can reveal an overlap of subscales endorsement: a subscale score may be very close to the next, with potential underreporting of respondents who are ready to move to another stage.
Decisional Balance Inventory (DBI)	O’Connell and Velicer (1988). A decisional balance (DB) measure for weight loss. Intern. J. of Addictions, 23, 729–750 Rossi et al. (2001). Validation of DB and temptation measures for dietary fat reduction in a large school-based population of adolescents. Eating Behavior 2, 1–18.	20 Items	Self-report measure assessing decision-making for weight-control on two subscales: the pros and cons of losing weight. The test two-factor structure is supported by factor analyses and principal component analyses (PCA). Item distribution is perfectly even: 10 items per subscale. Responses on a 5-point Likert scale ranging from 1 (Not important at all), to 5 (Extremely important). The score of the Pros scale is calculated by summing up the scores obtained from all even numbered questions; the score of the cons scale is calculated by summing up the scores obtained from all odd numbered questions. Subscales score range from a minimum of 10 to a maximum of 50. A total DB score is gained by subtracting the cons score from that of the pros, with possible scores ranging from -40 to +40. Higher scores indicate more perceived cons than pros in managing weight.	It has very good internal consistency (Cronbach’s alpha coefficients of 0.91 and 0.84, respectively, for the pros and cons scales). It has fair construct validity on various health behavior problems (Prochaska et al., 1994; Redding et al., 2000). Completion brevity (5 min or less) Simple and short Likert-scale scoring; trained personnel are neither required for administration nor scoring.	It evaluates RTC only according to the pros and cons of decision-making. It does not consider the stages and the processes of change. No test–retest reliability. No data on factor structure or internal consistency on weight-control samples. Clinical cut-offs in weight-management are unknown. No published study has evaluated the psychometric properties of this measure in overweight or obese adults engaged in weight-loss treatments.