A model-based educational intervention to increase physical activity among Iranian adolescents

Abstract

Objective: To conduct an evaluation of an educational program based on the health promotion model (HPM) and stages of change to improve physical activity (PA) behavior among Iranian adolescents. Methods:This was a group randomized controlled trial with 165 participants in two groups (intervention/control). Data were collected using self-reported questionnaires based upon HPM constructs (benefits and barriers of action, self-efficacy, activity-related affect, interpersonal influences, and situational influences). The stages of change scale was used to select eligible participants (were placed on precontemplation, contemplation, or preparation stages) and to assess the trend. After collecting baseline data, the intervention was administered to the participants and follow-up data was collected 3 months after intervention. Results:In all, 88 males and 77 females with a mean age of 13.99±0.4 participated in the study. The differences in all HPM constructs, except activity-related affect and social influences, were significant (p < 0.01) between baseline and follow-up measurements. Adolescents in the intervention as compared to the control group were placed in action (70%) or preparation (30%) stages at follow-up. Multiple regression analysis revealed that competing preferences, social norms, role models, (p < 0.001), and commitment to action plan can significantly predict PA behavior. The model accounted for 22.5% of the variance in PA. Conclusions:The results suggest that educational interventions based on stages of change can have important implications for improving PA among adolescents in more constructs of HPM. J Pediatr (Rio J). 2012;88(5):430-8:Health behavior, physical activity, health education, adolescent. ResumoObjetivo: Avaliar um programa educacional com base no modelo de promoção da saúde (MPS) e nos estágios de mudança para melhorar a atividade física (AF) entre adolescentes iranianos.Métodos: Este foi um ensaio randomizado controlado com 165 participantes divididos em dois grupos (intervenção/controle). Os dados foram coletados através de questionários de autopreenchimento com base em componentes do MPS (benefícios e barreiras para a ação, autoeficácia, sentimentos em relação ao comportamento, influências interpessoais e situacionais). A escala de estágios de mudança foi utilizada para selecionar participantes aptos (classificados nos estágios de pré-contemplação, contemplação ou preparação) e para avaliar a tendência. Após a coleta dos dados de base, a intervenção foi realizada nos participantes e os dados de acompanhamento foram coletados 3 meses depois.Resultados: Ao todo, 88 meninos e 77 meninas com idade média de 13,99±0,4 participaram do estudo. As diferenças em todos os componentes do MPS, exceto os sentimentos em relação ao comportamento e as influências sociais, foram significantes (p < 0,01) entre os valores de base e de acompanhamento. Comparados aos do grupo de controle, os adolescentes do grupo de intervenção foram categorizados nos estágios de ação (70%) ou preparação (30%) no ac...

Health Promotion Model: An Integrative Literature Review

“…Nevertheless, differences in all HPM constructs, except activity-related affect and social influences, were significant between baseline and follow-up measurements, adolescents in the intervention as compared to the control group were placed in action (70%) or preparation (30%) stages at follow-up, and the results revealed that competing preferences, social norms, role models, and commitment to action plan can significantly predict PA behavior, and the model accounted for 22.5% of the variance in PA [10]. Moreover, a group of pregnant women aged between 15 and 49 years coming to public health facilities to iden- was not significant, also the relationship between the uptake of IPTp and perceived seriousness of malaria infection during pregnancy was not significant, while perception about the duration suggesting up to 95% chance that the uptake of IPTp significantly associated with the duration taken at the health facilities before receiving services, and the attitude of most providers at the ANC facilities 99% chance that the uptake of IPTp significantly associated with perceived attitudes of providers towards pregnant women attending ANC clinics (P = 0.000) [12].…”

“…The 17 research studies that met the inclusion criteria were retrieved and reviewed, where 16 of them used quantitative research methodologies [6]- [21], and one used qualitative methodology [22]. Cross-sectional research design was the most commonly used design in the quantitative studies, and two studies used quasi experimental design [18] [20], and one study used a randomized clinical trial [10] (See Figure 1). …”

“…The second category included eleven studies which evaluated the HPM as a mean to predict physical activity (PA) in a sample of Iranian adolescent boys [7], compared perceived self-efficacy, exercise benefits, exercise barriers, and commitment to exercise between patients diagnosed with osteoporosis and osteoarthritis, and assessing the influence of perceived exercise self-efficacy, exercise benefits, and barriers on commitment [8], explored perceived exercise self-efficacy, benefits and barriers, and commitment to exercise among Jordanians with chronic illnesses [14], explored perception of exercise benefits and barriers among Jordanian patients' with End Stage Renal Disease (ESRD) [11], used HPM to provide insight into the relationship between dietary and fluid non-adherence, depressive symptoms, quality of life, perceived barriers and benefits of exercise, and perceived social support among Jordanian patients with ESRD receiving hemodialysis [9], conducted an evaluation of an educational program based on the HPM and stages of change to improve physical activity (PA) behavior among Iranian adolescents [10], used Pender's HPM to describe and identify the predictors of health-promoting behaviors in Nepalese migrant workers in Korea [13], examined the psychometric properties of the Arabic version of Bandura's Exercise Self-Efficacy scale (ESE-A) among Jordanian patients with different chronic diseases [16], assessed the effect of application of Pender's HPM on management of hypertension among adults in rural area [18], examined the impact of performing a HPM intervention on physical activity of the health Volunteers [19], and investigated the effect of Pender's HPM to improve the nutritional behavior of overweight and obese women admitted to Fatemiyeh…”

“…Generally, the samples and populations of these studies can be categorized into four categories. The first category is the studies that recruited students with different level of education, 79 students in a public school [6], 515 boys from 100 junior high [7], 165 adolescents aged 13 -15 years old from high schools [10], 525 university students receiving education from two governmental and one private universities [15], and 122 adolescents students between the ages of 13 and 18 years old [21]. The second category is the studies that tested a samples and populations of chronic illness.…”

“…For example, some studies evaluated the HPM concepts (perceived benefits, perceived barriers, exercise self-efficacy, enjoyment of PA, social support, and exposure to modeling, interpersonal norms, commitment to PA planning, competing demands) as a means to predict PA [7], compared perceived self-efficacy, exercise benefits, exercise barriers, and commitment to exercise between patients diagnosed with osteoporosis and osteoarthritis, and assessing the influence of perceived exercise self-efficacy, exercise benefits, and barriers to commitment [8], used HPM and its stages of change to improve PA behavior among adolescents [10], examined the impact of performing HPM intervention on PA of the health volunteers [19], and used HPM to examine relationship between dietary and fluid non adherence, depressive symptoms, quality of life, perceived barriers [9]. Moreover, some studies explored perception of exercise benefits and barriers along with the factors associated with such perceptions among patients with ESRD [11], assessed the relationship between perceived exercise self-efficacy, benefits and barriers, and commitment to exercise planning [14], used HPM to describe and identify the predictors of health-promoting behaviors among migrant workers [13], and examined facilitators and barriers that migrant women identified related to breast self-examination, clinical breast examination, and mammography [22].…”