Action status and willingness to change health-promoting behaviors during the COVID-19 pandemic among elementary school children: a study based on Prochaska’s stages of behavior change theory (TTM)

Abstract

Background & aim: COVID-19 pandemic has significant effects on lifestyle and health-promoting behaviors and adolescence is a very critical period due to the importance of identity formation and individual behaviors. Therefore, the aim of this study was to determine the status of health- promoting behaviors in the sixth grade male students attending elementary schools in Ardabil city based on Prochaska ‘s stages of behavior change (TTM). Materials & methods: This analytical cross-sectional study was conducted on the 619 sixth grade male students attending elementary schools during 2021. The data were collected using two instruments (a researcher-made questionnaire and Health Promoting Lifestyle Profile-II (HPLP-II) questionnaire). The data were analyzed using SPSS version 22 and one-way analysis of variance. Results: The majority of students in physical activity and healthy eating behaviors were in the pre-contemplation stage, 29.6% (183 people) and 33.1% (205 people), respectively. All dimensions of health-promoting behaviors were observed to have a significant relationship with the stages of Prochaska’s theory behavior change in students, their decision-making balance and self-efficacy scores (P < 0.001). Conclusion: The health of students is under serious threat due to the poor state of health-promoting behaviors and the weak desire to change behavior. By planning in educating the students, significant changes can be made in changing their behavior and improving their health.

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“…However, some other studies show similar results in the distribution of people in active and passive stages of behavior change. For example, Kamran et al (2023) reported that the distribution of students in the active phases of physical activity and healthy eating during COVID-19 was 38.3% and 45.4%, respectively [ 17 ]. A study in Japan has indicated that more than 60% of people are in the completely inactive stages of pre-contemplation and contemplation about increasing physical activity during the COVID-19 pandemic [ 18 ].…”

“…Kamran et al (2023) showed that the self-efficacy score related to physical activity and healthy nutrition in precontemplators was significantly lower than in the active stages (action and maintenance). This study shows that having more self-efficacy is an effective factor in placing people in higher stages of change and adopting health-promoting behaviors [ 17 ].…”

“…The stages of change have two subgroups: the passive stages of change (precontemplation, Contemplation, and Preparation), in which changes have not yet occurred, and the active stages of change (Action and Maintenance), in which behavioral changes have occurred [ 13 – 16 ]. Kamran et al (2023) found that all dimensions of health-promoting behaviors had a significant relationship with the stages of behavior change, decisional balance, and self-efficacy based on TTM in students [ 17 ]. In the study of Nishimoto et al (2023), the results showed that about a quarter of the participants were in the active stages (action and maintenance) of changing healthy behavior and physical activity during COVID-19 [ 18 ].…”