Cognitive and Behavioral Processes and Its Stages of Change for Fruit and Vegetable Consumption among Nursing and Midwifery Staff of Ardabil Hospitals, 1395: Application of the Trans Theoretical Model

Abstract

Background & objectives: Inappropriate nutrition places employees at risk of being overweight or obese, and not only affect their health but also indirectly may affect patients. The trans-theoretical model is one of the most common models of health promotion. It is recognized as one of the ways of identifying and changing diet, especially increasing the consumption of fruits and vegetables. In this model, behavioral changes can be seen in stages. Therefore, this study designed to determine the status of cognitive and behavioral processes and its stages of change for fruit and vegetable consumption. Methods: This cross-sectional study was conducted with the participation of 300 nursing and midwifery staffs of Ardabil hospital using systematic random sampling method. Data gathering instrument was a validated questionnaire to collect information on demographic characteristics, stages and the process of change for fruit and vegetables consumption. The data was analyzed by SPSS (ver. 23) to measure central tendency, spearman correlation test, ANOVA, and Post-hoc. Results: Average age and BMI of participants were 31±7.05 and 25.7±3.5 respectively. The majority of subjects (77.3%) were in the early stages of change (pre-contemplation, contemplation, and preparation) for fruit and vegetable consumption while, only 22.7% was in active stages (action and maintenance). The mean scores of cognitive and behavioral processes were at a higher level in the maintenance stage and the lowest in the contemplation. Finally, the mean scores of social liberation, environment re-evaluation, self re-evaluation, stimulus control and counter conditioning processes increased from the inactive stages to the active stages. Conclusion: Findings support the effect of processes of change in fruits and vegetables consumption among nursing and midwifery staffs, so that using behavioral process of change such as stimulus control and self liberation can lead to positive progress in stage of change. We suggest educational programs to increase consumption of fruits and vegetables, particularly considering individuals' current stages and processes of change.

Assessing readiness for change in the Helmet use: a motivational interview

“…Behavioral processes of change (such as self-liberation and stimulus control) were other motivators and predictors of helmet use, therefore training and disseminating rules and stimulators which can remind helmet use to motorcyclists is recommended. This finding is in line with other health-related studies (17,18). Similar with the results of other health-related studies (17)(18)(19)(20), counter conditioning as a behavioral process of change (e.g.…”

“…This finding is in line with other health-related studies (17,18). Similar with the results of other health-related studies (17)(18)(19)(20), counter conditioning as a behavioral process of change (e.g. instead of wearing a hat or nothing on my head when I ride a motorcycle) was a motivator to start helmet use, therefore the theory-based education can focus on this sub-construct to motivate motorcyclists to use helmets.…”

“…instead of wearing a hat or nothing on my head when I ride a motorcycle) was a motivator to start helmet use, therefore the theory-based education can focus on this sub-construct to motivate motorcyclists to use helmets. Similar to other health-related studies (8,(17)(18)(19)(20), other behavioral processes including "helping relationship", and, "reinforcement management" are other strong motivators which keep motorcyclists in action stage and conduct to maintenance stage.…”

Validation of an instrument for perceived factors affecting fruit and vegetable intake based on Pender's health promotion model

“…Other models and theories have also been applied to develop instruments regarding the predictors of F&V intake such as the theory of planned behaviour and the stages of change model. For instance, Babazadeh et al ( 59 ) and Narimani et al ( 60 ) developed their instruments based on the theory of planned behaviour and the stages of change model with reliability coefficients of 0·82 and 0·87, respectively. Therefore, considering the reliability coefficient in the present study (0·84), it can be stated that the reliability scores of instruments in these studies developed through three different theories or models were approximately equal.…”

Investigating the predictive power of constructs of extended Pender's health promotion model and some background factors in fruit and vegetable consumption behavior among government employees

“…[ 11 ] In another study conducted by Vakili et al on the general population of Mashhad in 2014, the results revealed that only about half of the participating men and women regularly consumed fruit, and the situation was even worse for consuming vegetables. [ 12 ] Narimani et al also reported that the majority of nursing and midwifery staff in Ardabil teaching and medical centers (77.3%) were in the inactive stages of changing the behavior of consuming F and V.[ 13 ] As quoted from Tassitano et al in their article, although there is evidence of environmental, economic, social, and demographic determinants in the documented scientific literature, understanding psychosocial factors can be the key to developing effective behavioral interventions to increase F and V consumption. [ 14 ] In this regard, it is very important to develop programs with an emphasis on the need to consider the facilitators of consuming F and V. The findings of Kasten et al in the Netherlands showed that high levels of intention and self-efficacy as well as strong habits of consuming F and V clearly help to develop action plans.…”