@2024 Afarand., IRAN
ISSN: 2383-3483 Journal of Police Medicine 2018;7(3):97-102
ISSN: 2383-3483 Journal of Police Medicine 2018;7(3):97-102
Effectiveness of Pender's Health Promotion Model on Reducing Drivers High-Risk Behaviors
ARTICLE INFO
Article Type
Original ResearchAuthors
Sadeghmoghadam L. (1)Tavakolizadeh J. (2)
Mazloum Shahri S.B. (3)
Taheri M. (*)
(*) Department of Social Health, Mental & Aging Nursing, Nursing Faculty, Gonabad Medical Sciences University, Gonabad, Iran
(1) ”Department of Social Health, Mental & Aging Nursing, Faculty of Nursing” and “Social Development & Health Promotion Research Center”, Gonabad University of Medical Sciences, Gonabad, Iran
(2) Department of Psychology, Medical Faculty, Gonabad Medical Sciences University, Gonabad, Iran
(3) Deputy of Research & Technology, Gonabad Medical Sciences University, Gonabad, Iran
Correspondence
Address: Gonabad Medical Sciences University, Imam Khomeini Avenue, Gonabad, Razavi Khorasan ProvincePhone: +98 (51) 38004257
Fax: +98 (51) 57223815
taherimahdi61@gmail.com
Article History
Received: February 25, 2018Accepted: May 1, 2018
ePublished: June 29, 2018
BRIEF TEXT
Cities are confronted with a lot of traffic phenomena such as traffic density, risky driving, accident, air pollution and nose. These factors are arising from outcomes of entering to the modern and industrial world [1]. Traffic accidents constitute 2.1% of the total deaths of the world [2]. … [3-5]. From the four factors of human, passage, vehicle and environment, human is considered the most important factor of driving accidents in Iran [6-8]. … [9]. In the taxi drivers among the human factors, traffic risky behavior, is the main recognized factor related to increase of accidents danger [10], particularly in men [11]. … [12].
Because the most health problems are closely related to human behavior, behavioral theories and pattern can be used to understand how to prevent health problems [13]. In this regard some studies with positive results have been conducted [14-16]. Given the international attempts to prevent and treatment, various models and patterns have been provided by theorists. One of these models called Pender’s health promotion has been presented in 1982 by emphasis on health promotion and empowering people to achieve health and prevention. Pender has defined health promotion as well-being and welfare [17]. According this model, the main activities of health team is encouraging healthy behaviors in clients and members of society. This model considers three constructs of self-efficacy, barriers and interests perceived related to behavior as important for change and improvement of behavior [18]. Various studies have shown that this model can be applied as a framework to plan interventions in order to improve health promotion behaviors [19-21].
… [22-24]. The study aims to examine effectiveness of training based on Pender’s health promotion model on the improvement of risky behaviors of intercity taxi drivers.
This research is of semi-experimental with pre-test and post-test and control group plan.
This study was conducted in 2017 on the all intercity taxi male drivers who were covered by the organization of management and supervision on Mashhad municipality taxi driving.
The sample size was estimated 345 people in view of Tahmasebi et. al. [23], by confidence level of 95% and prevalence rate of 42%. Finally, by accounting for the probable falling of 10%, using multistage random sampling method, 380 samples were selected.
Used tools in this research were demographic characteristic questionnaire, Manchester driving behavior and standardized questionnaire based on Pender’s health promotion model constructs. The reliability analysis of Manchester driving behavior questionnaire was estimated for sub-scales of slip .77, intentional violations .86, non-intentional violations .65, and mistakes .81. validity and reliability of the standardized questionnaire also was confirmed based on health promotion model as well as by opinion of 10 professors with Ph.D. in nursing and psychology. In order to gather data after approval of the research plan in the University higher education council and taking written introduction letter from the University education assistant, the Organization of management and supervision on the Mashhad municipality taxi driving received the permission of entering to the research environment. After acquiring written consent of drivers, Manchester questionnaire was distributed among the individuals and completed. Then drivers with a high score on risky behavior were identified. Among them 45 were selected for each group separately and in every region considering the higher number of the selected drivers from sample size estimation number using random numbers table. Then in both groups, the Pender’s model constructs standardized questionnaire was distributed and completed. After analyzing data and writing a training lesson plan according it, the training intervention of Pender’s health promotion model was performed by the researcher. Control group were left without a contact with training group and in the end of training sessions and 3 months after the end of sessions the Manchester driving behavior questionnaire and Pender’s constructs model questionnaire was provided to both groups. In order to comply with research ethics, after the end of investigation the training booklet of experiment group was given to control group as well. In order to compare results of the two groups in terms of normal quantitative variables, the independent t-test and for abnormal quantitative variables the Mann-Whitney U test was used. Comparison of pre-test, post-test and follow-up stages in both groups was performed using Freidman test. The gathered data was analyzed by SPSS 24 software in the significance level of 5%.
The average of driving behavior scores on the pre-test stage in the experiment group was 116.4±20.3 and in the control group was 119.8±20.8. The Mann-Whitney U test didn’t show this difference as significant (p=.385); but in the post-test (t=8.2) and follow-up (t=12.3) stages this difference became significant (p<.001; table1 1). It is necessary to mention that using Friedman test, the comparison values of pre-test, post-test and follow-up stages in the experiment group (df=2; Chi=80.3; p<.001) and control group (df=2; Chi=80.3; p=.002) was obtained. The average total score of studied constructs in the Pender’s health promotion model (interests, barriers, and perceived self-efficacy) wasn’t significant in the pre-test stage (t=1; p=.301) but in the post-test stage (t=11.4) using independent t-test and in the follow-up stage using Mann-Whitney U test was found significant (p<.001; table 2).
… [25-28]. In this study after performing the training intervention based on Pender’s health promotion model a significant changes was created in the driving behavior of experiment group. These results are aligned with results of Amiri et. al study [14]. The most risky driving behaviors in both groups included: changing radio wave, answering to cell phone, listening to music, inattention to the side and overhead mirrors when sudden pulling off or redirecting the taxi and inattention to the front at the streets. These results is aligned with studies [22-29-31]. The impact of training intervention in this study is consistent with the results of training studies performed to promote health level and professional ability and reduction of drivers’ risky behaviors [15-16]. The most of taxi drivers were agree with learning the methods of increasing concentration while driving as an effective intervention to reduce risky driving behaviors that is consistent with Majdzadeh et. al. findings [32]. In the Amiri et. al. study [14] that was performed on the taxi drivers of Langrood city, after 2 months training interventions, the average scores of healthy life has been increased that is consistent with results of our study. Results of another study conducted by Noruzi et. al. [33] in order to comparison of perceived interests construct from healthy driving behavior based on Pender’s model, significant changes in the experiment group have been made after training intervention compared to control group. In the studies [21] and [19] this construct has a significant change after training intervention. In the studies [20] and [34] similar results have been obtained that conform effectiveness of Pender’s model on research society. Results of this study concerning comparison of perceived self-efficacy construct from healthy driving behavior showed that the average scores of the construct in the experiment group had significant changes compared to control group after training intervention. In this regard studies by Banjedi et. al. [31], the perceived self-efficacy construct is the strongest predictor of healthy behavior that wasn’t aliened with results of this study on the strongest construct. In the study of examining Pender’s health promotion model as a scientific model to apply hearing protection equipment of building workers by Lask et. al. [35], the construct also has obtained high scores. In another study performed by Khodaversi et. al. [36], according health promotion model, a significant difference before and after intervention has been observed in the experiment group that these results support our results as well. The results of Hodsen et. al. study regarding low price of car and accident history is aligned with this study [24].
Performing similar investigations in women drivers using another training method to study drivers’ risky behaviors is suggested.
Among the limitations f this research is evaluation of driving behavior in self-report form and based on questionnaire and direct observation wasn’t taken place. Also this study just was performed on the men taxi drivers.
Training intervention based on Pender’s health promotion model constructs was effective on improvement and reduction of drivers’ risky behaviors.
We are very grateful of the assistants of education, research and technology, higher education of this university and also all intercity taxi drivers of Mashhad municipality regions 2 and 7.
This study was taken from a student thesis.
This study has been approved in the ethics committee of Gonabad Medicine Sciences University by codes IR.GMU.REC.1395.68.
This article according the regulations of student theses has been supported from research assistant of Gonabad Medicine Sciences University.
TABLES and CHARTS
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[15]Moeini B, Rezapur-Shahkolai F, Faradmal J, Soheylizad M. Effect of an educational program based on the health belief model to reduce cell phone usage during driving in taxi drivers. J Educ Community Health. 2014;1(2):56-66.
[16]Owsley C, Stalvey BT, Phillips JM. The efficacy of an educational intervention in promoting self-regulation among high-risk older drivers. Accid Anal Prev. 2003;35(3):393-400.
[17]Mock C, Quansah R, Krishnan R, Arreola-Risa C, Rivara F. Strengthening the prevention and care of injuries worldwide. Lancet. 2004;363(9427):2172-9.
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[19]Bahmanpor K,Nori R,Nadrian H,Salehi B. Determinants of oral health behavior among high school students in Marivan county, Iran based on the Pender's Health Promotion Model. J Sch Public Health Inst Public Health Res. 2011;9(2):93-106. [Persian]
[20]Kerman Saravi F, Rakhshani F, Sharakhipoor M. Applying Pender's Educational Model in promotion of health behavior of workers. J Guilan Univ Med Sci. 2006;15(58):54-60. [Persian]
[21]Asadzandi M, Sekarifard M, Ebadi A, Morovvati Sharif Abad MA, Salari MM. Effects of anger management training based on Health Promotion Model on soldiers engaged in risky behavior. Iran J Psychiatr Nurs. 2015;2(4):68-79. [Persian]
[22]Adl J, Dehghan N, Abbaszadeh M. The survey of unsafe acts as the risk factors of accidents in using taxis for intercity travelling in Tehran. Saf Promot Inj Prev. 2014;2(1):39-46. [Persian]
[23]Zamani Alavijeh F, Asadolahi A. Investigation of influencing factors of taxi drivers’ risky behavior in Ahvaz in 2013. Sci J Ilam Univ Med Sci. 2015;22(6):143-51. [Persian]
[24]Hassen A, Godesso A, Abebe L, Girma E. Risky driving behaviors for road traffic accident among drivers in Mekele city, Northern Ethiopia. BMC Res Notes. 2011;4(1):535. [Persian]
[25]Reason J, Manstead A, Stradling S, Baxter J, Campbell K. Errors and violations on the roads: a real distinction. Ergonomics. 1990;33(10-11):1315-32.
[26]Parker D, Reason JT, Manstead AS, Stradling SG. Driving errors, driving violations and accident involvement. Ergonomics. 1995;38(5):1036-48.
[27]Maibach EW, Rothschild ML Novelli,WD. Social Marketing. In: Glanz K, Rimer BK, Lewis FM, editors. Health Behavior and Health Education. San Francisco: Jossey-Boss; 2002. pp.437-61.
[28]Goshtasbi A, Vahdaninia M, Rezaee N. Knowledge of married women in Kohgilouyeh & Boyerahmad urban areas on AIDS and sexualy transmitted infections. Armaghane Danesh. 2006;11(3):100-7.[Persian]
[29] Shams M, Rahimi-Movaghar V. Risky driving behaviors in Tehran, Iran. Traffic Inj Prev. 2009;10(1):91-4
[30]National Highway Traffic Safety Administration. Traffic Safety Facts 2008. Washington: NCSA; 2008.
[31]Banaye Jedd M, Babazadeh T, Hashemian Z, Moradi F, Ghavami Z. Cognitive-behavioral determinants of oral health in students: an application of Pender's Health Promotion Model. J Educ Community Health. 2016;3(2):1-8. [Persian]
[32]Majdzadeh R, Rashidian A, Shams M, Shojaeizadeh D, Montazeri A. Using the social marketing model to reduce risky driving behaviors among taxi drivers in Tehran. J Sch Public Health Inst Public Health Res. 2011;9(2):21-40. [Persian]
[33]Noroozi A, Tahmasebi R, Ghofranipour F. Effect of Health Promotion Model (HPM) based education on physical activity in diabetic women. Iran J Endocrinol Metab. 2011;13(4):361-7. [Persian]
[34]Alaviani M, Khosravan S, Alami A, Moshki M. The effect of a multi-strategy program on developing social behaviors based on Pender’s Health Promotion Model to prevent loneliness of old women referred to Gonabad urban health centers. Int J Community Based Nurs Midwifery. 2015;3(2):132-40.
[35]Lusk SL, Ronis DL, Kerr MJ, Atwood JR. Test of the Health Promotion Model as a causal model of workers' use of hearing protection. Nurs Res. 1994;43(3):151-7.
[36]Khodaveisi M, Omidi A, Farokhi S, Soltanian A. Dietary behavior status and its predictors based on the Pender`s Health Promotion Model constructs among overweight women referred to Fatemieh hospital clinics in Hamedan, 2014. J Nurs Educ. 2016;5(2):31-9. [Persian]
[2]Ainy E, Soori H. 113 road traffic injury cost estimation by willingness to pay method. Inj Prev. 2016;22(S2):215-25.
[3]Shams M, Rashidian A, Shojaeizadeh D, Majdzadeh SR, Montazeri A. Dangerous driving behaviors in taxi drivers in Tehran: attitude, self-reporting and observational behaviors. Payesh. 2010;9(4):403-16. [Persian]
[4]Iranian Legal Medicine Organization. Examination of injuries and deaths of an accident [Internet]. Tehran: Iranian Legal Medicine Organization [Cited 2018 May]. Available from: http://www.lmo.ir/sis_products_services/79593-%D8%AA%D8%B5%D8%A7%D8%AF%D9%81.html. [Persian]
[5]Tansim News Agency. Road accidents cost 7% of gross national product [Internet]. Tehran: Tansim News Agency [Cited 2018 May]. Available from: https://www.tasnimnews.com/fa/news/1394/12/28/1030766/. [Persian]
[6]Yaghoobi H. The role of human factors in car accidents in Iran. Iran J Psychiatry Clin Psychol. 2000;6(1):60-7. [Persian]
[7]Haghshenas H, Hosseini M, Jamshidi M, Azizi H. Relation of personality traits with driving behavior in city of Shiraz in 2005. Hakim Res J. 2008;11(3):47-54. [Persian]
[8] Zamani AF. Design and evaluation of educational model in order to prevent harm risky driving behaviors in motorcycle drivers. J Tarbiat Modares Univ. 2009;5:98-100. [Persian]
[9]Babamiri M, Javdan M, Dehghani M, Baryaji H, Abbasi M. The study of the relationship between sensation seeking and type A personality with doing deliberate and unintentional violation in driving. J Life Sci Biomed. 2012;2(3):69-71.
[10]Çelik HE, Yilmaz V. Risky driving attitudes and self-reported traffic violations among Turkish drivers. Dogus Univ J. 2006;7(1):127-38.
[11]Rumar K. The role of perceptual and cognitive filters in observed behavior. In: Evans L, Schwing RC, editors. Human behavior and traffic safety. Boston, MA: Springer; 1985. pp 151-70.
[12]Nesari F. A total of 6 million inland trips take place in Mashhad, Iran, daily [Internet]. Mashhad: General News; 2015 Feb 1 [cited 2018 March 1]. Available from: https://news.mashhad.ir/news/1901654.html. [Persian]
[13]Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice, 4th edition. Hoboken, New Jersey: John Wiley & Sons; 2008.
[14]Amiri A, Rkhshany F, Farmanbar R. The effect of educational program based on BASNEF model on healthy lifestyle of taxi drivers in Langroud. J Torbat Heydariyeh Univ Med Sci. 2014;1(4):45-54. [Persian]
[15]Moeini B, Rezapur-Shahkolai F, Faradmal J, Soheylizad M. Effect of an educational program based on the health belief model to reduce cell phone usage during driving in taxi drivers. J Educ Community Health. 2014;1(2):56-66.
[16]Owsley C, Stalvey BT, Phillips JM. The efficacy of an educational intervention in promoting self-regulation among high-risk older drivers. Accid Anal Prev. 2003;35(3):393-400.
[17]Mock C, Quansah R, Krishnan R, Arreola-Risa C, Rivara F. Strengthening the prevention and care of injuries worldwide. Lancet. 2004;363(9427):2172-9.
[18]Sheikholeslam R, Mohamad A, Mohammad K, Vaseghi S. Non communicable disease risk factors surveillance in Iran. Asia Pac J Clin Nutr. 2004;13(Suppl2):S100. [Persian]
[19]Bahmanpor K,Nori R,Nadrian H,Salehi B. Determinants of oral health behavior among high school students in Marivan county, Iran based on the Pender's Health Promotion Model. J Sch Public Health Inst Public Health Res. 2011;9(2):93-106. [Persian]
[20]Kerman Saravi F, Rakhshani F, Sharakhipoor M. Applying Pender's Educational Model in promotion of health behavior of workers. J Guilan Univ Med Sci. 2006;15(58):54-60. [Persian]
[21]Asadzandi M, Sekarifard M, Ebadi A, Morovvati Sharif Abad MA, Salari MM. Effects of anger management training based on Health Promotion Model on soldiers engaged in risky behavior. Iran J Psychiatr Nurs. 2015;2(4):68-79. [Persian]
[22]Adl J, Dehghan N, Abbaszadeh M. The survey of unsafe acts as the risk factors of accidents in using taxis for intercity travelling in Tehran. Saf Promot Inj Prev. 2014;2(1):39-46. [Persian]
[23]Zamani Alavijeh F, Asadolahi A. Investigation of influencing factors of taxi drivers’ risky behavior in Ahvaz in 2013. Sci J Ilam Univ Med Sci. 2015;22(6):143-51. [Persian]
[24]Hassen A, Godesso A, Abebe L, Girma E. Risky driving behaviors for road traffic accident among drivers in Mekele city, Northern Ethiopia. BMC Res Notes. 2011;4(1):535. [Persian]
[25]Reason J, Manstead A, Stradling S, Baxter J, Campbell K. Errors and violations on the roads: a real distinction. Ergonomics. 1990;33(10-11):1315-32.
[26]Parker D, Reason JT, Manstead AS, Stradling SG. Driving errors, driving violations and accident involvement. Ergonomics. 1995;38(5):1036-48.
[27]Maibach EW, Rothschild ML Novelli,WD. Social Marketing. In: Glanz K, Rimer BK, Lewis FM, editors. Health Behavior and Health Education. San Francisco: Jossey-Boss; 2002. pp.437-61.
[28]Goshtasbi A, Vahdaninia M, Rezaee N. Knowledge of married women in Kohgilouyeh & Boyerahmad urban areas on AIDS and sexualy transmitted infections. Armaghane Danesh. 2006;11(3):100-7.[Persian]
[29] Shams M, Rahimi-Movaghar V. Risky driving behaviors in Tehran, Iran. Traffic Inj Prev. 2009;10(1):91-4
[30]National Highway Traffic Safety Administration. Traffic Safety Facts 2008. Washington: NCSA; 2008.
[31]Banaye Jedd M, Babazadeh T, Hashemian Z, Moradi F, Ghavami Z. Cognitive-behavioral determinants of oral health in students: an application of Pender's Health Promotion Model. J Educ Community Health. 2016;3(2):1-8. [Persian]
[32]Majdzadeh R, Rashidian A, Shams M, Shojaeizadeh D, Montazeri A. Using the social marketing model to reduce risky driving behaviors among taxi drivers in Tehran. J Sch Public Health Inst Public Health Res. 2011;9(2):21-40. [Persian]
[33]Noroozi A, Tahmasebi R, Ghofranipour F. Effect of Health Promotion Model (HPM) based education on physical activity in diabetic women. Iran J Endocrinol Metab. 2011;13(4):361-7. [Persian]
[34]Alaviani M, Khosravan S, Alami A, Moshki M. The effect of a multi-strategy program on developing social behaviors based on Pender’s Health Promotion Model to prevent loneliness of old women referred to Gonabad urban health centers. Int J Community Based Nurs Midwifery. 2015;3(2):132-40.
[35]Lusk SL, Ronis DL, Kerr MJ, Atwood JR. Test of the Health Promotion Model as a causal model of workers' use of hearing protection. Nurs Res. 1994;43(3):151-7.
[36]Khodaveisi M, Omidi A, Farokhi S, Soltanian A. Dietary behavior status and its predictors based on the Pender`s Health Promotion Model constructs among overweight women referred to Fatemieh hospital clinics in Hamedan, 2014. J Nurs Educ. 2016;5(2):31-9. [Persian]