@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(1):25-31
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(1):25-31
Effect of Targeted Educational Program Based on the Transtheoretical Model in Promoting Healthy Nutrition Behaviors in Middle-aged Women in Dehdez, Iran
ARTICLE INFO
Article Type
Original ResearchAuthors
Khajehlandi K. (1)Babaei Heydarabadi A. (*2)
Araban M. (2)
Haghighizadeh M.H. (3)
(*2) Socioal Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
(1) Health Education & Promotion Department, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
(3) Biostatistics Department, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Correspondence
Address: No. 370, Laleh Street, Ostadan Alley, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Postal Code: 6135713476Phone: +98 (61) 33116413
Fax: +98 (61) 33738282
babaeinmz2056@gmail.com
Article History
Received: August 31, 2018Accepted: February 20, 2019
ePublished: March 19, 2019
ABSTRACT
Aims
One of the most important causes of nutritional problems is the discrepancy between the performance of individuals on the basis of knowledge and the lack of proper nutritional knowledge. So, the aim of the current study was to investigate effect of targeted educational program based on the transtheoretical model in promoting healthy nutrition behaviors in middle-aged women in Dehdez, Iran.
Materials & Methods In this semi-experimental study with pre-test post-test design with control group conducted in 2017, 108 middle-aged women referring to Dehdez health center were selected by random sampling and were randomly divided into the experimental (54 subjects) and control (54 subjects) groups. The data were collected, using a nutritional behavior questionnaire in accordance with a transtheoretical model. Educational intervention was performed based on the transtheoretical model within 3 sessions for the experimental group. After 2 months of follow-up, participants completed the research questionnaire again. The data were analyzed by SPSS 22 software, using t-test, Mann–Whitney U test, Chi-square, and Wilcoxon test.
Findings After intervention, the mean scores of benefits and perceived self-efficacy and nutritional behavior in the experimental group was significantly increased compared to the control group (p<0.05). The mean score of the perceived barriers in the experimental group after the intervention was reduced, but this change was not significant in comparison with the control group (p>0.05).
Conclusion Educational program based on the transtheoretical model is effective in promoting healthy nutrition behaviors in the middle-aged women in Dehdez, Iran.
Materials & Methods In this semi-experimental study with pre-test post-test design with control group conducted in 2017, 108 middle-aged women referring to Dehdez health center were selected by random sampling and were randomly divided into the experimental (54 subjects) and control (54 subjects) groups. The data were collected, using a nutritional behavior questionnaire in accordance with a transtheoretical model. Educational intervention was performed based on the transtheoretical model within 3 sessions for the experimental group. After 2 months of follow-up, participants completed the research questionnaire again. The data were analyzed by SPSS 22 software, using t-test, Mann–Whitney U test, Chi-square, and Wilcoxon test.
Findings After intervention, the mean scores of benefits and perceived self-efficacy and nutritional behavior in the experimental group was significantly increased compared to the control group (p<0.05). The mean score of the perceived barriers in the experimental group after the intervention was reduced, but this change was not significant in comparison with the control group (p>0.05).
Conclusion Educational program based on the transtheoretical model is effective in promoting healthy nutrition behaviors in the middle-aged women in Dehdez, Iran.
CITATION LINKS
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[19]Araban M, Tavafian SS, Motesaddi Zarandi S, Heidarnia AR, Gohari MR, Lalooei A, et al. Prediction of air pollution exposure behavior among pregnant women: a trans-theoretical model based study. J Knowledge Health. 2013;8(2):83-8. [Persian]
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[23]Ghanad Natajdezfuli L, Shakerinejad Gh, Cheraghi M, Haghighizadeh MH. The effect of a transtheoretical model based education on nutritional behaviors of middle-aged women. Payesh. 2018;17(5):551-61. [Persian]
[24]Farhadi A, Farhadi M. The effect of transtheoretical model on healthy eating behavior in school students of Shirvan city. J Pediatr Nurs. 2016;3(1):16-23. [Persian]
[25]Findorff MJ, Stock HH, Gross CR, Wyman JF. Does the transtheoretical model (TTM) explain exercise behavior in a community-based sample of older women? J Aging Health. 2007;19(6):985-1003.
[26]Karami Daranjani S, Yazdanpanah A, Kharazmi E. The effect of health education program based on transtheoritical model on promotion of physical activity among children of patients with hypertension and diabetes. J Health. 2017;8(4):394-407. [Persian]
[27]Plotnikoff RC, Pickering MA, Rhodes RE, Courneya KS, Spence JC. A test of cognitive mediation in a 12-month physical activity workplace intervention: does it explain behaviour change in women? Int J Behav Nutr Phys Act. 2010;7:32.
[28]Fahrenwald NL, Atwood JR, Walker SN, Johnson DR, Berg K. A randomized pilot test of “moms on the move”: A physical activity intervention for WIC mothers. Ann Behav Med. 2004;27(2):82-90.
[29]Hassani L, Shahab Jahanlou A, Ghanbarnejad A, Salimian Rizi A. Effect of educational intervention based on TTM model about regular physical activity amoung high school gairl students in lenjan. J Prev Med. 2014;1(2):22-30. [Persian]
[30]Yeh MC, Ickes SB, Lowenstein LM, Shuval K, Ammerman AS, Farris R, Katz DL. Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promot Int. 2008;23(1):42-51.
[31]Heshmati H, Khajavi S, Alizadeh Siouki H. An Investigation of the Perceived Barriers of Fruit and Vegetable consumption among Female High School Students in Quchan, 2013. J Torbat Heydariyeh Univ Med Sci. 2014;1(4):67-77. [Persian]
[32]Luszczynska A, Tryburcy M, Schwarzer R. Improving fruit and vegetable consumption: a self-efficacy intervention compared with a combined self-efficacy and planning intervention. Health Educ Res. 2007;22(5):630-8.
[33]Long JD, Stevens KR. Using technology to promote self-efficacy for healthy eating in adolescents. J Nurs Scholarsh. 2004;36(2):134-9.
[34] Zhou G, Wang D, Knoll N, Schwarzer R. Planning mediates between self-efficacy and physical activity among motivated young adults. J Phys Act Heaht. 2016;13(1);87-93.
[35] Hildebrand DA, Betts NM. Assessment of stage of change, decisional balance, self-efficacy, and use of processes of change of low-income parents for increasing servings of fruits and vegetables to preschool-aged children. J Nutr Educ Behav. 2009;41(2):110-9.
[36]Lee YM. Process of change, decisional balance and self efficacy corresponding to stages of change in exercise behaviors in middle aged women. Taehan Kanho Hakhoe Chi. 2004;34(2):362-71. [Korean]
[37]DiNoia J, Schinke SP, Prochaska JO, Contento IR. Application of the transtheoretical model to fruit and vegetable consumption among economically disadvantaged African-American adolescents: Preliminary Findings. Am J Health Promot. 2006;20(5):342-8.
[38]Wilson GT, Schlam TR. The transtheoretical model and motivational interviewing in the treatment of eating and weight disorders. Clin Psychol Rev. 2004;24(3):361-78.
[39]Jiang G, Li J, Wang Z, Li W, Wang D, Liu H, et al. Applying a stage of behaviors change model on nutrition intervention in farmers. Wei Sheng Yan Jiu. 2010; 39(6):719-22. [Chinese]
[2]Dunneram Y, Ramasawmy D, Pugo-Gunsam P, Jeewon R. Determinants of eating habits among pre-retired and post-retired Mauritian. Int J Nutr Food Sci. 2013;2(3):109-15.
[3]Verbeke W, Vanhonacker F, Sioen I, Van Camp J, De Henauw S. Perceived importance of sustainability and ethics related to fish: a consumer behavior perspective. Ambio. 2007;36(7):580-5.
[4]Haghighatdoost F, Zaribaf F, Esmaeilzadeh A, Azadbakht L. Relationship between whole grain consumption and chronic diseases . Iran J Diabetes Metab. 2010;9(3):207-17. [Persian]
[5]Matallebi M, Sharifi Rad Gh, Mostafavi F, Mohebbi S, Azadbakht L. Factors affecting fish consumption based on structures of health education. J Health Syst Res. 2012;8(4):523-36. [Persian]
[6]Khodaveisi M, Omidi A, Farrokhi Sh, Soltanian AR. 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]
[7]Moeini B, Taheri M, Roshanaei Gh, Vahidinia AA, Rostami moez M. High school girl's adherence to 5-a-day serving's fruits and vegetables: an application theory of planned behavior. J Educ Community Health. 2014;1(2):10-19. [Persian]
[8]Khezeli M, Ramezankhani A, Bakhtiari M. Effect of education on nutritional knowledge and stages of fruit and vegetable intake in geriatrics according to stages of change model. J Mazandaran Univ Med Sci. 2012;22(91):88-98. [Persian]
[9]Mansorian M, Qorbani M, Soleimani M, Masoodi R, Rahimi E, Asayesh H. A survey of life style and its influential factors among the university students in Gorgan. Pars J Med Sci. 2009;7(1 and 2):62-71. [Persian]
[10]JafarPour Kh, Arastoo AA, Gholamnia Shirvani Z, Saki A, Araban M. The effect of health education intervention based on the theory of planned behavior to promote physical activity in women's health volunteers of Shushtar health centers. Iran J obstet Gynecol Infertil. 2016;19(37):62-74. [Persian]
[11]Olshansky SJ, Hayflick L, Carnes BA. Position statement on human aging. J Gerontol A Biol Sci Med Sci. 2002;57(8):B292-7.
[12]Amiri A, Rakhshani F, Farmanbar F. The effect of educational program based on BASNEF model on healthy lifestyle of taxi drivers in Langroud. J Torbat Heydarieh Univ Med Sci. 2014;1(4):45-54. [Persian]
[13]Butler JT. Principles of health education and health promotion. 3rd Edition. Wadsworth: Wadsworth Publishing; 2001.
[14]Sharma M. Theoretical foundations of health education and health promotion. Sudbury: Jones and Bartlett Learning; 2016.
[15]Velicer WF, Prochaska JO, Fava JL, Norman GJ, Redding CA. Smoking cessation and stress management: Applications of the transtheoretical model of behavior change. Homeostasis Health Dis. 1998;38(5-6):216-33.
[16]Saffari M, Shojaeizadeh D, Ghofranipour F, Heydarnia A, Pakpour Hajiagha A. Theories, models and methods of health education and health promotion. 1st Edition. Tehran: Sobhan; 2009. Pp. 66-68. [Persian]
[17]Geravandi A, Ghofranipour F, Rezaei M, Laghaei Z, Sepahi S. Effect of health education on promotion of physical activity in housewives who refer to health centers of Kermanshah. J Clin Res Med Sci. 2014;3(3):205-14. [Persian]
[18]Salehi L, Mohammad K, Montazeri A. Fruit and vegetables intake among elderly Iranians: a theory-based interventional study using the five-a-day program. Nutr J. 2011;10(1):123.
[19]Araban M, Tavafian SS, Motesaddi Zarandi S, Heidarnia AR, Gohari MR, Lalooei A, et al. Prediction of air pollution exposure behavior among pregnant women: a trans-theoretical model based study. J Knowledge Health. 2013;8(2):83-8. [Persian]
[20]Salehi L, Eftekhar H, Mohammad K, Taghdisi MH, Shojaeizadeh D. Physical activity among a sample of Iranians aged over 60 years: an application of the transtheoretical model. Arch Iran Med. 2010;13(6):528-36.
[21]de Vet E, de Nooijer J, de Vries NK, Brug J. Testing the transtheoretical model for fruit intake: comparing web-based tailored stage-matched and stage-mismatched feedback. Health Educ Res. 2008;23(2):218-27.
[22]Hashemi SZ, Rakhshani F, Navidian A, Mousavi SR. Effectiveness of educational program based on trans-theoretical model on rate of physical activity among household women in Zahedan, Iran. Health syst Res. 2013;9(2):144-52. [Persian]
[23]Ghanad Natajdezfuli L, Shakerinejad Gh, Cheraghi M, Haghighizadeh MH. The effect of a transtheoretical model based education on nutritional behaviors of middle-aged women. Payesh. 2018;17(5):551-61. [Persian]
[24]Farhadi A, Farhadi M. The effect of transtheoretical model on healthy eating behavior in school students of Shirvan city. J Pediatr Nurs. 2016;3(1):16-23. [Persian]
[25]Findorff MJ, Stock HH, Gross CR, Wyman JF. Does the transtheoretical model (TTM) explain exercise behavior in a community-based sample of older women? J Aging Health. 2007;19(6):985-1003.
[26]Karami Daranjani S, Yazdanpanah A, Kharazmi E. The effect of health education program based on transtheoritical model on promotion of physical activity among children of patients with hypertension and diabetes. J Health. 2017;8(4):394-407. [Persian]
[27]Plotnikoff RC, Pickering MA, Rhodes RE, Courneya KS, Spence JC. A test of cognitive mediation in a 12-month physical activity workplace intervention: does it explain behaviour change in women? Int J Behav Nutr Phys Act. 2010;7:32.
[28]Fahrenwald NL, Atwood JR, Walker SN, Johnson DR, Berg K. A randomized pilot test of “moms on the move”: A physical activity intervention for WIC mothers. Ann Behav Med. 2004;27(2):82-90.
[29]Hassani L, Shahab Jahanlou A, Ghanbarnejad A, Salimian Rizi A. Effect of educational intervention based on TTM model about regular physical activity amoung high school gairl students in lenjan. J Prev Med. 2014;1(2):22-30. [Persian]
[30]Yeh MC, Ickes SB, Lowenstein LM, Shuval K, Ammerman AS, Farris R, Katz DL. Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA. Health Promot Int. 2008;23(1):42-51.
[31]Heshmati H, Khajavi S, Alizadeh Siouki H. An Investigation of the Perceived Barriers of Fruit and Vegetable consumption among Female High School Students in Quchan, 2013. J Torbat Heydariyeh Univ Med Sci. 2014;1(4):67-77. [Persian]
[32]Luszczynska A, Tryburcy M, Schwarzer R. Improving fruit and vegetable consumption: a self-efficacy intervention compared with a combined self-efficacy and planning intervention. Health Educ Res. 2007;22(5):630-8.
[33]Long JD, Stevens KR. Using technology to promote self-efficacy for healthy eating in adolescents. J Nurs Scholarsh. 2004;36(2):134-9.
[34] Zhou G, Wang D, Knoll N, Schwarzer R. Planning mediates between self-efficacy and physical activity among motivated young adults. J Phys Act Heaht. 2016;13(1);87-93.
[35] Hildebrand DA, Betts NM. Assessment of stage of change, decisional balance, self-efficacy, and use of processes of change of low-income parents for increasing servings of fruits and vegetables to preschool-aged children. J Nutr Educ Behav. 2009;41(2):110-9.
[36]Lee YM. Process of change, decisional balance and self efficacy corresponding to stages of change in exercise behaviors in middle aged women. Taehan Kanho Hakhoe Chi. 2004;34(2):362-71. [Korean]
[37]DiNoia J, Schinke SP, Prochaska JO, Contento IR. Application of the transtheoretical model to fruit and vegetable consumption among economically disadvantaged African-American adolescents: Preliminary Findings. Am J Health Promot. 2006;20(5):342-8.
[38]Wilson GT, Schlam TR. The transtheoretical model and motivational interviewing in the treatment of eating and weight disorders. Clin Psychol Rev. 2004;24(3):361-78.
[39]Jiang G, Li J, Wang Z, Li W, Wang D, Liu H, et al. Applying a stage of behaviors change model on nutrition intervention in farmers. Wei Sheng Yan Jiu. 2010; 39(6):719-22. [Chinese]