The effect of nutrition education based on the Health Belief Model (HBM) on food intake in pregnant Afghan immigrant women: a semi-experimental study

BACKGROUND

According to the World Health Organization report, immigrants are at increased risk of malnutrition. Nutritional deficiencies in pregnancy are a public health concern and around 20 to 30 percent of pregnant women suffer from it worldwide. There has not been any investigation about the effect of any intervention on improving nutritional intake in pregnant Afghan immigrant women. Therefore, the present study was conducted to determine the effect of nutrition education based on the Health Belief Model (HBM) on food intake in pregnant Afghan immigrant women.

METHODS

A semi-experimental study study was conducted on 116 Afghan immigrant pregnant women who have the inclusion criteria, were referred to health center No. 2 in Mashhad, Iran in June 2022 until February 2023, and were randomly assigned to the intervention (56) and control (56) groups. The demographic, HBM questionnaire and the standard 24-h food reminder questionnaire were the research tools. The intervention consisted of four sessions of 45-60 min of nutrition education based on the Health Belief Model in groups of 8-10 people. The questionnaires were completed before, immediately, and one month after the intervention by the research units. Data were analyzed with SPSS version 21 software.

RESULTS

The intake of energy, protein, carbohydrates, and micronutrients such as iron, calcium, zinc, and vitamin D increased in the intervention group immediately and one month after the intervention significantly compared to before the intervention (P < 0.05). Although all these nutrients intake had a significant decrease in control group women (P < 0.05).

CONCLUSIONS

Nutrition education based on the health belief model is effective in the nutritional intake of Afghan immigrant pregnant women. According to the importance of getting enough nutrients in pregnancy and its effects on the mother and fetus's health, nutrition education based on the Health Belief Model model is suggested for these mothers.

TRIAL REGISTRATION

It is registered in the Iranian clinical trials database under the code: IRCT20220629055312N1, Date of first registration: 25/07/2022.

Explaining the personal cognitive factors affecting physical activity and nutritional behaviors in the middle-aged at risk of coronary artery disease: A directed qualitative content analysis

Background and Aims

Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. Nutrition and physical activity are recognized as the major lifestyle-related behaviors to reduce the risk of noncommunicable diseases. It is essential to explain personal cognitive factors to identify potential ways to increase physical activity and improve nutritional behavior. Therefore, the present study aimed to explain the personal cognitive factors affecting physical activity and nutritional behavior in the middle-aged population at risk of a CAD.

Methods

The present qualitative study was conducted with a directed content analysis approach. A purposive sampling was used with maximum variety of sex, age, education, marital status, job, and risk factors of CAD. The data were collected through semistructured interviews with 20 middle-aged participants at the risk of CAD visiting comprehensive health centers in Bandar Abbas city. The interviews continued until data saturation.

Results

The present findings led to the identification of 4 main categories (i.e., self-efficacy, collective efficacy, outcome expectations, knowledge) and 10 subcategories.

Conclusion

It seems that to increase the self-efficacy, attention should be paid to individuals' past experiences, self-efficacy of action and maintenance and successful middle-aged peers. Measures should be taken to improve and strengthen it. Peer support, networking, forming online groups (in social networks), and a comprehensive use of social media can help increase collective efficacy. Expectations of positive and negative outcomes and the public knowledge can also be modified through accurate and appropriate information provided in different campaigns for awareness-raising.

Effects of a theory-based training program with follow-up home visits on self-management behavior, glycemic index, and quality of life among Iranian patients with type 2 diabetes mellitus

Background

Uncontrolled diabetes is an important public health problem that endangers the quality of life of patients. Promoting self-management through well-planned training is an essential strategy to control diabetes effectively. This study aimed to examine the effects of a training program based on social cognitive theory (SCT) on self-management behavior, glycemic index, and quality of life among patients with type 2 diabetes mellitus.

Methods

This is a quasi-experimental study with a pretest–posttest design. The statistical population included 106 adults with type 2 diabetes mellitus assigned to the intervention and control groups [n₁ = n₂ = 53], who received services from two urban health centers. A multi-method, SCT-based training program consisting of six 60–80-min sessions was run, followed by 2–3 follow-up home visits [once a month for each participant] for the intervention group. The data were collected before and three months after the intervention and were analyzed in SPSS 19.

Results

Before the intervention, there was no significant difference between the two groups regarding the main variables. After the intervention, there was a significant increase in the intervention group's mean scores of knowledge, self-efficacy, social support, outcome expectations, self-regulation, self-management behavior, glycemic index, and quality of life. There were no significant changes in these constructs in the control group after the intervention. The regression analysis results indicated that social cognitive theory and self-management could explain the variance in quality of life [adjusted R-squared = 0.476].

Conclusions

The findings support the effectiveness of the multi-method, SCT-based educational intervention in improving self-management behaviors, glycemic index, and quality of life among patients with type 2 diabetes mellitus. It is suggested that the quality of type 2 diabetes care programs should be promoted. However, further research is needed to evaluate the long-term outcomes.

The effect of educational intervention on nutritional behavior in pregnant women based on social cognitive theory

BACKGROUND

One of the key issues for women's health is pregnancy. Healthy nutrition during pregnancy is a reliable guarantee for proper pregnancy and childbirth. This study sought to determine the impact of an educational intervention based on social cognitive theory on the nutritional behavior of pregnant women in Iran.

METHODS

This randomized controlled trial study was carried out in women of reproductive age in Iran, from February to April 2020. The samples were divided into experimental (n = 150) and control (n = 150) groups. The questionnaire included demographic questions, questions related to the structures of social cognitive theory and nutritional behavior questionnaire. The data were analyzed through the SPSS20 and AMOS23 software.

RESULTS

The mean age of the women was 28.11 ± 6.54 and 28.83 ± 6.62 years in the intervention and control groups, respectively. The results of the Structural Equation Model showed that direct effect of self-efficacy, self-regulation, and mutual determinants on behavior were significant. After the educational intervention, nutritional behavior in the experimental group was increased significantly. Also, there was a significant difference between two groups in structures such as outcome expectations, outcome value, self-efficacy and knowledge. But there was no significant increase in the self-regulation and social support after educational intervention.

CONCLUSION

Social cognitive theory as a theoretical framework is able to predict healthy eating behavior during pregnancy. Also educational intervention based on the structures of social cognitive theory, improved the behavior of pregnant mothers. Educational intervention based on social cognitive theory and providing simple and understandable training packages for pregnant women is recommended.

The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women

BACKGROUND

Nutritional factors have been identified as preventable risk factors for cardiovascular disease; this study aimed to investigate the application of the Theory of Planned Behavior (TPB) in nutritional behaviors related to cardiovascular diseases among the women in Fasa city, Fars province, Iran.

METHODS

The study was conducted in two stages. First, the factors affecting nutritional behaviors associated with cardiovascular disease on 350 women who were referred to Fasa urban health centers were determined based on the TPB. In the second stage, based on the results of a cross-sectional study, quasi-expeimental study was performed on 200 women covered by Fasa health centers. The questionnaire used for the study was a questionnaire based on TPB. The questionnaire was completed by the experimental and control groups before and three months after the intervention. Data were analyzed by SPSS software using logistic regression, paired t-test, independent sample t-test, and chi-square test. The level of significance is considered 0.05.

RESULT

The constructs of attitude, subjective norms, and perceived behavioral control (PBC) were predictors of nutritional behaviors associated with cardiovascular disease in women. The constructs predicted 41.6% of the behavior. The results showed that mean scores of attitude, subjective norms, PBC, intention, nutritional performance related to the cardiovascular disease before intervention were, respectively, 24.32, 14.20, 18.10, 13.37 and 16.28, and after the intervention, were, respectively, 42.32, 25.40, 33.72, 30.13 and 41.38. All the constructs except the attitude in the intervention group were significantly higher (p < 0.001) than the control group.

CONCLUSION

The results of the present study showed that the educational intervention based on the TPB would be consider an effective educational and promotinal strategy for the nutritional behaviors to prevent cardiovascular disease in women. Considering the role of mothers in providing family food baskets and the effect of their nutritional behaviors on family members, the education of this group can promote healthy eating behaviors in the community and family.

The efficacy of social cognitive theory-based self-care intervention for rational antibiotic use: a randomized trial

Background

Misuse of antibiotics can be described as a failure to complete treatment, skipping of the doses and reuse of leftover medicines and overuse of antibiotics. Health education interventions are expected to enhance awareness and general belief on rational antibiotics use. Therefore, the study aimed to determine the efficacy of social cognitive theory (SCT)-based self-care intervention for rational antibiotic use.

Methods

This randomized trial was conducted in a sample of 260 adults. The study participants were randomly assigned as the intervention (n=130) and a control (n=130) groups. The intervention group received self-care educational intervention of four sessions lasting 45-60 min augmented with the text messages and the control groups attended usual education program in health centers. The study participants were invited to complete questionnaires at the baseline and end of the intervention. The data were analyzed using SPSS version 23.0. Chi-square (X2), independent t-test and covariance analysis were used for data analysis. P<0.05 was considered statistically significant.

Results

After the intervention, all SCT constructs revealed significant differences in the intervention group compared with control groups (P<0.001). Awareness and general beliefs of rational antibiotic use showed a significant difference in intervention group before and after six months (P<0.001) whereas in control group no significant differences (P>0.05).

Conclusion

The study suggested that tailored appropriate educational programs based on SCT constructs can reflect a positive impact on appropriate antibiotics use. Therefore, a tailored health promotion intervention should be provided to enhance the awareness and general beliefs of the target groups.