Education based on the health belief model to improve the level of physical activity

Behavioral change interventions, theories, and techniques to reduce physical inactivity and sedentary behavior in the general population: a scoping review

BACKGROUND

Worldwide, physical inactivity (PIA) and sedentary behavior (SB) are recognized as significant challenges hindering the achievement of the United Nations (UN) sustainable development goals (SDGs). PIA and SB are responsible for 1.6 million deaths attributed to non-communicable diseases (NCDs). The World Health Organization (WHO) has urged governments to implement interventions informed by behavioral theories aimed at reducing PIA and SB. However, limited attention has been given to the range of theories, techniques, and contextual conditions underlying the design of behavioral theories. To this end, we set out to map these interventions, their levels of action, their mode of delivery, and how extensively they apply behavioral theories, constructs, and techniques.

METHODS

Following the scoping review methodology of Arksey and O'Malley (2005), we included peer-reviewed articles on behavioral theories interventions centered on PIA and SB, published between 2010 and 2023 in Arabic, French, and English in four databases (Scopus, Web of Science [WoS], PubMed, and Google Scholar). We adopted a framework thematic analysis based on the upper-level ontology of behavior theories interventions, Behavioral theories taxonomies, and the first version (V1) taxonomy of behavior change techniques(BCTs).

RESULTS

We included 29 studies out of 1,173 that were initially screened/searched. The majority of interventions were individually focused (n = 15). Few studies have addressed interpersonal levels (n = 6) or organizational levels (n = 6). Only two interventions can be described as systemic (i.e., addressing the individual, interpersonal, organizational, and institutional factors)(n = 2). Most behavior change interventions use four theories: The Social cognitive theory (SCT), the socioecological model (SEM), SDT, and the transtheoretical model (TTM). Most behavior change interventions (BCIS) involve goal setting, social support, and action planning with various degrees of theoretical use (intensive [n = 15], moderate [n = 11], or low [n = 3]).

DISCUSSION AND CONCLUSION

Our review suggests the need to develop systemic and complementary interventions that entail the micro-, meso- and macro-level barriers to behavioral changes. Theory informed BCI need to integrate synergistic BCTs into models that use micro-, meso- and macro-level theories to determine behavioral change. Future interventions need to appropriately use a mix of behavioral theories and BCTs to address the systemic nature of behavioral change as well as the heterogeneity of contexts and targeted populations.

Development of a scale for attitude toward sexually transmitted infections based on the Health Belief Model

OBJECTIVES

Determination of the attitudes of individuals toward sexually transmitted infections (STIs) can also help identify barriers to health service-seeking behavior. Hence, this study aimed to develop a scale for determining the attitudes of individuals toward sexually transmitted diseases.

STUDY DESIGN

This was a methodological study. The Health Belief Model (HBM) framework was used to elucidate the perceptions and interpretations of illnesses among individuals. After reviewing the relevant literature, an item pool was created to include 4 dimensions (perceived susceptibility (A), perceived severity (B), perceived benefit (C), and perceived barriers and self-efficacy (D)) about sexually transmitted diseases from the perspective of HBM. Exploratory factor analysis was conducted to evaluate the construct validity of the scale. Moreover, confirmatory factor analysis was used to examine the suitability of the items in terms of factor structures.

RESULTS

The final version of the scale comprised 19 items and 4 subdimensions. The first subdimension of the scale accounted for 20.11% of the total variance, whereas the second, third, and fourth subdimensions accounted for 17.83%, 12.50%, and 8.75% of the total variance, respectively. Collectively, these four subdimensions accounted for 59.19% of the total variance. The Cronbach's alpha reliability coefficient of the scale was found to be 0.74.

CONCLUSIONS

Briefly, the present study led to the development of a novel assessment tool, Attitude Toward Sexually Transmitted Infections Scale. Higher scores on the scale indicated higher likelihood of taking action for a possible STI treatment according to the HBM approach.

Applying behavioral change theories to optimize pulmonary rehabilitation in COPD patients: A review

This review meticulously evaluates the integration of behavioral change theories into pulmonary rehabilitation programs for chronic obstructive pulmonary disease (COPD) management, addressing the critical need for enhanced patient compliance and improved therapeutic outcomes. With COPD posing significant global health challenges, characterized by high morbidity and mortality rates, the manuscript underscores the potential of Self-Determination Theory, Social Cognitive Theory, the Transtheoretical Model, the Health Belief Model, and the Theory of Planned Behavior to foster meaningful health behavior changes among patients. Through a comprehensive literature analysis, it reveals how each model contributes to understanding patient behaviors in pulmonary rehabilitation contexts, advocating for their systematic application to craft more effective, patient-centered interventions. Despite the proven efficacy of these theories in various health domains, their current underutilization in pulmonary rehabilitation underscores a gap between theoretical knowledge and clinical practice. The review calls for an interdisciplinary approach that bridges this gap, highlighting the urgency of developing actionable, theory-based behavioral intervention plans. By doing so, it aims to advance COPD management strategies, ultimately improving the quality of life for individuals living with this debilitating disease.

Knowledge, attitudes, and practices among Chinese reproductive-age women toward uterine adenomyosis

Objective

This study aimed to assess the knowledge, attitudes and practices (KAP) among Chinese reproductive-age women toward uterine adenomyosis.

Methods

This web-based cross-sectional study was conducted between April 2023 and September 2023 at the Second Hospital of Hebei Medical University. A self-designed questionnaire was developed to collect demographic information of reproductive-age women, and assess their KAP toward uterine adenomyosis.

Results

A total of 520 valid questionnaires were collected. Among the participants, 127 (24.42%) were diagnosed with uterine adenomyosis, and 120 (23.08%) were accompanied by uterine fibroids. The mean knowledge, attitudes and practices scores were 3.54 ± 3.72 (possible range:0-10), 20.96 ± 3.19 (possible range:5-25) and 24.01 ± 4.95 (possible range:7-35), respectively. The structural equation model demonstrated that knowledge had direct effects on attitudes and practices, as indicated by a path coefficient of 0.714 (p < 0.001) and 1.510 (p < 0.001), respectively. Moreover, attitudes had direct effects on practices, with a path coefficient of 0.226 (p = 0.001).

Conclusion

The findings revealed that reproductive-age women have insufficient knowledge, negative attitudes, and poor practices toward the uterine adenomyosis. Comprehensive training programs are needed to improve reproductive-age women practices in this area.

Examining the effect of training with a teaching for understanding framework on intravenous therapy administration's knowledge, performance, and satisfaction of nursing students: a non-randomized controlled study

BACKGROUND

Nursing students require improvement in their intravenous infusion therapy management skills, yet traditional training models possess deficiencies. The Teaching for Understanding (TfU) Framework can enhance the teaching-learning process and support quality education. Therefore, utilizing TfU framework for training may promote the performance of nurses.

METHODS

Utilizing a non-synchronized design, 102 nurses were recruited using a convenience sampling method. Fifty-one student nurses from August 2019 to January 2021 were designated as the control group, and 51 student nurses from February 2021 to July 2022 were included as the intervention group. The control group received traditional teaching methods, while the intervention group was trained based on TfU framework. The impact was gauged through medical education environment perception, theory and practice assessments, and learning satisfaction surveys.

RESULTS

After the training, there was no significant difference between the control group and the intervention group in the theory assessment. However, the practice assessment scores of the intervention group were significantly higher than those of the control group. Compared with the control group, the learning satisfaction scores of the trained nurses in the intervention group were significantly higher, exhibiting significant differences, particularly in communication ability, teamwork cooperation, summing up capability, and interest in learning improvement. Furthermore, the scores of the learning perceptions, atmosphere, social self-perceptions, and total scores of the intervention group were significantly higher.

CONCLUSION

Training using TfU framework can heighten students' understanding and command over knowledge and skills, fuel their learning fervor, and enhance their communication and collaboration abilities. TfU framework should be disseminated in medical education to improve the quality of education.

Effect of health belief model-based training and social support on the physical activity of overweight middle-aged women: a randomized controlled trial

Introduction

The highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach.

Methods

A randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura's Exercise Self-Efficacy Scale (Bandura's ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values <0.05 were considered statistically significant.

Results

A training program based on HBM and social support led to improved perceived benefits (p < 0.001), cues to action (p = 0.03), and self-efficacy (p < 0.001) of physical activity; decreased perceived barriers (p = 0.001); increased social support (p = 0.001); and increased physical activity (p < 0.001). In addition, the BMI of the intervention group decreased after the training program (p = 0.01).

Conclusion

The findings of the study demonstrate the efficacy of the training program based on HBM and the social support approach in improving social support and physical activity of women. In addition, the study evaluates the long-term outcome in populations with varying social, economic, and cultural standings.

Clinical Trials Registration

https://clinicaltrials.gov/, (IRCT201706236261N17).

Effect of a supportive-educational program, based on COPE model, on quality of life and caregiver burden of family caregivers of heart failure patients: a randomized clinical trial study

BACKGROUND

Heart failure (HF) is one of the most common and spreading diseases worldwide. As HF symptoms progress, it is affected the quality of life and the caregiver burden of the family. The present study aimed to determine the effectiveness of the supportive-educational program, based on the COPE (creativity, optimism, planning and expert advice) care model, on the quality of life and caregiver burden of family caregivers of HF patients.

METHOD

This clinical trial was conducted on 90 caregivers of HF patients admitted to Isfahan in 2021. The samples were divided into experimental (n = 45 people) and control (n = 45 people) groups based on random allocation (card method). The experimental group received problem-solving skills based on the four components of the COPE model in six sessions during one month. to collect data, the 36-Item Short Form Survey (SF-36) and the Zarit Burden Interview (ZBI) were used in two groups before, after and three months after the intervention.

RESULTS

There was a significant difference between the experimental and control groups regarding gender, but This confounding factor had no significant effect on the two components of quality of life and caregiver burden. There was a significant difference between the two groups in terms of the mean score of quality of life immediately(75.99),and three months after the intervention (78.78) (P < 0.05) and the mean score of care burden, immediately (16.60) and three months after the intervention (12.73) (P < 0.05).

CONCLUSIONS

One of the important duties of nurses is to implement educational-supportive programs for patients after the discharge of patients, These programs are family-oriented remotely for their caregivers.

TRIAL REGISTRATION

This study was registered by the Iranian Registry of Clinical Trials with decree code: IRCT20211128053202N1on 2022-02-20.

The efficacy of phase I cardiac rehabilitation training based on augmented reality on the self-efficacy of patients undergoing coronary artery bypass graft surgery: A randomized clinical trial

BACKGROUND

Open-heart surgery is considered one of the primary treatments for severe coronary artery stenosis, but it comes with its own set of complications. However, these complications can be reduced through the implementation of proper cardiac rehabilitation during phase I. This study aimed to examine the impact of phase I cardiac rehabilitation training, using augmented reality, on the self-efficacy of cardiac management in patients undergoing coronary artery bypass grafting.

METHODOLOGY

This randomized clinical trial study involved 60 patients who were admitted to the Cardiac Surgery Intensive Care Unit at Ghaem Hospital in Mashhad. The software used in this study consisted of various videos and educational images demonstrating physical exercises for cardiac rehabilitation. The software was developed to train the patients in the intervention group on the rehabilitation program, starting from their admission to the Intensive Care Unit until their discharge from the hospital. The collected data were analyzed using statistical tests such as independent t-test, Mann-Whitney test, paired t-test, chi-square test, as well as descriptive indicators. Cohen's d was also used to evaluate the magnitude of the effect size.

RESULTS

The findings of this study revealed that the total mean score for cardiovascular management self-efficacy significantly increased during the transfer to the Intensive Care Unit and at the time of discharge. Notably, the increase observed in the intervention group was significantly greater than that of the control group (P < 0.001).

CONCLUSION

The results of this study indicated that implementing early rehabilitation programs, using innovative educational technology like augmented reality, enhanced the self-efficacy of patients undergoing coronary artery bypass grafting. These findings suggest that such programs can be effectively employed as educational tools throughout different stages of cardiac rehabilitation.

TRIAL REGISTRATION

This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20200203046361N1) on 16/02/2020.

A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study

BACKGROUND

There is slight evidence on the effectiveness of relaxation techniques to improve quality of life of the old people, and no comparative studies have particularly investigated this population. Hence, the present study was conducted to examine the effect of Mitchell relaxation versus Benson relaxation technique to improve quality of life of the old people.

METHODS

In the present quasi-experimental study, 96 eligible old people in a nursing home were selected by available sampling method. Afterwards, they were assigned to three groups: Mitchell's Relaxation Technique, Benson Relaxation Technique, and control (each of 32 participants) using the random block sampling method. The intervention groups received relaxation for 8 weeks and 3 sessions of 20 min each week. However, the control group did not receive any relaxation. Data was gathered by questionnaires (SF-36) and (CASP-19) before (week 0) and after the intervention (week 8) and were analyzed using the SPSS software version 26.

RESULTS

The results indicated that both Benson and Mitchell relaxation had improved the quality of life (SF-36) and (CASP-19) and their sub-scales in the participants compare to the control group (P < 0.001). Accordingly, the median (quartile 25, 75) of the specific quality of life of the participants before the intervention was 21 (18.25, 25.75) in the Benson group, 20.5 (16, 24) in the Michel group, and 21 (16.25, 24) in the control group. However, after the intervention they reached 35(26.25, 38.75), 34.5(26.75, 42.25), and 17 (14, 21) respectively. There was no statistically significant difference between the Benson and Michel relaxation groups.

CONCLUSIONS

Based on the results, Benson and Mitchell relaxation techniques improve the quality of life of the old people. If the results be confirmed in other studies, the education of each of them, especially for the old people living in nursing homes and their caregivers, is suggested as routine care.

An exploratory study of exercise behaviours and barriers to participation in people with Charcot-Marie-Tooth disease: a focus on resistance training

The aim of this study was to explore and describe the exercise behaviours and barriers in people with Charcot-Marie-Tooth disease (CMT), with a particular focus on resistance training (RT). Ninety-four Australian adults with a diagnosis of CMT completed an online survey. Fifty-seven percent of respondents reported performing some form of RT each week. Those performing RT engaged in more aerobic activity (P≤0.01) and were involved in longer periods of structured exercise (P<0.01) compared to those not performing RT. The RT group was more likely to perceive their exercise levels as acceptable (P<0.01), that following a program was important (P=0.02), and that exercise is beneficial (P=0.04). The RT group were more likely to have been advised to exercise (P=0.02). Common barriers to exercise were fatigue (64.9%), pain (57.4%), motivation (51.1%), and time (46.8%). RT status did not influence the type of barriers experienced. Weekly RT time was positively associated with exercise satisfaction (r=0.43, P<0.01) and walking distance prior to resting (r=0.29, P=0.04). The findings suggest that positive exercise experiences, advice, assistance from a trainer, and potentially greater resources may influence participation in RT for people with CMT.

The effect of educational intervention in the prevention of cardiovascular diseases in patients with hypertension with application of health belief model: A quasi-experimental study

Background

The best methods for preventing and controlling cardiovascular diseases are preventive behaviours.

Aim

The purpose of the current study is to ascertain how educational intervention affects cardiovascular disease prevention.

Methods

The current investigation is a quasi-experimental study conducted in Shiraz, Iran, in the year 2022, focusing on 200 hypertension patients (by sample random sampling) that were divided into two groups: a control group consisting of 100 participants (63 males and 37 females) and an intervention group also consisting of 100 participants (58 males and 42 females). The data collection instrument comprises inquiries pertaining to demographic factors as well as constructs of the health belief model (HBM) and preventive behaviours for cardiovascular diseases. The participants in both groups completed the questionnaire prior to and three months after the intervention. The intervention group underwent a total of six training sessions, each lasting 55 min.

Results

The results showed that after the intervention, the intervention group showed a significant increase in all cues of the HBM model except for the perceived barriers. Following a period of three months subsequent to the educational intervention, the experimental group also exhibited a notable reduction in blood pressure in comparison to the control group.

Conclusion

The findings of the study indicate that the utilisation of the HBM demonstrated positive outcomes in facilitating the promotion of cardiovascular disease prevention among patients diagnosed with hypertension. The promotion of health among individuals with high blood pressure can be both beneficial and feasible. Moreover, this particular model can be utilised as a comprehensive framework for the development, execution, and evaluation of advantageous and effective healthcare initiatives.

The relationship between health belief and sleep quality of Chinese college students: The mediating role of physical activity and moderating effect of mobile phone addiction

Background

Poor sleep quality has become a common health problem encountered by college students.

Methods

Health belief scale (HBS), physical activity rating scale (PARS-3), mobile phone addiction tendency scale (MPATS) and Pittsburgh sleep quality index (PSQI) were adopted to analyze the data collected from survey questionnaires, which were filled out by 1,019 college students (including 429 males and 590 females) from five comprehensive colleges and universities from March 2022 to April 2022. The data collected from survey questionnaires were analyzed using SPSS and its macro-program PROCESS.

Results

(1) Health belief, physical activity, mobile phone addiction and sleep quality are significantly associated with each other (P < 0.01); (2) physical activity plays a mediating role between health belief and sleep quality, and the mediating effects account for 14.77%; (3) mobile phone addiction can significantly moderate the effect size of health belief (β = 0.062, p < 0.05) and physical activity (β = 0.073, P < 0.05) on sleep quality, and significantly moderate the effect size of health belief on physical activity (β = -0.112, p < 0.001).

Conclusion

The health belief of college students can significantly improve their sleep quality; college students' health belief can not only improve their sleep quality directly, but also improve their sleep quality through physical activity; mobile phone addiction can significantly moderate the effect size of health belief on sleep quality, the effect size of health belief on physical activity, and the effect size of physical activity on sleep quality.

Physical Activities and Associated Factors Among HIV/AIDS Patients: A Questionnaire Survey

Purpose

Regular physical activity is essential for maintaining health and improving people's overall quality of life living with HIV; improving metabolic side effects associated with taking highly active antiretroviral therapy (HAART). This study investigated physical activity levels and associated factors among HIV/AIDS patients.

Patients and Methods

A single-center, cross-sectional study was conducted from July to September 2021. A convenience sample of 377 HIV/AIDS patients was recruited from a medical center in Zhuhai, China. Data were collected through self-report questionnaires and patients' medical records.

Results

The average physical activity of HIV/AIDS patients was 1007.15±868.63 met-min/w; 53.8% of patients expressed medium-level activity, and 46.2% in low-level activity. Log-link gamma generalized linear model results showed that gender, T-CD4+ at the latest visit, self-efficacy, and perceived barriers were significant predictors of assessing physical activity levels.

Conclusion

Nearly half of HIV/AIDS patients have low levels of physical activity. In particular, women and patients with lower CD4 cells, lower self-efficacy, and more perceived barriers had lower levels of physical activity. More knowledge is needed on the causes of physical inactivity among people with HIV, and physical activity programs need to be developed for people living with HIV in developing countries.

Effects of gradient and age on energy expenditure and fat metabolism during aerobic exercise at equal intensity in women

[Purpose]

This study aimed to investigate the effects of gradient and age on energy expenditure and fat metabolism during aerobic exercise at equal intensity in women.

[Methods]

Thirty women in their twenties (n=15) and fifties (n=15) were enrolled. All subjects performed aerobic exercise on a treadmill for 10 min at 0% and 6% gradient repeatedly to elicit 50%, 60%, and 70% VO₂max.

[Results]

Energy expenditure and fat oxidation were higher during aerobic exercise at 6% of the gradient than at 0%, and there was no significant difference in carbohydrate oxidation in any age group.

[Conclusion]

Aerobic exercise at a 6% gradient was more favorable for fat oxidation than a 0% gradient in all age groups. In particular, in the case of women in their fifties, walking on a gradient of 6%, which is favorable for increasing fat oxidation, was more effective than walking on flat ground for preventing and reducing obesity. However, to examine the difference in fat oxidation among exercise intensities more accurately, exercise performed for longer than 30 min is required. Follow-up studies are required to investigate the effect of various gradients on physiological and metabolic characteristics when carrying out aerobic exercises for more than 30 min.