Document Type : Original Article
Authors
1 Department of Health Education, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abstract
BACKGROUND: Adopting healthy behaviors can lead to better outcomes which can deeply impact
cardiovascular diseases (CVDs) development; consequently, tailoring appropriate theory‑based
interventions may improve various outcomes among patients at CV risks. This study aimed to assess
published researches on the application of health education and promotion of intrapersonal and
interpersonal theories/models’ interventions on patients with CVD.
MATERIALS AND METHODS: In this systematic review, PubMed, Web of Science, Google Scholar,
Scopus, Science Direct, and SID, Magiran databases for English and Persian studies were searched
using relevant keywords, respectively. We searched for interventional studies published with no time
limits until the end of 2020 assessing the application of health education and promotion theories/models
interventions on adult patients with CVDs. Two reviewers individually reviewed abstracts/full‑text
articles to assess inclusion according to predefined criteria. In case of discrepancy between the two
researchers, a third expert was requested to assess papers, and final selection decision was made
based on the agreement among the three evaluators. This systematic review was conducted using
the following data extraction steps and assessing the quality of the studies and results.
RESULTS: From 60 articles, 35 studies met inclusion criteria. Most interventions improved at least
some educational including models constructs (20%), clinical (14.2%), and practical (88.5%) outcome
related to CVDs. It is noted that attention to educational, practical, and clinical outcomes was focused
in published papers, respectively. Furthermore, based on the study categorization using models,
some CVDs and theories/models were more concerned compared to others.
CONCLUSIONS: Health education and promotion theory‑based interventions on patients with CVD
appeared beneficial in the most published paper.
Keywords
- Roth GA, Johnson C, Abajobir A, Abd‑Allah F, Abera SF, Abyu G,
et al. Global, regional, and national burden of cardiovascular
diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017;70:1‑5.
2. Firouzi A, Mohebbi B, Shafiei A. Endovascular repair of
interrupted aortic arch: Approach with hope for fewer
complications. Arch Iran Med 2017;20:756‑9.
3. Abbasi M, Poorzand H, Zirak N, Hosinikhah H, Parsaee M,
Mohebbi B, et al. Hydatid cyst mimicking heart tumor. Iran Heart
J 2011;12:51‑6.
4. Sadeghi M, Haghdoost AA, Bahrampour A, Dehghani M.
Modeling the burden of cardiovascular diseases in Iran from
2005 to 2025: The impact of demographic changes. Iran J Public
Health 2017;46:506‑16.
5. Mohebbi B, Tafaghodi B, Sadeghi R, Tol A, Yekanenejad M. Factors
predicting nutritional knowledge, illness perceptions, and dietary
adherence among hypertensive middle‑aged women: Application
of transtheoretical model. J Edu Health Promot 2021. [In this issue].
6. Sharma M. Theory of reasoned action and theory of planned
behavior. In: Text Book of Theoretical Foundations of Health
Education and Health Promotion. 2nd ed. Massachusetts: Jones
and Bartlett Publishers; 2016. p. 130‑6.
7. Tol A, Farhandi H, Mohebbi B, Sadeghi R. BASNEF model
intervention on blood pressure modification among hypertensive
diabetic patients. J Educ Health Promot 2017;6:47.
8. Sabouri M, Shakibazadeh E, Mohebbi B, Tol A, Yaseri M, Babaee S.
Effectiveness of an educational intervention using theory of
planned behavior on health care empowerment among married
reproductive‑age women: A randomized controlled trial. J Educ
Health Promot 2020;9:293.
9. DeBarr KA. Review of current health education theories. Calif J
Health Promot 2004;2:74‑87.
10. Tavassoli E, Hasanzadeh A, Ghiasvand R, Tol A, Shojaezadeh D.
Effect of health education based on the Health Belief Model
on improving nutritional behavior aiming at preventing
cardiovascular disease among housewives in Isfahan. Journal of
School of Public Health and Institute of Public Health Research
2010;8:12‑23.
11. Saffari M, Sanaeinasab H, Jafarzadeh H, Sepandi M, O’Garo KN,
Koenig HG, et al. Educational intervention based on the health
belief model to modify risk factors of cardiovascular disease in
police officers in Iran: A quasi‑experimental study. J Prev Med
Public Health 2020;53:275‑84.
12. Shen Y, Wang TT, Gao M, Hu K, Zhu XR, Zhang X, et al.
Effectiveness evaluation of health belief model‑based health
education intervention for patients with hypertension in
community settings. Zhonghua Yu Fang Yi Xue Za Zhi
2020;54:155‑9.
13. Yazdanpanah Y, Saleh Moghadam AR, Mazlom SR,
Haji Ali Beigloo R, Mohajer S. Effect of an educational program
based on Health Belief Model on medication adherence in elderly
patients with hypertension. Evid Based Care 2019;9:52‑62.
14. Li X, Yang S, Wang Y, Yang B, Zhang J. Effects of a transtheoretical
model‑based intervention and motivational interviewing on the
management of depression in hospitalized patients with coronary
heart disease: A randomized controlled trial. BMC Public Health
2020;20:420.
15. Zhu LX, Ho SC, Sit JW, He HG. The effects of a transtheoretical
model‑based exercise stage‑matched intervention on exercise
behavior in patients with coronary heart disease: A randomized
controlled trial. Patient Educ Couns 2014;95:384‑92.
16. Rahimdel T, Morowatisharifabad MA, Salehi‑Abargouei A,
Mirzaei M, Fallahzadeh H. Evaluation of an education
program based on the theory of planned behavior for salt
intake in individuals at risk of hypertension. Health Educ Res
2019;34:268‑78.
17. Wyer S, Earll L, Joseph S, Harrison J, Giles M, Johnston M.
Increasing attendance at a cardiac rehabilitation programme:
An intervention study using the theory of planned behaviour.
Coronary Health Care 2001;5:154‑9.
18. Flora PK, Anderson TJ, Brawley LR. Illness perceptions
and adherence to exercise therapy in cardiac rehabilitation
participants. Rehabil Psychol 2015;60:179‑86.
19. Karimy T, Saffari M, Sanaeinasab H, Khalagi K, Hassan‑Abadi M.
Impact of educational intervention based on theory of planned
behavior on lifestyle change of patients with myocardial
infarction. Iran J Health Educ Health Promot 2016;3:370‑80.
20. Mohseni PH, Majlessi F, Shojaeizadeh D, Rahimi FA. The Effect of
educational intervention based on the Pender’s health promotion
model on patients’ self‑efficacy for self‑care behaviors following
heart surgery. Iran J Nurs Res 2017;12:16‑23.
21. Mirsafaei L, Kaviani H. Explaining factors affecting the
effectiveness of self‑care education interventions in cardiac
patients. Journal of Payavard Salamat 2020;13:476‑91.
22. Mannion R, Goddard M. Impact of published clinical outcomes
data: Case study in NHS hospital trusts. BMJ 2001;323:260‑3.
23. Meslot C, Gauchet A, Hagger MS, Chatzisarantis N, Lehmann A,
Allenet B. A Randomised controlled trial to test the effectiveness
of planning strategies to improve medication adherence in
patients with cardiovascular disease. Appl Psychol Health Well
Being 2017;9:106‑29.
24. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA
Group. Preferred reporting items for systematic reviews and
meta‑analyses: The PRISMA statement. J Clin Epidemiol
2009;62:1006‑12.
25. Bennett C, Khangura S, Brehaut JC, Graham ID, Moher D,
Potter BK, et al. Reporting guidelines for survey research: An
analysis of published guidance and reporting practices. PLoS
Med 2010;8:e1001069.
26. Moradi Y, Aghakarimi K, Rahmani A, Sheikhy N. Effect of
applying follow‑up care model on self‑care management in
heart failure patients: A randomized clinical trial. J Urmia Nurs
Midwifery Fac 2017;15:208‑17.
27. Maslakpak MH, Merghati SZ, Didarloo A. Effectiveness of an
educational intervention (based on BASNEF Model) on lifestyle
of patients with heart failure. Payesh 2017;16:501‑10.
28. Borhani F, Khoshab H, Abbaszadeh A, Hamidreza R,
Mohammadi E. Study of the effect of partnership care model on
the quality of life in patients with heart failure. Iran J Crit Care
Nurs 2012;1:43‑8.
29. Aghakhani N, Alinejad V, Hemmati Maslak Pak M, Alizadeh S,
Khademvatan K. Study of the effect of self‑care program model
based on Orem’s pattern on the quality of life in patients with
heart failure. J Urmia Nurs Midwifery Fac 2018;16:65‑72.
30. Baghianimoghadam MH, Shogafard G, Sanati HR,
Baghianimoghadam B, Mazloomy SS, Askarshahi M. Application
of the health belief model in promotion of self‑care in heart failure
patients. Acta Med Iran 2013;51:52‑8.
31. Kaveh MH, Khoramaki Z, Kojouri J, Keshavarzi S. The impact of
a hospital‑based educational program based on the Health Belief
Model on self‑care behaviors of heart failure patients. Iran Red
Crescent Med J 2017;19:e36676.
32. Wu JR, Corley DJ, Lennie TA, Moser DK. Effect of a
medication‑taking behavior feedback theory–based intervention
on outcomes in patients with heart failure. J Card Fail 2012;18:1‑9.
33. Baghaei R, Mashallahi A, Khalkhali H. The effect of applying
continuous care model on the quality of life in heart failure
patients. Nurs Midwifery J 2015;13:666‑75.
34. Sieben A, van Onzenoort HA, van Dulmen S, van Laarhoven C,
Bredie SJ. A nurse‑based intervention for improving medication
adherence in cardiovascular patients: An evaluation of
a randomized controlled trial. Patient Prefer Adherence
2019;13:837‑52. - 35. Mohammadi R, Rahimi Bashar F, Etemadifar S, Salesi M,
Masoudi R. Effect of empowerment program based on the health
belief model on the activity daily living of patients’ with acute
coronary syndrome: A clinical trial. Koomesh 2019;21:639‑49.
36. Alsaleh E, Windle R, Blake H. Behavioural intervention to increase
physical activity in adults with coronary heart disease in Jordan.
BMC Public Health 2016;16:643.
37. Babaei S, Shakibazade E, Shojaeizadeh D, Yaseri M,
Mohammadzade A. Effectiveness the theory‑based intervention
based on health belief model on health promotion lifestyle in
individuals susceptible to cardiovascular diseases. Iran J Health
Educ Health Promot 2020;8:224‑39.
38. Azadi F, Mohammadi E. Effects of partnership care model on
quality of life. Iranian Journal of Nursing Research 2006;1:23‑9.
39. Baghaee R, Khalediyan N, Didarloo A. Changes in the body
weight and subsequent physical activity of hypertensive
patients using BASNEF model. Biosci Biotechnol Res Commun
2017;10(2):258‑63.
40. Baghianimoghadam MH, Rahaee Z, Morowatisharifabad MA,
Sharifirad G, Andishmand A, Azadbakht L. Effects of education
on self‑monitoring of blood pressure based on BASNEF model
in hypertensive patients. J Res Med Sci 2010;15:70‑7.
41. Motlagh Z, Hidarnia A, Kaveh MH, Kojuri J. Influence of a
trans‑theoretical model based intervention on physical activity
in hypertensive patients: A randomized clinical trial. Asian J
Sports Med 2017;8:1‑9.
42. Abedini S, Pourjalil F, Mohseni S. The impact of an educational
program based on the BASNEF model on knowledge and
self‑care behaviors of patients with hypertension. Health Scope
2020;9:e95588. [doi: 10.5812/jhealthscope.95588].
43. Izadirad H, Masoudi GR, Zareban I, Shahraki Poor M,
Haghshenas D. Effectiveness of an educational program based
on BASNEF model on blood pressure in hypertension. Payesh
2014;13:487‑95.
44. Zareipour M, Ghelichi Ghojogh M, Mahdi‑Akhgar M, Abbasi S,
Yoshany N, Hassanalilou T, et al. The impact of using
BASNEF model on self‑control behaviors among patients with
hypertension. Intern Med Med Invest J 2018;3:112.
45. Shojaei S, Farhadloo R, Aein A, Vahedian M. Effects of the health
belief model (HBM)‑based educational program on the nutritional
knowledge and behaviors of CABG Patients. J Tehran Heart Cent
2016;11:181‑6.
46. Zighaimat F, Ebadi A, Karimi‑Zarchi AA, Moradi N, Hajiamini Z,
Mehdizadeh S. The effect of education based on health belief
model on dietary behavior of coronary artery bypass graft
patients. IJN 2010;23:50‑60.
47. Torknejad A, Babaei S, Mirmohammadsadeghi M. Effect of an
educational intervention based on BASNEF model on treatment
adherence after coronary artery bypass surgery: A randomized
clinical trial. ARYA Atheroscler 2020;16:105‑14.
48. Zarani F, Sarami G, Sadeghian, S. Adherence in CABG patients:
An empirical test of a health behavior model. Int J Clin Med
2014;5:225‑33.
49. Hatami H, Hasanpoor A, Salehi S, Lotfizadeh M. Investigating
the effect of intervention based on BASNEF model on quality of
life among myocardial infarction patients. J Clin Nurs Midwifery
2020;8:526‑34.
50. Maghoul S, Jalili Z, Farmanbar R. Assessment of the effect
of educational intervention based on health belief model on
nutritional behavior of patients with myocardial infarction.
J Guilan Univ Med Sci 2018;27:54‑60.
51. Abbaszadeh A, Borhani F, Asadi N. Effects of face‑to‑face
health‑belief oriented education about risk factors on knowledge
and attitude of myocardial infarction patients after discharge. Iran
J Med Educ 2012;12:638‑46.
52. Torabi M, AliAkbari F, Aien F, Deriss F. The effect of
family‑centered empowerment model on the quality of life of
the patients with permanent pacemaker in Chamran hospital in
Isfahan. J Clin Nurs Midwifery 2018;7:218‑25.
53. Mahboobifar M, Zareiyan A, Aliyari SH. Effect of cognitive‑social
based care program on patient’s compliance in under heart valve
surgery in selected military hospital. Mil Caring Sci 2019;6:81‑91.
54. Boyde M, Peters R, New N, Hwang R, Ha T, Korczyk D. Self‑care
educational intervention to reduce hospitalisations in heart
failure: A randomised controlled trial. Eur J Cardiovasc Nurs
2018;17:178‑85.
55. Gagné M, Legault C, Boulet LP, Charbonneau L, Lemyre M,
Giguere AMC, et al. Impact of adding a video to patient
education on quality of life among adults with atrial fibrillation:
A randomized controlled trial. Patient Educ Couns 2019;102:1490‑8.