Document Type : Original Article
Authors
1 Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences
2 Social Determinants of Health Research Center, Lorestan University of Medical Sciences
3 Department of Biostatistics and Epidemiology, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
Abstract
BACKGROUND: An unhealthy lifestyle can threaten the health of nursing staff, especially in the
context of cardiovascular diseases (CVDs). Considering the importance of health education in
promoting preventive behaviors against these diseases, this study aimed to evaluate the effect of
an educational program based on the health belief model (HBM) on improving preventive behaviors
of nurses against CVDs.
MATERIALS AND METHODS: This is a randomized controlled trial with a pretest–posttest design
conducted on 104 nursing staff of Imam Khomeini Hospital in Kuhdasht, Lorestan, Iran, in 2017.
They were randomly assigned into two groups of HBM (n = 52) and control (n = 52). The HBM group
received the educational intervention for 6 weeks, one session per week each for 30–40 min. They
were measured before and after the intervention using a demographic form, a researcher‑made HBM
questionnaire, Baecke Habitual Physical Activity Questionnaire, and the 3‑day food intake record all in
Persian. The collected data were analyzed in the Statistical Package for the Social Sciences (SPSS)
v. 24 software using the Chi‑squared test and paired t‑test.
RESULTS: The educational program could only increase the perceived severity (22.64 ± 2.22),
perceived benefits (50.83 ± 5.22), and perceived self‑efficacy (42.37 ± 5.93) of nurses in the HBM
group compared to the controls (P < 0.05). The nurses’ perceived sensitivity was also increased,
but it was not significant (P > 0.05). In the HBM group, a significant change was found in the
food intake level for energy (t = 4.79, P = 0.000), protein (t = −2.99, P = 0.004), and unsaturated
fat (t = −2.94, P = 0.005) after intervention. No significant difference was observed in the total physical
activity score after the intervention (P > 0.05).
CONCLUSION: An educational program based on the HBM model can be used to increase the
severity, benefits, and self‑efficacy of the nurses’ preventive behaviors against CVDs and modify
their dietary regime.
Keywords
regional, and national life expectancy, all‑cause mortality, and
cause‑specific mortality for 249 causes of death, 1980‑2015:
A systematic analysis for the Global Burden of Disease Study
2015. Lancet 2016;388:1459‑544.
2. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ,
Cushman M, et al. Heart disease and stroke statistics‑2015 update:
A report from the American Heart Association. Circulation
2015;131:e29‑322.
3. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K,
Aboyans V, et al. Global and regional mortality from 235 causes
of death for 20 age groups in 1990 and 2010: A systematic
analysis for the Global Burden of Disease Study 2010. Lancet
2012;380:2095‑128.
4. Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease
in Iran in the last 40 years: Prevalence, mortality, morbidity,
challenges and strategies for cardiovascular prevention. Arch
Iran Med 2019;22:204‑10.
5. Gaziano TA, Bitton A, Anand S, Abrahams‑Gessel S, Murphy A.
Growing epidemic of coronary heart disease in low‑ and
middle‑income countries. Curr Probl Cardiol 2010;35:72‑115.
6. Karimy T, Saffari M, Sanaeinasab H, Khalagi K, Hassan‑Abadi M.
The impact of educational intervention based on the theory
of planned behavior on lifestyle change of patients with
myocardial infarction. Iran J Health Educ Health Promot
2016;3:370‑8.
7. Sharifzadeh G, Moodi M, Mazhari Majd H, Musaee I. Application
of Health Belief Model in predicting preventive behaviors against
cardiovascular disease in individuals at risk. J Health Sci Technol
2017;1:64‑9.
8. Darafshi Ghahroudi S, Bondarianzadeh D, Houshiar‑Rad A,
Naseri E, Shakibazadeh E, Zayeri F. Relationship between
perception of cardiovascular disease risk based on the health
belief model and food intake in a group of public employees in
Tehran. Iran J Nutr Sci Food Technol 2013;8:55‑64.
9. Abood DA, Black DR, Feral D. Nutrition education worksite
intervention for university staff: Application of the health belief
model. J Nutr Educ Behav 2003;35:260‑7.
10. Winham DM, Jones KM. Knowledge of young African American
adults about heart disease: A cross‑sectional survey. BMC Public
Health 2011;11:248.
11. Vyas MV, Garg AX, Iansavichus AV, Costella J, Donner A,
Laugsand LE, et al. Shift work and vascular events: Systematic
review and meta‑analysis. BMJ 2012;345:e4800.
12. Mehri A, Mohaghegh Nejad MR. Utilizing the health belief
model to predict preventive behaviors for heart diseases in the
students of Islamic Azad University of Sabzevar. Toloo Behdasht
2010;3:21‑33.
13. 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. J Sch Public
Health Inst Public Health Res 2010;8:12‑23.
14. Ardebili EH, Moradi H, Mahmoudi M. Effect of educational
intervention based on the health belief model in blood pressure
control in hypertensive women. J Mazandaran Univ Med Sci
2014;119:62‑71.
15. Khorsandi M, Shamsi M, Jahani F. The effect of education based on
Health Belief Model on osteporosis preventive behaviors among
pregnant women referred to Arak health centers. Daneshvar
2010;18:23‑32.
16. Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A.
The effect of an educational program based on health belief
model on preventing osteoporosis in women. Int J Prev Med
2015;6: 115.
17. Sadeghi R, Khanjani N, Hashemi M, Movagheripour M. Using
health belief model to prevent skin cancer among farmers. Iran J
Health Educ Health Promot 2014;2:215‑22.
18. Khazaee‑Pool M, Zarei F, Pashaei T, Shojaeizadeh D. The effect
of an educational intervention based on health belief model on
improving smoking preventive behaviors among students. Iran
J Health Educ Health Promot 2017;4:300‑8.
19. Jeihooni AK, Jamshidi H, Kashfi SM, Avand A, Khiyali Z.
The effect of health education program based on health belief
model on oral health behaviors in pregnant women of Fasa city
Fars Province South of Iran. J Int Soc Prev Community Dent
2017;7:336‑43.
20. Masoudiyekta L, Rezaei‑Bayatiyani H, Dashtbozorgi B,
Gheibizadeh M, Malehi AS, Moradi M. Effect of education based
on health belief model on the behavior of breast cancer screening
in women. Asia Pac J Oncol Nurs 2018;5:114‑20.
21. Osta A, Vasli P, Hosseini M, Nasiri M, Rohani C. The effects
of education based on the health belief model on adherence
to standard precautions among operating room staff. Iran Red
Crescent Med J 2018;20: E60112.
22. Mohammadi N, Soltani N, Amini R, Tapak L. The effect of
education based on health belief model on preventive behaviors
towards cardiovascular disease. Sci J Hamadan Nurs Midwifery
Fac 2018;26:227‑36.
23. Alidosti M, Feghhi H, Akbari F, Barati F, Baneshi M, Reisi M.
Effect of education based on health belief model on knowledge
and attitude of women towards nutritional behaviors related
to cardiovascular diseases prevention. Int J Pharm Technol
2016;8:18694‑705.
24. Abd El Aziz MS, Abdel‑Fatah Ibrahim H, Ibrahim Elgzar WT.
Effect of application of health belief model on pregnant women’
knowledge and health beliefs regarding urogenital infections.
IOSR J Nurs Health Sci 2016;5:34‑44.
25. Wickremasinghe WM, Ekanayake L. Effectiveness of a health
education intervention based on the health belief model to
improve oral health behaviours among adolescents. Asian Pac J
Health Sci 2017;4:48‑55.
26. Baecke JA, Burema J, Frijters JE. A short questionnaire for the
measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 1982;36:936‑42.
27. Sadeghisani M, Dehghan Manshadi F, Azimi H, Montazeri A.
Validity and reliability of the Persian version of Baecke habitual
physical activity questionnaire in healthy subjects. Asian J Sports
Med 2016;7:e31778.
28. Robinson T. Hypertension Beliefs and Behaviors of African
Amerricans in Selected Cleveland Public Housing. PhD Thesis.
Ohio, US: Kent State University; 2012.