BACKGROUND: Osteoporosis is one of the major problems associated with aging and is more common among women than men. This study was designed to modify osteoporosis‑related behaviors in female students based on the transtheoretical model (TTM). MATERIALS AND METHODS: This quasi‑experimental study was conducted on female secondary school students. The sample size was determined 100 by using Altman’s nomogram, including 50 cases and 50 controls. Participants were completed the Demographic Information and Osteoporosis‑Related Behavior Questionnaire based on TTM. Evaluation of the data showed that each participant was at what stage of change in physical activity and preventive dietary behavior of osteoporosis. The content of the training package was designed, and for the intervention group, 2‑h training sessions were held weekly by the instructor in accordance with the stage of change for 2 months, and the booklet was provided with the appropriate contents of the stage of change. Three months after the completion of training, the questionnaires were completed by intervention and control groups. Statistical analysis was performed using SPSS 23 software. RESULTS: Concerning the stages of change in physical activity and nutrition, a significant difference was before and after the intervention in the intervention group (P < 0.001), while no significant difference was observed in the control group. After the intervention, there was a significant difference in the self‑efficacy and some subconstruct of processes of change, but there wasnot a significant difference in the decisional balance. CONCLUSION: Educational intervention based on TTM has been successful in achieving the goal of modifying osteoporosis‑related behaviors in female students. The results of this study can be used by health planners to plan and implement health promotion interventions that will undoubtedly help reduce the burden of disease.
Kanis JA. Diagnosis and clinical aspects of osteoporosis. In: Ferrari SL, Roux C, editors. Pocket reference to osteoporosis. Switzerland: Springer Nature; 2019. p. 11-20. 2. Stevenson JC. A woman’s journey through the reproductive, transitional and postmenopausal periods of life: Impact on cardiovascular and musculo‑skeletal risk and the role of estrogen replacement. Maturitas 2011;70:197‑205. 3. Rizzoli R, Stevenson JC, Bauer JM, van Loon LJ, Walrand S, Kanis JA, et al. The role of dietary protein and Vitamin D in maintaining musculoskeletal health in postmenopausal women: A consensus statement from the European society for clinical and economic aspects of osteoporosis and osteoarthritis (ESCEO). Maturitas 2014;79:122‑32. 4. Komar C, Ahmed M, Chen A, Richwine H, Zia N, Nazar A, et al. Advancing methods of assessing bone quality to expand screening for osteoporosis. J Am Osteopath Assoc 2019;119:147‑54. 5. Hazavehei SM, Taghdisi MH, Saidi M. Application of the health belief model for osteoporosis prevention among middle school girl students, Garmsar, Iran. Educ Health 2007;20:23. 6. Ghaffari M, Tavassoli E, Esmaillzadeh A, Hassanzadeh A. Effect of Health Belief Model based intervention on promoting nutritional behaviors about osteoporosis prevention among students of female middle schools in Isfahan, Iran. J Educ Health Promot 2012;1:14.
7. Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z. Prevalence of osteoporosis in Iran: A meta‑analysis. J Res Med Sci 2013;18:759‑66. 8. Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, et al. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 2017;12:43. 9. Sharifi N, Majlessi F, Montazeri A, Shojaeizadeh D, Sadeghi R. Prevention of osteoporosis in female students based on the orem self‑care model. Electron Physician 2017;9:5465‑71. 10. Romano JL. Prevention Theories for Behavior Change. In: A. Butler, B.Hatch, S Reynolds, N. Seifert, & R. Teeter Prevention. psychology: Enhancingpersonal and social well‑being. Washington, DC, US: American Psychological Association; 2015. p. 23‑45. 11. de Menezes MC, Bedeschi LB, dos Santos LC, Lopes AC. Interventions directed at eating habits and physical activity using the transtheoretical model: A systematic review. Nutr Hosp 2016;33:586. 12. Lee JE, Lee DE, Kim K, Shim JE, Sung E, Kang JH, et al. Development of tailored nutrition information messages based on the transtheoretical model for smartphone application of an obesity prevention and management program for elementary‑school students. Nutr Res Pract 2017;11:247‑56. 13. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. San Francisco, CA: Jossey‑Bass; 2008. 14. Kaveh MH, Golij M, Nazari M, Mazloom Z, Zadeh AR. Effects of an osteoporosis prevention training program on physical activity‑related stages of change and self‑efficacy among university students, Shiraz, Iran: A randomized clinical trial. J Adv Med Educ Prof 2014;2:158. 15. Kim Y, Kang S, Hwang J. Physical activity distribution and differences in its related processes of change strategies in adolescents. Rev Psicol Deport 2017;26:5‑9. 16. Kim NH, Kim YH, Kim JS, Hwang SK, Jun SS. Application of the transtheoretical model to obese adolescents’ exercise behavior change stages. Korean J Health Educ Promot 2005;22:103‑15. 17. Lee YM, Park HS. A study on the stage of change in exercise behaviors, exercise self efficacy, depression and stress in middle aged women. Korean J Women Health Nurs 2004;10:218‑25. 18. Kim YH, Kim JS, Kim MS. Effectiveness of public health center smoking cessation counseling program using the transtheoretical model. J Korean Acad Nurs 2009;39:469‑79. 19. Sharma SV, Hoelscher DM, Kelder SH, Diamond P, Day RS, Hergenroeder A. Psychosocial factors influencing calcium intake and bone quality in middle school girls. J Am Diet Assoc 2010;110:932‑6. 20. Finnell DS, Wu YW, Jezewski MA, Meeker MA, Sessanna L, Lee J. Applying the transtheoretical model to health care proxy completion. Med Decis Mak 2011;31:254‑9. 21. Flemming SSC, Redmond N, Williamson DHZ, Thompson NJ, Perryman JP, Patzer RE, et al. Understanding the pros and cons of organ donation decision-making: decisional balance and expressing donation intentions among African Americans. J Health Psychol 2018;1359105318766212. 22. Horiuchi S, Tsuda A, Kobayashi H, Fallon EA, Sakano Y. Self‑efficacy, pros, and cons as variables associated with adjacent stages of change for regular exercise in Japanese college students. J Health Psychol 2017;22:993‑1003. 23. Kroll C, Keller R, Scholz U, Perren S. Evaluating the decisional balance construct of the transtheoretical model: Are two dimensions of pros and cons really enough? Int J Public Health 2011;56:97‑105. 24. Krigel SW, Grobe JE, Goggin K, Harris KJ, Moreno JL, Catley D. Motivational interviewing and the decisional balance procedure for cessation induction in smokers not intending to quit. Addict Behav 2017;64:171‑8. 25. Alinia A, Vahedian M, Alizadeh P, Attarzadeh R, Esmaeili H, Asgari MH. A study on effect of Transtheoretical Model‑based educational intervention on degree of exercising by femal adolescent, Tonekabon Township. J Basic Appl Sci Res. 2011;2:8843‑52. 26. Di Noia J, Prochaska JO. Dietary stages of change and decisional balance: A meta‑analytic review. Am J Health Behav 2010;34:618‑32. 27. Ivey MA, Maguire GP, Toelle BG, Marks GB, Abramson MJ, Wood‑Baker R. Characteristics in stages of change and decisional balance among smokers: The burden of obstructive lung diseases (BOLD)‑Australia study. Int J Environ Res Public Health 2019;16:3372. 28. Romain AJ, Attalin V, Sultan A, Boegner C, Gernigon C, Avignon A. Experiential or behavioral processes: Which one is prominent in physical activity? Examining the processes of change 1 year after an intervention of therapeutic education among adults with obesity. Patient Educ Couns 2014;97:261‑8. 29. Plotnikoff RC, Hotz SB, Birkett NJ, Courneya KS. Exercise and the transtheoretical model: A longitudinal test of a population sample. Prev Med (Baltim) 2001;33:441‑52. 30. Prochaska JJ, Nigg CR, Spring B, Velicer WF, Prochaska JO. The benefits and challenges of multiple health behavior change in research and in practice. Prev Med (Baltim) 2010;50:26‑9. 31. Nigg CR, Harmon B, Jiang Y, Ginis KA, Motl RW, Dishman RK. Temporal sequencing of physical activity change constructs within the transtheoretical model. Psychol Sport Exerc 2019;45:101557. 32. Malekshahi F, Hidarnia A, Niknami Sh AF, Fallahi Sh PY. Using Construct of the trans‑theoretical model to physical activity behavior in osteoporosis prevention: A theory‑based study. Indian J Fundam Appl Life Sci. 2015;5(S2):1169‑79. 33. Lach HW, Everard KM, Highstein G, Brownson CA. Application of the transtheoretical model to health education for older adults. Health Promot Pract 2004;5:88‑93. 34. Di Noia J, Prochaska JO. Mediating variables in a transtheoretical model dietary intervention program. Health Educ Behav 2010;37:753‑62. 35. Purnarani R, Hassani L, Aghamolaei T, Mohseni S. The Effect of educating based on the transtheoretical model on selfe‑efficacy and decision balancing of Junior School students in breakfast consumption. Iran J Health Educ Health Promot 2017;5:102‑12.
Vahid Kohpeima Jahromi,.. , Sepide Bahlouli Ghashghaei,.. and Nader Sharifi,.. (2020). Improvement of osteoporosis‑related behaviors in female students based on trans theoretical model. Journal of Education and Health Promotion, 10(8), 1-6.
MLA
Vahid Kohpeima Jahromi,.. , , Sepide Bahlouli Ghashghaei,.. , and Nader Sharifi,.. . "Improvement of osteoporosis‑related behaviors in female students based on trans theoretical model", Journal of Education and Health Promotion, 10, 8, 2020, 1-6.
HARVARD
Vahid Kohpeima Jahromi .., Sepide Bahlouli Ghashghaei .., Nader Sharifi .. (2020). 'Improvement of osteoporosis‑related behaviors in female students based on trans theoretical model', Journal of Education and Health Promotion, 10(8), pp. 1-6.
CHICAGO
.. Vahid Kohpeima Jahromi, .. Sepide Bahlouli Ghashghaei and .. Nader Sharifi, "Improvement of osteoporosis‑related behaviors in female students based on trans theoretical model," Journal of Education and Health Promotion, 10 8 (2020): 1-6,
VANCOUVER
Vahid Kohpeima Jahromi .., Sepide Bahlouli Ghashghaei .., Nader Sharifi .. Improvement of osteoporosis‑related behaviors in female students based on trans theoretical model. J Educ Health Promot, 2020; 10(8): 1-6.
