Application of a Health Behavior Theory Paper #2

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Application of a Health Behavior TheoryAssignment 1Nadezhda BoutchatskiCUNY School of Professional StudiesAbstractThe goal of given paper is to analyze and interpret the usage of Pender’s Health Promotion Model by using the research article “The Effect of Pender’s Health Promotion Model in Improving the Nutritional Behavior of Overweight and Obese Women”. The aforementioned article was found in CINAHL database. This study was used to investigate the effect of Pender’s Health Promotion Model (HPM) to improve the dietary behavior of overweight and obese woman admitted to Fatemiyeh Hospital clinics in Hamadan, west Iran in 2015. This experimental study included 108 women randomly assigned to two groups: experimental and control. 3 questionnaires were used in gathering information: demographic, Pender’s HPM constructs, and nutritional behavior. Data was analyzed by paired and independent t-tests, ANCOVA, and Spearmans’ correlation coefficient. The model showed an obvious difference in variables after the implementation of interventions. I believe this educative model should be considered in healthcare settings where a healthy lifestyle and weight loss would be advantageous to overweight and/or obese women. Keywords: Pender’s health promotion model, Obesity, Women, Nutritional behaviors IntroductionObesity is found to be ubiquitous all over the world and dangerous. Recent counts depict at least 2.8 million people dying each year as a result of being overweight or obese (WHO, 2018). Increased BMI is a major risk factor for non-communicable diseases including: cardiovascular diseases, diabetes, musculoskeletal disorders, and various cancers (WHO, 2018). Obesity was actually a widespread problem in many developed countries due to a lack of education in healthcare settings and proper enforcement of nutrition. In addition, many low- and middle-income countries today are now facing a “double burden” of disease (WHO, 2018). Basically, while these countries continue to deal with the problems of infectious diseases and undernutrition, they are also experiencing a rapid upsurge in obesity. Main causes of this is due to exposure to high-fat, high-sugar, high-salt, energy-dense, and micronutrient-poor foods, which tend to be lower in cost but also lower in nutrient quality (WHO, 2018). Obesity is considered a health priority in Iran. The prevalence rate of obesity in people aged over 18 years in Iran has been higher in woman than men (27.3% vs. 13.7%) (Khodaveisi, Omidi, Farokhi, Reza, & Soltanian, 2017). Due to recent modern advancements, Iranian community increased rate of women’s employment which in turn leads to prolonged absence from home, lifestyle and dietary changes (Khodaveisi et al., 2017). HPM mainly assist nurses in understanding of health behaviors as a basis for behavioral counseling to promote health lifestyle (Bastable, 2019). In this paper I will look to summarize the study which was intended to study the effect of Pender’s Health Promotion Model (HPM) to improve the nutritional behavior of obese women admitted to Fatemiyeh Hospital clinics in Hamadan, west Iran in 2015.Material and MethodsThe study population included overweight women referring to Fatemiyeh Hospital clinics in Hamadan in 2015. The participants were enrolled from October 2014 to May 2015. This study was done using two groups, and pre-test and post-test. The sample size was to include 54 people in each group. 108 women who met the inclusion criteria were selected by random convenience sampling and randomly assigned to two groups of 54 each. The inclusion criteria for the two groups were carefully decided and chosen. Requirements included 18-60 years old female, (BMI) of 25 and higher, having physical ability, not being pregnant or breast feeding, having no underlying diseases (verified by physician), consenting to participate in the study, not experiencing any acute events resulting in mental and physical problems within the previous month, and not using medications that may promote or hinder obesity. Data was collected using these researcher-developed inventories: Demographic and BMI data inventory consisting of 10 items: situational influences (5 items) with five-point Likert scale (5: very high, 4: high, 3: relative, 2: low, and 1: very low); and commitment to action (12 items) with four-point Likert scale (1: never, 2: sometimes, 3: often, and 4: always). Nutritional behavior inventory consisting of 20 items with four-point Likert scale, (11 items), interpersonal influences (12 items), and situational influences (5 items); ; an inventory on the components of the Pender’s HPM, including perceived benefits (11 items), perceived barriers (11 items), perceived self-efficacy (12 items), and behavior-related affect, (11 items), and interpersonal influences (12 items)In this study, the inventories were answered by both groups in the pretest. A training intervention was then held for the experimental group through lectures, questioning and answering, and group discussions in three 30-minute sessions within two weeks . The post-test was given two months after the intervention. A Paired t-test was then used to compare the mean values before and after the intervention in each group, and independent t-test to compare the data of the two groups after the intervention. The paired t test was necessary to see if a mean difference between the 2 groups existed and if it was significant. Analysis of covariance was used to compare the scores of components after the intervention in both groups. Spearman’s correlation coefficient was later used to determine the correlation between nutritional behavior and the components of the Pender’s HPM and demographic characteristics.Research FindingsThe Independent t-test did not show any significant difference in age, BMI, educational level, occupation, residence location, number of children and family size, and parity between the two groups. Meaning obesity is not affected by a woman’s education standing, family size, occupation or current weight has no bearing on future weight loss. According to paired t-test, a significant change was noticed in the mean scores of nutritional behaviors after the intervention in the experimental group. Women’s weight changed and behaviors improved when the desire to change was improved and weight loss education was increased. The healthy nutritional behaviors, in the experimental group, improved after learning the perceived benefits. The study also served to identify barriers to healthy behaviors and ideals. Study shows that knowledge about barriers and strategies significantly change mean score of perceived self-efficacy in the experimental group (Khodaveisi et al., 2017). In addition, study shows people are more likely to perform healthy nutritional behaviors when they feel their family members and relatives will encourage them (Khodaveisi et al., 2017). This study found that nurses and physicians were influential people on healthy nutritional behaviors because of their respective authoritative roles; this finding highlights the role of nurses in health promotion (Khodaveisi et al., 2017). In conclusion, I want to say that Health Promotion Model is very efficient for people engagement in healthy diet and lifestyle. Numerous similar studies were conducted and results were consistent with the results of given study. I believe this model should be implemented in healthcare and community settings for reducing obesity and overweight statistic. Nurses and healthcare providers as most influential people should take an active role in health promotion. Their ability to perform as a role model, facilitator, and evaluator would serve as authoritative motivation in weight loss and obesity reduction. ReferencesBastable S. B. (2019). Nurse as Educator Principles of Teaching and Learning for Nursing Practice, 5th ed. Jones & Bartlett Learning, USA Khodaveisi, M., Omidi, A., Farokhi, S., & Soltanian, A. R. (2017). The Effect of Pender’s Health Promotion Model in Improving the Nutritional Behavior of Overweight and Obese Women. International Journal of Community Based Nursing & Midwifery, 5(2), 165–174. Retrieved from Health Organization (2018). Obesity and overweight. Retrieved from: