Abstract
The objectives of this mixed methods research were 1) to study effects of the health behavior modification program (HBMP) conducted under the principles of the PROMISE Model and the CIPP Model and 2) to compare the 3-self health behaviors and the biomedical indicators before with after the program completion. During the program, three sample groups including 30 program leaders, 30 commanders and 120 clients were assessed, and there were assessments taken on 4,649 volunteers who were at risk of metabolic syndrome before and after the program conducted in 17 hospitals. The collected data were analyzed by the t-test and the path analysis. The research instruments were questionnaires used for program evaluation, structuralized interview forms, and questionnaires used for 3-self health behavior assessment. The findings were as follows: 1) During the program, the assessment result deriving from comparing the overall opinions toward the program among the three sample groups showed no difference (F=2.219), 2) The program management factors based on the PROMISE Model (positive reinforcement, optimism, context, and process or activity provision) had an overall influence on the product or success of the HBMP (p< 0.05) with size effects at 0.37, 0.13, 0.31 and 0.88 respectively. All of the factors could predict the product of the program by 69%. 3) After participating in the program, the clients’ 3-self health behaviors (self-efficacy, self-regulation, and self-care) were significantly higher than those appeared before the participation (p< 0.05), and their biomedical indicators (BMI, blood pressure, waistline, blood glucose, lipid profiles, cholesterol, and HbA1c) were significantly lower than those measured before the program (p< 0.05).
Highlights
The findings were as follows: 1) During the program, the assessment result deriving from comparing the overall opinions toward the program among the three sample groups showed no difference (F=2.219), 2) The program management factors based on the PROMISE Model had an overall influence on the product or success of the HBMP (p< 0.05) with size effects at 0.37, 0.13, 0.31 and 0.88 respectively
All of the factors could predict the product of the program by 69%. 3) After participating in the program, the clients’ 3-self health behaviors were significantly higher than those appeared before the participation (p< 0.05), and their biomedical indicators (BMI, blood pressure, waistline, blood glucose, lipid profiles, cholesterol, and HbA1c) were significantly lower than those measured before the program (p< 0.05)
The main purpose of this study were 1) evaluating the HBMP carried out by the participating hospitals, based on the CIPP Model and the 360 Degree Feedback, 2) examining effects of the health programs administered according to the PROMISE Model by focusing on the context, the input, and the process toward the product received from the programs, 3) comparing the 3-self health behaviors of the clients before participating the program with the ones occurred at the end of the program, and 4) making a comparison of the biomedical indicators (BMI, blood pressure, waistline, blood glucose, lipid profiles, cholesterol, and HbA1c) before and after the program
Summary
The National Health Security Office (NHSO) has underlined health problems associated with metabolic syndrome (MS) including obesity, high hypertension, diabetes, and stroke as such diseases cause illness to people worldwide: the U.S (24% of the total population or 44% of adults aged over 50 years); Saudi Arabia (39.3%); Turkey (33%); Tehran, Iran (30%); and South Korea (14.2%) (Shila et al, 2010). The mortality rate attributed to both cardiovascular disease and diabetes was as high as 85,000 people per year or 236 people per day. It was found that 58% of people who survived a stroke remained permanently disabled and became a burden on the society due to high medical expenditures of long-term treatment (Health Research Network, 2009). The health behavior modification adhering to accurate psychological techniques and strict occupational ethics is approved to be sustainable prevention of health problems and the safest way for people in that it can reduce mortality rate and risk of medications (Innis, 1981; Watanabe et al, 1998). Many developed nations lay importance on the health problem prevention with the use of health behavior modification techniques that combine psychological theories with social cognitive learning (Bandura, 1986). The techniques are used to design activities that suit specific features of the at risk group so as to reduce risky health behaviors and reinforce preferred ones which lessen occurrence of chronic diseases
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