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Abstract
BackgroundColorectal cancer is a major public health problem. A way to decrease this cancer is through dietary behavioural changes. The aim of this study was to determine the effects of education on dietary behaviour based on the health belief model (HBM) using multimedia.MethodsIn this clinical trial study, 98 participants were randomly allocated to an HBM group (n = 48) and a control group (n = 50). The HBM group received an audiovisual compact disc (CD) that contained information about nutritional behaviour of colorectal cancer (CRC) prevention based on HBM that lasted 45 min. Both groups completed questionnaires regarding demographic factors, knowledge and HBM constructs, and a three-day dietary recall at the beginning of the study, 1 week after, and 3 months after the education. The outcome of this study was measured by the amount of food servings consumed and dietary micronutrient intake.ResultsAt the baseline, there were no significant differences between groups regarding demographic factors. Findings showed that self-efficacy (P < 0.001), severity (P < 0.001), and benefits (P < 0.001) were perceived to be higher, and knowledge (P < 0.001) was increased in the HBM group compared to control group 3 months after education. There was a significant increase in fruit and vegetable (P < 0.001) and dairy (P = 0.001) intake and a significant decrease in red meat servings (P = 0.016) in the HBM group compared to the control group. Also, intake of vitamin D (P < 0.001), folate (P < 0.001), calcium (P = 0.008), and dietary fibre (P < 0.001) was increased in the HBM group compared to the control group 3 months after education.ConclusionEducation plans based on HBM and implemented through multimedia can change nutritional beliefs and behaviours for the prevention of colorectal cancer.
Highlights
About one million new cases of colorectal cancer (CRC) are detected every year worldwide [1]
There were no significant differences between the health belief model (HBM) and control groups regarding demographic and predisposing factors
Comparison of the two groups during that time showed no notable differences in the scores of perceived susceptibility (P = 0.746) and perceived barriers (P = 0.099), but knowledge, perceived severity, self-efficacy, and benefits were perceived to be higher in the HBM group compared to the control group
Summary
About one million new cases of colorectal cancer (CRC) are detected every year worldwide [1]. In Iran, about 15%–35% of cases occur in individuals under 40 years of age [3] This cancer was the third-most costly cancer in European countries, and according to Vahdatimanesh’s study results, the economic burden of CRC in Iran was $298 million in 2012 [4]. The increasing incidence and high economic burden of CRC in the past three decades in Iran has made it a major public health problem [3]. The incidence of the cancer in recent years has increased in Iran because of changes to lifestyle and diet [6]. Many studies have attributed the increased risk of CRC to the prevalence of a Western diet that is high-meat, high-calorie, fat-rich, and fibre-deficient [7, 8]. The aim of this study was to determine the effects of education on dietary behaviour based on the health belief model (HBM) using multimedia
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