Explaining the personal cognitive factors affecting physical activity and nutritional behaviors in the middle-aged at risk of coronary artery disease: A directed qualitative content analysis.

Abstract

Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. Nutrition and physical activity are recognized as the major lifestyle-related behaviors to reduce the risk of noncommunicable diseases. It is essential to explain personal cognitive factors to identify potential ways to increase physical activity and improve nutritional behavior. Therefore, the present study aimed to explain the personal cognitive factors affecting physical activity and nutritional behavior in the middle-aged population at risk of a CAD. The present qualitative study was conducted with a directed content analysis approach. A purposive sampling was used with maximum variety of sex, age, education, marital status, job, and risk factors of CAD. The data were collected through semistructured interviews with 20 middle-aged participants at the risk of CAD visiting comprehensive health centers in Bandar Abbas city. The interviews continued until data saturation. The present findings led to the identification of 4 main categories (i.e., self-efficacy, collective efficacy, outcome expectations, knowledge) and 10 subcategories. It seems that to increase the self-efficacy, attention should be paid to individuals' past experiences, self-efficacy of action and maintenance and successful middle-aged peers. Measures should be taken to improve and strengthen it. Peer support, networking, forming online groups (in social networks), and a comprehensive use of social media can help increase collective efficacy. Expectations of positive and negative outcomes and the public knowledge can also be modified through accurate and appropriate information provided in different campaigns for awareness-raising.