Physical Activity and Healthy Eating Promotion among Adults with Cardiovascular Metabolic Risk Factors: An Application of Intervention Mapping Framework

Abstract

Background: Intervention mapping (IM) is a systematic development of interventions for designing health promotion programs. Objectives: Promoting physical activity (PA) as well as healthy eating (HE) has an important role in improving individuals with cardiovascular metabolic risk factors (CVMRFs). This paper describes development of an intervention based on intervention mappings’ steps to promote PA and HE among Iranian adults with CVMRFs. Methods: We developed an intervention following 6 steps of IM framework and PRECEDE Model. Needs assessment (Step 1) consisted of interviews with 50 adults with CVMRF and 12 healthcare providers (HPs) located in Karaj, Iran to know if their perceptions of risk behaviors are related to the CV risk factors as well as predisposing, enabling and reinforcing factors for PA, and HE behaviors. Next, we conducted a survey with 450 patients to assess the relationship between determinants and 2 behaviors. Then a program was planned for changeable determinants based on 2 - 4 steps of IM, and finally a plan for implementation (Step 5) and evaluation (Step 6) was developed. Results: Findings of the qualitative part showed unhealthy eating and inactivity as behaviors that predict CVMRFs and also the theoretical determinants that were related to engagement in PA and HE included; self-efficacy and perceived barriers (predisposing factors), individual skills, laws and policies (enabling factors), and social support, motivation to comply and behavioral consequences (reinforcing factors). The steps 2 to 6 of IM was conducted based on the findings of the needed assessment. Conclusions: IM, as systematic development of a theory-based intervention, is a suitable framework to design comprehensive programs in order to promote healthy behaviors and reduce CV metabolic risk factors.