Health Promotion Model Constructs Research Articles

The effect of web-based education on self-care behaviors in cardiovascular patients: application of the pender’s health promotion model

BackgroundCoronary artery disease is the most common cardiovascular disease, the mortality rate of which is increasing significantly. The most important way to prevent a second attack in patients undergoing angioplasty is self-care, which can be influenced by several factors such as the patient’s beliefs. Thus, the present study aimed to determine the effect of a web-based intervention based on the Pender’s health promotion model in patients with cardiovascular disease.MethodsThe present clinical trial study was conducted with 99 patients undergoing angioplasty treatment referring to Bushehr Heart Specialist Center. Random sampling was done and the participants were divided into two groups (50 subjects in intervention group and 49 subjects in control group). The data collection tool was a three-part questionnaire (including demographic information, a researcher-made questionnaire based on the health promotion model constructs, and self-care behaviors), which was completed in three stages (before, two weeks, and three months after the intervention). In addition to routine hospital services, the intervention group received multimedia training based on the constructs of the Pender’s health promotion model from the website. The control group received usual hospital services. Data were analyzed with chi-square, independent T-test and repeated measure ANOVA using SPSS-22 software.ResultsThe results showed that 2 weeks and 3 months after the intervention, the mean scores of perceived benefits, perceived self-efficacy and perceived social support had a significant increase in the intervention group compared to the control group, but the mean score of perceived barriers had a significant decrease in the intervention group (p < 0.001). Regarding self-care behaviors, after the intervention, the mean scores of self-care behaviors, physical activity, healthy diet, medication adherence and stress management had a significant increase in the intervention group compared to the control group (p < 0.001), but no significant was observed between the two groups in terms of changes in the non-smoking (p = 0.38).ConclusionThe results of the study showed that the web-based educational intervention based on the health promotion model is useful in improving the self-care behaviors of cardiac patients undergoing angioplasty. Nursing education and care have a great role in improving the self-care behaviors of cardiovascular patients.Trial registrationRegistration number: IRCT2017080635429N2. Registration date: 09/03/2017 (https://en.irct.ir/trial/26775).

Determinants of Adherence to Treatment in Type 2 Diabetic Patients: A Directed Qualitative Content Analysis Based on Pender's Health Promotion Model.

Adherence to the treatment of type 2 diabetes (T2D), which includes the use of prescribed drugs, following a healthy diet, and adopting a physically active lifestyle, is important to control the disease and improve the patients' quality of life. The present study aimed to explain the determinants of adherence to treatment in patients with T2D based on Pender's Health Promotion Model (HPM). The present research used a qualitative content analysis and was based on Pender's HPM. The data were collected through in-depth semi-structured interviews with 20 T2D patients using a purposive sampling in Bandar Abbas, southern Iran. Maximum variation was considered in terms of gender, age, history of diabetes, type of drug used, education, and occupation. The data collection continued until data saturation. At the same time, the collected data were analyzed using the directed content analysis. MAXQDA 10 was used to manage codes and facilitate data analysis. The data analysis led to the extraction of 10 categories and 19 subcategories as the determinants of adherence to the treatment of T2D patients. The participants shared their experiences about personal characteristics and their ecological environment, specific cognition and emotions, and the behavioral results and experience as the determinants of adherence to T2D treatment. The categories extracted from this study in the form of HPM constructs provided a framework to explain treatment adherence. This information can help policy makers and planners in designing future programs.

A comprehensive health-promoting neighborhood intervention to improve health care seeking behavior among reproductive age Iranian women

BackgroundWomen’s health care seeking delays remains an unresolved major public health problem in developing and underdeveloped countries. This study aimed to evaluate a health-promoting neighborhood intervention to improve health care seeking behavior (HCSB) among reproductive age Iranian women using Health Promotion Model (HPM).MethodThis randomized controlled trial was conducted on 160 women of reproductive age in two groups: experimental and control. Data were collected by self-administered questionnaire based on HPM constructs and a medical symptom checklist. A health-promoting neighborhood intervention was performed in seven sessions for the experimental group. HCSB and HPM constructs were measured before and 3 months after intervention in the two groups. p < 0.05 was considered significant level.ResultsThe average mean age of participants was 30.45 ± 7.80 years. After intervention, the mean score of self-efficacy, interpersonal influences, commitment to plan and HCSB was increased significantly in women in the experimental group, while negative constructs such as perceived barriers, negative activity-related affect, and immediate competing demands and preferences significantly decreased (p < 0.05). In addition, the mean score of referring for symptoms such as excessive sweating, persistent fatigue or weakness, headache, bleeding or spotting between periods, vaginal itching and irritation, unusual vaginal discharge, flashing, chest pain, rapid heartbeats, aching muscles or joints, urinary problems and some mental disorder was increased significantly in experimental group compared to control group (p < 0.05).ConclusionsThe results of study show that an intervention based on the HPM have a positive impact on HCSB and its associated factors and can help improve women’s health behaviors and health outcomes.

Investigating the predictive power of constructs of extended Pender's health promotion model and some background factors in fruit and vegetable consumption behavior among government employees

BACKGROUND:Daily consumption of fruit and vegetable (F and V) can effectively reduce the risk factors of cardiovascular diseases; therefore it is necessary to identify the factors affecting this behavior. This study aimed to determine the Predictive Power of Pender's Health promotion model (HPM) constructs in F and V consumption behavior and the effects of some background variables on this behavior.MATERIALS AND METHODS:A descriptive-correlation study was conducted on 418 employees working in different offices of Qaemshahr, Mazandaran Province from April 8, 2019, to July 23, 2019. The participants filled out a questionnaire about perceived F and V Consumption behavior based on Pender's HPM Constructs. The data were statistically analyzed by descriptive statistics and parametric tests, including the Pearson correlation, Independent– Sample t-test, One-Way analysis of variance test, and multiple linear regression, in SPSS-22.RESULTS:The mean age of participants was 40.25 ± 7.56 years. The results showed that F and V consumption behavior was positively correlated with some constructs of Pender's HPM including, behavioral outcome (r = 0.51, P < 0.001), previous related behavior (r = 0.48, P < 0.001), commitment to action (r = 0.47, P < 0.001), perceived self-efficacy and behavior-related emotions (r = 0.39, P < 0.001). Behavioral outcome alone explained 26% of the dependent variable changes (F and V consumption behavior). The results also indicated that there was a significant relationship between gender and F and V consumption behavior (P = 0.01).CONCLUSION:The study findings demonstrated that some of Pender's HPM Constructs could predict F and V consumption behavior. Behavioral outcome alone was a strong predictor of this behavior. Therefore, in addition to background variables, these constructs should be taken into account in the development of training interventions and courses.

The Development and Testing of a Perinatal Tobacco Attitudes and Behaviors Survey.

Background and Purpose: Accurate assessment of tobacco use in pregnant smokers is key to effective nursing intervention. There is a lack of valid and reliable tools easily integrated into prenatal care. Therefore, the purpose of this study was to develop and test a perinatal survey, guided by the Health Promotion Model (HPM). Methods: The survey was tested with 107 pregnant women via iPad. Urine cotinine assays and a process evaluation were conducted. Results: Reliability yielded a Cronbach's alpha of .873 for the ever-smoker sample and .835 for the total sample. Factors dovetailed with HPM constructs. Conclusions: Perinatal Tobacco Attitudes and Behaviors Survey (PTABS) exhibits high reliability and validity and is easily utilized. Updates need to include questions on all nicotine products and to be streamlined. With accurate identification of nicotine users nurses can provide targeted interventions early in pregnancy.

The role of correlated factors based on Pender health promotion model in brushing behavior in the 13\u201316\u2009years old students of Guilan, Iran

BackgroundTooth decay is one of the diseases that is closely related to people’s behaviors and it can have adverse effects on their performance and their success in the future. Brushing twice a day is the simplest and most effective way to reduce tooth decay. The study aim was to determining the roles of correlational factors based on the Pender’s health promotion model in brushing behavior of ninth grade students at urban public schools of Guilan province during the academic year 2019.MethodsThe present study was cross-sectional and had a descriptive-analytical type. We performed the multi-stage random sampling on 761 ninth-grade students (374 girls and 387 boys) at urban public schools of six counties (ten cities) of Guilan province in 2019. The primary tool was a questionnaire on oral health behaviors focusing on brushing behavior. In the present study, which was conducted only on brushing behavior, we revised and changed the initial questionnaire during the sessions of the research team, and then confirmed its validity and reliability. The questionnaire consisted of three parts, demographic characteristics, constructs of health promotion model, and brushing behavior. We analyzed data in SPSS 21 using regression models.Results20.1% of students brushed their teeth at least twice a day. Optimal behavior had a statistically significant relationship with parents’ education level, and gender. Based on the regression model, the health promotion model constructs described 58% of the variance of the commitment to plan of action. Perceived self-efficacy, situational influences, and perceived barriers of action had significantly stronger relationships with commitment to plan of action respectively. Multiple logistic regression analysis indicated that one-unit increase in scores of commitment to plan of action and self-efficacy increased the chance of desired behavior by 12 and 14% respectively.ConclusionDue to the low rate of brushing behavior in the students and the predictive power of the health promotion model in brushing behavior, we suggest planning and implementation of educational interventions for this group with an emphasis on influencing the commitment to plan of action, self-efficacy, and also the level of knowledge.

Physical activity determinants among students based on Pender’s health promotion model constructs: a cross-sectional study using path analysis

Background: Over recent years, new lifestyles have raised ongoing concerns about the quality of life of students, especially inactivity. The purpose of this study was to determine the factors associated with regular physical activity among students using Pender’s health promotion model. Methods: The present cross-sectional correlational study was conducted on 650 students of Isfahan University of Medical Sciences, Iran, who were selected by stratified sampling with probability proportional to size. Data were collected using a three-part questionnaire, including demographic profile, Pender’s health promotion model constructs and the international physical activity questionnaire. The strongest determinants of physical activity were identified using structural equation modeling by Amos software. Data were analysed by SPSS software (16) using chi-square, one-way analysis of variance and Spearman correlation. Results: The results showed walking activity in 69.1%, moderate activity in 3.8% and vigorous activity in 27.1%. According to path analysis, perceived barriers were the most efficient predictor of physical activity among students, and Pender’s health promotion model constructs explained 84.9% of physical activity changes. Conclusion: The satisfactory predictive value of Pender’s health promotion model constructs for physical activity behaviour focused on effective structures, such as perceived barriers, supports the application of this model to design educational interventions better.

Comparison of Health Promoting Lifestyle Predictors in High School Students with and without Overweight and Obesity: An Application of Health Promotion

Background: Adolescents who have overweight and obesity face many physical and psychological problems and this condition may extend to adult life. The aim of this study was to compare factors related to health promotion lifestyle based on Pender Health Promotion Model (HPM) among high school students with and without overweight and obesity. Materials and MethodsThis was a comparative cross-sectional study conducted on high school students in Deyyer city, Bushehr province, Iran. 353 students (180 students with overweight and obesity and 173 without overweight and obesity) were studied. The data collection tool consisted of three sections (baseline characteristics, HPM constructs and Health-Promoting Lifestyle Profile II). Data were analyzed using SPSS software version 22.0.Results: The mean score of health promoting lifestyle behaviors in spiritual-growth (p

Determinants of medication adherence among hypertensive patients using the Pender's health promotion model

BACKGROUND:Poor adherence in treatment and medication is a global issue in curing the chronic diseases such as hypertension. The present study was conducted to identify the factors related with medication adherence among hypertensive patients referred to the health centers of Borujerd based on the Pender's Health Promotion Model (HPM).MATERIALS AND METHODS:This cross-sectional study was conducted on 463 patients who were referred to the comprehensive health centers of Borujerd city by cluster sampling method in 2019. The data were collected using a questionnaire including demographic variables and Pender's HPM constructs. Data were analyzed by SPSS 18 software using Pearson correlation coefficient and linear regression.RESULTS:The mean and standard deviation of the participants' age was 63.29 ± 11.2 years. The results showed that hypertensive patients had a relatively desirable level of medication adherence behavior. Perceived barriers (β = −0.169), perceived self-efficacy (β = 0.196), activity related affect (β = 0.232), and following medication regimen (β = 0.225) were the best predictors of performing the medication adherence behavior. In total, different structures of the HPM explained 42.2% of the variation of medication adherence behavior changes.CONCLUSIONS:According to the findings, the design of educational programs using HPM is recommended to increase the medication adherence among hypertensive patients.

The Effects of a Training Program Based on the Health Promotion Model on Physical Activity in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial.

Background:Physical activity among women with type 2 Diabetes Mellitus (DM) is an undesirable level. This study aimed to determine the effect of a training program based on the Health Promotion Model (HPM) on physical activity in women with type 2 DM.Materials and Methods:This randomized clinical trial was performed on 128 women with type 2 DM, who were randomly assigned to control and intervention groups. Data were collected using the Baecke Physical Activity Questionnaire (BPAQ) and a researcher-made questionnaire designed based on the HPM constructs before and 2 months after the intervention. The training was carried out in four sessions in the intervention group and the control group received regular education at the clinic. Data were analyzed using Chi-square, Fisher's exact test, paired t-test, independent t-test, and Mann–Whitney and Wilcoxon tests in Statistical Package for the Social Sciences (SPSS) software.Results:The findings showed that the mean [Standard Deviation (SD)] of physical activity in the intervention and control groups before the intervention was 6.52 (0.86) and 6.56 (1.07), respectively, and there was no significant difference between the groups (p = 0.95). However, after the intervention, the mean (SD) of physical activity in the intervention and control groups was 8.04 (0.92) and 6.33 (1.60), respectively, which showed a significant difference (t126= 9.71, p < 0.001).Conclusions:The findings of this study revealed that the training program based on the HPM has a positive effect on improving physical activity in women with type 2 DM.

The effect of a Pender’s health promotion model-based educational intervention on physical activity in office staff

Physical inactivity is a common health issue and also a behavioral risk factor for a wide spectrum of defects. This study was conducted to investigate the effect of a Pender’s health promotion model (HPM)-based educational intervention on physical activity of health insurance office staff in Iran. This quasi-experimental study was conducted on 130 office staff of the Health Insurance Office of the province under purpose. Participants were selected by convenience sampling according to inclusion criteria and then randomly assigned to two groups of 65 each, namely, experimental and control. Practical skills training sessions were held based on Pender’s HPM model (three sessions; each session 30 min; with 4 days intervals only for the experimental group). Data collection instrument was a questionnaire consisting of three sections, demographic information, International Physical Activity Questionnaire, and a researcher-developed Pender’s HPM constructs questionnaire, that was administered before and 2 months after intervention completion. Changes in HPM constructs and the physical activity levels in the two groups were analyzed after the intervention using Wilcoxon and the Mann–Whitney tests in SPSS 16. The level of significance (P) was considered < 0.05. Mean scores of physical activities in the experimental and control groups were 4402.3 ± 3470.6 and 4111 ± 3351.4 METs × min/week before intervention and 4752 ± 4137.6 and 4062.5 ± 3287.2 METs × min/week after intervention, respectively. In the experimental group, mean scores of physical activity and Pender’s HPM constructs changed significantly after intervention (P < 0.001). Pender’s HPM-based education can help enhance physical activity. It is therefore recommended to use an HPM-based education program with the office staff to increase the benefits of physical activity and decrease the complications of sedentary jobs among them.

FACTORS PREDICTING THE STRETCHING EXERCISE BEHAVIORS OF OFFICE EMPLOYEES WORKING IN THE SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES IN TEHRAN, IRAN.

Office employees of all ages are at risk for non-communicable diseases such as musculoskeletal disorders (MSDs) due to physical inactivity. Stretching exercise (SE) behavior could help office employees prevent MSDs. This research aimed to study the predictors of SE among office employees working in Shahid Beheshti University of Medical Sciences (SBUMS) of Iran through a health promotion model (HPM). In the present study, 430 eligible office employees were randomly selected. To assess the predictors of SE, all the HPM constructs were examined as risk factors to determine whether they influence the probability of SE behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. A total of 420 office employees with mean age of 37.1±8.03 years took part in the study. This study showed that perceived barriers to action could prevent participants from engaging in SE (OR [95%CI]: 0.875 [0.815-0.939], p < 0.001). However, perceived self-efficacy (OR [95%CI]: 1.248 [1.137-1.370], p < 0.001), commitment to a plan of action (OR [95%CI]: 1.189 [1.033-1.367], p = 0.016), and interpersonal influences (OR [95%CI]: 1.104 [1.041-1.217], p = 0.003) were significant predictors for SE behavior. This study showed that the office employees who were more confident and committed to a plan of action, and perceived fewer barriers, were more likely to engage in SE behavior.

Impact of Short Message Service (SMS) Education Based on a Health Promotion Model on the Physical Activity of Patients with Type II Diabetes.

IntroductionPhysical activity is the most important self-management behaviour in diabetes. The aim of this study was to evaluate the impact of a short message service (SMS) based on a health promotion model (HPM) on the physical activity of diabetic patients.MethodsThis quasi-experimental study consisted of 37 type II diabetes patients in an SMS group and 36 type II diabetes patients in a control group. The patients in both groups completed written consent forms and questionnaires at the beginning of the study. The patients in the SMS group received training messages within two weeks (two or three messages daily) in the field of physical activity based on HPM constructs. Both groups completed questionnaires in three stages (at the beginning of the study, four weeks after the first visit, and three months later) comprising demographic factors, questions regarding the constructs, and 7-day physical activity recall. After data collection, statistical analysis was conducted using an independent t-test, a Chi-square test, and a repeated measures analysis of variance (ANOVA).ResultsAs compared with the control group, changes in mean scores of perceived self-efficacy (P = 0.001) and family support (P = 0.046) of physical activity in the training group were significantly greater and perceived barriers (P < 0.001) were significantly lower over time. The physical activity performance of the SMS group was better three months after training as compared with that of the control group (P < 0.001).ConclusionThe results demonstrated the efficacy of training messages in changing the beliefs and physical activity behaviours of diabetic patients.

Health Promotion Model: An Integrative Literature Review

Background: The Health Promotion Model (HPM) indicates that each person is a biopsychosocial creature that is partially shaped by the environment, but also seeks to create an environment in which inherent and acquired human potential can be fully expressed. The HPM is proposed as a holistic predictive model of health-promoting behavior for use in research and practice. Purpose: The purpose of this review is to examine how the HPM has been applied in various research studies. Methods: An integrative review was used to find studies that were guided by the HPM. Data search was between 2008 to 2018 using Google Scholar, Scopus, Web of Science, Science Direct, PubMed, Medline, CINAHL, EBSCO, Cochrane, ERIC, Joanna Briggs Institute and EBSCO host. The keywords used were Pender’s and Health Promotion Model. Results: Seventeen studies were reviewed; most of them were quantitative studies. These studies discussed variables from the HPM. Most of the study variables were measured using instruments derived from the HPM. The results of the reviewed studies revealed that the HPM had predictive value in estimating health-promoting behaviors. Conclusion: The HPM was widely established in the nursing community and was implemented in nursing practice, education, and research. In addition, the HPM constructs were used to hypothesize conceptual frameworks in many studies to predict health-promoting behaviors in many chronic diseases.

Cognitive-Behavioral Determinants of Oral Health in students: an Application of Pender's Health Promotion Model

Identifying the effective factors on oral health behaviors could have an important role in promotion of oral health in diabetic patients. Terefore, the aim of the present study was the assessment of cognitive-behavioral determinants of oral health in students using Pender's Health Promotion Model. Materials and Methods: In this cross-sectional study, 251 subjects were selected from Azad University, Payame Noor University and Sarab Faculty of Medical Sciences by multistage random sampling in 2016. To collect data, a standard instrument was applied based on Health Promotion Model (HPM) structures. Tis questionnaire consisted of three parts: demographic variables, Pender’s HPM constructs items based on oral and dental health promotion, and health behavior. Results: Te mean age (standard deviation) was (21.9 ± 1.67). Oral health behaviors had statistically signifcant correlations with all of the HPM structures except for situational influences (r = 0.048). Te HPM structures were able to predict 43.6% of oral heath behaviors and 24.6% of commitment to action. Self-efcacy (β = 0.342) was the strongest predictor to behavior and perceived barriers of commitment to action (β = -0.217). conclusions: According to the results, self-efcacy was the strongest predictor of oral health behaviors and perceived barriers was the strongest predictors of commitment to action plan. Generally, based on the present study fndings, HPM may be used as an appropriate framework for identifying factors and developing educational interventions, aiming at improving oral health behaviors among students

131: THE EFFECT OF PENDER'S HEALTH PROMOTION MODEL IN IMPROVING THE NUTRITIONAL BEHAVIOR OF OVERWEIGHT AND OBESE WOMEN

Background and aims:Changes in lifestyle and eating habits have put women at risk of obesity and overweight more than ever. This aim of this study was to investigate the effect...

Sodium intake prediction with health promotion model constructs in rural hypertensive patients.

Hypertension is the most common cause of cardiovascular disease, and the growing epidemic is a serious warning to pay more attention to this disease. The aims of this study were to examine the relationships between the health promotion model (HPM) constructs and sodium intake, and to determine the predictive power of the HPM constructs as the possible mediators of sodium intake in rural Iranian hypertensive patients. This cross-sectional study was conducted on 671 hypertensive patients in Ardabil, Iran in 2013. The data were obtained during a 25-40 min face-to-face conversation by validated and reliable instruments. The nutritional data were assessed with Nutritionist version 4 (N4) software. Descriptive statistics, Spearman's correlations were calculated using SPSS Statistics version 18.0. Structural equation modeling was conducted using AMOS version 18. Sodium intake was negatively correlated with perceived benefits (r = -0.707; P < 0.01), perceived self-efficacy (r = -0.719; P < 0.01), situational influences (r = -0.590; P < 0.01), interpersonal influences (r = -0.637; P < 0.01), commitment to action (r = -0.605; P < 0.01), affects related behavior (r = -0.499; P < 0.01), and positively associated with the perceived barriers score (r = 0.563; P < 0.01). The structural equation modeling showed that the model explained 63.0% of the variation in sodium intake. HPM constructs were significantly associated with sodium intake and dietary perceptions based on HPM constructs can predict acceptable rate of the variation of sodium intake. Therefore, we suggest using this model constructs to improve the effectiveness of nutritional interventions.

Effects of Educational Intervention on Health-Promoting Lifestyle and Health-Related Life quality of Methamphetamine Users and Their Families: a Randomized Clinical Trial.

Background:Family-centered empowerment of drug and stimulant users is an effective program for a better response to treatment, prevention of treatment adverse effects, and promotion quality of life (QoL) and lifestyle in the process of discontinuing drug abuse.Objectives:This study aimed to determine the effects of educational intervention, based on family-centered empowerment and Pender's health promotion models, on health-promoting lifestyle and health-related QoL among methamphetamine users and their families.Patients and Methods:In a randomized clinical trial, methamphetamine users, who were admitted to Tehran University of Medical Sciences Substance Abuse Treatment Centers, were randomly allocated to three groups: a group for training of methamphetamine users who were in recovery phase (intervention group 1;95 subjects);a group for training of a family member of methamphetamine users who were in recovery phase (intervention group 2; 95 subjects); and a control group (95 subjects). A demographic checklist and a standard questionnaire covering health-promoting lifestyle, health-related QoL, self-efficacy, perceived affect, perceived social support, and perceived barriers dimensions were used to gather required data. Independent-samples t test, paired-samples t-test, and ANCOVA were used to analyze the data.Results:Analysis of covariance showed that after adjusting for effects of pretest scores, the difference between mean post-test scores of health-promoting lifestyle scale, health-related QoL scale, and all constructs of Pender's health promotion model (self-efficacy, perceived affect, perceived social support, and perceived barriers) in the intervention group 1 and control group were significant (P< 0.0001). In addition, changes in mean scores of lifestyle scale (42.4 ± 13.6), QoL scale (29.1 ± 14.2), self-efficacy (16.1 ± 2.6), perceived affect (16.1 ± 8), social support (35.4 ± 12.4), and barriers (17.2 ± 15.8) before and after intervention were significant in the intervention group 2 (P < 0.0001).Conclusions:Application of family-centered empowerment model among methamphetamine users and their families is practically feasible and can result in enhancement and improvement of their QoL, lifestyle, and health promotion model constructs.

Developing and Testing a Measurement Tool for Assessing Predictors of Breakfast Consumption Based on a Health Promotion Model

To develop an instrument for measuring Health Promotion Model constructs in terms of breakfast consumption, and to identify the constructs that were predictors of breakfast consumption among Iranian female students. A questionnaire on Health Promotion Model variables was developed and potential predictors of breakfast consumption were assessed using this tool. One hundred female students, mean age 13 years (SD ± 1.2 years). Two middle schools from moderate-income areas in Qom, Iran. Health Promotion Model variables were assessed using a 58-item questionnaire. Breakfast consumption was also measured. Internal consistency (Cronbach alpha), content validity index, content validity ratio, multiple linear regression using stepwise method, and Pearson correlation. Content validity index and content validity ratio scores of the developed scale items were 0.89 and 0.93, respectively. Internal consistencies (range, .74-.91) of subscales were acceptable. Prior related behaviors, perceived barriers, self-efficacy, and competing demand and preferences were 4 constructs that could predict 63% variance of breakfast frequency per week among subjects. The instrument developed in this study may be a useful tool for researchers to explore factors affecting breakfast consumption among students. Students with a high level of self-efficacy, more prior related behavior, fewer perceived barriers, and fewer competing demands were most likely to regularly consume breakfast.

Psychometric testing of an instrument designed to measure nutritional perceptions of hypertensive patients.

Introduction:Measurement tools designed to ensure the achievements of studies’ objectives must be evaluated. Based on the health promotion model (HPM), the present study was conducted to assess the validity and reliability of the designed questionnaire of hypertensive patients’ nutritional perceptions.Methodology:In a cross-sectional study, the mentioned questionnaire was assessed based on opinions of 11 experienced faculty members and 671 hypertensive patients in rural areas in the year 2013. To evaluate the reliability, internal consistency (Cronbach's alpha) was calculated. Concerning the validity of the questionnaire, its content and construct validity were examined. Data analysis was performed using Statistical Package for the Social Sciences version 18 (SPSS Inc., Chicago, IL, USA).Results:Spearman-Brown and Cronbach's alpha coefficients results were acceptable in all constructs indicating a satisfactory reliability of the questionnaire. Questionnaire's questions were highly correlated with the total score signifying the internal consistency of the questions; therefore, all questions had a similar effect on the total score and the removal of each did no increase the alpha significantly (all questions had acceptable reliability). Factor analyses showed that all questions had acceptable factor loading and suitable validity. Moreover, the entire constructs of the questionnaire were approved by experts with high validity coefficient of 0.9.Conclusion:The designed questionnaire for assessment of the HPM constructs regarding hypertensive patients’ nutritional issues had appropriate psychometric characteristics. Reliability and validity of the questionnaire were also satisfactory and its overall structure was approved.