Evaluating the impact of HBM-based education on exercise among health care workers: the usage of mobile applications in Iran

Prevalence and influencing factors of micronutrient powder adoption among children aged 6-24 months by parental and grandparental caregivers: an analysis from rural China

BACKGROUND

Micronutrient powder (MNP or Yingyangbao, a dietary supplement that contains multiple vitamins and minerals) programs can reduce the risk of anemia among children. One such program in China distributed free MNP to children aged 6-24 months in poor rural areas. However, there are indications that the generation of primary caregiver (i.e., parent or grandparent) may influence MNP feeding behavior. The purpose of this study was to investigate the prevalence and influencing factors of effective MNP feeding behavior among parents and grandparents in a rural developing setting.

METHODS

We conducted a cross-sectional study of 884 caregivers and children in formerly impoverished rural areas of Sichuan Province using multi-stage random sampling. Data were collected on caregivers' MNP feeding behavior, their core perceptions and health beliefs about MNP, children's responses to MNP, MNP delivery patterns, and demographic characteristics. Influencing factors of parents' and grandparents' MNP feeding behavior were analyzed using two-level logistic regression.

RESULTS

Total effective MNP feeding behavior rate among caregivers was 40.95%. Grandparents demonstrated higher MNP adoption than parents (χ2 = 4.445, P = 0.035). After controlling for sociodemographic characteristics, grandparents were more likely than parents to achieve effective MNP adoption (OR = 1.360, P = 0.035); child's preference for MNPs (ORparental subgroup = 1.736, ORgrandparental subgroup = 1.496; P < 0.050) and caregiver's self-efficacy (ORparental subgroup = 1.157, ORgrandparental subgroup = 1.393; P < 0.050) were influencing factors of feeding behavior for caregivers of both generations. Parents were also influenced by perceived barriers to feeding MNPs (OR = 0.904, P = 0.040), while grandparents were more strongly influenced by child's discomfort to MNPs (OR = 0.240, P = 0.023) and caregiver's knowledge about MNPs (OR = 1.557, P = 0.014).

CONCLUSION

Future efforts to improve the feeding behavior of caregivers in MNP programs both in China and abroad should improve children's preference for MNP by changing its composition and taste, and increase caregivers' feeding self-efficacy through health education. Moreover, parents should be taught to cope with time and ability barriers that may limit MNP adoption, while grandparents should be emphasized the importance and potential side effects of MNP.

Can mobile software-based physical activity education enhance the quality of life in perimenopausal women?

BACKGROUND

Menopause is a natural occurrence signifying the cessation of menstrual bleeding in middle-aged women. Perimenopause refers to a period of 2-8 years leading up to menopause, characterized by irregular cycles or the absence of menstruation for less than 12 months. The perimenopausal phase can be challenging for women due to the negative impact of associated symptoms on their quality of life. Recognizing the potential benefits of physical activity in mitigating these symptoms, this study aimed to evaluate the impact of physical activity education delivered via WhatsApp, using the Health Belief Model as a foundation, on the quality of life in perimenopausal women.

MATERIALS AND METHODS

This quasi-experimental study involved 80 women aged 40-50 recruited from comprehensive health centers in Isfahan. Cluster sampling was employed for participant selection. The study employed three questionnaires: the "International Physical Activity Questionnaire," "Menopausal Women Quality of Life," and the Health Belief Model Questionnaire. For the intervention group, education based on the Health Belief Model was delivered via WhatsApp via videos, posters, and podcasts every two weeks (a total of 5 packages). Additionally, exercise training videos were sent to participants. Data was collected two months after the intervention and analyzed using SPSS 26, with independent and paired t-tests applied (significance level: 0.05).

RESULTS

The results indicated a significant increase in knowledge scores, Health Belief Model constructs, and physical activity levels within the intervention group, whereas no significant changes were observed in the control group. Notably, menopausal symptom scores decreased in the intervention group, particularly in psychological symptoms, and there was a significant decrease in the overall quality of life score (P = 0.018).

CONCLUSION

Providing education via WhatsApp, grounded in the Health Belief Model, enhanced physical activity levels and improved the quality of life among perimenopausal women. This approach holds promise for promoting well-being in perimenopause.

The effectiveness of multidisciplinary interventions based on health belief model on musculoskeletal pain in the elderly living in nursing homes: a study protocol for a randomized controlled trial

BACKGROUND

Due to the burden of musculoskeletal diseases in the elderly and the multifactorial nature of such conditions, controlling the pain caused by these disorders requires multidisciplinary approach. This approach requires the participation of the elderly in applying effective prevention measures. This study aims to design a multidisciplinary educational intervention based on health belief model (HBM) for elderly residents of nursing homes.

METHODS

This is a parallel randomized clinical trial among elderly people aged 60 years and over living in a nursing home who suffer from musculoskeletal pain. Eligible participants will be divided into two groups including the intervention group who will receive a multidisciplinary intervention (vitamin D consumption, psycho-social stress management, and physiotherapy) and the control group who will receive usual care. Data collection instruments will include demographic data, the Depression, Anxiety, and Stress Scale (DASS), the visual analogue scale (VAS), and a self-designed questionnaire containing the HBM constructs. The interventions will be carried out by the educational team (general practitioner, psychologist, physiotherapist, and health education specialist). Interventions include changing the wrong beliefs of the elderly, taking 800 units of vitamin D daily, daily walking exercise by the elderly for at least 30 min and maintaining proper body posture during daily activities, muscle relaxation, relaxation techniques, regular exercise, examining their diet and eliminating stimulants (such as smoking and coffee), regular visits with friends and family, and deep breathing techniques. All questionnaires will be completed by the elderly before, after, 3, and 6 months after the intervention.

DISCUSSION

The present study will evaluate the effect of an educational intervention based on a multifaceted pain control approach for elderly people who reside in nursing homes in order to reduce musculoskeletal pain in the elderly living in nursing homes. One of the features of this study is its focus on improving the health of elderly residents in nursing homes. Given the increase in the elderly population worldwide, the findings from the current trial might benefit elderly populations.

TRIAL REGISTRATION

IRCT20220904055881N1 . Registered on 11 February 2023.

The Perceived Benefits and Self-Efficacy of an Exercise Intervention on Tobacco Withdrawal Symptoms: A Qualitative Study Based on the Health Belief Model

Background

This study examined the effectiveness of an exercise programme as an adjunct to smoking cessation treatments. The effects of exercise on smoking habits and tobacco withdrawal symptoms (TWS) were evaluated among smokers who were in the pre-contemplation and contemplation stages.

Methods

This was a case study with convenience sampling techniques. This study lasted approximately 2 years, beginning in February 2016. This study was divided into two phases: an intervention phase followed by an interview. The participants were invited to undergo the 8-week supervised moderate aerobic exercise programme. This qualitative study involved 14 participants selected from the intervention phase. They were interviewed about their experiences using a semi-structured questionnaire guided by the health belief model.

Results

This study involved 14 participants who were aged between 26 years old and 40 years old and smoked from 11 to 20 cigarettes per day. Most participants perceived benefits and self-efficacy regarding smoking habits and tobacco withdrawal symptoms (TWS) following the exercise intervention.

Conclusion

This study demonstrated that moderate exercise might be helpful in increasing self-efficacy in smoking cessation and the findings encourage further research on exercise programmes as an adjunct to smoking cessation treatments in Malaysia.

The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis

BACKGROUND

The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region.

OBJECTIVE

This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit).

METHODS

A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools.

RESULTS

In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes.

CONCLUSIONS

The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region.

TRIAL REGISTRATION

PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.

Effect of health belief model-based training and social support on the physical activity of overweight middle-aged women: a randomized controlled trial

Introduction

The highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach.

Methods

A randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura's Exercise Self-Efficacy Scale (Bandura's ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values <0.05 were considered statistically significant.

Results

A training program based on HBM and social support led to improved perceived benefits (p < 0.001), cues to action (p = 0.03), and self-efficacy (p < 0.001) of physical activity; decreased perceived barriers (p = 0.001); increased social support (p = 0.001); and increased physical activity (p < 0.001). In addition, the BMI of the intervention group decreased after the training program (p = 0.01).

Conclusion

The findings of the study demonstrate the efficacy of the training program based on HBM and the social support approach in improving social support and physical activity of women. In addition, the study evaluates the long-term outcome in populations with varying social, economic, and cultural standings.

Clinical Trials Registration

https://clinicaltrials.gov/, (IRCT201706236261N17).

A scoping review of digital workplace wellness interventions in low- and middle-income countries

INTRODUCTION

Digital technology-based interventions have gained popularity over the last two decades, due to the ease with which they are scalable and low in implementation cost. Multicomponent health promotion programmes, with significant digital components, are increasingly being deployed in the workplace to assess and promote employees' health behaviours and reduce risk of chronic diseases. However, little is known about workplace digital health interventions in low- and middle- income countries (LMICs).

METHODS

Various combinations of keywords related to "digital health", "intervention", "workplace" and "developing country" were applied in Ovid MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Scopus and Cochrane Library for peer-reviewed articles in English language. Manual searches were performed to supplement the database search. The screening process was conducted in two phases and a narrative synthesis to summarise the data. The review protocol was written prior to undertaking the review (OSF Registry:10.17605/OSF.IO/QPR9J).

RESULTS

The search strategy identified 10,298 publications, of which 24 were included. Included studies employed the following study designs: randomized-controlled trials (RCTs) (n = 12), quasi-experimental (n = 4), pilot studies (n = 4), pre-post studies (n = 2) and cohort studies (n = 2). Most of the studies reported positive feedback of the use of digital wellness interventions in workplace settings.

CONCLUSIONS

This review is the first to map and describe the impact of digital wellness interventions in the workplace in LMICs. Only a small number of studies met the inclusion criteria. Modest evidence was found that digital workplace wellness interventions were feasible, cost-effective, and acceptable. However, long-term, and consistent effects were not found, and further studies are needed to provide more evidence. This scoping review identified multiple digital health interventions in LMIC workplace settings and highlighted a few important research gaps.

mHealth interventions targeting movement behaviors in Asia: A scoping review

mHealth interventions can promote healthy movement behaviors (physical activity, sedentary behavior, and sleep). However, recent reviews include few studies from Asia, despite it being home to over 60% of the world population. The aim is to map the current evidence for mHealth interventions targeting movement behaviors in Asia. Six databases were searched up until August 2021. Included studies described an mHealth intervention targeting one or more movement behaviors, delivered in a country/territory in Asia, to a general population. A total of 3986 unique records were screened for eligibility in duplicate. Eighty studies with 1,413,652 participants were included. Most were randomized (38.8%) or quasi-experimental (27.5%) trials. Studies were from 17 countries/territories (out of 55); majority were high- (65.0%) or upper middle-income (28.7%). Physical activity was targeted most often (93.8%), few targeted sedentary behavior (7.5%), or sleep (8.8%). Most targeted one movement behavior (90.0%), and none targeted all three together. Interventions typically incorporated a single mHealth component (70.0%; app, pedometer, text messages, wearable) and were delivered remotely (66.3%). The average intervention length was 121.8 (SD 127.6) days. mHealth interventions in Asia have primarily targeted physical activity in high- and upper middle-income countries. There are few interventions targeting sedentary behavior or sleep, and no interventions in low-income countries.

Examining the Effect of the Training Program by Using the Health Belief Model in Performing Self-Care Behaviors of Rural Patients Having High Blood Pressure

BACKGROUND

High blood pressure effects on patients' life. One of the problems in controlling blood pressure is lack of self-care. As a primary form of care, self-care is under patients' control and the patient's belief plays an important role in self-care behaviors. Using the Health Belief Model, this study aimed to determine the effect of educational program on self-care behaviors of rural patients afflicted with hypertension in Toyserkan city.

METHODS

This study was a quasi-experimental research. It studied 100 hypertensive patients in four health centers in rural areas in Toyserkan city in 2019. The samples were simple random sampling among those people referred to the four health centers. Participants in the intervention group attended three training sessions, but the control group did not take part in any training program. The assessment was conducted in both groups before and after the intervention through personal interviews with patients. The questionnaire including the Health Belief Model and self-care behavior constructs was administered.

RESULTS

Perceived susceptibility, perceived severity, self-efficacy and self-care behavior constructs did not have significant statistical differences in terms of mean scores before intervention between the two groups, but after intervention, there were statistically significant differences between the two groups. Examining the model factor in predicting self-care in the intervention group showed that the perceived severity and self-efficacy constructs had the highest predictive power.

CONCLUSION

The results showed that planning and intervention based on HBM, as the models that were used in education and health promotion could be effective in achieving better performance and attitude of patients suffering from hypertension and their self-care. Also, special mention is needed to health care providers to improve self-care training in patients with high blood pressure.