Fruit and vegetable consumption in diabetics patients: Effect of pender health promotion model (HPM) intervention.

BACKGROUND: This study was aimed to investigate the effect of the intervention based on Pender's health promotion model (Pender's HPM) to improve the consumption of fruits and vegetables in diabetic patients. MATERIALS AND METHODS: The present study was quasi-experiment community-based research conducted on 112 diabetic patients in Sirjan City. Eligible diabetic patients were randomly divided into two experimental and control groups. The data were collected by two questionnaires, Behavioral Risk Factor Surveillance System and the researcher-made based on Pender's HPM. In order to compare qualitative variables between two groups, Chi-square test was performed. P value <0.05 was considered significant. RESULTS: The findings showed that there is a significant difference in the consumption of fruit juice in men and women (P value = 0.016). In this study, the perceived obstacles structure and interpersonal influences structure was effective on the consumption of vegetables and salad in diabetic patients before and after the educational intervention. CONCLUSION: Perceived benefits and interpersonal and situational influencers are effective on the consumption of fruits and vegetables in diabetic people and health planners should design educational interventions in order to increase the consumption of fruits and vegetables in the target group by considering these effective determinants.

Knowledge and safe handling practices affecting the occupational exposure of nurses and midwives to hazardous drugs: A mixed methods systematic review.

BACKGROUND: Hazardous drugs are inherently toxic and present a potential occupational exposure risk to nurses and midwives. Hazardous drugs require special handling to minimise the risk of exposure and adverse health effects. Although the use of hazardous drugs in oncology services is well recognised, they are also used in other healthcare areas where nurses and midwives may be unaware there is a risk. OBJECTIVE: To investigate what nurses and midwives know and do about their occupational exposure to hazardous drugs, and what factors affect their knowledge and practice. DESIGN: Mixed methods systematic review. METHODS: A systematic review was conducted, and studies were included if the authors described what nurses or midwives knew about hazardous drugs, or what they did in their clinical practice to reduce their risk of occupational exposure (PROSPERO registration CRD42024437493). The databases were searched for any year until the 26th of January 2024.Two independent reviewers extracted data using Covidence and assessed the risk of bias. The data were extracted into the categories of knowledge of risk and safe handling practices, attitude and factors affecting these, and activities that posed the greatest risk of exposure (preparation, administration, and disposal of hazardous drugs, cleaning hazardous drug spills, and handling excreta from patients who had recently been treated with hazardous drugs). RESULTS: Of the 2702 articles that were identified, 59 quantitative and 3 qualitative studies were included in this review. No studies reported on midwives handling hazardous drugs. Most studies investigated nurses working in oncology services. Nurses reported a lack of education about the risk and safe handling. They were often responsible for preparing hazardous drugs and there was inconsistency in their compliance when using personal protective equipment. Nurses did not always perceive that there was a real risk of exposure, were concerned about the effect of wearing personal protective equipment on their relationship with patients and perceived they lacked the time to don equipment. CONCLUSIONS: The risk of occupational exposure to hazardous drugs outside of oncology services was rarely investigated. There were no studies reporting what midwives knew and did about their risk of occupational exposure to hazardous drugs. When nurses were aware of the risks, this did not necessarily translate into the implementation of safe handling practices or the consistent use of personal protective equipment because of a perceived low risk, lack of personal protective equipment availability, and prioritising personal or patient comfort over safety measures. TWEETABLE ABSTRACT: Nurses and midwives are often unknowingly exposed to the toxic effects of hazardous drugs when they prepare and administer these drugs for patients, although knowledge does not always equal safe handling practices.

Psychometrics properties of type 2 diabetes treatment adherence questionnaire (DTAQ): a study based on Pender's health promotion model.

BACKGROUND: Management of type 2 diabetes (T2D) as a chronic disease requires treatment adherence such as controlling the blood glucose level and adopting a healthy lifestyle. The present study aimed to develop and psychometrically evaluate a questionnaire based on the Pender's Health Promotion Model (HPM) to measure treatment adherence and the associated factors among T2D patients. METHODS: The present study was conducted in qualitative and the quantitative phases between March 2022 and March 2023. The participants were T2D patients visiting Shahid Mohammadi hospital Diabetes Clinic in Bandar Abbas in the south of Iran. The first draft of items was extracted from the qualitative phase. The present study used interviews with T2D patients, item construction, validity and reliability evaluation of the instrument, and the relevant statistical analyses. It emphasized the significance of content, face, and construct validity, along with reliability testing using Cronbach's alpha and test-retest method. Data were analyzed using SPSS software, V16 and AMOS, V23. RESULTS: A 97-item questionnaire was developed through the qualitative phase and, after content validity, it was reduced to 86 items. Five items were removed in face validation, and after the test-retest method, 79 items were retained. The confirmatory factors analysis confirmed a 65-item model with appropriate fitness of data. Cronbach's alpha coefficient showed an acceptable reliability of the diabetes treatment adherence questionnaire (α = 0.92). CONCLUSION: The questionnaire developed based on the HPM model provides a standard and comprehensive measurement of the degree of adherence to treatment and the associated factors among Iranian T2D patients. This is especially valuable in the Iranian healthcare context, where effective management of chronic diseases such as diabetes is of a top priority. Questionnaires can help identify barriers and facilitators of treatment adherence to inform systematic and goal-oriented interventions. The proposed questionnaire had good psychometric properties, and can be used as a valid and practical instrument to measure the factors related to treatment adherence behaviors.

A health promotion model-based intervention to enhance treatment adherence in patients with type 2 diabetes.

BACKGROUND: The present study aimed to determine the effect of an intervention based on Pender's health promotion model (HPM) on treatment adherence in patients with type 2 diabetes (T2D). METHODS: The present quasi-experimental study with a 3-month follow-up was conducted in Bandar Abbas, a city in the south of Iran in 2023. The intervention group (IG) with a total number of 95 T2D patients was selected from Hormuz diabetes clinic and the control group (CG) with 95 T2D patients was selected from comprehensive health centers through a clustering sampling method. The educational intervention was implemented in 10 sessions to improve patients' treatment adherence. The teaching methods in training sessions were lectures, joint discussions, Q&A, role-play and peer training. The participants were evaluated using a researcher-made questionnaire including the constructs of Pender's HPM about T2D treatment adherence, hemoglobin A1C (HbA1C), and BMI. Independent-samples t-test, paired-samples t-test, covariance analysis and stepwise regression analysis were used. Data analysis was done in SPSS 26. FINDINGS: Three months after the intervention, in comparison to the CG, the mean and standard deviation of treatment adherence benefits (p = 0.002), treatment adherence self-efficacy (p = 0.010), treatment adherence related affect (p = 0.001), interpersonal influences (p = 0.012), commitment to plan of action (p < 0.001), treatment adherence behavior (p = 0.022), treatment adherence experiences (p = 0.001) was higher in the IG. The mean and standard deviation of situational influences (p < 0.001), immediate competing demands and preferences (p = 0.018) were lower than the CG. The results obtained from the analysis of covariance proved the effectiveness of the intervention in the constructs of Pender's HPM and HbA1C in participants of the IG (p < 0.001). The regression analysis showed, after the intervention, for every 1 unit of change in commitment to behavior planning, action related affect and perceived self-efficacy, compared to before the intervention, there were 0.22 units, 0.16 units and 0.26 units of change in the behavior score in the IG. CONCLUSION: The findings proved the effectiveness of the educational intervention in improving the constructs in Pender's HPM and the blood sugar level of T2D patients. As the results of the educational intervention showed, the use of a suitable educational approach as well as the development of appropriate educational content for the target population can significantly improve the treatment adherence behavior. TRIAL REGISTRATION: This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1: https://www.irct.ir/trial/61741 ) and first release date of 17th March 2022.

Motivational Interviewing With Pender's Health Promotions Model: Diabetics Self-Management Behavior.

The purpose of the study was to determine the effects of motivational interviewing as based on Pender's health promotion model (HPM) on diabetes self-management behavior among individuals with Type 2 diabetes. Apart from their routine care, the individuals in the intervention group were given a 30-45-minute motivational interview based on Pender's HPM once a week for three months. Statistically significant differences were determined between the groups in the total score of the scales and its sub-dimensions (p < .05). The intervention applied in the present study can be used as an effective and easy method through which to develop and maintain diabetes self-management behaviors.

Evaluation of child with asthma and her caregivers based on the Pender health promotion model, and linkages of NANDA, NIC-NOC: A case presentation.

PURPOSE: Despite highly effective asthma treatments, the prevalence of asthma is increasing in children and adolescents. Despite easy access to asthma control, sufficient control and management are not achieved. Asthma management is crucial to prevent the development of asthma symptoms and attacks, reduce repeated hospitalizations, and prevent a decrease in the quality of life for both the child and caregivers. This case study aims to increase the utilization of theories, models, and classification systems by evaluating a child diagnosed with asthma for 6 years and their caregivers based on Pender's health promotion model (PHPM). Furthermore, the study aims to establish a connection with NANDA, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), thereby formulating a nursing care plan. METHODS: This case study evaluated a child diagnosed with asthma for 6 years and their caregivers based on PHPM. A nursing care plan was developed by establishing connections with NANDA, NIC, and NOC and based on Pender's health promotion. FINDINGS: By establishing connections with NANDA, NIC, and NOC, a nursing care plan of a total of six included nursing diagnoses has been created as five based on the PHPM. CONCLUSION: The care plan implemented improved S.B.K.'s clinical condition. Furthermore, the mother's social support increased, and her confidence in managing asthma improved. As a result of implementing the model, the mother reached the potential to develop healthy behaviors for S.B.K. and make future-oriented plans. IMPLICATIONS FOR NURSING PRACTICE: It is recommended that NANDA-I, NIC, and NOC, along with PHPM, be used in clinical nursing care and scientific research to enhance the presentation of quality care and the individual's future health potential.

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.

The Impact of Training Based on the Pender Health Promotion Model on Self-Efficacy: A Systematic Review and Meta-Analysis.

OBJECTIVE: The concept of self-efficacy is a determining factor in many behaviours related to health promotion and health education. Several pilot studies have been conducted in different parts of the world on different populations regarding the impact of training based on the Pender Health Promotion Model on self-efficacy, yielding conflicting results. Therefore, the present systematic review and meta-analysis were conducted with the aim of evaluating and summarizing the results of studies on the impact of training based on the Pender Health Promotion Model on self-efficacy. DATA SOURCE: MagIran, SID, PubMed, Embase, Web of Science (WoS), Scopus and Google Scholar. STUDY INCLUSION AND EXCLUSION CRITERIA: Original scientific research articles; Interventional studies; Studies investigating the effects of education based on the Pender Health Promotion Model on self-efficacy; Studies irrelevant to the objective; Cross-sectional studies; case reports; and papers presented in conferences; letters to the editor; systematic and meta-analysis studies. DATA EXTRACTION: Two independent reviewers extracted data and assessed the quality of the 18 included studies using a pre-prepared checklist for the systematic review and meta-analysis process. DATA SYNTHESIS: We conducted meta-analyses and reported the characteristics, outcomes, and risk of bias of studies. METHODS: The present study was conducted according to PRISMA guidelines until December 2022. The quality assessment of the included articles for meta-analysis was performed using the JBI checklist. Heterogeneity of the studies was calculated using the I2 statistics, and Egger's regression intercept was used to assess publication bias. RESULTS: In the initial search, 13,943 studies were found, and after excluding studies irrelevant to the research objective, a total of 18 articles were included in the meta-analysis. These articles represented a sample size of 1015 individuals in the intervention group and 999 individuals in the control group. The combined results of the studies showed a significant increase in self-efficacy in the intervention group when compared to the control group (1.788 ± .267; CI: 95%, P < .001). With an increase in the year of study and the quality assessment score of the articles, the effect of the intervention decreased (P < .001). CONCLUSION: The results of this study indicated that training based on the Pender Health Promotion Model significantly increased self-efficacy. Therefore, it seems that training based on this model can have positive effects on individuals' self-efficacy.

Explaining the perspective of people living with HIV on health-promoting behaviours based on Pender's model: A directed content analysis.

AIM: Health-promoting behaviours are an important challenge in people living with HIV (PLHIV). Knowing PLHIV's perspective can be helpful for more effective health-promoting behaviour planning. Therefore, the present study aims to explain PLHIV's perspective on health-promoting behaviours based on Pender's health-promotion model. DESIGN: A qualitative study with a directed content analysis approach. METHODS: Altogether, 17 PLHIV referring to the Behavioural Diseases Consultation and Control Center in Tehran, Iran and were selected through purposive sampling. The data were collected through semi-structured individual interviews and the results were analysed through directed content analysis based on Pender's model. Data management was done by MAXQDA V10. RESULTS: Data analysis led to the extraction of 396 codes in 35 subcategories and 15 main categories in 6 constructs of Pender's model, including the perceived benefits (health assurance and optimal disease control), perceived barriers (insufficient knowledge and awareness, lack of motivation, adverse outcomes of the disease and socioeconomic status), perceived self-efficacy (endeavouring to have a healthy lifestyle, responsibility for one's health and that of others), activity-related affect (positive and negative feelings), the interpersonal influences (family, friends and relatives and social media) and situational influences (the resources available to the community and community's culture). PATIENT OR PUBLIC CONTRIBUTION: In this study, the contribution of PLHIV was used and their perspectives were surveyed. The findings of this study can help policymakers and planners formulate health policies to select the most appropriate strategies and approaches to promoting effective healthy behaviours among PLHIV.

Intervention Effect of Pender's Model on Mental Health of Patients With Diabetes Mellitus: A Meta-analysis.

OBJECTIVE: Our aim in this study was to better understand the intervention effect of Pender's model on the physical and mental health of patients with diabetes mellitus. METHODS: According to the principle of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, various databases, including CNKI, Wanfang Data, SinoMed, VIP, Web of Science, Cochrane, PubMed and ScienceDirect, were searched to collect and select relevant reports for the implementation of a meta-analysis. RESULTS: Ten randomized controlled trials in 6 foreign reports and 4 Chinese reports were included in this study. A total of 863 participants were involved, including 439 in the experimental group and 424 in the control group. Results of the meta-analysis show that Pender's model has a good intervention effect on the health knowledge (Z=3.371, p<0.050), self-management behaviour (Z=3.781, p<0.050) and psychological function (Z=2.902, p<0.050) of patients with diabetes mellitus as compared to the control group. The subgroup analysis showed that the intervention effect on self-management behaviour would not be affected by the measurement tool used (Z=3.295, p=0.001). CONCLUSIONS: Pender's model showed a good intervention effect on the health knowledge, self-management behaviour and psychological function of patients with diabetes mellitus.

Analysis Effects of Pender Health Promotion Model Education on Health Behaviors and Maternal and Infant of Cardiac Disease in Pregnancy.

Pregnancy with cardiac disease includes pregnancy in women with a history of heart disease and cardiac disease during pregnancy. Therefore, we aim to investigate the effect of Pender health promotion model (HPM) on the health behaviors and maternal and fetal outcomes in pregnant patients with cardiac disease. 80 pregnant women with cardiac disease were enrolled in the study from January 2016 to December 2017. 40 patients who received HPM health education were selected as treatment group by convenient sampling method. 40 patients were selected to receive routine health education. After 12 weeks of education, the awareness of health knowledge before and after education, health behavior compliance, level of pre-partum cardiac function, and maternal and fetal outcomes were compared between the two groups. After education, the knowledge rate in observation group was higher than that in control group (P < 0.01, P < 0.05); the compliance of health behavior in observation group was higher than that in control group (P < 0.01, P < 0.05); before delivery, the rate of cardiac function(I+II) in observation group was 67.50% and significantly lower than 42.50% in control group (P < 0.05); after education, the incidence rate of severe heart failure, cesarean delivery, premature delivery and full-term infants with low body mass in observation group was significantly lower than that in control group (P < 0.05). The Pender health promotion model can improve the knowledge of health knowledge and compliance of health behaviors of pregnancy with cardiac disease effectively, and it can help reduce heart burden and improve maternal and child outcomes.

Self-care behavior prevention of COVID-19 in the general population based on Pender Health Promotion Model: A cross-sectional study.

Background and Aims: Coronavirus with its sudden and widespread outbreak has obviously imposed devastating consequences in various aspects of human life. The purpose of this study was to determine the predictive value of Pender's Health Promotion Model (HPM) structures in self-care preventive behavior against coronavirus disease 2019 (COVID-19) among the general population of Ardabil, Iran. Methods: The present retrospective descriptive-correlational study was conducted on citizens of Ardabil aged 18 years and over in 2021. After dividing the city of Ardabil into four parts, 50 people from each area of the city and a total of 200 people were selected through the available sampling method through social media. Data collection tools included a demographic profile, perceived self-efficacy scale, perceived emotional questionnaire, perceived social support questionnaire, perceived benefits and barriers questionnaire, researcher-made COVID-19 self-care questionnaire, and commitment to action questionnaire based on Pender's HPM structures in an online manner. Data were analyzed by Amos 22 software and using structural equation modeling. Results: According to the results, direct path analysis to COVID-19 self-care behavior indicated that the variables of perceived self-efficacy (ß = 0.18, p < 0.01), interpersonal effects (ß = 0.19, p < 0.01), positive emotion (ß = 0.15, p < 0.05) and perceived benefits (ß = 0.20, p < 0.01) are able to significantly predict self-care behaviors. Moreover, the bootstrapping test results in the indirect path analysis demonstrated that the variables of perceived self-efficacy (95% confidence interval [CI], 0.012, 0.066), perceived social support (95% CI, 0.002, 0.026), and perceived barriers (95% CI, -0.019, -0.002) and benefits (95% CI, 0.001, 0. 015) through the mediator variable of commitment to action are able to significantly predict COVID-19 self-care behavior. Conclusions: Based on the findings of the present study, it can be claimed that the proposed model of COVID-19 self-care behavior has an acceptable fitness in the general population. This model can be used in developing educational programs and intervention techniques to modify people's attitudes and behaviors.

The Impact of Educational Intervention Based on Pender's Health Promotion Model on Healthy Lifestyle in Women of Reproductive Age in Iran.

Background: Lifestyle is one of the most important factors affecting women's health. Women's quality of life and health depends on their health-promoting behaviors and lifestyles. The aim of this study was to determine the impact of an educational intervention based on Pender model on healthy lifestyle in women of reproductive age in Iran. Methods: This randomized controlled trial study was carried out in women of reproductive age in Iran, from August to December 2019. The samples were divided into experimental (n = 120) and control (n = 120) groups. 6 training sessions were provided for the experimental group. The questionnaire consisted of several items including socio-demographic characteristics, health-promoting lifestyle profile-II (HPLP-II), self-efficacy, social support and constructs of Pender's health promotion model. SPSS-18 software has been applied for statistical analysis. Results: The mean age of the experimental group was 31.88±7.624 years and for the control group was 30.33±6.89 years. There was no statistically significant relationship between demographic variables such as marital status, education, employment status, age and body mass index with lifestyle in women. Lifestyle in women had a statistically significant relationship with the structure prior health-related behavior (p < 0.001). The score of women in structures of prior health-related behavior, perceived benefits, commitment to action, and social support increased after educational intervention (p < 0.001). Conclusion: Findings showed that educational intervention based on Pender health promotion model has increased the score of healthy lifestyle in women. Therefore, planning and performing educational interventions to improve health promotion behaviors based on this model is essential.

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.

Factors influencing the consumption of fruits and vegetables in diabetic patients based on Pender's health promotion model.

BACKGROUND: To control blood sugar and prevent complications related to diabetes, eating fruits and vegetables in standard amounts is recommended. The aim of this study was to investigate the factors affecting the consumption of fruits and vegetables in diabetic patients based on the Pender health promotion model. MATERIALS AND METHODS: This cross-sectional study was conducted on 260 diabetic patients in Sirjan; one of the cities of Kerman in Iran in 2020. To collect data, a researcher-made questionnaire of Pender's Health Promotion Model and a standard Behavioral Risk Factor Surveillance System questionnaire were used to measure fruit and vegetable consumption. Data were analyzed using SPSS24 software. Data were analyzed using t-test, Pearson correlation coefficient, linear regression, and path analysis. Significance level <0.05 was considered. RESULTS: The study showed that 71.5% of patients consumed fruits three or more times and 52.3% consumed vegetables per week. Employment, income, education, and gender were significantly associated with fruit and vegetable consumption (P < 0.05). Perceived barriers (P < 0.0001, ß =0.23), self-efficacy (P < 0.0001, ß =0.32), and commitment to action plan (P = 0.002, ß =0.20) were the main predictors of fruit and vegetable consumption. CONCLUSION: In this study, self-efficacy was the strongest predictor of fruit and vegetable consumption in diabetic patients. Therefore, it is necessary to consider health education as well as health promotion interventions based on these variables is considered to increase the consumption of fruits and vegetables for diabetic patients.

Evaluation of a self-care education program for older adults in Iran using a lifestyle improvement model.

BACKGROUND: Older adults and their caregivers often believe it is either too late or too difficult to make health-focused lifestyle changes. However, this is inaccurate, as older adults can make health promotion focused lifestyle changes thereby improving their health. This study developed and evaluated a self-care education program using Pender's Health Promotion Model and its influence on health-focused behaviour changes among older Iranians. METHOD: This was a quasi-experimental study with a convenience sample of 136 community-living older adults from Tabriz, Iran. The participants were randomly assigned to either an intervention (n = 69) or control (n = 67) group. Chi-square test, independent t tests and Analysis of covariance (ANCOVA) statistical methods were used to compare pre- and post-intervention data, control and intervention groups and changes over time. The intervention was an eight-week educational program with pre- and post-intervention data collected using the Health Promoting Lifestyle Profile II (HPLP II) questionnaire. RESULTS: The mean difference and confidence limits of the older adults' health behaviours pre- and post-intervention scores were 2.228 (-5.450 - 9.916) and - 35.820 (-32.051 - 39.588). The covariance analysis adjusting for the baseline values showed significant differences post-intervention (p<0.0001) in the areas of interpersonal communication, physical activity, nutrition, stress management and spiritual growth. CONCLUSION: The health promotion education intervention illustrated that older Iranians could improve their health outcomes in several areas. Thus, culturally tailored intervention programs can be successful in challenging the opinion that older adults cannot make behaviour changes supporting their health.

Applying the Pender's Health Promotion Model to Identify the Factors Related to Older Adults' Participation in Community-Based Health Promotion Activities.

Aging societies have garnered global attention regarding issues related to older adults' health promotion. This cross-sectional study aimed to identify factors associated with older adults' participation in community-based health promotion activities. The Older Adults' Health Promotion Activity Questionnaire was developed to collect data, and a total of 139 older adults were recruited from a community care center in Taoyuan City. Participants' mean age was 72.7 years (SD = 6.0 years), 74.8% were females, 64.7% were married, 59% had a lower level of education, 51.8% had lower income, 59% reported their health status not good, and 76.3% had chronic disease. Our findings indicated that age, perceived benefits, and self-efficacy were identified as significant predictors of participation in health promotion activities. Among them, perceived benefits were found to have the strongest association with participation in health promotion activities (ß = 0.305; p < 0.05). The findings showed that the Pender's Health Promotion Model is useful to provide information for predicting and detecting significant factors related to older adults' participation in community-based health promotion activities. By using this model as a framework, researchers can design more specific studies that are directed towards improving healthy lifestyles and detecting the key components of health-related behaviors among different age groups.

Improving Hand Hygiene Compliance of Intensive Care Unit by Using Pender's Model.

BACKGROUND: Hand hygiene (HH) compliance is an effective behavior in controlling hospital-acquired infection because the hand is the main means of transmitting infections in patient-medical staff communication as well as the inanimate environment. This study aimed to explore the effect of applying Pender's Health Promotion Model on the HH compliance of intensive care unit staff. METHODS: This quasi-experimental study with a single research group was conducted from January to July in 2019. The required data were collected from 90 staff of the intensive care units of Imam Reza Hospital in Mashhad, Iran through 1796 and 2343 opportunity of monitoring before and after the intervention. The data collection instruments were a standard HH observation form and a researcher-made HH questionnaire in the light of Pender's health promotion model. The data were statistically analyzed in SPSS using Paired-samples T-test and Chi-squared test. RESULTS: The mean age of the 90 included participants was 35.92 (± 6.5) years and the mean length of their work experience was 10 (±1.5). The hand hygiene index rose from 23% before the intervention to 41.4% after the intervention (p=0.001). Moreover, statistically significant differences were found in moments after touching surroundings (p=0.001), before and after touching a patient (p=0.001), and also in perceived barriers (p=0.015), interpersonal influences (p=0.008) and situational influences (p<0.001). CONCLUSION: Pender's model showed to have improved the staff's HH compliance as a professional behavior.

Effect of a theory-based educational intervention for enhancing nutrition and physical activity among Iranian women: a randomised control trial.

OBJECTIVE: The relative contribution of health promotion models (HPM) to improve health-related behaviours in intervention programmes is still limited. Here, we tested whether Pender's HPM operationalised in the educational intervention was effective to modify nutrition and physical activity (PA) behaviours among Iranian women. DESIGN: A randomised controlled field trial evaluating the efficacy of an educational intervention based on Pender's HPM to improve PA and nutrition behaviours from August 2016 to October 2016. R version 3.0.2 and SPSS version 16 were used to conduct multiple statistical analyses. SETTING: Ten public healthcare centres in Bojnourd, Iran were randomly divided into intervention and control groups. The experimental group received the full intervention programme, which included nine 4-h training sessions and consulting support via phone contact and social media group. The control group did not receive any intervention. PARTICIPANTS: Women aged 4-6 years (n 202) were randomised to intervention (n 102) and control conditions (n 100) and completed baseline and 3-month follow-up. RESULTS: In the experimental group, the intervention programme had a significant effect (P < 0·05) on all construct of Pender's HPM and behaviour outcome, and the estimates for prior behaviours, self-efficacy, interpersonal influences, feeling, perceived benefits and barriers, commitment and behaviour outcomes in the intervention group were 0·72 (95 % CI 0·31, 0·98), 0·54 (95 % CI 0·27, 0·71), 0·74 (95 % CI 0·27, 0·91), 0·52 (95 % CI 0·19, 0·75), 0·62 (95 % CI 0·22, 0·91), 0·63 (95 % CI 0·30, 0·86) and 0·56 (95 % CI 0·37, 0·85), respectively. CONCLUSIONS: Educational intervention based on Pender's HPM was feasible and highly acceptable to modify PA and nutrition behaviours in the women population.

Designing and evaluation of E-health educational intervention on students' physical activity: an application of Pender's health promotion model.

BACKGROUND: The present study was conducted to design and evaluate the software and web-based curriculum based on Pender Model in order to promote students' physical activity. METHODS: This is a quasi-experimental study conducted on 225 eligible students who were randomly divided into two groups of web and software-based intervention and control. The sample size of the study was selected using stratified sampling method. The evaluation was done with pre-test and post-test and follow-up, which were performed immediately two and six months following the intervention. The data were analyzed employing statistical software SPSS using descriptive statistics, chi-square, one way ANOVA, and repeated measures ANOVA. RESULTS: The obtained results revealed that the level of physical activity after the intervention in the web and software groups significantly increased compared to the control group (p < 0.001). Moreover, the mean score of Pender model constructs, immediately two and six months after the intervention, was significantly different in the web and software groups (p < 0.001). CONCLUSION: Our results indicated that, providing tailored message based on health promotion model's constructs has a positive effect on promoting physical activity of students. TRIAL REGISTRATION: Name: Iranian Registry of Clinical Trials. Registration number: IRCT20181009041298N1 . Registration date: 2018-12-02 [retrospectively registered].