Effect of educational intervention based on PRECEDE model on lifestyle modification, self-management behaviors, and hypertension in diabetic patients.

BACKGROUND: Inappropriate lifestyle and poor self-management in diabetic patients lead to many complications including hypertension and increased disease burden. Because of insufficient studies on Effect of educational interventions on lifestyle, self-management and hypertension in diabetic patients, the present study aimed to evaluate the Effect of educational intervention based on PRECEDE model on lifestyle, self-management, and hypertension of diabetic patients. METHODS: This clinical trial was conducted on 300 diabetic patients with hypertension. The patients were selected using simple random sampling and divided into 2 groups of intervention (150 people) and control (150 people). The intervention group was trained through ten 50-55 min sessions on lifestyle skills, self-management, and hypertension control based on the PRECEDE model. Before and after the intervention, lifestyle skills, self-management, and PRECED model constructs were evaluated using a standard questionnaire. Data were analyzed by SPSS 20 software using t-test, Kolmogorov-Smirnov, and Chi-Square tests (P < 0.05). RESULTS: In the intervention group, the mean score of different dimensions of lifestyle and self-management significantly increased from 110.45 ± 18.78 to 172.58 ± 186.66 and 64.33 ± 15.24 to 144.32 ± 15.82, respectively (P = 0.001). Mean systolic and diastolic blood pressure also decreased from 148.5 ± 5.39 to 123.54 ± 5.32 and 95.41 ± 3.12 to 72.24 ± 3.06 (P < 0.001). Moreover, the mean score of all the PRECEDE model constructs significantly increased after the intervention. In the control group, the mean score of the PRECEDE model constructs, the dimensions of lifestyle, self-management, and systolic and diastolic blood pressure did not change significantly before and after the intervention (P > 0.05). CONCLUSION: | Based on the study's results, the PRECEDE model was found to be a non-invasive, non-pharmacological, cost-effective method without any complication and as a complementary action along with other methods in the treatment of diabetic patients.

Effects of online social media on improving mothers' behaviors towards preventing their children's otitis media based on the PRECED model: a randomized educational intervention trial.

BACKGROUND: Otitis media is one of the most common diseases in children, especially those under 2 years of age. This study aimed to investigate the effect of educational intervention based on the PRECEDE model on mothers' preventive behaviors of middle ear infections in infants. METHODS: This study was conducted as an educational randomized controlled trial on 88 mothers with infants referred to health centers in Arak, Iran. Sampling from September 2021 to February 2022 selected trough stratified random sampling who were assigned to two groups of experimental = 44 and control = 44. The data collection tool was a reliable and valid questionnaire that included demographic information, constructs of PRECEDE model regarding otitis media, and preventive behaviors. The experimental group received 4 training sessions (each session 60 min) through WhatsApp social network. Information was collected through an online questionnaire before and 3 months after the educational intervention from both groups. Data analysis was also performed with SPSS version 23. RESULTS: Before the educational intervention there was no significant difference between the experimental and control groups in the otitis media preventive behaviors and structures of PRECEDE model (p > 0.05). After the educational intervention, in the experimental group the average score of knowledge from 0.49 to 0.81, attitude from 4.01 to 4.58, enabling factors from 0.72 to 0.85, reinforcing factors from 3.31 to 3.91 and behavior from 3.25 to 3.66 increased significantly (p < 0.001). CONCLUSIONS: PRECEDE-based education with controlling, monitoring and follow-up during the program was effective in promoting the preventive behaviors of otitis media. Therefore, due to the side effects of otitis media, especially in vulnerable periods such as childhood, it is recommended that trainings based on this model be carried out in other health care centers and clinics in order to maintain children health. TRIAL REGISTRATION: This trial has been registered at the Iranian Registry of Clinical Trials, IRCT20210202050228N1. Prospectively registered at 2021-May-21, (2021/05/21) available at: URL: https://en.irct.ir/trial/54073 .

Determinants of stress coping behaviors in patients with Multiple Sclerosis (MS-DSCB): development and psychometrics of a PRECEDE model-based questionnaire.

OBJECTIVE: Stress management delays the onset or exacerbation of symptoms of multiple sclerosis. The present study aimed to develop and psychometrically evaluate a questionnaire to measure the determinants of stress coping behaviors in patients with multiple sclerosis. METHODS: This was a methodological study that was conducted in two stages: qualitative and quantitative phases. Participants in this study were patients with multiple sclerosis who referred to the MS Association and Charity Foundations for Special Diseases in Isfahan in 2021. Preliminary item pool was developed by qualitative part of the study. The validity of the questionnaire was determined with item impact, content validity ratio (CVR), content validity index (CVI), face validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS: In the first stage, an item pool containing 97 items were generated and after removing duplicate items and merging some of them, a questionnaire containing 51 items was developed. Ten items were removed based on the results of face validity and content validity. The EFA revealed 11 factors containing 41 items that explained 64% of the total variance of test. In CFA, 9 other items were deleted, and the questionnaire was reduced to 32 phrases in general. The results of the CFA determined the 9-factor structure of the questionnaire including awareness, attitude, self-efficacy, access to resources, skills of using resources, social support, important others, behavioral consequences and social comparison. The Cronbach's alpha coefficient of the questionnaire was 0.726. CONCLUSION: The results showed that the designed questionnaire is a valid and reliable tool for assessing the determinants of stress coping behaviors in patients with multiple sclerosis. Identifying these factors and designing interventions based on them, in order to control or reduce stress in these patients, can help to improve the quality of life in these patients.

Exploring the factors affecting preschool educators' health teaching capacity of life skills using the PRECEDE model: a study of preschool educators in northern Taiwan.

BACKGROUND: The purpose of this study was to apply the Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model to analyze the factors influencing preschool educators' ability to teach health education through life skills. METHODS: This cross-sectional study utilized stratified random sampling and administered survey questionnaires to 503 preschool educators in public and private kindergartens in Taipei City and New Taipei City in 2019. Descriptive and hierarchical regression analyses were conducted. The PRECEDE model demonstrated a significant correlation between the enabling, reinforcing, and predisposing factors explored in this study and the preschool educators' ability to teach health education through life skills. RESULTS: The variables explained 25% of the total variance in the ability to teach health education through life skills. When controlled in individual layers, the background variables and the enabling, reinforcing, and predisposing factors demonstrated explanatory powers of 6, 5, 7, and 7%, respectively, with respect to the ability to teach health education by utilizing life skills. CONCLUSIONS: Enhancement of the enabling, reinforcing, and predisposing factors can improve preschool educators' ability to teach health education through life skills. The support provided by the governmental policies for related training can facilitate the effective implementation of health promotion programs in kindergartens. Preschool educators must also receive on-the-job training to facilitate the effective transaction of the health education curriculum. Health classes centered on life skills in kindergartens are vital and must be incorporated into the curricula.

Explaining stress coping behaviors in patients with multiple sclerosis based on the PRECEDE model: a qualitative directed content analysis.

BACKGROUND: Stress can be regarded as one of the consequences of Multiple Sclerosis (MS) and a factor in exacerbating or recurring the symptoms resulting from the disease. This study aimed to explain the stress coping behaviors in patients with MS based on the PRECEDE model. METHODS: This study is a qualitative directed content analysis research based on the PRECEDE model. Data were obtained through in-depth semi-structured interviews with 26 patients with MS, who were selected using a purposive sampling and maximum diversity in terms of gender, age, education, marital status, and employment. Data collection continued until the saturation occurred. Simultaneously, collected data were analyzed using a qualitative directed content analysis method. RESULTS: Data analysis led to the identification of 11 sub-categories. Of these, 10 sub-categories were assigned to three categories of predisposing factors (awareness, attitude, self-efficacy, and perceived severity), enabling factors (existence of resources, access to resources, skills of using resources, and educational preferences), and reinforcing factors (social support, important others and behavioral consequences). The social comparison category was a new category identified from the analysis of interviews. CONCLUSIONS: Based on the results, individual, environmental and social factors play a role in the stress of these patients. Designing programs that lead to their empowerment and improvements in the environmental and social conditions can be effective in controlling stress in these patients. Based on the results, planners can adopt the most appropriate strategies to change these determinants, help reduce stress, and promote the psychological standard of living in these patients.

The effect of nutrition education based on PRECEDE model on iron deficiency anemia among female students.

BACKGROUND: Iron deficiency anemia disrupts the concentration of adolescent girls; reduces their academic achievement, productivity, and physical strength, and increases the risk of infection. This research aim was to evaluate the effectiveness of the PRECEDE model nutrition education on iron deficiency anemia among female students of Fasa City, Fars Province, Iran. METHODS: This quasi-experimental study was done on 160 students (80 experimental and 80 control groups) who were selected using a random sampling method in Fasa City, Fars Province, Iran, in 2018-2019. The educational intervention included six sessions based PRECEDE model for 45 or 50 min. A scale of this study consisted of two parts; demographic information, and PRECEDE constructs were used to determine the nutritional behaviors status concluding preventing iron deficiency anemia and hemoglobin, hematocrit, and ferritin blood level in two (before and 4 months after intervention) times. RESULTS: In the experimental group of the students the mean age was 13.85 + 1.72 years and in the controlled group was 13.60 + 1.81 years. Moreover, there was no significant difference in the PRECEDE constructs, and nutritional behaviors preventing iron deficiency anemia before the intervention in two groups of study. However, the experimental group showed a significant increase 4 months after the intervention. Also, there was no significant difference in the mean score of hemoglobin, hematocrit, and ferritin blood level between the two groups before the intervention. However, in ferritin level, a significant increase was shown in 4 months after the intervention in the experiential group. CONCLUSIONS: Based on results, the nutrition intervention education base on PRECEDE model has a positive effect to improve iron deficiency anemia preventive behaviors in female students.

Development and validation of the tool for the evaluation of the behavioral factors affecting the prevalence of musculoskeletal disorders in Iranian students.

BACKGROUND: This study was conducted with the aim of developing a standard and valid questionnaire to evaluate the behavioral factors affecting musculoskeletal disorders among adolescent students based on the educational and ecological diagnosis phase of the PRECEDE model. METHODS: Based on the PRECEDE model and by using available resources and a panel of experts, a reservoir of items was proposed. The content validity of the questions was measured using content validity ratio (CVR) and content validity index (CVI). 400 Iranian first-year female high school students completed the questionnaire. The construct validity was assessed using confirmatory factor analysis (CFA). The reliability of the questionnaire was evaluated using Cronbach's alpha coefficient. RESULTS: The age range of study students was 13.69 ± 0.86 years. The final developed questionnaire included 25 items in three dimensions: knowledge (9 items), attitude (10 items) and enabling factors (6 items). The mean scores of CVI and CVR were 0.97 and 0.92, respectively. The results of CFA confirmed the three-factor structure of the questionnaire. The Cronbach's alpha coefficients of the dimensions of knowledge, attitude and enabling factors were 0.65, 0.80 and 0.71, respectively. CONCLUSIONS: The present questionnaire had appropriate psychometric properties and could be used as a valid tool in evaluating the factors affecting the development of musculoskeletal disorders among adolescent students.

The Effect of an Educational Intervention Based on PRECEDE Model on Oral Cancer Prevention Behaviors in Hookah Users.

Educational intervention about oral cancer prevention is essential for all people, especially in hookah users. The aim of this study is investigating the effect of an educational intervention based on PRECEDE model on oral cancer prevention in hookah users living in Fasa, Fars Province, Iran, in 2017-2018. In this quasi-experimental study, 360 hookah users were selected and divided into experimental and control groups (180 subjects for each group). Educational intervention was performed for experimental group in 12 sessions. A questionnaire consisting of items evaluating demographic information and PRECEDE model constructs (knowledge, attitude, self-efficacy, enabling factors, and reinforcing factors) was used to measure oral cancer prevention behaviors and nicotine dependency of subjects before and 6 months after intervention. Obtained data were analyzed by SPSS-22 software through paired t test, independent t test, and chi-square test at significance level of P < 0.05. Six months after intervention, experimental group showed significant increase in knowledge, attitude, self-efficacy, enabling factors, reinforcing factors, oral cancer prevention behaviors, and reduction of nicotine dependency compared with control group. This study showed the efficiency of educational intervention based on PRECEDE model in adoption of oral cancer prevention behaviors and reduction of nicotine dependency of hookah users 6 months after intervention.

The Effect of Educational Program Based on PRECEDE Model in Promoting Prostate Cancer Screening in a Sample of Iranian Men.

Prostate cancer is one of the most prevalent diseases among men. This study aimed to assess the effect of educational program based on Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation (PRECEDE) model in promoting prostate cancer screening in a sample of Iranian men. This is a quasi-experimental study carried out on 300 men aged 40 to 70 (the subjects 150 experimental and 150 control groups) in Shiraz City, Fars Province, Iran, in 2016. The participants of the intervention group attended training based on the PRECEDE model. The study compared mean scores of knowledge, attitude, enabling factors, perceived social support, quality of life, general health, self-efficacy, and screening behaviors of the subjects before and 6 months after intervention in experimental and control groups. The mean age of experimental group was 56.45 ± 8.65, and the mean age of the control group was 55.64 ± 8.71 years (P = 0.521). The study showed that there was a significant increase in the mean score of knowledge, attitudes, perceived self-efficacy, enabling factors, perceived social support, quality of life, public health and screening behaviors of the experimental group; however, no significant change was observed in the mean score of knowledge, attitudes, self-efficacy, quality of life, general health, perceived social support, enabling factors, and screening behaviors of the control group. Our findings showed that the health education programs designed based on PRECEDE could positively affect prostate cancer screening behaviors of individuals by improving their knowledge level and attitude, enabling factors, perceived social support, quality of life, general health, and self-efficacy.

The Effect of Educational Intervention Based on PRECEDE Model on Promoting Skin Cancer Preventive Behaviors in High School Students.

School-based education programs can be an effective way of educating adolescents about the dangers of exposure to sunlight and about preventive measures against this exposure and its relation to skin cancer. The aim of this study is to survey the effect of educational intervention based on the PRECEDE model on promoting skin cancer preventive behaviors in high school students of Fasa City, Fars Province, Iran. In this quasi-experimental study, 300 students (150 in experimental group and 150 in control group) in Fasa City, Fars Province, Iran, were selected in 2016-2017. The educational intervention for the experimental group consisted of six training sessions. A questionnaire consisting of demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure skin cancer preventive behaviors before and 4 months after the intervention. Data were analyzed using SPSS 22 and paired t test, independent t test, and chi-square test at a significance level of p < 0.05. The mean age of the students was 16.05 ± 1.76 years in the experimental group and 16.20 ± 1.71 years in the control group. Four months after the intervention, the experimental group showed a significant increase in the knowledge, attitude, self-efficacy, enabling factors, social support, and skin cancer preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the PRECEDE constructs in adoption of skin cancer preventive behaviors in 4 months post-intervention in students. Hence, this model can act as a framework for designing and implementing educational intervention for the prevention of skin cancer.

Can education improve clinical practice concerning delirium in older hospitalised patients? Results of a pre-test post-test study on an educational intervention for nursing staff.

BACKGROUND: Delirium is a common and serious complication of hospitalisation in older adults. It can lead to prolonged hospital stay, institutionalisation, and even death. However, it often remains unrecognised or is not managed adequately. The aim of this study was to evaluate the effects of an educational intervention for nursing staff on three aspects of clinical practice concerning delirium in older hospitalised patients: the frequency and correctness of screening for delirium using the 13-item Delirium Observation Screening score (DOS), and the frequency of geriatric consultations requested for older patients. The a priori expectations were that there would be an increase in all three of these outcomes. METHODS: We designed an educational intervention and implemented this on two inpatient hospital units. Before providing the educational session, the nursing staff was asked to fill out two questionnaires about delirium in older hospitalised patients. The educational session was then tailored to each unit based on the results of these questionnaires. Additionally, posters and flyers with information on the screening and management of delirium were provided and participants were shown where to find additional information. Relevant data (outcomes, demographics and background patient data) were collected retrospectively from digital medical files. Data was retrospectively collected for four different time points: three pre-test and one post-test. RESULTS: There was a significant increase in frequency of delirium screening (P = 0.001), and both units showed an increase in the correctness of the screening. No significant effect of the educational intervention was found for the proportion of patients who received a geriatric consultation (P = 0.083). CONCLUSION: The educational intervention was fairly successful in making positive changes in clinical practice: after the educational session an improvement in the frequency and correctness of screening for delirium was observed. A trend, though not significant, towards an increase in the proportion of geriatric consultations for older hospitalised patients was also observed.

Effectiveness of a PRECEDE-based education intervention on quality of life in elderly patients with chronic heart failure.

BACKGROUND: One of the most important challenges in public health is to improve the quality of life in patients with chronic heart failure (CHF). Depression, self-care capacity, and quality of life interact each other in these patients. It's difficult to treat with general education programs and conventional therapy. PRECEDE model is a comprehensive and exclusive theory-based education programs. Its effectiveness for reducing depression and increasing quality of life has been demonstrated in patients with coronary artery bypass grafting, type 2 diabetes, and the elderly. It has not been used in elderly patients with CHF. Thus, this study aims to investigate the effects of this model on self-care behaviors, depression, and quality of life in these patients. METHODS: Patients who met the inclusion criteria were randomly assigned to the intervention or control group. All the patients received conventional medical care. The patients in the intervention group also received 9 sessions of education intervention based on the PRECEDE model and then followed up for 3 months after the intervention. Data were collected before and 3 months after the intervention using 4 questionnaires, namely a PRECEDE-based questionnaire to evaluate predisposing, reinforcing, and enabling factors; the 9-item European Heart Failure Self-care Behavior Scale (EHFScBS-9); the 9-item Personal Health Questionnaire (PHQ-9); and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). RESULTS: No significant differences were found in the mean scores for the predisposing, enabling, and reinforcing factors, and the mean total scores in EHFScBS-9, PHQ-9, and MLHFQ before the intervention between the intervention and control groups. After the intervention, the scores for the predisposing, reinforcing, and enabling factors increased significantly, and the mean total scores in EHFScBS-9, PHQ-9, and MLHFQ decreased significantly in the intervention group. In addition, these scores significantly differed from those of the control group. Furthermore, the MLHFQ score significantly correlated with the EHFScBS-9 and PHQ-9 scores. CONCLUSION: This study demonstrates a trend that PRECEDE model of health education promotion is effective in relieving depression symptoms, enhancing self-monitoring, and improving the quality of life of elderly patients with CHF. TRIAL REGISTRATION: Trial registration number: ChiCTR-IOR-17012779 ; Trial registry: Chinese Clinical Trial Registry; Date registered: 22 Sep 2017; Retrospectively registered.

The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran.

AIM: The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. MATERIAL AND METHODS: It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t-test, and χ2 were used. RESULTS: The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors (p < 0.001), enabling factors, reinforcing factors and behavioral factors were significantly increased (p < 0.001) as compared to the control group. A significant difference was observed in the mean scores of quality of life in two groups after the intervention (p < 0.001), and the quality of life of patients in the experimental group was improved after the training intervention. CONCLUSIONS: The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

The effect of mothers education program based on the precede model on the mean weight in children (6-12 months) at health centers in Shiraz, Fars Province.

BACKGROUND: Growth retardation in children is a result of nutritional ignorance, inappropriate care, and inadequate monitoring of growth monitoring. This study was performed to assess the effect of mothers education program based on the precede model on the mean weight of children (6-12 months) at health centers in Shiraz, Fars Province. METHODS: This quasi experimental study was conducted on 120 mothers (60 in the experimental and 60 in the control group) with single child and exclusively on breast feeding who were cared by health centers in Shiraz, Fars province. The data were gathered through a questionnaire which included demographic characteristics, the components of the precede model (knowledge, attitude, enabling as well as reinforcing factors, and maternal function) and child weight. Educational intervention was performed during 6 sessions each of which lasted for 55 to 60 minutes. The questionnaire was completed by the experiment a land control group before and 4 months after the training program. RESULTS: The results showed that the educational intervention program in the experimental group caused significant increase in the means of knowledge (p<0.001) and attitude scores (p<0.001). This study showed that enabling and reinforcing factors (and training sessions), performance score of mothers as well as weight of children among experimental group were significantly higher than control group (p=0.01). CONCLUSION: The results of this study can be used as a guideline prevents growth retardation in health centers and other related organizations.

Risk perception and preventive behaviors related to brucellosis among Iranian livestock farmers.

Background and Aims: Brucellosis is one of the zoonotic diseases that endanger the health of the population, particularly in developing countries. This study aimed to assess risk perception and behaviors of livestock farmers on brucellosis based on PRECEDE model in a rural area in the northwest of Iran. Methods: This was a cross-sectional study conducted with 365 livestock farmers in rural areas of Germi, Iran. Participants were selected random sampling method. Data were gathered using a PRECEDE model based questionnaire consisted of five sections including demographic characteristics, predisposing factors (knowledge and attitudes), reinforcing factors, enabling factors, and brucellosis preventive behaviors. Results: The mean ± SD of age of participants was 47.1 ± 14.7 years. The state of knowledge about preventive behaviors and ways of disease transmission was evaluated as appropriate (with 87% and 81% of the maximum score, respectively). Three aspects of attitude in participants were desirable. Predisposing factors including knowledge of prevention ways, knowledge of transmission ways, and attitudes toward prevention, reinforcing factors, as well as education were significant predictors of brucellosis preventive behaviors. R 2 and adjusted R 2 were 0.312 and 0.310, respectively, according to which, about 31% of the changes in the brucellosis preventive behaviors explained by significant dependent variables. Conclusions: Given that farmers are at particular high risk of exposing brucellosis, improving their knowledge and desirable attitudes of brucellosis is crucial to increasing control the disease.

Potential Factors of Primary Hospital Healthcare Professionals in Hindering the Abolition of Routine Skin Test for Cephalosporin: A Cross-Sectional Study.

Background: In 2021, National Health Commission of the People's Republic of Chinese issued a document that no longer recommended the routine skin test for cephalosporin (RSTC). However, there is still resistance to the cancellation of RSTC in a primary hospital. The study aimed to explore the potential factors for hindering the abolition of the RSTC in a county-level hospital based on the PRECEDE model. Methods: The cross-sectional study was conducted on healthcare workers in the Pidu District People's Hospital, Chengdu, by online questionnaire from September 10 to September 25 in the 2021.The PRECEDE model was used to divide the potential factors of healthcare professionals in hindering the abolition of the RSTC into predisposing factors, enabling factors and reinforcing factors. Data were analyzed by ANOVA, Chi-square test, multiple linear and multiple logistic regression analysis. Results: We collected 605 respondents' valid questionnaires. 254 healthcare professionals were against cancellation of the RSTC, accounting for 41.98%. Multiple linear regression analysis showed that working for 6~10 years (ß = 1.953, P = 0.024), medium (ß = 1.995, P = 0.030) or senior (ß = 4.003, P = 0.007) professional qualification, pharmacists (ß = 3.830, P = 0.013) and working in surgical department (ß= 4.462, P < 0.001) were significantly associated with higher score of predisposing factors, enabling factors, and reinforcing factors on abolition of RSTC. Furthermore, multiple logistic regression analysis showed that pharmacists (OR=3.113, 95% CI: 1.341-7.223, P=0.030), medium professional qualification (OR=1.272, 95% CI: 0.702-2.302, P=0.008), scores of predisposing factors (OR=1.335, 95% CI: 1.033-1.726, P=0.009), and scores of enabling factors (OR=1.208, 95% CI: 1.109-1.315, P<0.001) were independently associated with the positive anticipated behavior on the abolition of RSTC. While nurses (OR=0.516, 95% CI: 0.284-0.938, P<0.001) were independently associated with anticipated negative behavior. Conclusion: Pharmacists, medium professional qualification, and healthcare professionals with higher scores of predisposing and enabling factors were more likely to have a positive anticipated behavior on the abolition of RSTC, while nurses did not.

The Effect of Educational Intervention Based on PRECEDE Model on Health Promotion Behaviors, Hope Enhancement, and Mental Health in Cancer Patients.

In this experimental study, 200 cancer patients (100 subject in experimental group and 100 subjects in control group) referred to Amir Oncology Hospital in Shiraz were investigated. Educational intervention for experimental group consisted of 12 educational sessions for 50 to 55 minutes. A questionnaire including demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure health promotion behaviors, patients' hope, and mental health before and 6 months after intervention. Six months after intervention, experimental group showed significant increase in knowledge, attitude, self-efficacy, enabling factors, social supports, health promotion behaviors, patients' hope, and mental health compared to the control group. This study showed the effectiveness of intervention based on PRECEDE constructs in mentioned factors 6 months after intervention. Hence, this model can act as a framework for designing and implementing educational intervention for health promotion behaviors of cancer patients.

Identification of Health Characteristics of People with Physical Disability by Applying the PRECEDE Model.

This study aimed to diagnose the health characteristics of people with grade 1-4 physical disability (but without intellectual disability) by analyzing factors affecting their health through social, epidemiological, behavioral, and ecological diagnoses by partially applying the PRECEDE model. Those registered with physical disability in 2022 and attending a welfare center were selected, with samples extracted from Seoul, Gyeonggi-do, Chungcheong-do, Jeolla-do, and Gyeongsang-do. A total of 1200 people were selected, and the data of 1000 people were finally analyzed. A frequency analysis was performed to identify the participants' characteristics. An independent t-test and one-way analysis of variance were performed to verify the hypotheses. To clarify the relationship between each variable, normality verification, confirmatory factor analysis, and structural equation model analysis were performed. First, the differences in factors influencing health promotion according to personal background variables (gender, age, and income level), including quality of life, showed partial differences according to age and income level. Second, according to disability-related variables (time of onset and disability grade), quality of life and health status showed partial differences. These results can be used as basic data or indicators to build a health promotion system that considers the health characteristics of individuals with a physical disability.

The Application of PRECEDE Model on Preventing Osteoporosis in Women.

The aim of this study is investigating the efficiency of educational intervention based on PRECEDE model on promotion of osteoporosis prevention behaviors in women. This quasi-experimental study was conducted on 200 women registered in two health centers of Fasa city, Fars province, Iran in 2017 to 2018. A questionnaire including items evaluating demographic information and PRECEDE model constructs was used for measuring nutrition and walking performance of studied women in osteoporosis prevention before and 12 months after intervention. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and 12 months after intervention. One year after intervention, the intervention group showed a significant increase in knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, nutrition, and walking performance compared to the control group. Also, the value of lumbar spine and hip BMD T-Score of the intervention group was increased, while this value was reduced in the control group. Our findings showed that educational interventions based on PRECEDE model can positively affect prevention behaviors from osteoporosis by improving subjects' knowledge, attitude, enabling factors (resources such as health care access and services that can provide motivation for prevention behaviors from osteoporosis in women), self-efficacy, and reinforcing factors.

Effect of education based on "PRECEDE" model on self-care behavior in hemodialysis patients.

BACKGROUND AND OBJECTIVE: Patients undergoing hemodialysis due to multiple drug therapies, special diet plans, and need to acquire the ability to adapt to physical and mental disabilities require special monitoring. The PRECEDE-PROCEED model is a process for behavior change and can lead to the promotion of self-care behavior. The aim of this study was to evaluate the effect of a health promotion program based on the PRECEDE-PROCEED model on self-care behaviors in hemodialysis patients. METHODS: This was a clinical trial study that was performed on 67 patients undergoing hemodialysis in Lordegan Hospital that has been distributed in two groups randomly. Data were collected using self-care assessment form according to the PRECEDE-PROCEED model. Based on the results of this questionnaire, five educational sessions were held in the fields of knowledge, attitude, enabling factors, reinforcement, and behavioral factors for the samples. Data were analyzed using descriptive and analytical statistics with SPSS version 21 software. RESULTS: According to statistical analysis before intervention, no significant difference was observed between the mean scores of self-care among the two groups. However, instantly and 3 months after intervention, the mean score of self-care (P = 0/03), knowledge, attitude, reinforcement factors, and behavioral factors (P < 0.05) significantly increased in the experimental group. CONCLUSION: Based on the results of this study PRECEDE-PROCESS model, the health promotion program increased the mean self-care score of hemodialysis patients. This program has been able to improve their self-care behaviors by changing knowledge, attitudes, and reinforcement and behavioral factors of patients and is recommending as an application in the nursing of these patients.