We live in a 21st-century world, a world of technological advancement. We don’t have enough time to sit down and eat with a family member. Everyone is working at a fast pace and a compact schedule. Therefore, the food we eat is also not nourishing and healthy. We lean to easy fast foods, pre-packaged foods which nutrient content not comparable to the food we cook from scratch with fresh vegetables, legumes, and grains. Our body needs nourishment and energy and we get that from the food we eat. Choosing a healthy well-balanced diet from the beginning of life is important and beneficial to maintain a good healthy life. Unhealthy poor eating habits lead to many problems in life such as the risk for hypertension from consuming a diet with high sodium, and cardiovascular problems from consumption of high fat intake and obesity and Diabetes. Therefore, establishing a healthy habit of well nutritious and balanced eating habit from early childhood can lead to a healthier life in the future and prevent lots of health problems in the long run.
This study was conducted in Iran in 2014, the purpose of this study is to find out the effect of education based on Pender’s health promotion model on nutrition behavior of adolescent student females. The study was done on 128 adolescent of Omidiyeh. City Khuzestan province, Iran. These 128 adolescent females were divided into two groups of 64-student female chosen for the control group and the rest of 64-student female for the intervention group. The sampling of all these female students was done by random gathering from three female schools from Omidiyeh, one of the high schools was for the experimental group and other two female schools for the control group, the classes were selected randomly. The mean age group in the experimental group was 14.9±0.7 and in the control group 15.2±0.7. The mean body mass index was 20.8 ±3.5 in the experimental group and 20.2±2.8 in the control group. All consent from parents; students and teacher were obtained before the study. The initial sample size was 175 female, a total of 75 in each group. Students who did not continuously participate in the educational session were excluded. Therefore, a total of 128 students was the final study.
The instruments used to measure the health behavior were questionnaires, group discussions, education sessions, t and chi tests to analyze data. The questionnaires designed were based on Pender's Health Promotion Model structures such as healthy nutrition behavior, perceived benefits of behavior, perceived barriers, self-efficacy, and interpersonal influences. It consists of a student's demographics, information about age, BMI, parent’s background of education and job and income. Health-promoting behavior section had used 4 questions to assess compliance to healthy eating behaviors options like any day of the week, 6- 7 days a week, scores ranging from 4 (highest level of respect for healthy nutrition) to 20 (lowest level of respect for healthy nutrition). For perceived barriers and self-efficacy, 8 questions based on Likert Scale from 1 to 5 points, 1 meaning strongly agree and 5 meaning strongly disagree. For perceived benefits section of the questionnaire, 7 questions scores were ranging from 7 to 35 points and 2 questions on interpersonal norms. The first face of data collection was the questionnaires were distributed among female student and provided sufficient time to finish questionnaires. The second phase was given 4 educational sessions for the samples and 4 educational sessions for mothers. Based on Pender’s Health Promotion Model, students were provided teaching on eating a healthy diet and choosing nutritious foods and obtaining healthy behaviors and educated on the risk of health problems of unhealthy. Moreover research and scientific sources, group discussions were used.
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As per Bastable, 2019; Pender’s Health Promotion Model, “emphasis on actualizing health potential and increasing the level of well-being using approach behaviors rather than avoidance of disease behaviors distinguish this model as focusing on health promotion rather than disease prevention.” (pg. 237) The outcome of this study using Pender's Health promotion Model increased in the teens healthy eating behaviors with emphasizing on self-efficacy perceived benefits and reducing barriers to following a healthy diet. Prior to the education intervention there were not many differences in the control group and experimental group for healthy nutrition behavior, but after education intervention implemented the average healthy behavior increased and also there was a significant increased in self-efficacy in the experimental group which can lead them into changes in feeding behavior, and positive interpersonal norms and decrease in perceived barriers. Therefore, the theory of Pender's Health promotion model expressed that if proper education and knowledge are given, can make a big difference and make these adolescent girls increase in their self believe willingness and make them feel competent to accomplishment in healthy eating habit and behavior which can lead them to a healthier life in future. Decreased in perceived barriers suggests that adolescent female will have the capabilities to overcome the obstacles and will commit more to follow a healthy diet. Therefore, Pender’s Theory emphasizes that with positive modeling, support from family, teachers, and friends can make a big difference promoting healthy nutrition behaviors in these young girls.
According to U.S Department of Health and Human Services, 'Typical American diets exceed the recommended intake levels or limits in four categories: calories from solid fats and added sugars; refined grains; sodium; and saturated fat. Americans eat less than the recommended amounts of vegetables, fruits, whole-grains, dairy products, and oils. About 90% of Americans eat more sodium than is recommended for a healthy diet. Since the 1970s, the number of fast-food restaurants has more than doubled. Prevalence of obesity for children ages 12 to 19 years – tripled.' The prevention measures like healthy eating behavior and habit, daily exercises and engaging in physical activity can prevent a lot of chronic health problems such as obesity, Type 2 Diabetes, hyperlipidemia, and hypertension. Lifestyle modification should be done in early age with the help and support from family, schoolteacher so that we don’t enter into the epidemic of America children with obesity and Diabetes.
The study done with adolescent’s girls in Iran roved that Health Promotion theories and Model such as Pender’s can bring a positive change in health-promoting behavior and habit. As health care professionals we can promote awareness on health-promoting behavior like encouraging children and family member choosing healthy eating habit, encouraged children to eat more fresh fruits, vegetables, whole grains, advised on voiding carbonated beverages, sugary drinks, a limit on fast foods. Emphasize the importance of physically active by exercising at least 30 minutes a day, family members and teacher can motivate children to pick sports they like so children can stay active and avoid all screen time.
References
- Naserpoor, F., Alavijeh, F. Z., Shahri, P., & Malehi, A. S. (2018). Effect of education based on Pender's health promotion model on nutrition behavior of adolescent girls. Journal of Research & Health, vol. 8, no. 5, 2018, pp. 394–402.
- Bastable, S. (2019). Nurse as educator: Principles of teaching and learning for nursing practice (5th ed.). Burlington, MA: Jones and Bartlett.
- HHS Office, & Council on Sports. (2017, January 26). Facts & Statistics. Retrieved from https://www.hhs.gov/fitness/resource-center/facts-and-statistics/index.html.
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