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Pourjalil F, Homayuni A. Investigating the Factors Related to the Reduction of Salt Consumption in Women in Southern Iran: Application of ranstheoretical Model. TB 2023; 22 (5) :67-88
URL: http://tbj.ssu.ac.ir/article-1-3532-en.html
URL: http://tbj.ssu.ac.ir/article-1-3532-en.html
Ph.D in Health Education and Health Promotion , atefeh_0913@yahoo.com
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Investigating the Factors Related to the Reduction of Salt Consumption in Women in Southern Iran: Application of ،ranstheoretical Model
Farzaneh Pourjalil(Ph.D.s)1, Atefeh Homayuni(Ph.D.)2
1.Ph.D.s Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2.Corresponding Author: Ph.D in Health Education and Health Promotion, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Email: atefeh_0913@yahoo.com Tel: 09138362709
Abstract
Introduction: Reducing salt consumption in population is one of the easiest, most efficient and cost-effective ways to reduce the burden of cardiovascular diseases. The present study was conducted with the aim of investigating the factors related to the reduction of salt consumption using transtheoretical model among women in southern Iran.
Methods: This was a cross-sectional study (descriptive-analytical) conducted from November 2022 to February 2023 on women of 18-59 who visited comprehensive health centers in Bastak city. A total number of 452 subjects were selected using convenient sampling method. Data were collected using a questionnaire with three sections: demographic information, a researcher-made questionnaire based on transtheoretical model constructs, and salt consumption reduction questionnaire. Data were analyzed using Kruskal-Wallis tests, Pearson's correlation and regression analysis with SPSS software (v. 22).
Results: The results showed that participants were between 18 and52 with a mean of 35/51±10/13. 23/5% of the participants were in pre-contemplation stage, 21/7% in the contemplation stage, 20/8% in preparation stage, 11/3% in action stage, and 22/8% in maintenance stage. Pearson correlation analysis results indicated that there were significant positive relationships between cognitive processes (r= 0/44, p<0/01), behavioral processes (r= 0/54, p<0/01), self-efficacy (r=0/43, p<0/01) , decision balance (r= 0/37, p<0/01), and salt consumption reduction behavior; but, there was a significant negative correlation between temptation and salt consumption reduction behavior (r=-0.34, p<0/01). Moreover, regression analysis results revealed that age, counter conditioning, self-efficacy, raising awareness, decision balance, helping relationships, and temptation can predict 38/1% of the total variance in salt consumption reduction behavior (p<0/05).
Conclusion: According to the findings, self-efficacy, temptation, cognitive and behavioral change processes, and advantages and disadvantages of salt reduction play a major role in salt consumption reduction behavior. It is suggested that these variables be taken into account in developing and implementing educational interventions.
Keywords: Salt, Stages of Change, Transtheoretical Model, Women
References
1-Aljuraiban GS, Jose AP, Gupta P & et al. Sodium intake, health implications, and the role of population-level strategies. Nutrition Reviews. 2021;79(3):351-9.
2-Afshin A, Sur PJ, Fay KA & et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The lancet. 2019;393(10184):1958-72.
3-Fang X, Wei J, He X & et al. Landscape of dietary factors associated with risk of gastric cancer: A systematic review and dose-response meta-analysis of prospective cohort studies. European Journal of Cancer. 2015;51(18):2820-32.
4-Robinson AT, Edwards DG, Farquhar WB. The influence of dietary salt beyond blood pressure. Current hypertension reports. 2019;21:1-11.
5-Mozaffarian D, Fahimi S, Singh GM & et al. Global sodium consumption and death from cardiovascular causes. New England Journal of Medicine. 2014;371(7):624-34.
6-Roger VL, Go AS, Lloyd-Jones DM & et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18-e209.
7-Shepherd R, Farleigh C. Attitudes and personality related to salt intake. Appetite. 1986;7(4):343-54.
8-Naghibi SA, Yahyazadeh R, Yazdani Cherati J. Knowledge, attitude referred to health centers on salt intake. Journal of Mazandaran University of Medical Sciences. 2012;22(95):99-104.
9-Organization WH. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5-7 October 2006, Paris, France. 2007.
10-Briand P, Beaglehole R. Reducing salt intake in populations. NLM classification: QU. 2006;145.
11-Agh Atabay R, Zareban I, Shahrakipoor M & et al. Application of planned behaviour theory to predict salt consumption in the rural women of chabahar. Health Education and Health Promotion. 2014;2(1):3-15.
12-Rafieifar S, Pouraram H, Djazayery A & et al. Strategies and opportunities ahead to reduce salt intake. Archives of Iranian Medicine. 2016;19(10):0.
13-Kloss L, Meyer JD, Graeve L & et al. Sodium intake and its reduction by food reformulation in the European :union:—A review. NFS journal. 2015;1:9-19.
14-Malekshahi F, Heydarnia A, Niknami S & et al. Application of the transtheoretical model in preventing of Osteoporosis (physical activity) in women 30-50 years old in KhorramAbad: A study based on transtheoretical model. Yafteh. 2016;17(2):69-80.
15-Tavafian S, Aghamolaei T, Zare S. Distribution of smokers by stages of change of smoking: a population based study from BndarAbbass, Iran. Payesh. 2009;8(3):263-9.
16-Pirasteh P, Davati A, Jouhari Z, Mohamadi L. Predicting physical activity behavior among Iranian medical college students using the transtheoretical model Scientific-Research Journal of Shahed University 2012;19(100):11-1.
17-Eybpoosh S, Rahnavard Z, Yavari P & et al. Effect of an Educational Intervention based on the transtheoretical Model on Vitamin Intake in Female adolescent. Journal of Faculty of Nursing and Midwifery. 2010;16(3-4):15-30.
18-Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice: John Wiley & Sons; 2008.
19-Charkazi A, Nazari N, Samimi A & et al. The Relationship between Regular Physical Activity and The Stages of Change and Decisional Balance among Golestan University of Medical Sciences's Students Journal of Research Development in Nursing & Midwifery. 2013;9(2):74-81.
20-Lauby JL, Semaan S, Cohen A & et al. Self-efficacy, decisional balance and stages of change for condom use among women at risk for HIV infection. Health Education Research. 1998;13(3):343-56.
21-Sharifi RG, Charkazi A, Shahnazi H & et al. Smoking behavior among male student’s bases on trans-theoretical model. Journal of Fundamentals of Mental Health. 2012;13(4):386-95.
22-Charkazi A, Fazli L, Alizadeh F, & et al. Regular physical activity based on transtheoretical model among health and paramedic schools of Golestan University of medical sciences. Iranian Journal of Health Education and Health Promotion. 2014;1(4):57-68.
23-Callaghan P, Khalil E, Morres I. A prospective evaluation of the Transtheoretical Model of Change applied to exercise in young people. International journal of nursing studies. 2010;47(1):3-12.
24-Kowalski K, Jeznach A, Tuokko HA. Stages of driving behavior change within the transtheoretical model (TM). Journal of safety research. 2014;50:17-25.
25-Ham OK, Yoo JB. Mediating effects of self-efficacy in the transtheoretical model among adolescent male smokers in Korea. Asian nursing research. 2009;3(1):15-23.
26-De Vet E, De Nooijer J, De Vries NK & et al. The Transtheoretical model for fruit, vegetable and fish consumption: associations between intakes, stages of change and stage transition determinants. International Journal of Behavioral Nutrition and Physical Activity. 2006;3(1):13.
27-Henry H, Reimer K, Smith C & et al. Associations of decisional balance, processes of change, and self-efficacy with stages of change for increased fruit and vegetable intake among low-income, African-American mothers. Journal of the American Dietetic Association. 2006;106(6):841-9.
28-Mazloomi-Mahmodabadi S, Mohammadi M. Investigation the structures of transtheoretical model on nutrition of pre-diabetic individuals in Yazd villages. Iranian Journal of Diabetes and Metabolism 2013;12(2):167-72.
29-Cornélio ME, Gallani MCBJ, Godin G & et al. Development and reliability of an instrument to measure psychosocial determinants of salt consumption among hypertensive patients. Revista latino-americana de enfermagem. 2009;17:701-7.
30-Ahn S, Kwon J-S, Kim K & et al. Development and evaluation of a nutrition education program for housewives to reduce sodium intake: application of the social cognitive theory and a transtheoretical model. Journal of Nutrition and Health. 2022;55(1):174-87.
31-Pirasteh A, Pouraram H, Kholdi N, Abtahi M. Discretionary salt intake and readiness for behavioral change among women in Tehran. International Journal of Preventive Medicine. 2019, 10.
32-Ahn S-H, Kwon J-S, Kim K & et al. Perceptions and Feasibility of Actions Related to Sodium Reduction among Restaurant Owners and Cooks in Seongnam, South Korea: Comparison According to Stages of Behavioral Change. Nutrients. 2021;13(12):4375.
33-Zhang N, Leary E, Teti M & et al. Examining the factors that influence African Americans in the Midwest to reduce salt intake. Health Equity. 2020;4(1):183-9.
34-Khoram K, Asghari-Jafarabadi M, Ebrahimi-Mamagani M & et al. The Magnitude of Salt Intake Behaviors and Its Predictors among Saqez Urban Population of Kurdistan District in Iran: A Cross-Sectional Study. International Journal of Hypertension. 2022.
35-Felix¹ A, Venmathi E, Kalyani P & et al. Study on the Influences of Health Promotion Model Constructs on Salt Restriction Behaviour among Hypertensive Patients Using Structural Equation Model.
36-Radmerikhi S, Ahmadi Tabatabaei V & et al. People's knowledge, Attitude, and Self-efficacy towards Preventive Nutritional Behaviors of Cardiovascular Diseases. Journal of Nutrition and Food Security. 2017;2(4):279-87.
37-Ahn Y, Kim KW, Kim K & et al. Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake. Journal of nutrition and health. 2015;48(5):429-40.
38-Suh Y, Seok Y-H, Chung Y-J. Relationship of dietary self-efficacy and illness beliefs, perceived benefits and perceived barriers for the reduction of sodium intake in the elderly. Korean Journal of Nutrition. 2012;45(4):324-35.
39-Ahn S-h, Kwon JS, Kim K & et al. Stages of behavioral change for reducing sodium intake in Korean consumers: comparison of characteristics based on social cognitive theory. Nutrients. 2017;9(8):808.
40-Elangovan V, Nirupama A. Impact of perceived self-efficacy among hypertensives in adapting to low salt diet. Current Medical Issues. 2022;20(2):57-62.
41-Kim MJ, Kim KW. Nutrition knowledge, outcome expectations, self-efficacy, and eating behaviors by calcium intake level in Korean female college students. Nutrition research and practice. 2015;9(5):530-8.
42-Gordali M, Bazhan M. Determining the relationship between the transtheoretical model constructs and dietary fat intake in obese or overweight middle-aged women. Iranian Journal of Nutrition Sciences & Food Technology. 2021;15(4):41-50.
43-Hassani L, Pournarani R, Aghamolaei T & et al. Breakfast Eating in Elementary School Students in Jiroft, Iran: An Application of Transtheoretical Model. Progress in Psychiatry and Behavioral Sciences. 2023;17(1).
44-Aghamolaei T, Ghanbarnejad A. Relation between decisional balance and self-efficacy with stages of change for fruits and vegetables consumption among high school students in Bandar Abbas. Journal of Preventive Medicine. 2015;2(1):36-46.
45-Fang M, Zhang J, Wu X & et al. The relationship between fat intake behavior and psychological impact factor in adolescent. Zhonghua yu Fang yi xue za zhi [Chinese Journal of Preventive Medicine]. 2015;49(2):156-60.
46-Mohebbi B, Tafaghodi B, Sadeghi R & et al. Factors predicting nutritional knowledge, illness perceptions, and dietary adherence among hypertensive middle-aged women: Application of transtheoretical model. Journal of Education and Health Promotion. 2021;10.
47-Therawiwat M, Imamee N, Khamklueng T. Self-efficacy, decisional balance and stages of change on dietary practices among metabolic syndrome persons, Uthai Thani Province. Journal of the Medical Association of Thailand= Chotmaihet Thangphaet. 2013;96:S131-7.
48-Kidd T, Peters PK. Decisional balance for health and weight is associated with whole-fruit intake in low-income young adults. Nutrition Research. 2010;30(7):477-82.
49-Pirasteh A, Davati A, Jouhari Z & et al. Predicting physical activity behavior among Iranian medical college students using the transtheoretical model. Daneshvar Medicine. 2012; 20(3):1-10.
50-Charkazi A, Shahnazi H, Mahmoudi Badi S & et al. Nicotine dependency, smoking temptation, decisional balance and their relationship with readiness to quit in cigarette smokers. Health and Development Journal. 2015;4(1).
51-Bagheri M, Roozbahani N, Shamsi M. Predictive Factors of Smoking among Adults Based on Transtheoretical Model. Iranian Journal of Health Education and Health Promotion. 2015;3(3):211-8.
52-Namazi N, Naini A, Mostafavidarani F, Boroumandfar Z. Investigation of stage of change and behavior and cognitive behavioral processes (transitional model) in the use of nutrients in overweight middle-aged women. Journal of School of Public Health & Institute of Public Health Research. 2019. 17(2).
53-Narimani S, Farmanbar R, Mozaffari N & et al. Cognitive and behavioral processes and its stages of change for fruit and vegetable consumption among nursing and midwifery staff of Ardabil hospitals, 2016: Application of the trans theoretical model. Journal of Health. 2018;9(2):182-95.
54-Hildebrand DA, Shriver LH. A quantitative and qualitative approach to understanding fruit and vegetable availability in low-income african-american families with children enrolled in an urban head start program. Journal of the American Dietetic Association. 2010;110(5):710-8.
55-Di Noia J, Thompson D. Processes of change for increasing fruit and vegetable consumption among economically disadvantaged African American adolescents. Eating behaviors. 2012;13(1):58-61.
Farzaneh Pourjalil(Ph.D.s)1, Atefeh Homayuni(Ph.D.)2
1.Ph.D.s Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2.Corresponding Author: Ph.D in Health Education and Health Promotion, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Email: atefeh_0913@yahoo.com Tel: 09138362709
Abstract
Introduction: Reducing salt consumption in population is one of the easiest, most efficient and cost-effective ways to reduce the burden of cardiovascular diseases. The present study was conducted with the aim of investigating the factors related to the reduction of salt consumption using transtheoretical model among women in southern Iran.
Methods: This was a cross-sectional study (descriptive-analytical) conducted from November 2022 to February 2023 on women of 18-59 who visited comprehensive health centers in Bastak city. A total number of 452 subjects were selected using convenient sampling method. Data were collected using a questionnaire with three sections: demographic information, a researcher-made questionnaire based on transtheoretical model constructs, and salt consumption reduction questionnaire. Data were analyzed using Kruskal-Wallis tests, Pearson's correlation and regression analysis with SPSS software (v. 22).
Results: The results showed that participants were between 18 and52 with a mean of 35/51±10/13. 23/5% of the participants were in pre-contemplation stage, 21/7% in the contemplation stage, 20/8% in preparation stage, 11/3% in action stage, and 22/8% in maintenance stage. Pearson correlation analysis results indicated that there were significant positive relationships between cognitive processes (r= 0/44, p<0/01), behavioral processes (r= 0/54, p<0/01), self-efficacy (r=0/43, p<0/01) , decision balance (r= 0/37, p<0/01), and salt consumption reduction behavior; but, there was a significant negative correlation between temptation and salt consumption reduction behavior (r=-0.34, p<0/01). Moreover, regression analysis results revealed that age, counter conditioning, self-efficacy, raising awareness, decision balance, helping relationships, and temptation can predict 38/1% of the total variance in salt consumption reduction behavior (p<0/05).
Conclusion: According to the findings, self-efficacy, temptation, cognitive and behavioral change processes, and advantages and disadvantages of salt reduction play a major role in salt consumption reduction behavior. It is suggested that these variables be taken into account in developing and implementing educational interventions.
Keywords: Salt, Stages of Change, Transtheoretical Model, Women
References
1-Aljuraiban GS, Jose AP, Gupta P & et al. Sodium intake, health implications, and the role of population-level strategies. Nutrition Reviews. 2021;79(3):351-9.
2-Afshin A, Sur PJ, Fay KA & et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The lancet. 2019;393(10184):1958-72.
3-Fang X, Wei J, He X & et al. Landscape of dietary factors associated with risk of gastric cancer: A systematic review and dose-response meta-analysis of prospective cohort studies. European Journal of Cancer. 2015;51(18):2820-32.
4-Robinson AT, Edwards DG, Farquhar WB. The influence of dietary salt beyond blood pressure. Current hypertension reports. 2019;21:1-11.
5-Mozaffarian D, Fahimi S, Singh GM & et al. Global sodium consumption and death from cardiovascular causes. New England Journal of Medicine. 2014;371(7):624-34.
6-Roger VL, Go AS, Lloyd-Jones DM & et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18-e209.
7-Shepherd R, Farleigh C. Attitudes and personality related to salt intake. Appetite. 1986;7(4):343-54.
8-Naghibi SA, Yahyazadeh R, Yazdani Cherati J. Knowledge, attitude referred to health centers on salt intake. Journal of Mazandaran University of Medical Sciences. 2012;22(95):99-104.
9-Organization WH. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5-7 October 2006, Paris, France. 2007.
10-Briand P, Beaglehole R. Reducing salt intake in populations. NLM classification: QU. 2006;145.
11-Agh Atabay R, Zareban I, Shahrakipoor M & et al. Application of planned behaviour theory to predict salt consumption in the rural women of chabahar. Health Education and Health Promotion. 2014;2(1):3-15.
12-Rafieifar S, Pouraram H, Djazayery A & et al. Strategies and opportunities ahead to reduce salt intake. Archives of Iranian Medicine. 2016;19(10):0.
13-Kloss L, Meyer JD, Graeve L & et al. Sodium intake and its reduction by food reformulation in the European :union:—A review. NFS journal. 2015;1:9-19.
14-Malekshahi F, Heydarnia A, Niknami S & et al. Application of the transtheoretical model in preventing of Osteoporosis (physical activity) in women 30-50 years old in KhorramAbad: A study based on transtheoretical model. Yafteh. 2016;17(2):69-80.
15-Tavafian S, Aghamolaei T, Zare S. Distribution of smokers by stages of change of smoking: a population based study from BndarAbbass, Iran. Payesh. 2009;8(3):263-9.
16-Pirasteh P, Davati A, Jouhari Z, Mohamadi L. Predicting physical activity behavior among Iranian medical college students using the transtheoretical model Scientific-Research Journal of Shahed University 2012;19(100):11-1.
17-Eybpoosh S, Rahnavard Z, Yavari P & et al. Effect of an Educational Intervention based on the transtheoretical Model on Vitamin Intake in Female adolescent. Journal of Faculty of Nursing and Midwifery. 2010;16(3-4):15-30.
18-Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice: John Wiley & Sons; 2008.
19-Charkazi A, Nazari N, Samimi A & et al. The Relationship between Regular Physical Activity and The Stages of Change and Decisional Balance among Golestan University of Medical Sciences's Students Journal of Research Development in Nursing & Midwifery. 2013;9(2):74-81.
20-Lauby JL, Semaan S, Cohen A & et al. Self-efficacy, decisional balance and stages of change for condom use among women at risk for HIV infection. Health Education Research. 1998;13(3):343-56.
21-Sharifi RG, Charkazi A, Shahnazi H & et al. Smoking behavior among male student’s bases on trans-theoretical model. Journal of Fundamentals of Mental Health. 2012;13(4):386-95.
22-Charkazi A, Fazli L, Alizadeh F, & et al. Regular physical activity based on transtheoretical model among health and paramedic schools of Golestan University of medical sciences. Iranian Journal of Health Education and Health Promotion. 2014;1(4):57-68.
23-Callaghan P, Khalil E, Morres I. A prospective evaluation of the Transtheoretical Model of Change applied to exercise in young people. International journal of nursing studies. 2010;47(1):3-12.
24-Kowalski K, Jeznach A, Tuokko HA. Stages of driving behavior change within the transtheoretical model (TM). Journal of safety research. 2014;50:17-25.
25-Ham OK, Yoo JB. Mediating effects of self-efficacy in the transtheoretical model among adolescent male smokers in Korea. Asian nursing research. 2009;3(1):15-23.
26-De Vet E, De Nooijer J, De Vries NK & et al. The Transtheoretical model for fruit, vegetable and fish consumption: associations between intakes, stages of change and stage transition determinants. International Journal of Behavioral Nutrition and Physical Activity. 2006;3(1):13.
27-Henry H, Reimer K, Smith C & et al. Associations of decisional balance, processes of change, and self-efficacy with stages of change for increased fruit and vegetable intake among low-income, African-American mothers. Journal of the American Dietetic Association. 2006;106(6):841-9.
28-Mazloomi-Mahmodabadi S, Mohammadi M. Investigation the structures of transtheoretical model on nutrition of pre-diabetic individuals in Yazd villages. Iranian Journal of Diabetes and Metabolism 2013;12(2):167-72.
29-Cornélio ME, Gallani MCBJ, Godin G & et al. Development and reliability of an instrument to measure psychosocial determinants of salt consumption among hypertensive patients. Revista latino-americana de enfermagem. 2009;17:701-7.
30-Ahn S, Kwon J-S, Kim K & et al. Development and evaluation of a nutrition education program for housewives to reduce sodium intake: application of the social cognitive theory and a transtheoretical model. Journal of Nutrition and Health. 2022;55(1):174-87.
31-Pirasteh A, Pouraram H, Kholdi N, Abtahi M. Discretionary salt intake and readiness for behavioral change among women in Tehran. International Journal of Preventive Medicine. 2019, 10.
32-Ahn S-H, Kwon J-S, Kim K & et al. Perceptions and Feasibility of Actions Related to Sodium Reduction among Restaurant Owners and Cooks in Seongnam, South Korea: Comparison According to Stages of Behavioral Change. Nutrients. 2021;13(12):4375.
33-Zhang N, Leary E, Teti M & et al. Examining the factors that influence African Americans in the Midwest to reduce salt intake. Health Equity. 2020;4(1):183-9.
34-Khoram K, Asghari-Jafarabadi M, Ebrahimi-Mamagani M & et al. The Magnitude of Salt Intake Behaviors and Its Predictors among Saqez Urban Population of Kurdistan District in Iran: A Cross-Sectional Study. International Journal of Hypertension. 2022.
35-Felix¹ A, Venmathi E, Kalyani P & et al. Study on the Influences of Health Promotion Model Constructs on Salt Restriction Behaviour among Hypertensive Patients Using Structural Equation Model.
36-Radmerikhi S, Ahmadi Tabatabaei V & et al. People's knowledge, Attitude, and Self-efficacy towards Preventive Nutritional Behaviors of Cardiovascular Diseases. Journal of Nutrition and Food Security. 2017;2(4):279-87.
37-Ahn Y, Kim KW, Kim K & et al. Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake. Journal of nutrition and health. 2015;48(5):429-40.
38-Suh Y, Seok Y-H, Chung Y-J. Relationship of dietary self-efficacy and illness beliefs, perceived benefits and perceived barriers for the reduction of sodium intake in the elderly. Korean Journal of Nutrition. 2012;45(4):324-35.
39-Ahn S-h, Kwon JS, Kim K & et al. Stages of behavioral change for reducing sodium intake in Korean consumers: comparison of characteristics based on social cognitive theory. Nutrients. 2017;9(8):808.
40-Elangovan V, Nirupama A. Impact of perceived self-efficacy among hypertensives in adapting to low salt diet. Current Medical Issues. 2022;20(2):57-62.
41-Kim MJ, Kim KW. Nutrition knowledge, outcome expectations, self-efficacy, and eating behaviors by calcium intake level in Korean female college students. Nutrition research and practice. 2015;9(5):530-8.
42-Gordali M, Bazhan M. Determining the relationship between the transtheoretical model constructs and dietary fat intake in obese or overweight middle-aged women. Iranian Journal of Nutrition Sciences & Food Technology. 2021;15(4):41-50.
43-Hassani L, Pournarani R, Aghamolaei T & et al. Breakfast Eating in Elementary School Students in Jiroft, Iran: An Application of Transtheoretical Model. Progress in Psychiatry and Behavioral Sciences. 2023;17(1).
44-Aghamolaei T, Ghanbarnejad A. Relation between decisional balance and self-efficacy with stages of change for fruits and vegetables consumption among high school students in Bandar Abbas. Journal of Preventive Medicine. 2015;2(1):36-46.
45-Fang M, Zhang J, Wu X & et al. The relationship between fat intake behavior and psychological impact factor in adolescent. Zhonghua yu Fang yi xue za zhi [Chinese Journal of Preventive Medicine]. 2015;49(2):156-60.
46-Mohebbi B, Tafaghodi B, Sadeghi R & et al. Factors predicting nutritional knowledge, illness perceptions, and dietary adherence among hypertensive middle-aged women: Application of transtheoretical model. Journal of Education and Health Promotion. 2021;10.
47-Therawiwat M, Imamee N, Khamklueng T. Self-efficacy, decisional balance and stages of change on dietary practices among metabolic syndrome persons, Uthai Thani Province. Journal of the Medical Association of Thailand= Chotmaihet Thangphaet. 2013;96:S131-7.
48-Kidd T, Peters PK. Decisional balance for health and weight is associated with whole-fruit intake in low-income young adults. Nutrition Research. 2010;30(7):477-82.
49-Pirasteh A, Davati A, Jouhari Z & et al. Predicting physical activity behavior among Iranian medical college students using the transtheoretical model. Daneshvar Medicine. 2012; 20(3):1-10.
50-Charkazi A, Shahnazi H, Mahmoudi Badi S & et al. Nicotine dependency, smoking temptation, decisional balance and their relationship with readiness to quit in cigarette smokers. Health and Development Journal. 2015;4(1).
51-Bagheri M, Roozbahani N, Shamsi M. Predictive Factors of Smoking among Adults Based on Transtheoretical Model. Iranian Journal of Health Education and Health Promotion. 2015;3(3):211-8.
52-Namazi N, Naini A, Mostafavidarani F, Boroumandfar Z. Investigation of stage of change and behavior and cognitive behavioral processes (transitional model) in the use of nutrients in overweight middle-aged women. Journal of School of Public Health & Institute of Public Health Research. 2019. 17(2).
53-Narimani S, Farmanbar R, Mozaffari N & et al. Cognitive and behavioral processes and its stages of change for fruit and vegetable consumption among nursing and midwifery staff of Ardabil hospitals, 2016: Application of the trans theoretical model. Journal of Health. 2018;9(2):182-95.
54-Hildebrand DA, Shriver LH. A quantitative and qualitative approach to understanding fruit and vegetable availability in low-income african-american families with children enrolled in an urban head start program. Journal of the American Dietetic Association. 2010;110(5):710-8.
55-Di Noia J, Thompson D. Processes of change for increasing fruit and vegetable consumption among economically disadvantaged African American adolescents. Eating behaviors. 2012;13(1):58-61.
Type of Study: Research |
Subject:
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Received: 2023/07/11 | Accepted: 2023/12/3 | Published: 2024/01/16
Received: 2023/07/11 | Accepted: 2023/12/3 | Published: 2024/01/16
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