Volume 20, Issue 6 (1-2022)
TB 2022, 20(6): 100-115 |
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jalili Z, Tavakoli R, Jalili S. The predictors of Omega-3 Supplements Consumption Based on the Constructs of the Health Belief Model in the Elderly Alzheimer Prevention. TB 2022; 20 (6) :100-115
URL: http://tbj.ssu.ac.ir/article-1-2925-en.html
URL: http://tbj.ssu.ac.ir/article-1-2925-en.html
, zahra.jalili@gmail.com
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The predictor’s Consumption of Omega-3 Supplements Based on the Constructs of Health Belief Model (HBM) in the Elderly Alzheimer Prevention
Zahra Jalili(Ph.D.)1, Reza Tavakoli(Ph.D.)2,Sahar Jalili(Ph.D.)3
1.Corresponding Author:Associate Professor,Department of Health Education and Promotion, Science and Research Branch, Islamic Azad University,Tehran, Iran. Email:Zahra.Jalili@gmail.com Tel:09128114882
2.Associate Professor, Department of Health Education and Promotion, Science and Research Branch, Islamic Azad University, Tehran, Iran.
3.Assistant Professor, Department of Fisheries, Abadan Branch, Islamic Azad University, Abadan, Iran.
Abstract
Introduction: Omega-3 is one of the most essential fatty acids for human being that must intake from diet. Many studies showed that, there is a relationship between consumption of diet containing omega-3 fatty acids (EPA, DHA) and reduction of dementia. The aim of present study was to determine predictors of consumption of omega-3 supplements in order to prevent AD based on the Health Belief Model (HBM) constructs in elderly.
Methods: In this analytical cross-sectional study, 323 elderly, who referring to the Health centers of Tehran city in 2016, have been selected by using a multistage sampling method. Data collection tools included demographic, information, knowledge and Health Belief Model (HBM) constructs. The questionnaire was distributed after confirming its validity and reliability. The results were analyzed by using SPSS-18 software and statistical tests, including Chi 2 test, independent T test, person correlation coefficient, Spearman test, and logistic regression model.
Results: Logistic regression analysis showed that the best predictors of omega supplementation are respectively, knowledge, performance, self-efficacy, and perceived susceptibility that could predict 74.5% consumption or not consumption of omega3 supplementation. The other result of present study indicated that the score mean of , knowledge, susceptibility, severity, severity and benefits perceived, self-efficacy and performance was significantly more in elderly who consumed omega-3 supplements that those who not (P<0.001).
Conclusion: The present study leads to identify the most powerful constructs of HBM in predicting the behavior of consumption of omega-3 supplement in elderly. Therefor this model could act as a reference framework in planning and educational interventions in order to prevent be Alzheimer disease.
Keywords: Alzheimer’s disease, Health Belief Model, Omega-3 supplementation, elderly
Conflict of interest: The authors declared that there is no conflict of interest.
Reference
1-Seaman AT. The consequence of “doing nothing”: Family caregiving for Alzheimer’disease as non-action in the US. Social Science & Medicine.2018(197):63-70.
2-Abbishe K, singh SS, Geetika G, Rizvi SE. Chapter 5: Multinutrient Approach to Slow down Brain Aging and Related Neurodegenerative Disorders in: Role of the Mediterranean Diet in the brain and Neurodegenerative Disease .Academic Prees.2018:77-88.
3-Maghsoudnia Sh. Primary health care for old adults in IRAN. University of social welfare and rehabilitation sciences publication. 1st Ed. 2007: 117- 25. [Persian]
4-Zverova M.Clinical aspects of Alzheimer’s disease. Clinical Biochemistry. 2019,73:3-6.
5-Swanson D, Mousa A. Shaker . Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life. American Society for Nutrition.Adv.Nutr.2012;(3):1-7.
6-Thomas J, Thomas CJ, Radcliffe J, Itsiopoulos C. Omega-3 Fatty Acids in Early Prevention of Inflammatory Neurodegenerative Disease: A Focus on Alzheimer's disease. Biomed Res Int. 2015: 1-14.
7-Wikler EM, Blendon RJ, Benson J. Would you want to know? Public attitudeson early diagnostictesting for Alzheimer’s disease. Alzheimer’s Research and Therapy.2013; 5( 43):1-13.
8-Yung CK, Rajendiran R.A critical overview of therapeutic strategy and advancement for Alzheimer’s disease treatment .Journal of Taiwan Institute of Chemical Engineer.2017;77:92-105.
9-Cummings JL. Alzheimer’s disease. N Engl J Med.2004;351:56-67.
10-Gelder BM, Tijhuis M, Kalmijn S, Kromhout D. Fish consumption, with the n-3 Fatty Acids, and subsequent 5-y cognitive decline in elderly men: the Zutphen Elderly Study.AAm J Clin Nutr .2007; 85:1142- 7.
11-Bagheri D, lavi N, Yekaninejad MI, Mirzaei KH. The relationship between dietary patterns and mild cognitive impairment in retired elderly women in Tehran. The Medical Journal of Mashhad University of Medical Sciences.2007;(10):502-690.[Persian]
12-Lim GI, Calon FR, Morihara TA, et al. A Diet Enriched with the Omega-3 Fatty Acid Docosahexaenoic Acid Reduces Amyloid Burden in an Aged Alzheimer Mouse Model. Journal of Neuroscience .2005;25(12):3032-40
13-Newton W, Mc Manus A. Consumption of fish and Alzheimer's disease. J Nutr Health Aging. 2011; 15(7):551-2.
14-Anad A,Zanwar AJ, Mahabale sh, Hegde V .Chaper25,Effect of Dietary omega-3 fatty acid consumption.In: Role of the Mediterranean Diet in the brain and Neurodegenerative Disease .Academic Prees.2018:385-99
15-Manor I. The effect of phosphatidylserine containing omega-3 fatty acids on attention-deficit hyperactivity disorder symtoms in children: Adouble-blind placebo controlled trial, followed by an open-label extension. European psychiatry.2012(27): 335-42
16-Virginie F. Short-term long chain omega-3 diet protects from neuroinflammatory process and memory impairment in aged mice. Plos One . 2012;7(5):1-13.
17-Agineszka W, Anderzej F M. Chapter 15 Fatty acid in human diet and their impact on cognitive and emotional functioning. In: Role of functional food security in Global Health.2019: 261-70.
18-Gateau PB, Samieri C, Cunnane SC.Long chain omega3 polysaturated fatty acids and cognition in order people:Interaction with Apoe genotype. 2016;23(1) :111.
19-Matlabi MO, Sharifirad GH, Mostavafi FI, Mohebi SI, Azadbakht LE. Factors Affecting Fish Consumption Based on Structures of Health Education. Journal of Health System Research.2012; 8(4): 523-36[Persian]
20-Dadgar Sh,Salehi H,Hajimirrahimi SD, Teimoori M. Measuring of per capita fish consumption and assessing barriers and development strategies for consumption in Markazi Province. Iranian Scientific fisheries Journal. Winter.2014: 23(4): 17-28. [Persian]
21-Hosseini S,Adeli M, Vahedi A. Evaluating factors and barriers affecting on per capita fish conception in Sari. Journal of fisheries. 2016; 431-350. [Persian]
22-Nejad Dadgar NA, Shojaeizadeh DA, Tol AZ, Hossaini MO, Amani FI. Assessing the Effect of Blended Educational Program Based on Health Belief Model on Adopting Preventive Behaviors in Alzheimer among Elders under Covering Ardebil Health Care Setting. Journal of Health System Research. 2014; 10(2): 386-94.[Persian]
23-Fotuhi M, Mohassel P, Yaffe K.Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer's disease: a complex association. Nature Clinical Practice Neurology.2009;5( 3).[Persian]
24-Cole Greg M. Prevention of Alzheimer's disease: Omega-3 Fatty Acids and phenolic anti-oxidant interventions. Neurobiology of Aging.2005;1:133-6.
25-Werner P. Factors influencing intentions to seek a cognitive status examination: A study based on the Health Belief M.Int J Geriatr Psychiatr. 2003; 18: 787-94.
26-Kim S, Sargent CK, Cherbuin N , Anastey K. Development of Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction Scale. Dement Geriatr Cogn Disord Extra.2014;4:172-83
27-Glanz KA, Rimer BA, Viswanath K. Health Behavior and Health Education: Theory, Research and Practice. 5th ed. San Francisco: Jossey - Bass publisher.2015 (2);8- 30.
28-Sharma MA, Romas JO.Theoretical Foundations of Health Education and Health Promotion 3nd Edition. Jones &Bartlett. 2018; 3:74-90.
29-Ghaffari MO, Sharifirad GH, Akbari ZE, Khorsandi MA, Hassanzadeh AK. Health Belief Model-Based Education & Reduction of Cesarean among Pregnant Women: An Interventional Study. Journal of Health System Research.2011;7(2):201-7.[Persian]
30-Goharinezhad S, Maleki M, Baradaran H, Ravaghi H. Futures of elderly care in Iran: A protocol with scenario approach. Med J Islam Repub Iran.2016; 30: 416.
31-Maghsoudi Ah, Mohammadi Bavariani FA, Salim SA. The association between health promoting behaviors and quality of life in the elderly people of Ewaz, Navid No.2016;19(62):16-23.[Persian]
32-Morovati MA, Rohani Tonekaboni N, Baghyani Moghadam MH. Study of self-care predictors in diabetic patient referring to Yazd Diabet Research Center based on the developed HBM. Juornal of Yazd Shahid Sadoughi University of Medical Sciences and Health Services.2007;15(31):85-93.[Persian]
33-BrownleeDuffeck M,Peterson L,Simonds JF,Goldstein D,et al. The role of health beliefs in theregimen adherence and metabolic control ofadolescents and adults with diabetes mellitus.Journalof Consulting and Clinical Psychology.1987; 55(2):139-44.
34-Mahdavi Sh, Malekzadeh K, Fararooei JM. preventing of osteoporosis: Applying the Health Belief Model.Journal of Nursing and Midwifery Shahid Behshti University of Medical Sciences. 2014;24( 87):15-22.[Persian]
35-Karimy MA, Taher MO, Azarpira HA. Measure health belief model construct about nutritional practices of pregnant women in Saveh University of Medical Sciences. Sci J Hamadan Nurs Midwifery Fac.2016; 24 (3):167-73 [Persian]
36-Babanezhad M.Investigating the Frequency and Factors Affecting the Consumption of Supplements in Southern People, Tehran City. Research in Medicine The Quarterly Journal of School of Medicine, Shahid Beheshti University of Medical Sciences.2013;37(2):93-7.[Persian]
37-Najmabadi Sh, Noojoomi M. Consumption of nutritional supplements in adults west of Tehran.Iranian Journal of Endocrinology and Metabolism .2010;12(4):365-75.[Persian]
38-Nejad Dadgar NA, Shojaeizadeh DA, Tol AZ, Hossaini MO, Amani FI. Assessing the Effect of Blended Educational Program Based on Health Belief Model on Adopting Preventive Behaviors in Alzheimer among Elders under Covering Ardebil Health Care Setting. Journal of Health System Research.2014; 10(2): 386-94 [Persian]
39-Tan MY. The relationship of health beliefs and complication prevention behaviors of Chinese individuals with Type 2 Diabetes Mellitus. Diabetes Res Clin Pract .2004;66(1):71-7.
40-Horvath J DC. Human papillomavirus knowledge,beliefs,and behaviors: questionnaire adaptation. European Journal of Obstetrics &Gynecology and Reproductive Biology.2016; 230: 103-8
41-Pham DT, Fortin F, Thibaudeau MF. The role of the Health Belief Model in amputees' self-evaluationof adherence to diabetes self-care behaviors. Diabetes educe .1996 ; 22(2):126-32.
42-Rodrigues RT.Claudia VG A, Rodrigues NG. Nutritonal status and eating habits of professors of Health Ere. Int J Sport Stud Hlth.2018; (1):e64335.
43-Kaewsutas M, Sarikaphuti A, Narartwanchai T, Sittiprapaporn PH, Patchanee.Electroencephalographic study of micro alage DHA omega-3 egg consumption on cognitive function. Journal of functional foods.2017; 29:46-52.
44-Mazloomy SA, Zahed SH, Emami MA, et al. A study on the evaluation of relationship between the predisposing factors and practice and demographic variables in caregivers of patients with Alzheimer's diseases. Journal of Isfahan Medical School.2015; 33(329):429-41.[Persian]
45-Mehri A, Sedighi Z, Koochak S.Application and Comparison of the Theories of Health Belief Model and Planned Behavior in Determining the Predictive Factors Associated with Seat Belt Use among Drivers in Sabzevar. Iranian Journal of Medical Education.2011;11(7):807. [Persian]
46-Hassanzadeh GH, Yekke Zare S, Vaziri S, Soroori Rad B, Darki L. Knowledge of women about menopause in Qazvin. The Journal of Qazvin Univ of Med Sci.2003;7(4): 21-5[Persian]
47-Abedini ZA, Bidgoli Sh,Ahmari Tehrani H. Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients. Qom University of Medical Sciences Journal, Summer .2008 ; 2 :2. [Persian]
48-Ramezankhani A, Mohamadi G, Akrami F, Zinali M. A Survey on the Knowledge, Attitude and Practice of the Elderly on Healthy Lifestyle in Tehran. Journal of Behdasht dar Arse (Health in the field).2013;1(1):1-5. [Persian]
49-Zarei1 E, Hatami H, Shahnam A, et al. Knowledge, Attitude and Practice of Health Science Students About the Outbreak of Water and Foodborne Diseases: A Survey in Shahid Beheshti University of Medical Sciences Journal of Environmental Health Engineering.2018;5(3):251-63.[Persian]
50-Sabzevari S, Nikbakht Nasrabadi A, Negahban Bonabi T. Sources of Women's Health Information: A Qualitative Study. J Qual Res Health Sci.2015; 3(4): 349-62. [Persian]
Zahra Jalili(Ph.D.)1, Reza Tavakoli(Ph.D.)2,Sahar Jalili(Ph.D.)3
1.Corresponding Author:Associate Professor,Department of Health Education and Promotion, Science and Research Branch, Islamic Azad University,Tehran, Iran. Email:Zahra.Jalili@gmail.com Tel:09128114882
2.Associate Professor, Department of Health Education and Promotion, Science and Research Branch, Islamic Azad University, Tehran, Iran.
3.Assistant Professor, Department of Fisheries, Abadan Branch, Islamic Azad University, Abadan, Iran.
Abstract
Introduction: Omega-3 is one of the most essential fatty acids for human being that must intake from diet. Many studies showed that, there is a relationship between consumption of diet containing omega-3 fatty acids (EPA, DHA) and reduction of dementia. The aim of present study was to determine predictors of consumption of omega-3 supplements in order to prevent AD based on the Health Belief Model (HBM) constructs in elderly.
Methods: In this analytical cross-sectional study, 323 elderly, who referring to the Health centers of Tehran city in 2016, have been selected by using a multistage sampling method. Data collection tools included demographic, information, knowledge and Health Belief Model (HBM) constructs. The questionnaire was distributed after confirming its validity and reliability. The results were analyzed by using SPSS-18 software and statistical tests, including Chi 2 test, independent T test, person correlation coefficient, Spearman test, and logistic regression model.
Results: Logistic regression analysis showed that the best predictors of omega supplementation are respectively, knowledge, performance, self-efficacy, and perceived susceptibility that could predict 74.5% consumption or not consumption of omega3 supplementation. The other result of present study indicated that the score mean of , knowledge, susceptibility, severity, severity and benefits perceived, self-efficacy and performance was significantly more in elderly who consumed omega-3 supplements that those who not (P<0.001).
Conclusion: The present study leads to identify the most powerful constructs of HBM in predicting the behavior of consumption of omega-3 supplement in elderly. Therefor this model could act as a reference framework in planning and educational interventions in order to prevent be Alzheimer disease.
Keywords: Alzheimer’s disease, Health Belief Model, Omega-3 supplementation, elderly
Conflict of interest: The authors declared that there is no conflict of interest.
Reference
1-Seaman AT. The consequence of “doing nothing”: Family caregiving for Alzheimer’disease as non-action in the US. Social Science & Medicine.2018(197):63-70.
2-Abbishe K, singh SS, Geetika G, Rizvi SE. Chapter 5: Multinutrient Approach to Slow down Brain Aging and Related Neurodegenerative Disorders in: Role of the Mediterranean Diet in the brain and Neurodegenerative Disease .Academic Prees.2018:77-88.
3-Maghsoudnia Sh. Primary health care for old adults in IRAN. University of social welfare and rehabilitation sciences publication. 1st Ed. 2007: 117- 25. [Persian]
4-Zverova M.Clinical aspects of Alzheimer’s disease. Clinical Biochemistry. 2019,73:3-6.
5-Swanson D, Mousa A. Shaker . Omega-3 Fatty Acids EPA and DHA: Health Benefits Throughout Life. American Society for Nutrition.Adv.Nutr.2012;(3):1-7.
6-Thomas J, Thomas CJ, Radcliffe J, Itsiopoulos C. Omega-3 Fatty Acids in Early Prevention of Inflammatory Neurodegenerative Disease: A Focus on Alzheimer's disease. Biomed Res Int. 2015: 1-14.
7-Wikler EM, Blendon RJ, Benson J. Would you want to know? Public attitudeson early diagnostictesting for Alzheimer’s disease. Alzheimer’s Research and Therapy.2013; 5( 43):1-13.
8-Yung CK, Rajendiran R.A critical overview of therapeutic strategy and advancement for Alzheimer’s disease treatment .Journal of Taiwan Institute of Chemical Engineer.2017;77:92-105.
9-Cummings JL. Alzheimer’s disease. N Engl J Med.2004;351:56-67.
10-Gelder BM, Tijhuis M, Kalmijn S, Kromhout D. Fish consumption, with the n-3 Fatty Acids, and subsequent 5-y cognitive decline in elderly men: the Zutphen Elderly Study.AAm J Clin Nutr .2007; 85:1142- 7.
11-Bagheri D, lavi N, Yekaninejad MI, Mirzaei KH. The relationship between dietary patterns and mild cognitive impairment in retired elderly women in Tehran. The Medical Journal of Mashhad University of Medical Sciences.2007;(10):502-690.[Persian]
12-Lim GI, Calon FR, Morihara TA, et al. A Diet Enriched with the Omega-3 Fatty Acid Docosahexaenoic Acid Reduces Amyloid Burden in an Aged Alzheimer Mouse Model. Journal of Neuroscience .2005;25(12):3032-40
13-Newton W, Mc Manus A. Consumption of fish and Alzheimer's disease. J Nutr Health Aging. 2011; 15(7):551-2.
14-Anad A,Zanwar AJ, Mahabale sh, Hegde V .Chaper25,Effect of Dietary omega-3 fatty acid consumption.In: Role of the Mediterranean Diet in the brain and Neurodegenerative Disease .Academic Prees.2018:385-99
15-Manor I. The effect of phosphatidylserine containing omega-3 fatty acids on attention-deficit hyperactivity disorder symtoms in children: Adouble-blind placebo controlled trial, followed by an open-label extension. European psychiatry.2012(27): 335-42
16-Virginie F. Short-term long chain omega-3 diet protects from neuroinflammatory process and memory impairment in aged mice. Plos One . 2012;7(5):1-13.
17-Agineszka W, Anderzej F M. Chapter 15 Fatty acid in human diet and their impact on cognitive and emotional functioning. In: Role of functional food security in Global Health.2019: 261-70.
18-Gateau PB, Samieri C, Cunnane SC.Long chain omega3 polysaturated fatty acids and cognition in order people:Interaction with Apoe genotype. 2016;23(1) :111.
19-Matlabi MO, Sharifirad GH, Mostavafi FI, Mohebi SI, Azadbakht LE. Factors Affecting Fish Consumption Based on Structures of Health Education. Journal of Health System Research.2012; 8(4): 523-36[Persian]
20-Dadgar Sh,Salehi H,Hajimirrahimi SD, Teimoori M. Measuring of per capita fish consumption and assessing barriers and development strategies for consumption in Markazi Province. Iranian Scientific fisheries Journal. Winter.2014: 23(4): 17-28. [Persian]
21-Hosseini S,Adeli M, Vahedi A. Evaluating factors and barriers affecting on per capita fish conception in Sari. Journal of fisheries. 2016; 431-350. [Persian]
22-Nejad Dadgar NA, Shojaeizadeh DA, Tol AZ, Hossaini MO, Amani FI. Assessing the Effect of Blended Educational Program Based on Health Belief Model on Adopting Preventive Behaviors in Alzheimer among Elders under Covering Ardebil Health Care Setting. Journal of Health System Research. 2014; 10(2): 386-94.[Persian]
23-Fotuhi M, Mohassel P, Yaffe K.Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer's disease: a complex association. Nature Clinical Practice Neurology.2009;5( 3).[Persian]
24-Cole Greg M. Prevention of Alzheimer's disease: Omega-3 Fatty Acids and phenolic anti-oxidant interventions. Neurobiology of Aging.2005;1:133-6.
25-Werner P. Factors influencing intentions to seek a cognitive status examination: A study based on the Health Belief M.Int J Geriatr Psychiatr. 2003; 18: 787-94.
26-Kim S, Sargent CK, Cherbuin N , Anastey K. Development of Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction Scale. Dement Geriatr Cogn Disord Extra.2014;4:172-83
27-Glanz KA, Rimer BA, Viswanath K. Health Behavior and Health Education: Theory, Research and Practice. 5th ed. San Francisco: Jossey - Bass publisher.2015 (2);8- 30.
28-Sharma MA, Romas JO.Theoretical Foundations of Health Education and Health Promotion 3nd Edition. Jones &Bartlett. 2018; 3:74-90.
29-Ghaffari MO, Sharifirad GH, Akbari ZE, Khorsandi MA, Hassanzadeh AK. Health Belief Model-Based Education & Reduction of Cesarean among Pregnant Women: An Interventional Study. Journal of Health System Research.2011;7(2):201-7.[Persian]
30-Goharinezhad S, Maleki M, Baradaran H, Ravaghi H. Futures of elderly care in Iran: A protocol with scenario approach. Med J Islam Repub Iran.2016; 30: 416.
31-Maghsoudi Ah, Mohammadi Bavariani FA, Salim SA. The association between health promoting behaviors and quality of life in the elderly people of Ewaz, Navid No.2016;19(62):16-23.[Persian]
32-Morovati MA, Rohani Tonekaboni N, Baghyani Moghadam MH. Study of self-care predictors in diabetic patient referring to Yazd Diabet Research Center based on the developed HBM. Juornal of Yazd Shahid Sadoughi University of Medical Sciences and Health Services.2007;15(31):85-93.[Persian]
33-BrownleeDuffeck M,Peterson L,Simonds JF,Goldstein D,et al. The role of health beliefs in theregimen adherence and metabolic control ofadolescents and adults with diabetes mellitus.Journalof Consulting and Clinical Psychology.1987; 55(2):139-44.
34-Mahdavi Sh, Malekzadeh K, Fararooei JM. preventing of osteoporosis: Applying the Health Belief Model.Journal of Nursing and Midwifery Shahid Behshti University of Medical Sciences. 2014;24( 87):15-22.[Persian]
35-Karimy MA, Taher MO, Azarpira HA. Measure health belief model construct about nutritional practices of pregnant women in Saveh University of Medical Sciences. Sci J Hamadan Nurs Midwifery Fac.2016; 24 (3):167-73 [Persian]
36-Babanezhad M.Investigating the Frequency and Factors Affecting the Consumption of Supplements in Southern People, Tehran City. Research in Medicine The Quarterly Journal of School of Medicine, Shahid Beheshti University of Medical Sciences.2013;37(2):93-7.[Persian]
37-Najmabadi Sh, Noojoomi M. Consumption of nutritional supplements in adults west of Tehran.Iranian Journal of Endocrinology and Metabolism .2010;12(4):365-75.[Persian]
38-Nejad Dadgar NA, Shojaeizadeh DA, Tol AZ, Hossaini MO, Amani FI. Assessing the Effect of Blended Educational Program Based on Health Belief Model on Adopting Preventive Behaviors in Alzheimer among Elders under Covering Ardebil Health Care Setting. Journal of Health System Research.2014; 10(2): 386-94 [Persian]
39-Tan MY. The relationship of health beliefs and complication prevention behaviors of Chinese individuals with Type 2 Diabetes Mellitus. Diabetes Res Clin Pract .2004;66(1):71-7.
40-Horvath J DC. Human papillomavirus knowledge,beliefs,and behaviors: questionnaire adaptation. European Journal of Obstetrics &Gynecology and Reproductive Biology.2016; 230: 103-8
41-Pham DT, Fortin F, Thibaudeau MF. The role of the Health Belief Model in amputees' self-evaluationof adherence to diabetes self-care behaviors. Diabetes educe .1996 ; 22(2):126-32.
42-Rodrigues RT.Claudia VG A, Rodrigues NG. Nutritonal status and eating habits of professors of Health Ere. Int J Sport Stud Hlth.2018; (1):e64335.
43-Kaewsutas M, Sarikaphuti A, Narartwanchai T, Sittiprapaporn PH, Patchanee.Electroencephalographic study of micro alage DHA omega-3 egg consumption on cognitive function. Journal of functional foods.2017; 29:46-52.
44-Mazloomy SA, Zahed SH, Emami MA, et al. A study on the evaluation of relationship between the predisposing factors and practice and demographic variables in caregivers of patients with Alzheimer's diseases. Journal of Isfahan Medical School.2015; 33(329):429-41.[Persian]
45-Mehri A, Sedighi Z, Koochak S.Application and Comparison of the Theories of Health Belief Model and Planned Behavior in Determining the Predictive Factors Associated with Seat Belt Use among Drivers in Sabzevar. Iranian Journal of Medical Education.2011;11(7):807. [Persian]
46-Hassanzadeh GH, Yekke Zare S, Vaziri S, Soroori Rad B, Darki L. Knowledge of women about menopause in Qazvin. The Journal of Qazvin Univ of Med Sci.2003;7(4): 21-5[Persian]
47-Abedini ZA, Bidgoli Sh,Ahmari Tehrani H. Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients. Qom University of Medical Sciences Journal, Summer .2008 ; 2 :2. [Persian]
48-Ramezankhani A, Mohamadi G, Akrami F, Zinali M. A Survey on the Knowledge, Attitude and Practice of the Elderly on Healthy Lifestyle in Tehran. Journal of Behdasht dar Arse (Health in the field).2013;1(1):1-5. [Persian]
49-Zarei1 E, Hatami H, Shahnam A, et al. Knowledge, Attitude and Practice of Health Science Students About the Outbreak of Water and Foodborne Diseases: A Survey in Shahid Beheshti University of Medical Sciences Journal of Environmental Health Engineering.2018;5(3):251-63.[Persian]
50-Sabzevari S, Nikbakht Nasrabadi A, Negahban Bonabi T. Sources of Women's Health Information: A Qualitative Study. J Qual Res Health Sci.2015; 3(4): 349-62. [Persian]
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Received: 2019/07/2 | Accepted: 2019/07/22 | Published: 2022/01/30
Received: 2019/07/2 | Accepted: 2019/07/22 | Published: 2022/01/30
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