Applying the trans-theoretical model to determine the mediating effect self-efficacy in breakfast consumption among children

Purpose Regular breakfast with a variety of nutrients can lead to improving educational performance, learning ability, reducing behavioral problems in elementary students. This study aims to use the Trans-Theoretical Model (TTM) to assess the mediating effect of self-efficacy in regular breakfast consumption among children of Ardabil elementary schools. Design/methodology/approach This cross-sectional study was performed between 300 students from elementary schools of different regions of Ardabil city by cluster sampling method. The instrument used in this study was the TTM standard questionnaire. Data was analyzed with Spearman correlation and regression using SPSS v18 software to identify the mediating effects of self-efficacy. Findings The mean age (SD) OF children was 11.2 (1.26) and 50% of them were female. Self-efficacy was the strongest predictor in stage promotion (ß = 0.44, P = 0.001), as well as had a mediating effect on the impact of other constructs of the model such as experiential processes (ß = 0.35, P = 0.04) and pros (ß = 0.44, P = 0.03) with stages of change. Pros were a significant predictor of self-efficacy in the first equation (ß = 0.17, P = 0.001) and Pros were a significant predictor of stages of change in the second equation when mediated by self-efficacy (ß = 0.11, P = 0.03). In the third equation, both the mediator, myself-efficacy and the predictor, Pros of breakfast consumption, were significantly associated with stages of change. The mediating effects of self-efficacy on the association between experiential processes and stages of change were also confirmed. The increased standardized beta coefficients of experiential processes between equations 3(ß = 0.35) and 2(ß = 0.29). Originality/value Due to the importance of eating a healthy breakfast regularly in children, this study aimed to use TTM to assess mediating effects of self-efficacy in regular breakfast consumption in Ardabil elementary students.

THE EFFECT OF TRANS-THEORETICAL MODEL BASED-MOTIVATIONAL INTERVIEWING ON PROMOTING EXERCISE BEHAVIOR IN HEALTHY ELDERLY: STUDY PROTOCOL OF A RANDOMIZED-CONTROLLED TRIAL

Individualized health promotion activities are needed to bring the disadvantaged groups into healthy lifestyle behaviors. The elderly is both the most inactive and the most affected by inactivity in the community. Primary care nurses can help 65+ individuals to gain exercise behavior by using their educator and guidance roles. The Trans-Theoretical Model (TTM) is an individualized counselling model that evaluates the behavior change as a process. TTM with motivational interviews (MI) is used to promote various health behaviors. This randomized-controlled trial will be conducted to investigate the effect of TTM based-MI on promoting exercise behavior in healthy elderly. The population is constituted of voluntary seniors who meet the inclusion criteria (n=117) from 65-74 aged individuals (N=1630) who registered to a family health center. A power analysis was performed for sample size estimation with .30 effect size and .80 power. The projected sample size was found 90. The participants are divided into stratums, blocking according to the age, gender and exercise behavior stages of change. The seniors from the created stratums is allocated into intervention and control groups randomly. The data will be gathered via a questionnaire, TTM scales, KATZ Activities of Daily Living Scale (KATZ-ADL) and Physical Activity Scale for Elderly (PASE). Waist circumferences will be measured and average weekly step counts will be calculated via a pedometer. The data will be collected via an independent researcher, blinded to the study groups. TTM-based MI for gaining exercise behavior program is planned to apply to the intervention group overall six times (face-to-face for four times biweekly and twice via telephone by four weeks). Intervention period is planned to be six months. The results obtained are expected to guide the community health nurses in terms of gaining the exercise behavior of the older individuals. This study is registered to clinicaltrials.gov, NCT04128553.

Designing and Psychometrics of a Questionnaire of Stretching Movement Assessment in the Workplace Based on the Trans-theoretical Model

Background: The trans-theoretical model is a model that is very sensitive to changes in the minor progress of behavior. Therefore, the trans-theoretical model is more practical than other patterns of behavior change, which have been considered all or no to measure physical activity. This study aimed to standardize and determine the validity and reliability of the tensile movement questionnaire at the University of Medical Sciences employees. methods: In this study, after searching the texts and the study of the same questionnaires and tools and among the available and related tools, the initial questionnaire was designed. First, the validity and content of the questionnaire were measured using experts' comments. Then, the ability to understand the questionnaire based on the opinions of 10 employees was investigated. Finally, to determine the reliability with the experimental-open test method, 30 employees, Cronbach's alpha, and the correlation coefficient were obtained using SPSS software. Results: After performing the necessary reforms with experts' opinions, finally, the questionnaire with increasing the number of questions of the field of self-efficacy from 6 to 7 questions, the reduction of the number of questions of the interests of stretching movements from 10 to 5 questions, increasing the number of questions of the barriers of stretching movements from 4 to 7 questions and increasing the number of questions of In the validation stage, each 40 of the questions had acceptable content validity (8.0 to 99.0). Also, at least 80% of the questions were diagnosed in terms of the target group acceptable. Cronbach's alpha coefficient and correlation coefficient were 86.0 and 7.0, respectively. Conclusion: A designed questionnaire based on the trans-theoretical model constructs to assess educational intervention to enhance the tensile movements of employees has acceptable reliability and validity.

Adhering to lifestyle change recommendations via the trans-theoretical model: a mixed-methods study among type 2 diabetes patients

Purpose This paper aims to identify and explore the factors affecting type 2 diabetes mellitus (T2DM) patients' adherence to lifestyle change recommendations, with the guidance of the trans-theoretical model (stages of change). Design/methodology/approach This study was conducted in two parts. In Part A, 163 randomly selected participants were asked to complete a cross-sectional survey. Data regarding demographics, stages of change and levels of confidence to engage in lifestyle changes were collected. In Part B, in-depth interviews were conducted among 30 individuals, aged between 30 and 65 years, had been diagnosed with T2DM and had seen dietitian at least once. Purposive sampling was used to recruit participants with different sociodemographic characteristics. Findings Part A showed that most of the participants were in the pre-action group (60%), with a higher mean HbA1c (8.9%) as compared to the action group (40%) which had a mean HbA1c of 6.9%. Part B further revealed the pre-action group and action group identified four key themes concerning lifestyle changes adherence: stumbling block; self-care belief; knowledge implementation; and self-empowerment. Practical implications Health-care providers should identify patients' stages of change before lifestyle changes implementation. Originality/value This study highlighted that many factors might influence a T2DM patient's adherence to lifestyle change recommendations. Determining the stages of change and self-confidence of T2DM patients is needed to ascertain long-term adherence.

Intention to stop khat chewing and associated factors among khat chewers in Gondar city, northwest Ethiopia: using Trans Theoretical Model

Background Khat chewing practice is rapidly increasing worldwide and currently an estimated over 10 million people chew khat. Trans Theoretical Model (TTM) is a promising model to assess the of stages of behavior change is a combination of intention. Given a sufficient control over the behavior, people carry out their intentions when the enabling environments arises. Assessing intention to quit chewing khat, motivational factors that influence behavior, is important to design effective interventions. Methods Community-based cross-sectional study was conducted from March to April 2019 in Gondar city, northwest Ethiopia. Six hundred five khat chewers were selected from six kebeles using cluster sampling method. Structured interviewer-administered questionnaire was used to collect data. Bivariate and multi-variable logistic regression model were fitted. Adjusted Odds ratio (AOR) with 95% confidence interval and p-values <0.05 in the multi-variable model were used to declare significant association. Results Out of the total participants, 69.3% (95% CI: 65.8-72.9) had intention to stop khat chewing within six months from the day of interview or before. Majority of the study participants 55.4% were on contemplation stage. Higher self-reevaluation [AOR=2.8, (95%CI: 1.6-5.0)], environmental reevaluation [AOR=1.9, (95%CI: 1.1-3.3)] and social liberation [AOR=1.8, (95% CI: 1.0-3.1)] process of changes were associated with intention to quit khat chewing. In addition, using additional substances and start chewing at earlier age were associated with lower intention to quit chewing. Conclusion Majority of the khat chewers had the intention to stop khat chewing. Increased self-reevaluation, environmental reevaluation and social liberation process of changes enhance the intention of quitting khat chewing. Thus, stage-based interventions should be done to motivate Khat chewers to stop khat chewing.