The Effect of Health Belief Model on Posture of Tehrani Secondary Students

By: Mohammad Kamali, PhD, PT

Assistant Professor of Iran University of Medical Science

Abstract

There were 260 first class pupils of the secondary (leading) school in the 3rd region of Tehran investigated and researched by the choice of a questionnaire which was regulated on the basis of the Health Belief Model and were examined and observed by the New York Test for measuring the late impression of applying the Health Belief Model on the body posture.  The findings represented that the preventive behaviors and body posture before teaching intervention were in a low level and there was not a significant between the two groups of witness and experiment. The results obtained from the study after the instructional intervention involved the significant difference (P<0.000) between the two groups following the preventive behavior choice. There was also a recuperation of the body posture in the experiment group with a significant difference (P<0.000(. The preventive behavior analysis involved six behaviors and the body posture eight states and the performance of the Wilcoxon test included the significant difference (P<0.000) for the whole behaviors and five body postural states. The above-cited results emphasized the effects of instruction on the basis of Health Belief Model and were accommodated with some previous researches. The perceived benefits out of the ingredients of the Health Belief Model represented the best significant correlation with preventive behaviors which was in accordance with the revious studies

 Introduction

 An indication of human being is his motion. Motion is one of human activities,  sign and vend index and its continuation causes the growth of living creatures.  The human motion begins from the fertilization within the human body and is the primitive gentians of the evolution of physical and psychological aspects of human generation. Preventing the human from moving, leads to various psychological and physical complications. Due to the motion the organs develop to the best and the muscles become bulkier and stronger. The blood coalition and pulmonary system and skeletons of the human body become more completed and robust.  

The recent progresses and tendency of humans to mechanical life is one of the causes for movement poverty in the organs. Nowadays the evacuate motion within the different groups is widespread and the young are specially exposed to the danger of in adequate movement that can give rise to various implications. Among all these, posture of the human body is very important, and if we all these, posture of the human body is very important, and if we consider various postures of the young we can observe various muscle weakness, deviate postures and faulty habits of body maintenance hypnosis and scoliosis are the most important of them. The studies represent the relationship between the postural deviations and the manner of sitting, standing, walking, weight bearing, daily physical exercises and the muscle condition.  

The above studies indicate the involvement of about 40% to 80% of the pupils and students to have various abnormalities. (1 to 5( The possibility of preventing the above complications and damages by presenting education and corrective exercises and on the other hand regarding superiority of the preventing aspects over the treatment in health education programs and the application of various health education models, it will be possible to prevent the onset and improvement of the disease by developing correct healthy habits and changing life-styles. The health belief model is one of the suitable health education models, which is based on the various researches and is used for preventing the diseases and developing correct health models. Regarding to the rapid growth of the secondary school among adolescence , in attention to their body posture and correct maintenance of various body conditions and lack of dealing with their postural deviation can bring irretrievable damages for them in the future. The recent study has tried, by  applying the Health Belief Model, to investigate its effect on the pupil’s body posture and to approach the preventive behaviors.

 Methods and Materials

 The recent research was done in random and multi-sectional Method by selecting 260 first grade of secondary school out of the 3rd region of Tehran's education department, 8 schools were selected in random, one class was chosen from each school and then four classes out of and classes (2 male classes and 2 female classes) were selected as witness and experiment group. The research objectives were specifying the impression of the Health Belief Model on approaching preventive behavior and body postures of the pupils in two groups of witness and experiment.

The research hypothesis emphasized on the significant variables between the preventive behaviors and body postures before and after teaching intervention in the witness and experiment groups. The information were collected by choosing the questionnaire and observation paper of the body posture based on the New York Test, in the meantime 6 distinguished behaviors were observed by the research in the questionnaire. The questionnaires and observation papers were completed twice, before and after teaching intervention for all the pupils. Based on the first results, educational programs and contents were prepared and performed for the experiment group by attendance education in class, preparing educational posters and hanging them in class and talking with the exercise teacher. The questionnaires were completed again completed by testing the pupils.

The instruments used for completing the network test papers were checkered sheets and a plumb line, which were adequately respond to the test. Tape-meter and ordinary scales were also measures for the pupils, height and weight. The New York Test evaluates and different body conditions. The questionnaire was regulated based on the Health Belief Model and its 4 important factors (the perceived sensitivity, perceived sensitivity, perceived severity that determine the perceived threat overall, the perceived benefits, perceived obstacles and the cues to action (internal and external). All the questions were accompanied with answers (agreeable, opposed, abstainer) measuring 16 perceived sensitivity questions, 13 perceived severity questions, 8 perceived benefit questions, 8 perceived obstacle questions and 15 cues to action questions.  To represent the forgiving distribution and diagrams for the data analysis, the descriptive statistics and to test the research hypothesis, the inferential statistics were used. T-test, dual T-test, Wilcoxon test, coefficient of correlation, analysis of variance and regression analysis were used for this purpose.  

 Results

 The study data represented no significant variance between the pupils body posture scores acquired before the teaching intervention in groups of witness and experiment. (Table 3) Also the dual T-test didn't represent any significant variance in the witness group before and after educational intervention. But this test, in the two testing groups indicated significant variance before and after ducational intervention with P<0.001. (Table 2(

Regarding body postures, eight various states were measured and that posture changes of the above conditions were also evaluated by the Wilcoxon statistics test. Five postures (bilateral rotation of head, shoulders asymmetry, scoliosis, kyphosis and round shoulders with (P<0.000) and (P= .4) related to shoulder asymmetry showed significant variable before and after educational intervention) while in the witness group, none of the conditions showed significant variance. (Table 3 and 4(

Regarding adopting preventive behaviors no significant variance was shown before teaching intervention between the two experiment and witness group. Meanwhile at this time, the behaviors were not at a suitable level. Also after teaching intervention the T-test showed significant variance P<0.001 between the experiment and witness groups.

The mean marks changed from 15.95 to 10.12 and in the experiment group and from 15.24 to 15.09in the witness group. Also the dual T-test indicated no significant variance in the witness group before teaching intervention .Although there was a significant variance P<0.000 in the experiment group. (Table 5( The preventive behaviors indicated 6 different behaviors which the Wilcoxon test showed that all behaviors have a significant variance before and after teaching intervention in the experiment group P<0.000,although this variance was not seen in the witness group.(Table 6 and 7(

 Discussion

 Health education is known as behavior modification and adopting Healthy behaviors and/or replacing them with unhealthy behaviors and behaviors without preventing aspects can be marked as a success in the health educating program. In the current research, two factors were in mind for deliberating the amount of Health Belief Models impact, first, adopting preventive behaviors and second, body postures of pupil. With consideration of the obtained results in the experiment and witness groups it is possible to discover the impression of the presented education based on the health belief model related to the 2 above factors and it can be said that only the presented education factor leads to adopting preventive behaviors and followed by that the body change condition in the experiment group.

This note was considered in a study performed by Mrs. Laleh Behbudi (1993),(which involved the investigation of the impact of a period of special corrective movements on the FVC of kyphotic female students 15-18 years old, in Karadj and recorded the significant effects of corrective exercises on the Kyphotic complication (1(. Also Mrs.Faranak Soltanian (1990) recorded the positive effect applying the health belief model for the function of people suffering from high blood pressure relating to diet and sport before and after education showed a significant variance (2). Shima Sam (1994) recorded in her study named "Investigation of the late impression of physical health education to primary school pupils in Tonkabon for prevention of postural scoliosis", the significant variance before and after education that are in coordination with this research (3) Also those results were in coordination with the results of researches of Habib Honarie (1992) (4) and Reza Gharakhanlo (1989). (5(

In the Health Belief Model respect, the correlation between the Models various factors and the preventive behaviors decision were measured. Pierson's correlation Test represented significant correlation with perceived benefits on the test group at P<0. 01, while such correlation was not observed in other Health Belief Model factors in the witness group. Barker (1995) recorded that health belief to perceived benefits as a variable, by its own, has a significant relationship with the participation and acceptance of the preventative orders about the dental diseases (6). French and others (1992) represented that between the tests variable, only the perceived benefits factors were significant. (7( Hyman and others (1994) studied the Health Belief Model variables to see the use of breast cancer test, the data indicated the serious need of women under research to negotiate about the benefits and probable obstacles of the above test.(8) Shilo and Kohens (1992), Boeds, Aikins, and Somerville (1992) Researches emphasized the correlation between the perceived benefits and the function of the two-research group.(9-12)

There was also significant correlation between the difference of marks before and after body postures at P<0.001, in the experiment group but there was no significant correlation in the witness group. This also indicated the impression of the preventive behaviors diversion on the pupil’s body postures. The results obtained from the data show that the health belief model based on education has had positive impression on the preventive behaviors decision and the tested pupil’s body postures in the experiment group.

Table1: Comparison of the posture between experiment and witness group, Before an after intervention.

Table 2: Comparison of the mean of score after posture before and after, in Experiment and witness groups.

Table3: Comparison of the posture before and after intervention in Experiment groups.

Table 4: Comparison of the posture before and after of Intervention in Witness group.

Table 5: Comparison of the mean of score of preventive behavior in Experiment and Witness group, before and after of intervention.

Table 6: Comparison of preventive behavior before and after of Intervention in experiment group.

Table7: Comparison of preventive behavior before and after of Intervention, in witness group.

Reference

1 - Behabudi, L. "The effect of corrective movement on FVC of Kyphotic girl students 15-18 years in Karadj city" Thesis for Msc. Course University of Tarbiat Moallem. Tehran

2 - Soltanian, F. "The effect of Health belief Model on performance of Hypertension patients on Diet and sport …… "Thesis for Msc. University of Welfare and Rehabilitation. Tehran

3 - Sam, S. "The effect of physical Health Education on primary school students in Tonkabon city on prevention of scoliosis. “Thesis for MSC.  Course in Health Education. Tarbiat Modarress University. Tehran.

4 - Honari, H., "Survey on conditional deformities in sport students in Iran." Thesis, for Msc in physical Education tarbit Modaress University Tehran.

5 - Mahdavineyad, R. "The effect of physical activities and sports on correction of conditional deformities of spin in secondary school studies of Tehran. Thesis for Msc in physical Education. Tarbiat Modaress University Tehran.

6 - Barker T. "Role of Health belief Model in patient compliance with preventive dental advice: Community Dent Oral Epidemiology 1994. No 22. PP 124-8

7 - French BN; Kurezynski TW; Weaver MT; Pitch MY. “Evaluation of the Health belief Model about decision making regarding amniocentesis in women of advanced maternal age".  Health education Q. 1992 Vol.19.No (2) .pp 177-86

8- Hyman RB; Baker S; Ephraim R; philipy J. “Health Belief Model variables as predictors of screening mammography utilization". J Behov Med. 1994. Vol.17. No (4) .PP 391-406

9 - Orr DP; longefeld Cd. "Factors associated with condom use by sexually active adolescents at risk for sexually transmitted disease" pediatrics. 1993.  Vol.91. No (5). Pp. 873-9

10 - Champion VL. "Compliance with guidelines for mammography screening" cancer detects prevention. 1992. Vol.16. No (4) PP 363-70

11 -Sagi M; Shiloh S; Cohen T. "Application for mammography screening ". Ncer detects prevention. 1992 Vol.11, No (6). PP 303-70

12 - Bond GG; Aiken LS: Somerville Sc. "The health belief model and adolescents with insulin-dependent diabetes mellitus", Health psychology. 1992. Vol.11. No (3). PP 195-8