The Determinants of Hypertension and Commitment to Implementing a Nutrition Program: Application of Pender Health Promotion Model

Authors

1 Assistant Professor, Ph.D of Health Education and Promotion, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran

2 MSc of Health Education and Promotion, Public Health School, Golestan University of Medical Sciences, Gorgan, Iran.

3 Ph.D of Counseling, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

4 Medical Doctor,Tehran University of Medical Sciences, Tehran, Iran.

5 Assistant Professor, Ph.D of Health Education and Promotion, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran

6 Assistant Professor, Cereal Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

Abstract

Background and objective: The high prevalence of hypertension and its serious complications on body organs have made the disease a major health problem in all communities across the world. Given the high burden of hypertension, the present study was aimed at investigating the determinants factors of hypertension and commitment to implementing a nutritional program based on the Pender Health Promotion Model.
Methods:Across-sectional survey was conducted on 420 patients with hypertension supervised by the urban health centers of Gorgan city health district. Sampling technique was random multi-stage cluster sampling. Data was collected using a standard questionnaire based on the Pender Health Promotion Model (HPM). To analyze, descriptive methods and inferential statistical tests including independent t-test, one-way ANOVA, pearson correlation coefficient and linear regression model were used through SPSS version 18. The significance level was considered less than 0.05.   
Results: The results showed that 386 (91.9%) had no drug changes based on doctor comment and 352 (83.8%) did not use any drugs to control blood pressure. Statistical tests reported that commitment to implementing nutrition program had a remarkable differences with perceived barriers (p=0.001), self-efficacy (p=0.001), feelings related to behavior (p=0.001), situational determinants (P=0.038), and interpersonal factors (p=0.001).
Conclusion: The score of most constructs of the HPM was moderate; therefore, designing the effective interventions using HPM may be helpful in controlling hypertension.
Paper Type:Research Article.

Keywords

References

1.    Baghianimoghadam M, Aivazi S, Mzloomy S, Baghianimoghadam B. Factors in relation with self–regulation of Hypertension, based on the Model of Goal Directed behavior in Yazd city. JML. 2011;4(1):30.
2.    Abdollahy A, Bazrafshan H, Salehi A, Behnampour N, Hosayni S, Rahmany H, et al. Epidemiology of hypertension among urban population in Golestan province in north of Iran. J Gorgan Univ Med Sci. 2007;8(4):37-41.
3.    Brock CM, King DS, Wofford MR, Harrell TK. Exercise, insulin resistance, and hypertension: a complex relationship. Metab Syndr Relat Disord. 2005;3(1):60-5.
4.    Rahimian Mashhad Z, Attarzade Hoseyni SR. The effect of aerobic training and diet on cardiovascular risk factors and blood pressure in overweight and obese women with hypertension. IJEM. 2010;12(4):376-84.
5.    Rezazadehkermani M. Epidemiology and heterogeneity of hypertension in Iran: a systematic review. Arch Iran Med. 2008;11(4):444-52.
6.    Khodaveisi M, Omidi A, Farokhi S, Soltanian A. Dietary behavior status and its predictors based on the penders health promotion model constructs among overweight women referred to Fatemieh hospital clinics in Hamedan, 2014. J. Nurs. Educ. 2016;5(2):31-9.
7.    Chaman R, Yunesian M, Hajimohamadi A, Taramsari MG. Investigating hypertension prevalence and some of its influential factors in an ethnically variant rural sample. Knowledge and Health. 2008;3:39-42.
8.    Kamran A, Azadbakht L, Sharifirad G, Mahaki B, Mohebi S. The relationship between blood pressure and the structures of Pender's health promotion model in rural hypertensive patients. JEHP. 2015;4.
9.    Yano Y, Ning H, Muntner P, Reis JP, Calhoun DA, Viera AJ, et al. Nocturnal blood pressure in young adults and cognitive function in midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Hypertens. 2015;28(10):1240-7.
10.    Unni S, White K, Goodman M, Ye X, Mavros P, Bash LD, et al. Hypertension control and antihypertensive therapy in patients with chronic kidney disease. Am J Hypertens. 2014;28(6):814-22.
11.    Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. TLGS. 2009;10(1):5.
12.    Almas A, Godil S, Lalani S, Samani Z, Khan A. Good knowledge about hypertension is linked to better control of hypertension; a multicentre cross sectional study in Karachi, Pakistan. BMC Res Notes. 2012;5:579.
13.    Roca B, Nadal E, Rovira RE, Valls S, Lapuebla C, Lloria N. Usefulness of a hypertension education program. South Med J. 2003;96(11):1133-8.
14.    Pires CG, Mussi FC. [Health beliefs regarding diet: a perspective of hypertensive black individuals]. Rev Esc Enferm USP. 2012 Jun;46(3):580-9.
15.    Pawlak R, Colby S. Benefits, barriers, self-efficacy and knowledge regarding healthy foods; perception of African Americans living in eastern North Carolina. Nutr Res Pract. 2009;3(1):56-63.
16.    Henry H, Riemer K, Smith C, Reicks M. 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. J Am Diet Assoc. 2006;106:841-9.
17.    Tol A, Esmaeili Shahmirzadi S, Shojaeizadeh D, Eshraghian MR, Mohebbi B. Determination of perceived barriers and benefits of adopting health-promoting behaviors in cardiovascular diseases prevention: Application of preventative behavior model. Journal of Payavard Salamat. 2012;6(3):204-14.
18.    Mohebi S SG, Feizi A, Botlani S, HozoriM, Azadbakht L. . Can health promotion model constructs predict nutritional behavior among diabetic patients? J Res Med Sci. 2013;18:346-59.
19.    Shiplett B. An Examination of Knowledge, Health, Beliefs, and Health Promoting Behaviors Related to Heart Disease Among University Women: Southern Illinois University Carbondale; 2007.199 p.
20.    Mularcik K. Self-Efficacy Toward Health Behaviors to Improve Blood Pressure in Patients who Receive Care in a Primary Care Network: The Ohio State University; 2010.
21.    Paryad E, Hosseinzade T, Kazemnejad E, Asiri S. A Study of Self-efficacy in  Patients with Coronary Artery Disease and Its Predictors. Qom Univ Med Sci J 2013;7(2):41-8.
22.    Ard JD, Coffman CJ, Lin PH, Svetkey LP. One-year follow-up study of blood pressure and dietary patterns in dietary approaches to stop hypertension (DASH)-sodium participants. Am J Hypertens. 2004;17(12 Pt 1):1156-62.
23.    Parker WA, Steyn Np Fau - Levitt NS, Levitt Ns Fau - Lombard CJ, Lombard CJ. Health promotion services for patients having non-comminicable diseases: feedback from patients and health care providers in Cape Town, South Africa. BMC public health. 2012 Jul (12):503.
24.    Khatib R, Schwalm J-D, Yusuf S, Haynes R, McKee M. Patient and Healthcare Provider Barriers to Hypertension Awareness, Treatment and Follow Up: A Systematic Review and Meta-Analysis of Qualitative and Quantitative Studies. PLoS ONE. 2014;9(1):e84238.
25.    Lloyd H, Paisley C, Mela D. Barriers to the adoption of reduced-fat diets in a UK population. J Am Diet Assoc. 1995;95:316-22.
26.    Wexler R, Elton T Fau - Pleister A, Pleister A Fau - Feldman D, Feldman D. Barriers to blood pressure control as reported by African American patients. J Natl Med Assoc. 2009 Jun;101(6):597-603.
27.    Horowitz C, Tuzzio L, Rojas M, Monteith S, Sisk J. How do urban African Americans and Latinos view the influence of diet on hypertension? J Health Care Poor Underserved. 2004 15(4):631-44.
28.    Motlagh Z MS, Mozaffari Khosravi H, Morowatisharifabad M, Askarshahi M. . Salt Intake Among Women Refer to Medical Health Centers, Yazd, Iran. J Med Uni Sadoughi Shahid. 2011. JSSU. 2011;19(4):550-60.
29.    Hargreaves MK, Schlundt Dg Fau - Buchowski MS, Buchowski MS. Contextual factors influencing the eating behaviours of African American women: a focus group investigation. Ethn Health. 2002 7(3):133-47.
30.    Keshani P, Farvid M. Perceived benefits and barriers regarding high fiber food intake in type 2 diabetes patients- A qualitative study. Iranian Journal of Nutrition Sciences & Food Technology. 2012;7(1):11-22.
31.    Morowatisharifabad M, Rouhani-Tonekaboni N. The relationship between perceived benefits/Barriers of self-care behaviors and self management in diabetic patients. Hayat 2007;13(1):17-28.
32.    Center for Substance Abuse Treatment. Enhancing Motivation for Change in Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 35.) Chapter 1-- Conceptualizing Motivation And Change. Available from: http://www.ncbi.nlm.nih.gov/books/NBK64972/.
33.    Story MT, Neumark-Stzainer Dr Fau - Sherwood NE, Sherwood Ne Fau - Holt K, Holt K Fau - Sofka D, Sofka D Fau - Trowbridge FL, Trowbridge Fl Fau - Barlow SE, et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatr. 2002 Jul(1):210-4.


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