Effect of theory-based intervention to promote physical activity among adolescent girls
A randomized control trial
Keywords:
Theory-based intervention, Adolescents, Physical activity, TPBAbstract
Background: Physical activity (PA) rates decline among most high school female students, and due to cultural restrictions, the reduction of physical activity might be exacerbated in female Iranian adolescents.
Objective: To determine the effects of the physical activity education theory-based intervention to promote activity among adolescent girls.
Methods: This randomized clinical trial was conducted at public high schools in Tehran, Iran, from September 2015 to July 2016 on 578 girls. The subjects were assigned randomly to two groups of experiment and control (n=289 per group). All participants in the experimental group received an educational program based on a modified TPB. Measures were assessed before and 6 months after the experiment. The data were analyzed using SPSS version 23. We used descriptive statistics, multilevel analysis, Likelihood Ratio (LR) test, P-value less than 0.05 were considered statistically significant.
Results: Five hundred and seventy-eight participants with a mean age of 14.26±0.96 years were studied in two groups of experiment (n=289) and control (n=289). Moreover, adjusted for the baseline values, the mean of the scores of the knowledge (84.1±13.6), attitude (31.2±13.6), subjective norm (40.4±11.1), behavioral intention (34.3±14.7), perceived behavioral control (38.4±11.6), perceived parental control (42.9±14.2), behavioral (42.6±17.1) was significantly higher in the experiment group compared with the control group (p<0.001).
Conclusions: The results of this study implicate that theory based educational intervention is considered to be more effective in improving physical activity in adolescents. This result can be used to increase adolescent’s health promotion.
Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (IRST) with the identification number: IRCT2015070623089N2.
Funding: The authors received no financial support for the research from Kermanshah University of Medical Sciences.
References
Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, et al. A 2 year multidomain
intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent
cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;
(9984): 2255-63. doi: 10.1016/S0140-6736(15)60461-5. PMID: 25771249.
Pivovarov JA, Taplin CE, Riddell MC. Current perspectives on physical activity and exercise for youth
with diabetes. Pediatric diabetes. 2015; 16(4): 242-55. doi: 10.1111/pedi.12272. PMID: 25754326.
Roberto CA, Swinburn B, Hawkes C, Huang TT, Costa SA, Ashe M, et al. Patchy progress on obesity
prevention: emerging examples, entrenched barriers, and new thinking. Lancet. 2015; 385(9985): 2400-9.
doi: 10.1016/S0140-6736(14)61744-X. PMID: 25703111.
Popkin BM, Slining M. New dynamics in global obesity facing low‐and middle‐income countries.
Obesity Reviews. 2013; 14(S2): 11-20. doi: 10.1111/obr.12102. PMID: 24102717, PMCID: PMC4074506.
Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, et al. Youth risk behavior surveillance- United States, 2011. Morbidity and mortality weekly report Surveillance summaries. 2012; 61(4): 1-162.
Taymoori P, Rhodes R, Berry T. Application of a social cognitive model in explaining physical activity in
Iranian female adolescents. Health Educ Res. 2010; 25(2): 257-67. doi: 10.1093/her/cyn051. PMID:
Hills AP, Dengel DR, Lubans DR. Supporting public health priorities: recommendations for physical
education and physical activity promotion in schools. Prog Cardiovasc Dis. 2015; 57(4): 368-74. doi:
1016/j.pcad.2014.09.010. PMID: 25269062.
Hardy LL, Barnett L, Espinel P, Okely AD. Thirteen-year trends in child and adolescent fundamental
movement skills: 1997-2010. Med Sci Sports Exerc. 2013; 45(10): 1965-70. doi:
1249/MSS.0b013e318295a9fc. PMID: 24048319.
Taymoori P, Niknami S, Berry T, Lubans D, Ghofranipour F, Kazemnejad A. A school-based randomized
controlled trial to improve physical activity among Iranian high school girls. Int J Behav Nutr Phys Act.
; 5(1): 18. doi: 10.1186/1479-5868-5-18. PMID: 18387174, PMCID: PMC2386503.
Janghorbani M, Amini M, Willett WC, Gouya MM, Delavari A, Alikhani S, et al. First nationwide survey
of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity. 2007; 15(11):
-808. doi: 10.1038/oby.2007.332. PMID: 18070771.
Allafi A, Al-Haifi AR, Al-Fayez MA, Al-Athari BI, Al-Ajmi FA, Al-Hazzaa HM, et al. Physical activity,
sedentary behaviours and dietary habits among Kuwaiti adolescents: gender differences. Public Health
Nutr. 2014; 17(09): 2045-52. doi: 10.1017/S1368980013002218. PMID: 23987909.
Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO. Physical activity, sedentary
behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr
Phys Act. 2011; 8(1): 140. doi: 10.1186/1479-5868-8-140. PMID: 22188825, PMCID: PMC3339333.
Belton S, O’Brien W, Meegan S, Woods C, Issartel J. Youth-Physical Activity Towards Health: evidence
and background to the development of the Y-PATH physical activity intervention for adolescents. BMC
Public Health. 2014; 14(1): 122. doi: 10.1186/1471-2458-14-122. PMID: 24499449, PMCID:
PMC3922546.
Lai SK, Costigan SA, Morgan PJ, Lubans DR, Stodden DF, Salmon J, et al. Do school-based interventions
focusing on physical activity, fitness, or fundamental movement skill competency produce a sustained
impact in these outcomes in children and adolescents? A systematic review of follow-up studies. Sports
Med. 2014; 44(1): 67-79. doi: 10.1007/s40279-013-0099-9. PMID: 24122775.
Vasconcellos F, Seabra A, Katzmarzyk PT, Kraemer-Aguiar LG, Bouskela E, Farinatti P. Physical activity
in overweight and obese adolescents: systematic review of the effects on physical fitness components and
cardiovascular risk factors. Sports med. 2014; 44(8): 1139-52. doi: 10.1007/s40279-014-0193-7. PMID:
Ribeiro IC, Parra DC, Hoehner CM, Soares J, Torres A, Pratt M, et al. School-based physical education
programs: evidence-based physical activity interventions for youth in Latin America. Glob Health Promot.
; 17(2): 5-15. doi: 10.1177/1757975910365231. PMID: 20587626, PMCID: PMC2904544.
Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, et al. Evidence-based intervention
in physical activity: lessons from around the world. Lancet. 2012; 380(9838): 272-81. doi:
1016/S01406736(12)60816-2. PMID: 22818939, PMCID: PMC4978123.
Vernon SW, Bartholomew LK, McQueen A, Bettencourt JL, Greisinger A, Coan SP, et al. A randomized
controlled trial of a tailored interactive computer-delivered intervention to promote colorectal cancer
screening: sometimes more is just the same. Ann Behav Med. 2011; 41(3): 284-99. doi: 10.1007/s12160- 010-9258-5. PMID: 21271365, PMCID: PMC3265931.
Chatzisarantis NL, Hagger MS. Effects of a brief intervention based on the theory of planned behavior on
leisure-time physical activity participation. Journal of Sport and Exercise Psychology. 2005; 27(4): 470-87.
doi: 10.1123/jsep.27.4.470.
Kothe EJ, Mullan B, Butow P. Promoting fruit and vegetable consumption. Testing an intervention based
on the theory of planned behaviour. Appetite. 2012; 58(3): 997-1004. doi: 10.1016/j.appet.2012.02.012.
PMID: 22349778.
Srinivasan SM, Pescatello LS, Bhat AN. Current perspectives on physical activity and exercise
recommendations for children and adolescents with autism spectrum disorders. Phys Ther. 2014; 94(6):
doi: 10.2522/ptj.20130157. PMID: 24525861, PMCID: PMC4040426.
Mbonile L, Kayombo EJ. Assessing acceptability of parents/guardians of adolescents towards introduction
of sex and reproductive health education in schools at Kinondoni Municipal in Dar es Salaam city. East Afr
J Public Health. 2008; 5(1): 26-31. PMID: 18669120.
Mirzaei K, Olfati F. Educational needs of adolescent girls for reproductive health in teachersُ views.
JQUMS 2014; 18(2): 67-76.
Cleland J, Verrall J, Vaessen M. Preferences for the sex of children and their influence on reproductive
behaviour. 1983.
Darabi F, Khalaj abadi farahani F, Kaveh MH, Safari M, Yaseri M, Majlesi F, et al. Development and
Psychometric Properties of a Belief-Based Reproductive Health Behavior Questionnaire for Female
Adolescents. Iranian journal of public health. 2016; in press.
Brauer P, Gorber SC, Shaw E, Singh H, Bell N, Shane AR, et al. Recommendations for prevention of
weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in
adults in primary care. CMAJ. 2015; 187(3): 184-95. doi: 10.1503/cmaj.140887. PMID: 25623643,
PMCID: PMC4330141.
Cesari M, Vellas B, Hsu FC, Newman AB, Doss H, King AC, et al. A physical activity intervention to treat
the frailty syndrome in older persons-results from the LIFE-P study. J Gerontol A Biol Sci Med Sci. 2015;
(2): 216-22. doi: 10.1093/Gerona/glu099. PMID: 25387728, PMCID: PMC4311184.
Taghdisi MH, Babazadeh T, Moradi F, Shariat F. Effect of Educational Intervention on the Fruit and
Vegetables Consumption among the Students: Applying Theory of Planned Behavior. J Res Health Sci.
; 4(16): 195-9. PMID: 28087851.
Sallis JF, Haskell WL, Fortmann SP, Vranizan KM, Taylor CB, Solomon DS. Predictors of adoption and
maintenance of physical activity in a community sample. Prev med. 1986; 15(4): 331-41. PMID: 3763558.
Lubans DR, Foster C, Biddle SJ. A review of mediators of behavior in interventions to promote physical
activity among children and adolescents. Prev med. 2008; 47(5): 463-70. doi:
1016/j.ypmed.2008.07.011. PMID: 18708086.
Hosseini Z, Aghamolaei T, Gharghani ZG, Ghanbarnejad A. Effect of educational interventions based on
theory of planned behavior to promote breakfast consumption behavior in students. Hormozgan Medical
Journal. 2014; 19: 35-43.
Barati M, Allahverdipour H, Moinei B, Farhadinasab A, Mahjub H. Evaluation of theory of planned
behavior-based education in prevention of MDMA (ecstasy) use among university students. Medical
Journal of Tabriz University of Medical Sciences. 2011; 33(3): 20-9.
Bhatti T. Exploring factors influencing the adoption of mobile commerce. The Journal of Internet Banking
and Commerce. 2015; 2007.
Sohrabi F, Hadian M, Daemi H, Farid AA. The effectiveness of healthy behavior training program in
changing attitude of students towards substance abuse. International Journal of Behavioral Sciences. 2008;
(3): 209-20.
Borawski EA, Ievers-Landis CE, Lovegreen LD, Trapl ES. Parental monitoring, negotiated unsupervised
time, and parental trust: The role of perceived parenting practices in adolescent health risk behaviors. J
Adolesc Health. 2003; 33(2): 60-70. PMID: 12890596, PMCID: PMC3142794.
Jahangiry L, Shojaeizadeh D, Farhangi MA, Yaseri M, Mohammad K, Najafi M, et al. Interactive web- based lifestyle intervention and metabolic syndrome: findings from the Red Ruby (a randomized controlled
trial). Trials. 2015; 16: 418. doi: 10.1186/s13063-015-0950-4. PMID: 26390998, PMCID: PMC4578667.
Sanavi FS, Navidian A, Rakhshani F, Ansari-Moghaddam A. The effect of education on base the Theory of
Planned Behavior toward normal delivery in pregnant women with intention elective cesarean. Bimonthly
Journal of Hormozgan University of Medical Sciences. 2014; 17(6): 531-9
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