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Volume 10, Issue 4 (1-2024)                   J Prevent Med 2024, 10(4): 304-315 | Back to browse issues page

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Salari S, Aghamolaei T, Hosseini Z, Mohseni S. The Effectiveness of Educational Intervention Based on the Information-motivation-behavioral Skills Model in Improving Self-care Behaviors of Patients With Hypertension. J Prevent Med 2024; 10 (4) :304-315
URL: http://jpm.hums.ac.ir/article-1-699-en.html
The Effectiveness of Educational Intervention Based on the Information-motivation-behavioral Skills Model in Improving Self-care Behaviors of Patients With Hypertension
Shiva Salari1 , Teamur Aghamolaei * 2, Zahra Hosseini2 , Shokroallah Mohseni3
1- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2- Department of Health Education and Health Promotion, Social Determinants in Health Promotion Research Center, School of Health, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
3- Department of Epidemiology, Social Determinants in Health Promotion Research Center, School of Health, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Keywords: Self-care, Hypertension, Information-motivation-behavioral skills
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Introduction
Hypertension is defined as systolic blood pressure above 140 mm Hg and diastolic blood pressure above 90 mm Hg. This disease is a global health problem that affects approximately one billion people worldwide. It is associated with an increased risk of cardiovascular diseases, especially in developing countries. The prevalence of hypertension in Iran, like in many other countries, is increasing due to reasons such as rapid social changes such as urbanization, changes in lifestyle, and the increase in the life expectancy of patients following the advancement of medical knowledge. Although this disease is chronic in nature, it can be controlled by modifying the lifestyle, having proper diet and improving self-care behaviors. Teaching self-care behaviors, in addition to preventing the aggravation of symptoms, can reduce the number of hospitalizations, mortality rate, and treatment costs, make patients feel healthy and comfortable, and improve their functional abilities. Theory-based interventions in health-related behaviors are more effective than methods without a theoretical framework, because they are a means of developing interventions and a guide for the evaluation of interventions. The present study aims to determine the effect of educational intervention based on the information-motivation-behavioral skills (IMB) model on increasing the self-care behavior of patients with hypertension in Iran.

Methods
This is a quasi-experimental study on 250 participants with hypertension in Darab County, Iran in 2022. The sample size was determined to be 112 in each group. However, considering a sample drop of 10%, it increased to 125 in each group of control and intervention. The random sampling method in a two-stage method was used. Darab County has four comprehensive health service centers, out of which two centers that were adjacent to each other were used for recruiting the patients for the intervention group and the other two centers were used to select controls. The data was collected using a three-part questionnaire with acceptable validity and reliability measuring demographic information, constructs of the IMB model, and self-care behaviors. Four educational sessions of 60 minutes were held for the participants and their family members in the intervention group. A post-test was conducted 2 months after the educational intervention. The data collected in the pre-test and post-test phases were finally analyzed. The Kolmogorov-Smirnov test was used to check the normality of the data distribution. Based on its results, paired t-test and independent t-test were used to compare two groups before and after the intervention. Mean and standard deviation were used to describe quantitative data, while frequency and percentage were used to describe qualitative variables. All data analysis was done in SPSS software, version 22, considering the significance level at 0.05.

Results
Participants in the intervention group were 43.2% male and 56.8% female. In the control group, 34.4% were male and 65.6% were female. In terms of other demographic information, including age, marital status, educational level, occupation, body mass index, and history of education intervention, there was no significant difference between the two groups.
The mean knowledge score before and after education was significantly different in the intervention group (P<0.001). The knowledge score increased after the IMB-based education. The score of knowledge before and after the intervention was not significantly different in the control group (P=0.08). Therefore, it can be said that the educational intervention was effective in increasing the knowledge score of patients. The mean motivation score before and after education was also significantly different in the intervention group (P<0.001), such that it increased after education. There was no significant difference between the pretest and post-test motivation scores in the control group (P=0.68). After the educational intervention, the average score of behavioral skills in the intervention group increased significantly, and there was a statistically significant difference between the two groups (P=0.001). Therefore, a significant difference was observed in all IMB model domains after education in the intervention group, where the motivation domain showed more increase. The mean score of self-care behaviors before and after education was also significantly different in the intervention group, such that it increased after the education (P<0.001).

Conclusion
The results of this study showed that the IMB model-based education increased knowledge about the behavior, motivation to perform the behavior, and behavioral skills, as well as self-care behaviors of patients with hypertension. Knowledge and motivation have a direct impact on behavioral skills and healthy behaviors. In addition, behavioral skills have a direct impact on healthy behavior. Therefore, considering the high prevalence of hypertension in Iran and the importance of improving the self-care of these patients to prevent early and late complications of hypertension, it seems that educational interventions based on the IMB model in the field of self-care behaviors, can have beneficial results. If doctors and health workers use the IMB model to educate patients with hypertension in the field of self-care behaviors, the improvement in self-care can reduce the complications caused by hypertension.

Ethical Considerations

Compliance with ethical guidelines
This study was approved by the Hormozgan University of Medical Sciences (Code: R.HUMS.REC.1400.384).

Funding
This paper was financially supported by the Hormozgan University of Medical Sciences.

Authors' contributions
Study design: Shiva Salari, Teamur Aghamolaei and Zahra Hosseini; Data collection; Shiva Salari; Statistical analysis: Shokrollah Mohseni; Writing the original draft: Shiva Salari and Zahra Hosseini; Review and editing: Teamur Aghamolaei and Zahra Hosseini.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors appreciate Hormozgan University of Medical Sciences for the support.




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Type of Study: Orginal | Subject: Health Education
Received: 2023/03/28 | Accepted: 2023/05/7 | Published: 2024/01/1
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