Journal of Preventive Medicine

Introduction
Obesity is one of the most important nutritional diseases in developed countries with high prevalence in the last two decades. It can be seen in any age, gender, race, and socio-economic groups. women have mentioned family responsibilities as a barrier to participation in sports activities more than men. Despite conducting numerous studies in the field of physical activities, there is little information about the factors affecting the participation of obese women in health promotion programs related to physical activities in Iran. Fewer studies have considered the physical activities of obese women based on health models. The effectiveness of health interventions depends on the use of educational theories and models. A model puts the educational program on the right track and provides a framework for measuring and evaluating the educational programs. The health belief model (HBM) is based on the assumption that the behavior is based on the personal attitude of the people and also the behavior depends on belief of the individual. Due to the high prevalence of overweight and obesity and related diseases in women living in Minab county, the present study aims to determine the effect of HBM-based educational program on increasing physical activity in obese women in Minab county, Iran.
Methods
This is a quasi-experimental study that was conducted on 220 obese women referred to comprehensive health centers in Minab county (110 in the intervention group and 110 in the control group). Minab county has two comprehensive health centers; one of them was randomly assigned to the intervention group and the other center to the control group. From each center, 110 obese women (BMI>25) were selected based on their health records. The data collection tool was a three-part questionnaire. The first part surveys demographic information; the second part was a researcher-made questionnaire based on the HBM, and the third part was the Global Physical Activity Questionnaire. The educational program was presented at 4 sessions of 45 min through lectures, collaborative discussions, brainstorming, photos and videos. All subjects were present until the end of the study and there was no dropout. The questionnaire was completed at baseline and 3 months after the end of intervention. The data was analyzed in SPSS v. 26 software using paired t-test, independent t-test, chi-square test, and McNemar’s test.
Results
At baseline, there was no statistically significant difference between the two groups in terms of the mean score of knowledge, metabolic equivalent of task (MET), and the HBM domains. However, three months after the intervention, a statistically significant difference was observed between the two groups in these variables. Before the intervention, 2.7% had appropriate physical activity in the intervention group; after the intervention, 20% had appropriate physical activity, and this difference was statistically significant (P<0.001). In the control group, 3.6% had appropriate physical activity before the intervention, and 1.8% had appropriate physical activity after the intervention (P>0.5). The chi-square test results showed that before the intervention, there was no statistically significant difference between the two groups in duration of physical activity (P>0.7), but after the intervention, the difference was statistically significant (P<0.001). The results of the McNemar’s test showed a statistically significant difference in the duration of physical activity before and after the intervention in the intervention group (P<0.001), while there was no significant difference in the control group (P>0.5).
Conclusion
The results of the present study showed an increase in the knowledge of obese women in the intervention group after the intervention, which shows the positive effect of the educational intervention. The findings of the present study also indicated the effect of the educational intervention on the cues to action. The discrepancies between the results of this study and other studies may be due to the difference in the study population, study methods, and educational materials. The findings also showed the effect of the educational intervention on the physical activity of obese women. Perhaps, it can be said that increasing knowledge through influencing the domains of the HBM was able to have a positive effect on women’s physical activity. Therefore, the necessary education for overweight and obese women is necessary to accept the benefits of physical activity and to overcome existing obstacles to have proper physical activity.

Ethical Considerations
Compliance with ethical guidelines
This study has ethical approval number IR.HUMS.REC.1399.378 from Hormozgan University of Medical Sciences.

Funding
This study was funded by Hormozgan University of Medical Sciences.

Authors' contributions
Collecting samples and drafting the article: Atefeh Mazaheri; Guidance and writing: Timur Aghamelai; Statistical and data analysis consultant: Shokraleh Mohseni; Reviewing the article: Ali Mosoli; Writing discussion and conclusion: Sara Dadipour.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors would like to thank Hormozgan University of Medical Sciences for financial support.
 

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