Osteoporosis is a progressive and preventable metabolic disease. This study aimed to assess the short-term effect of the educational program based on the Beliefs, Attitude, Subjective Norms, Enabling Factors (BASNEF) model on the osteoporosis preventive behaviors in adolescent girls. It was found that the BASNEF model improved the osteoporosis preventive behaviors in adolescent girls.
Osteoporosis is a progressive and preventable metabolic disease. This study aimed to investigate the short-term effect of the education program based on the BASNEF model on the osteoporosis preventive behaviors in adolescent girls.
This randomized clinical trial was conducted on adolescent girls from January to August 2018 in an urban area of Iran. Subjects were 120 adolescent girls aged 13–14 years studying in the girls’ high school that were randomly assigned to intervention and control groups. The data collection tool was the demographic questionnaire and the researcher-made questionnaire consisting of six domains based on the BASNEF model. Validity and reliability of the questionnaires were confirmed before data collections. The educational program was developed based on the BASNEF model in four sessions lasting from 30 to 45 min. Data was collected before, immediately and 1 month after the educational program and was analyzed via the SPSS software v.18.
No statistically significant differences were reported between the groups in terms of knowledge (p = 0.48), attitude (p = 0.94), subjective norms (p = 0.17), behavioral intention (p = 0.82), enabling factors (p = 0.62), and osteoporosis preventive behaviors (p = 0.32). Meanwhile, immediately and 1 month after the educational program, differences were reported between the two groups in knowledge (p < 0.001), attitude (p = 0.002, p < 0.001), subjective norms (p = 0.024, p = 0.001), behavioral intention (p < 0.001, p = 0.001), enabling factors (p < 0.001), and osteoporosis preventive behaviors (p < 0.001).
It is suggested that educational program based on the BASNEF model is used to strengthen the osteoporosis preventive behaviors among adolescent girls.
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Sözen T, Özışık L, Başaran NÇ (2017) An overview and management of osteoporosis. Eur J Rheumatol 4(1):46–56. https://doi.org/10.5152/eurjrheum.2016.048
Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson-Hughes B (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29:2520–2526. https://doi.org/10.1002/jbmr.2269
Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A (2016) Application of the health belief model and social cognitive theory for osteoporosis preventive nutritional behaviors in a sample of Iranian women. Iran J Nurs Midwifery Res 21:131–141. https://doi.org/10.4103/1735-9066.178231
Alswat KA (2017) Gender disparities in osteoporosis. J Clin Med Res 9:382–387. https://doi.org/10.14740/jocmr2970w
Kaveh MH, Golij M, Nazari M, Mazloom Z, Zadeh AR (2014) Effects of an osteoporosis prevention training program on physical activity-related stages of change and self-efficacy among university students, Shiraz, Iran: a randomized clinical trial. J Adv Med Educ Prof 2:158–164
Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z (2013) Prevalence of osteoporosis in Iran: a meta-analysis. J Res Med Sci 18:759–766
Liu J, Wang L, Sun J, Liu G, Yan W, Xi B, Xiong F, Ding W, Huang G, Heymsfield S, Mi J (2017) Bone mineral density reference standards for Chinese children aged 3–18: cross-sectional results of the 2013–2015 China Child and Adolescent Cardiovascular Health (CCACH) Study. BMJ Open 7(5):e014542. https://doi.org/10.1136/bmjopen-2016-014542
Ha AS, Ng JYY (2017) Rope skipping increases bone mineral density at calcanei of pubertal girls in Hong Kong: a quasi-experimental investigation. PLoS One 12:e0189085. https://doi.org/10.1371/journal.pone.0189085
Hetherington-Rauth M, Bea JW, Blew RM, Funk JL, Hingle MD, Lee VR, Roe DJ, Wheeler MD, Lohman TG, Going SB (2017) Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls. Bone 113:144–150. https://doi.org/10.1016/j.bone.2018.05.023
Tan VPS, Macdonald HM, Gabel L, Mckay HA (2018) Physical activity, but not sedentary time, influences bone strength in late adolescence. Arch Osteoporos 13:31. https://doi.org/10.1007/s11657-018-0441-9
Shawwa k AA, Nabulsi M, Maalouf J, Salamoun M, Choucair M et al (2016) Predictors of trabecular bone score in school children. Osteoporos Int 27:703–710. https://doi.org/10.1007/s00198-015-3255-2
Alghadir AH, Gabr SA, Rizk AA (2018) Physical fitness, adiposity, and diets as surrogate measures of bone health in schoolchildren: a biochemical and cross-sectional survey analysis. J Clin Densitom 21:406–419. https://doi.org/10.1016/j.jocd.2017.12.006
Brennan-Olsen SL, Hosking SM, Dobbins AG, Pasco JA (2017) Translating osteoporosis prevention guidelines. J Aging Health 29:531–545. https://doi.org/10.1177/0898264316641076
Jo WS, Cho EH, Kang BJ, Kwon GD, Ha Y-C, Jang S, Kim HY (2018) The impact of educational interventions on osteoporosis knowledge among Korean osteoporosis patients. J Bone Metab 25:115–121. https://doi.org/10.11005/jbm.2018.25.2.115
Azar FE, Solhi M, Darabi F, Rohban A, Abolfathi M, Nejhaddadgar N (2018) Effect of educational intervention based on PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients. Diabetes Metab Syndr 12:1075–1078. https://doi.org/10.1016/j.dsx.2018.06.028
Hubley J (1988) Understanding behaviour: the key to successful health education. Trop Dr 18(3):134–138. https://doi.org/10.1177/004947558801800316
Arefi Z, Hekamatpou D, Orouji M, Shaahmadi Z, Khushemehri G, Shaahmadi F (2015) The effect of educational intervention based on BASNEF model on decreasing the cesarean section rate among pregnant women in Khomain country. J Family Reprod Health 9:101–105
Sarayloo K, Moghadam KB, Mansoure JM, Mostafa H, Mohsen S (2015) The impact of an educational program based on BASNEF model on the selection of a contraceptive method in women. Iran J Nurs Midwifery Res 20:171–178
Masoumi SZ, Kazemi F, Ahmadi S (2017) Investigating the effects of instructing mothers using BASNEF model on continuing exclusive breastfeeding of late- preterm infants. J Compr Ped 8:1–9. https://doi.org/10.5812/compreped.59243
Momenabadi V, Kaveh MH, Hashemi SY (2018) Effect of educational intervention on intention of university students’ disuse of hookah smoking: BASNEF model. J Subst Use 23(3):262–267. https://doi.org/10.1080/14659891.2017.1394376
Shahnazi H, Bee Koon P, Abd Talib R, Lubis SH, Ganjali Dashti M, Khatooni E, Bahreini Esfahani N (2016) Can the BASNEF model help to develop self-administered healthy behavior in Iranian youth? Iran Red Crescent Med J 18:1–9. https://doi.org/10.5812/ircmj.23847
Baghianimoghadam MH, Rahaee Z, Morowatisharifabad MA, Sharifirad G, Andishmand A, Azadbakht L (2010) Effects of education on self-monitoring of blood pressure based on BASNEF model in hypertensive patients. J Res Med Sci 15(2):70–77
Nguyen V, Nguyen MD, Tri A, Dinh MD, Quang V, Ngo MD et al (2015) Awareness and knowledge of osteoporosis in Vietnamese women. Asia Pac J Public Health 27:95–105. https://doi.org/10.1177/1010539511423569
Sharma M (2016) Theoretical foundations of health education and health promotion. Jones & Bartlett Publishers
Miller LA, McIntire SA, Lovler RL (2011) Foundations of psychological testing: a practical approach. Sage Publications
Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar A-R (2015) Design and implementation content validity study: development of an instrument for measuring patient-centered communication. J Caring Sci 4:165–178. https://doi.org/10.15171/jcs.2015.017
Buckley L, Sheehan M, Shochet I (2010) Short-term evaluation of a school-based adolescent injury prevention program: determining positive effects or iatrogenic outcomes. J Early Adolesc 30(6):834–853. https://doi.org/10.1177/0272431609361201
Sharifi N, Majlessi F (2016) Self-empowerment of female students in prevention of osteoporosis. Glob J Health Sci 9(2):7. https://doi.org/10.5539/gjhs.v9n2p7
Saffari H, Shojaeizadeh D, Ghofranipour F, Heydarnia A, Pakpour Hajiagha A (2012) BASNEF model. Health education & promotion theories, models & methods. Tehran: Sobhan
Ghaffari M, Tavassoli E, Esmaillzadeh A, Hassanzadeh A (2012) Effect of health belief model based intervention on promoting nutritional behaviors about osteoporosis prevention among students of female middle schools in Isfahan, Iran. J Educ Health Promot 1:14. https://doi.org/10.4103/2277-9531.98572
Ahmadi S, Kazemi F, Masoumi SZ, Parsa P, Roshanaei G (2016) Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial. Int Breastfeed J11 11:1–10. https://doi.org/10.1186/s13006-016-0089-2
Saghafipour A, Nejati J, Mozaffari E, Rezaei F, Gharlipour Z, Mirheydari M (2017) The effectiveness of education based on BASNEF model on promoting preventive behavior of cutaneous leishmaniasis in students. Int J Pediatr 5:5125–5136. https://doi.org/10.22038/ijp.2017.22373.1875
Momenabadi V, Kaveh MH, Hashemi SY (2017) Effect of educational intervention on intention of university students’ disuse of hookah smoking: BASNEF model. J Subst Use 23:1–6. https://doi.org/10.1080/14659891.2017.1394376
Liu L, Liu Y-P, Wang J, An L-W, Jiao J-M (2016) Use of a knowledge-attitude-behaviour education programme for Chinese adults undergoing maintenance haemodialysis: randomized controlled trial. J Int Med Res 44:557–568. https://doi.org/10.1177/0300060515604980
Huang H-T, Kuo Y-M, Wang S-R, Wang C-F, Tsai C-H (2016) Structural factors affecting health examination behavioral intention. Int J Environ Res Public Health 13:395. https://doi.org/10.3390/ijerph13040395
The authors express their gratitude and appreciation to the educational and research departments of SBMU and the girls for their collaboration in this study.
This study was approved by the Ethics Committee of SBMU (decree code: IR.SBMU.PHNM.1395) and the Center for Registering Clinical Trials in Iran (decree code: IRCT20171019036883N3). The consent form was signed by the participants before the data collection.
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Rastgoo, F., Vasli, P., Rohani, C. et al. Osteoporosis preventive behaviors in adolescent girls: the educational program based on BASNEF model. Arch Osteoporos 14, 71 (2019). https://doi.org/10.1007/s11657-019-0623-0