Peer Education Physical Activity Promotion Program among Iranian Guidance Student Based on Theory of Planned Behavior

Background: Reduction of physical activity among adolescents one is the most important problems of society. Regular physical activity has been established as a mechanism to prevent and treat various chronic illnesses such as heart disease, diabetes, cancer, obesity, osteoporosis and psychological ailments. Objectives: The aim of this study is determine effects of training programs to promote physical activity among school students by using the theory of planned behaviour. Methods: This study was conducted among guidance student in Gachsaran. Four guidance schools randomly selected within all boy and girl guidance school. 150 participants as intervention and 150 as control groups were enrolled at the baseline survey, of whom all were followed up after 2-month intervention. Results: The age range of students was between 11 and 15 yr and mean 12.78 (SD = 0.98). 154 student girl (51.3%) and 146 student boy (48.7%).there were a statistical significant difference for mean score of attitude (p-value = 0.003), intention (p-value = 0.000), subjective norms (p-value = 0.013), perceived behavioural control (p-value = 0.001) and increasing physical activity (p-value = 0.000) among interventional group after implementing education program. Conclusion: Considering that the present curriculum was effective on improving physical activity levels of students; it seems that if the behavioural theories and models analysis in education programs can be properly used beneficial results have be followed. Key word: Physical activity Students Theory of planned behaviour INTRODUCTION increase in the risk of stroke among middle aged men. Regular physical activity has been established as a from insufficient physical activity is dramatic and a lack of mechanism to prevent and treat various chronic physical activity has been identified as one of the ten illnesses such as heart disease, diabetes, cancer, leading global causes of death, disease and disability [3]. obesity, osteoporosis and psychological ailments [1]. Physical activity is inversely associated with several Physical activity during childhood and adolescence is health outcomes in adults. Individuals who are more crucial, as it contributes to a normal skeletal development active and fit have lower risks of depressive symptoms and is necessary for young adults to attain and maintain and may have a lower risk of obesity and osteoporosis. an appropriate bone mass. Moreover, teenager’s physical Given the growing wealth of evidence of the health activity has been consistently associated with higher benefits of a physically active life, efforts to increase levels of self-esteem and lower levels of anxiety, stress physical activity among adults have proliferated. and gain psychological health [2]. Inactive people have Moreover expert's advocate promotion of physical more than double the risk of heart attack, whilst activity among children and adolescents for health appropriate physical activity programmers reduce the risk enhancement and to install lifelong behavioural patterns of mortality after heart attack by about 20%. It is also that will result in more active and fit adult populations in estimated that one quarter of stroke incidence could be the future [4]. For these reasons recommended that avoided by appropriate exercise and that physical engage in 30 minutes of at least moderate intensity inactivity may be responsible for up to a threefold activity on at least five days of the week [5]. But, while the Also should be added that the range of negative impacts World Appl. Sci. J., 23 (8): 1073-1078, 2013 1074 positive effects of regular physical activity participation participants in the main study to obtain feedback about are well established in children and adolescents, there is evidence to demonstrate that young people in many developed nations do not participate in enough physical activity of the type and intensity associated with health benefits [6]. In this regards the low prevalence of regular leisure time physical exercise is a cause for concern in many countries [7]. And increasing population levels of activity therefore continues to be a major public health challenge [8]. The worldwide reduce physical activity as well as Iran indicates necessity of designing comprehensive and effective interventions to promotion physical activity among adolescents student. In the field of promotion physical activity research, it would be useful to know how cognitive related factors like knowledge, social norms or beliefs are responsible to predict intention and consequently behaviour. In addition to sufficient information, certain psychosocial factors, such as attitude, subjective norm and perceived behavioural control, seem to be significant factors in determining the probability of adopting or rejecting a healthy behaviour. In this regard, the theories of planned behaviour in numerous studies as a research theoretical framework were applied; and several studies have also reported TPB variables’ predictability to explain physical activity among student [9-11]. The objective of this study was designing and implementing a peer based educational intervention to promotion physical activity among students based on theory of planned behaviour. MATERIALS AND METHODS Participants: This study was conducted among guidance student in Gachsaran during 2009–2010. Four guidance schools randomly selected within all boy and girl guidance school in Gachsaran, Iran. Of the 665 student enrolled at the four schools, 300 (45.11%) student participated in this study. 150 participants as intervention and 150 as control groups were enrolled at the baseline survey, of who all were followed up after 2-month intervention. This study was conducted with approval from Tehran University of Medical sciences’ institutional review board. Informed assent and consent were obtained from participants. Measures: Prior to conducting the main project a pilot study was carried out. Initially the relevant questionnaires were administered to 30 students who were similar to the clarity, length comprehensiveness, time of completion and also internal reliability of the measures. Moreover, participants were instructed about how to fill questioners before gathering information. Background Variable: Background data collected in this research include: age, gender (boy/girl), parent education (elementary; secondary; high school; and university), parent job, Family income and History of sports club membership. Behavior (Physical Activity): For physical activity were used an international physical activity questioner (IPAQ) [12]. TPB Theoretical Variables: The items which assessed components of the TPB were modified from scales of physical activity related attitudes and intention to doing physical activity (Armitage [10]; Hagger [11]) for physical activity practice and 23 items were composed under four major constructs, [1] attitude positive toward physical activity; [2] subjective norms about physical activity; [3] perceived behavioral control to physical activity; [4] behavioral intention to physical activity. Nine items were designed to measure attitude toward physical activity (e.g., “If I were to be regular physical activity it would help me cope with stress.”). Six items were designed to measure subjective norms toward physical activity (e.g., “My best friend thinks I should be regular physical activity”). Four items were designed to perceived behavioral control toward physical activity (e.g., “For me to have regular physical activity would be difficult”). Four items were designed to evaluate behavior intention toward physical activity (e.g., “I intend to regular physical activity a next month”). In order to facilitate respondents’ responses to the items, all items were standardized to a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Estimated reliability coefficients for each TPB constructs questionnaire were as follows: attitude ( = 0.70); subjective norms ( = 0.73); perceived behavior control ( = 0.75) and behavioral intention ( = 0.72). These results demonstrated that questionnaires were internally consistent. Procedure: This was a longitudinal randomized pretest posttest series control group design panel study to implement a health education based intervention to promotion physical activity among a sample of student recruited from four randomly selected guidance student in World Appl. Sci. J., 23 (8): 1073-1078, 2013 1075 Gachsaran, Iran. After obtaining informed consent Forth Stage: It consists of six 60 to 90 minutes participants were enrolled in the study, a structured questionnaire with the aforementioned measures was distributed to the student to complete. Prior to the selfadministration of the questionnaire, study staff explained the logistics of answering different type of questions and clarified any concerns and questions that were raised by participants. The intervention aimed to promotion physical activity in participants. The intervention activates were tailored and implemented based on student educational needs assessment based on TPB. Educational planning in this study was based on active learning and during the intervention was attempted to students actively participate in educational programs. education have used methods such as lectures, group discussions, peer groups and to use booklet, pamphlets and CD regarding physical activity for intervention groups students that was performed in four stages. First Stage: Before starting education programs in intervention groups schools, attempting to print slogans on physical activity and install in the hall and class course and also reading a sport slogan in the morning, that purpose of this was the sensitization of inervention group to education and make chance to physical activity. Second Stage: These step was conducted by teachers and education administrators and parents groups education, in 60-minute education sessions. Administrators and teachers in educational sessions were taught about the importance of exercise and the role of exercise in physical and mental health of students and teachers and parents role in encouraging students to perform physical activities. Teachers, administrators and parents were asked to promoting and encouraging students to be active lifestyle by encouraging verbal support and create encouragement and supportive environments for physical activity in schools. For this purpose a educationasl manual was placed at their disposal (emphasis on the impact of subjective norms). Third Stage: One of the educational methods used by researchers in the study was the use of peer groups education, for this purpose from 20 students (10 female students and 10 male students) that were active in an sport and interested in cooperation in this area were selected and conducted educational programs for their in order to they can have educational facilitator role to the other participants in the intervention group. For these students a two-hour training program was implemented. educational sessions for students that conducted by the researcher and a female master of physical education (for holding classes in girl's schools), a male master of physical education (for training classes boys schools) and an a one aerobics instructor. The Educational Sessions Include: Session one: Orientation educational purposes, to draw attention to educational programs and the role of physical activity on life. Session II: Emphasis on attitude structure, complications and diseases caused by sedentary life style. Session III: Emphasis on perceived behavioral control structure, the amount of physical activity rate in different ages. Session IV: Emphasis on behavioral intention structure, the effect of exercise on health and exercise activities benefits. Sessions V and VI: Aerobic education classes. Data Analysis: Analyses were conducted by using SPSS-13 and a probability level of 0.05 was used throughout. Cross -tabulation and T-test were employed to determine comparability of the intervention in compare with control group.