The impact education based on the Health Belief Model on the nutritional knowledge and Performance of Female health ambassadors

Background: Every personchr('39')s nutrition is closely related to his physical and mental condition, and adequate consumption of nutrients maintains a personchr('39')s health and increases his efficiency, and Improper nutrition leads to physical and mental problems and complications. The fact that Foodborne illnesses, which constitute a very large group of diseases in the world, are considered as one of the most important health problems in different countries. Improper nutrition as one of the pillars of an unhealthy lifestyle and one of the most important causes. And further progression of chronic diseases these include type 2 diabetes, cardiovascular disease, and many cancers, which cost billions of dollars in medical care and reduce annual production. Malnutrition and obesity are also the main factor of creation or contributing factors to mortality. The study of dietary patterns among Iranians showed significant deficiencies in daily food consumption in different social groups. A national health survey has shown that Iranians consume more saturated fatty acids and energy than the recommended amount. Changing health behaviors is the greatest hope for reducing the burden of disease and death worldwide. The importance of womenchr('39')s nutritional health as a part of society and as a mother on the one hand, and their impact on maintaining the health of other family members on the other hand, this group are of society raised as a suitable target group to improve nutritional behavior. About half of the worldchr('39')s population are women and their health guarantees the health of society and is of particular importance. For this reason, when the comprehensive program of health ambassadors was implemented in urban and rural health centers; Women were considered as the main educators of the family. The majority of health ambassadors are women, who are usually selected from among the covered families in the health service units. Women health ambassadors are housewives or working women who help improve community health by receiving education and passing it on to other family members and the population under their care. Studies have shown that use of patterns and theories of behavior change increases the likelihood of increasing the impact of health education programs and takes into account individual and environmental characteristics that influence behaviors. For this reason, researchers use models to change behavior, with training based on an educational model, starting and continuing training is in the right direction and is more effective. One of the effective models in the field educate some aspects of health, including of nutritional behaviors is the health belief model. Which is a waiting value model and emphasizes decision balance.The aim of this study was to evaluate the effect of nutrition education based on health belief model on nutrition knowledge and nutrition performance of female health ambassadors in Saqez health centers in 1398. Method: This study is an evaluation research of the type of effect Analysis, with a pretest-posttest design, among women health messenger was selected in a simple random method and using a random number table of 48 people. Sampling started on 1398/8/14 and ended on 1398/9/21, which lasted about 5 weeks. For the intervention group, a written training program in the field of nutrition based on the Health Belief Model was performed in 3 sessions of 120 minutes. To conduct this research, was used the structured questionnaire of the Ministry of Health and Medical Education, which was designed in 2011 in collaboration with Tehran University of Medical Sciences (NUTRI-KAP). The questionnaire was completed by the sample before the start of the training classes and one month after the end of theclasses. It had 3 sections of questions related to demographic characteristics form included data on age, marital status education level, occupation status, number of family members, and history of being a health messengers. Ouestions related to knowledge, and nutritional performance on the basic principles of nutrition, food groups, nutrient sources and nutritional needs at different stages of life. The retes method was used to determine the reliability of the tools. For this purpose, the tools were completed by 18 individuals with the same characteristics as the research community, who were not among the research samples, and re-completed by the same individuals two weeks later, and with the help of these data, reliability was calculated with Kuder-Richardson. This rate for knowledge is .83 and .97 for performanc It was found that the reliability coefficient was acceptable and appropriate. Of course the opinion of 3 professors of the College of Nursing and Midwifery was that because in previous studies in the country, the NUTRI-KAP standard questionnaire was used, and it had an acceptable and high validity, the instrument does not need to be validated. The validity of the educational content was examined by 3 professors of the School of Nursing and Midwifery and the corrections were applied based on the opinions of the professors. In terms of ethical considerations, the necessary permission was obtained from the ethics committee of Iran University of Medical Sciences, and after receiving a letter of introduction from the university, the necessary coordination was made with the Kurdistan University of Medical Sciences. The research process was explained to the participants and they were morally informed that participating in the research was voluntary. In addition, female health ambassadors were assured that their personal information was confidential. After completing training classes and collecting data for data analysis, SPSS software version 23 was used in two sections: descriptive statistics and inferential statistics. In the descriptive statistics section, frequency distribution tables were used for qualitative variables of the research and numerical indices of minimum, maximum, mean and standard deviation were used for quantitative variables of the research. In inferential statistics, paired t-test was used. In all statistical analyzes, P value less than 0.05 was considered significant. Results: Following the educational intervention, the mean score of knowledge and performance, participants in the study before the intervention was 18.39 with a standard deviation of 4.38 and 8.81 with a standard deviation of 1.87, which after the intervention was 24.70 with a standard deviation of 4.41 and 12.27 were changed with a standard deviation of 2.67 and a significant difference was observed between before and after the intervention in the field of knowledge (P <0.001) and performance (P <0.001). . Conclusion: The results of this study showed an increase in knowledge and improvement of nutritional performance and the effect of education based on the pattern of health belief model on the knowledge and performance of female health ambassadors. Therefore, it is suggested that educational programs based on this model be implemented for female health ambassadors on a larger scale.