Effectiveness of Health Promotion Program Using Action Planning Strategy for Young Adults

Su Hyun Kim; Min Ji Kim; Sang Hee Kim; So Yeon Kim; Chae Yeon Park; Jee Yun Bang

doi:10.4040/jkan.2019.49.4.461

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Kim, Kim, Kim, Kim, Park, and Bang: Effectiveness of Health Promotion Program Using Action Planning Strategy for Young Adults

Original Article

J Korean Acad Nurs 2019;49(4):461-471.

Published online: 15 January 2019

DOI: https://doi.org/10.4040/jkan.2019.49.4.461

Effectiveness of Health Promotion Program Using Action Planning Strategy for Young Adults

Su Hyun Kim, Min Ji Kim, Sang Hee Kim, So Yeon Kim, Chae Yeon Park, Jee Yun Bang

College of Nursing, Kyungpook National University, Daegu, Korea

Address reprint requests to : Kim, Su Hyun College of Nursing · Research Institute of Nursing Science, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea Tel: +82-53-420-4928 Fax: +82-53-421-2758 E-mail: suhyun_kim@knu.ac.kr

Received 31 January 2019 Revised 28 May 2019 Accepted 29 May 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to evaluate the effectiveness of a health promotion program utilizing action planning strategy for young adults.

Methods

A non-equivalent control group pre-post-test design was used. One hundred three university students participated in the study. Participants in the experimental group (n=51) were provided the health promotion program utilizing action planning strategy for five weeks. The program consisted of weekly sessions that included action planning and group feedback. The control group (n=52) was provided with health information every week for 5 weeks. Program outcomes, including self-efficacy, physical activity health behaviors, total exercise time per week, daily cigarette consumption, frequency of alcohol drinking per month, nutritional health behaviors, and subjective health status, were assessed at baseline and at follow-up after 5 weeks.

Results

The participants in the experimental group demonstrated significant increases in self-efficacy, physical activity health behaviors, weekly exercise time, and nutritional health behaviors and significant decreases in daily cigarette consumption than those in the control group.

Conclusion

The health promotion program utilizing action planning strategy is a brief and effective intervention to promote health behaviors among young adults. Further investigation is warranted to assess the program's effectiveness among other age groups and populations at high risk for chronic illness.

Keywords: Health Behavior, Health Promotion, Self Efficacy, Young Adults

References

1. Korea Centers for Disease Control & Prevention (KNHANES). 2015 Health behavior and chronic disease statistics: Korea National Health and Nutrition Examination Survey (KNHANES VI-3) and youth health behavior online survey. Cheongju: KN-HANES;2016. Report No.: 11-1352159-000313-01.

2. Korea Health Promotion Institute. Health plan 2020, 2016-2020. Sejong: Ministry of Health and Welfare;2015. Dec. Report No.: 11-1352000-000285-13.

3. Park YR, Wee H, Kim SJ. Lifestyle, depression, and health related quality of life among women in Jeju province. Journal of Korean Academy of Community Health Nursing. 2010; 21(2):148–155. https://doi.org/10.12799/jkachn.2010.21.2.148.

4. Lee HJ, Jung EH. Socioeconomic status and elderly health in life course perspective: Testing of multi-mediational effects of socioeconomic status in early adult and middle aged. Health and Social Welfare Review. 2016; 36(3):53–84. https://doi.org/10.15709/hswr.2016.36.3.53.

5. Kim JH, Park EY, Lim KC. Self-reported realities of health behavior of undergraduate students after web-based health promotion education: Qualitative content analysis. The Journal of Korean Academic Society of Nursing Education. 2012; 18(3):413–423. https://doi.org/10.5977/jkasne.2012.18.3.413.

6. Yoo SH, Kim HK. Program theory evaluation of a lifestyle intervention program for the prevention and treatment of metabolic syndrome. Korean Journal of Health Education and Promotion. 2010; 27(4):165–175.

7. Kim JA, Kim SL, Jung HS. The effects of tailored life style improvement program for the hypertensive workers provided by occupational health nurse. Korean Journal of Occupational Health Nursing. 2009; 18(2):242–251.

8. Min SY, Paek KS. The effects of a health education program on health promoting behavior and self-efficacy in university students. Journal of Korean Academy of Community Health Nursing. 2007; 18(4):562–571.

9. Kang ES, Kim YH, Lee KR. The effect of holistic health program on spiritual well-being and mental health in nursing students. Journal of the Korea Academia-Industrial cooperation Society. 2011; 12(5):2172–2179. https://doi.org/10.5762/KAIS.2011.12.5.2172.

10. Park BN. Effects of the tailored exercise program on health and life satisfaction in college students. Journal of Health Informatics and Statistics. 2007; 32(1):49–70.

11. Kim HK, Kim YS. The effects of smartphone application to increase physical activity among university students. The Korean Journal of Physical Education. 2012; 51(5):457–466.

12. Bodenheimer T, Davis C, Holman H. Helping patients adopt healthier behaviors. Clinical Diabetes. 2007; 25(2):66–70. https://doi.org/10.2337/diaclin.25.2.66.

13. Howcroft M, Walters EH, Wood-Baker R, Walters JAE. Action plans with brief patient education for exacerbations in chronic obstructive pulmonary disease. The Cochrane database of systematic reviews. 2016; 12:CD005074. https://doi.org/10.1002/14651858.CD005074.pub4.

14. Gatheral TL, Rushton A, Evans DJW, Mulvaney CA, Halco-vitch NR, Whiteley G, et al. Personalised asthma action plans for adults with asthma. The Cochrane database of systematic reviews. 2017; 4:CD011859. https://doi.org/10.1002/14651858.CD011859.pub2.

15. Sniehotta FF, Schwarzer R, Scholz U, Schüz B. Action planning and coping planning for long‐term lifestyle change: Theory and assessment. European Journal of Social Psychology. 2005; 35(4):565–576. https://doi.org/10.1002/ejsp.258.

16. Lenzen SA, Daniëls R, van Bokhoven MA, van der Weij-den T, Beurskens A. Disentangling self-management goal setting and action planning: A scoping review. PLoS One. 2017; 12(11):e0188822. https://doi.org/10.1371/journal.pone.0188822.

17. Benyamini Y, Geron R, Steinberg DM, Medini N, Valinsky L, Endevelt R. A structured intentions and action-planning intervention improves weight loss outcomes in a group weight loss program. American Journal of Health Promotion. 2013; 28(2):119–127. https://doi.org/10.4278/ajhp.120727-QUAN-365.

18. Erasmus V, Kuperus MN, Richardus JH, Vos MC, Oene-ma A, van Beeck EF. Improving hand hygiene behaviour of nurses using action planning: A pilot study in the intensive care unit and surgical ward. The Journal of Hospital Infection. 2010; 76(2):161–164. https://doi.org/10.1016/j.jhin.2010.04.024.

19. Bandura A. Self-efficacy: The exercise of control. New York: W. H. Freeman;1997. p. 1–604.

20. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009; 41(4):1149–1160. https://doi.org/10.3758/BRM.41.4.1149.

21. Williams SL, French DP. What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour—and are they the same? Health Education Research. 2011; 26(2):308–322. https://doi.org/10.1093/her/cyr005.

22. Naver. Naver Office: Introduction to Naver form [Internet]. Seongnam: Naver;[cited 2018 Aug 11]. Available from:. http://office.naver.com/userGuide.nhn?level1=form.

23. Becker H, Stuifbergen A, Oh HS, Hall S. Self-rated abilities for health practices: A health self-efficacy measure. Health Values: The Journal of Health Behavior, Education & Promotion. 1993; 17(5):42–50.

24. Choi JM, Moon IO. The effects of college students’ self-efficacy on their health promotion behavior. The Journal of the Korean Public Health Association. 2005; 31(2):105–113.

25. Walker SN, Sechrist K, Pender N. Health promoting lifestyle profile II [Internet]. Omaha (NE): College of Nursing, University of Nebraska Medical Center;c1995. [cited 2019 Jan 15]. Available from. https://www.unmc.edu/nursing/faculty/health-promoting-lifestyle-profile-II.html.

26. Walker SN, Hill-Polerecky DM. Psychometric evaluation of the health-promoting lifestyle profile II. Unpublished Manuscript, Omaha (NE): University of Nebraska Medical Centre;1996. p. 1–30.

27. Kim SH. The association between expectations regarding aging and health-promoting behaviors among Korean older adults. Journal of Korean Academy of Nursing. 2007; 37(6):932–940. https://doi.org/10.4040/jkan.2007.37.6.932.

28. Haddock CK, Poston WSC, Pyle SA, Klesges RC, Vander Weg MW, Peterson A, et al. The validity of self-rated health as a measure of health status among young military personnel: Evidence from a cross-sectional survey. Health and Quality of Life Outcomes. 2006; 4:57. https://doi.org/10.1186/1477-7525-4-57.

29. Handley M, MacGregor K, Schillinger D, Sharifi C, Wong S, Bodenheimer T. Using action plans to help primary care patients adopt healthy behaviors: A descriptive study. Journal of the American Board of Family Medicine. 2006; 19(3):224–231. https://doi.org/10.3122/jabfm.19.3.224.

30. Lorig K, Gonzalez V, Laurent D. The chronic disease self-management workshop: Implementation manual. Palo Alto (CA): Stanford University;2006. p. 9.

31. Patrick H, Williams GC. Self-determination theory: Its application to health behavior and complementarity with motivational interviewing. International Journal of Behavioral Nutrition and Physical Activity. 2012; 9:18. https://doi.org/10.1186/1479-5868-9-18.

Figure 1.

Conceptual framework of the study.

Figure 2.

Participant flow diagram.

Table 1.

The Component of the Health Promotion Program Utilizing Action Planning Strategy

Session	Construct	Component	Method	Performer	Time (min)
1	-	Opening ceremony	Announcement	Peer leader	5
	Social modeling	Introducing “Put Your Health UP” program	Demonstration	Peer leader	10
	Mastery experience, social modeling	Setting a goal and making an action plan with a partner	Peer discussion, documentation	Participants	10
	Social modeling	Presenting an action plan to full group	Group presentation	Participants	10
2~4	Verbal persuasion	Feedback & problem solving in a group	Group discussion	Peer leader, participants	10
	Mastery experience, social modeling	Setting a goal and making an action plan with a partner	Peer discussion, documentation	Participants	10
	Social modeling	Presenting an action plan to full group	Group presentation	Participants	10
	Verbal persuasion	Encouragement of carrying out action plan by phone message	Text messaging	Peer leader	-
5	Verbal persuasion	Feedback & problem solving in a group	Group discussion	Peer leader, participants	10
	Mastery experience, social modeling	Setting up a new action plan with a partner	Peer discussion, documentation	Participants	10
	Social modeling	Presenting an action plan to full group	Group presentation	Participants	10
	-	Completion ceremony	Announcement	Peer leader	5

Table 2.

Characteristics of the Participants at Baseline and Comparisons between the Groups

Characteristics	Exp. (n=51)	Cont. (n=52)	Total (N=103)	χ²/t/U	p
Characteristics	n (%) or M±SD			χ²/t/U	p
Age (yr)	23.14±1.65	22.06±1.73	22.59±1.77	3.32	.002
Gender
Male	29 (56.9)	16 (30.8)	45 (43.7)	7.13	.008
Female	22 (43.1)	36 (69.2)	58 (56.3)
Grade
Freshman	2 (3.9)	10 (19.2)	12 (11.7)	6.85	.077
Sophomore	14 (27.5)	16 (30.8)	30 (29.1)
Junior	24 (47.0)	17 (32.7)	41 (39.8)
Senior	11 (21.6)	9 (17.3)	20 (19.4)
Major
Nursing	10 (19.6)	15 (28.8)	25 (24.3)	7.12	.790
Engineering	16 (31.4)	10 (19.3)	26 (25.2)
Economics & business	9 (17.6)	10 (19.2)	19 (18.4)
Humanities	8 (15.7)	10 (19.2)	18 (17.6)
Agriculture sciences	6 (11.8)	7 (13.5)	13 (12.6)
Music and arts	2 (3.9)	0 (0.0)	2 (1.9)
Living arrangement
Home	21 (41.2)	25 (48.1)	46 (44.7)	1.71	.636
Dormitory	15 (29.4)	12 (23.1)	27 (26.2)
Rent house	15 (29.4)	14 (26.9)	29 (28.1)
Relative’s house	0 (0.0)	1 (1.9)	1 (1.0)
Monthly allowance (10,000 won)	36.33±10.94	36.65±16.47	35.50±13.94	-0.12	.908
Exercise status
Exercising	21 (41.2)	22 (42.4)	43 (41.7)	1.10	.577
Not exercising	19 (37.2)	15 (28.8)	34 (33.0)
Exercised in the past	11 (21.6)	15 (28.8)	26 (25.3)
Total exercise time (minutes per week)	41.56±44.92	51.30±50.71	46.48±47.92	921.50^†	.351^†
Drinking frequency (per month)	4.41±3.63	4.29±3.36	4.35±3.48	1319.00^†	.965^†
Smoking status
Currently smoking	6 (11.8)	7 (13.5)	13 (12.6)	0.41	.814
Never smoked	44 (86.3)	43 (82.7)	87 (84.5)
Had smoked in the past	1 (1.9)	2 (3.8)	3 (2.9)
Cigarette consumption (per day)^††	0.96±2.95	1.35±3.55	1.16±3.26	1295.00^†	.723^†
Self-efficacy for health practices	77.29±12.12	82.08±8.55	79.71±10.69	-2.32	.022
Subjective physical condition	2.82±0.91	3.29±0.75	3.06±0.86	-2.83	.006
Body mass index	22.60±2.86	21.38±2.64	21.99±2.80	2.25	.027

M=Mean; SD=Standard deviation; Exp.=Experimental group; Cont.=Control group.

^† Mann-Whitney U test;

^†† analyzed for the current smokers (n=13).

Table 3.

Comparisons of Outcome Variables between Experimental and Control Groups

Variables	Group	M±SD		Adjusted mean difference between baseline and follow-up^a Exp. vs. Cont. (95% CI)	p	Partial h²
Variables	Group	Baseline	Follow-up at 5 weeks		p	Partial h²
Self-efficacy	Exp.	77.29±12.12	89.12±12.64	5.39 (0.91 to 9.86)	.019	0.11
	Cont.	82.08±8.55	84.50±8.30
Physical activity behaviors	Exp.	1.92±0.73	2.89±0.73	0.66 (0.39 to 0.92)	<.001	0.20
	Cont.	2.10±0.58	2.23±0.52
Total time of physical activity	Exp.	41.56±44.92	57.35±37.12	21.32 (1.91 to 40.74)	.032	0.06
(minutes per week)	Cont.	51.30±50.71	45.60±47.79
Drinking frequency (per month)	Exp.	4.41±3.63	4.12±3.15	-0.24 (-1.39 to 0.91)	.681	0.01
	Cont.	4.29±3.36	3.87±3.32
Cigarette consumption (per day)^†	Exp.	0.96±2.95	0.59±2.38	-2.63 (-5.23 to -0.04)	.047	0.37
	Cont.	1.35±3.55	1.33±3.50
Nutritional behaviors	Exp.	2.06±0.47	2.59±0.66	0.33 (0.11 to 0.56)	.005	0.08
	Cont.	2.17±0.47	2.35±0.47
Subjective physical condition	Exp.	2.82±0.91	3.57±0.94	0.35 (0.04 to 0.66)	.030	0.05
	Cont.	3.29±0.75	3.39±0.60

M=Mean; SD=Standard deviation; 95% CI=95% confidence interval; Exp.=experimental group; Cont.=control group.

^a Adjusted for age, gender, body mass index, and baseline score of each outcome variable;

^† Analyzed for the current smokers (n=13).

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