The Effect of an Educational Program Based on the Health Belief Model on Self-Efficacy among Patients with Type 2 Diabetes Referred to the Iranian Diabetes Association in 2014


Background: Patient self-efficacy is one of the most important factors in treating and overcoming disease. Objective: The aim of this study was to evaluate the effect of an educational program based on the health belief model on self-efficacy among patients with type 2 diabetes referred to the Iranian Diabetes Association in 2014. Method: A randomized controlled clinical trial was conducted. Eighty patients with type 2 diabetes were selected randomly by the double block sample method. They were then divided into two groups of intervention and control (40 patients in each group) by random allocation. Data were collected by a questionnaire based on the Health Belief Model and self-efficacy. The data were gathered two months after the educational program was held. The educational program was designed on the basis of data collected in the pre-test phase. Then, the educational program was executed for the intervention group in 8 sessions (each 30 minutes) using lectures and an educational booklet. Data analysis was done with Chi-square Test, Pearson’s correlation, Independent samples T-test and paired T-test. The significance level was considered at 0.05. Results: Before intervention, no significant difference was detected between the two groups. However, after intervention all variables were significantly different except for perceived threat. Moreover, there were significant linear relationships between Self-efficacy and all Health Belief Model components after the educational intervention in both groups (p < 0.05). Conclusion: The educational program based on the health belief model increased self-efficacy in type 2 diabetes mellitus patients.

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Vahidi, S. , Shahmirzadi, S. , Shojaeizadeh, D. , Haghani, H. and Nikpour, S. (2015) The Effect of an Educational Program Based on the Health Belief Model on Self-Efficacy among Patients with Type 2 Diabetes Referred to the Iranian Diabetes Association in 2014. Journal of Diabetes Mellitus, 5, 181-189. doi: 10.4236/jdm.2015.53022.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Khoshniat Niko, M., Madarshahian, F., Hassanabadi, M., Heshmat, R. and Khaleghian, N. (2007) Comparative Study of Cognitive Status in Elderly with and without Type 2 Diabetes. Iranian Journal of Diabetes and Metabolism, 7, 71-76.
[2] Ramachandran, A., Snehalatha, C., Mary, S., Mukesh, B., Bhaskar, A. and Vijay, V. (2006) The Indian Diabetes Prevention Programme Shows That Lifestyle Modification and Metformin Prevent Type 2 Diabetes in Asian Indian Subjects with Impaired Glucose Tolerance (IDPP-1). Diabetologia, 49, 289-297.
[3] Esteghamati, A., Gouya, M.M., Abbasi, M., Delavari, A., Alikhani, S., Alaedini, F., et al. (2008) prevalence of Diabetes and Impaired Fasting Glucose in the Adult Population of Iran National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes Care, 31, 96-98.
[4] Rosenstock, I.M., Strecher, V.J. and Becker, M.H. (1988) Social Learning Theory and the Health Belief Model. Health Education & Behavior, 15, 175-183.
[5] Rosenstock, L. (1974) Historical Origins of The Health Belief Model.
[6] Safari, M. and Shojaeizadeh, D. (2009) Theories Models and Methods of Health Education and Promotion. Asar-E Sobhan Publishing, Iran, 22-24.
[7] Borhani, F., Abbaszadeh, A., Taebi, M. and Kohan, S. (2010) The Relationship between Self-Efficacy and Health Beliefs among Type 2 Diabetic Patients.
[8] Harvey, J. and Lawson, V. (2009) The Importance of Health Belief Models in Determining Self-Care Behaviour in Diabetes. Diabetic Medicine, 26, 5-13.
[9] Aghamolaei, T., Eftekhar, H., Mohammad, K., Sobhani, A., Shojaeizadeh, D., Nakhjavani, M., et al. (2005) Influence of Educational Intervention Using Interaction Approach on Behavior Change, Hemoglobin Alc and Health-Related Quality of Life in Diabetic Patients. Journal of School of Public Health and Institute of Public Health Research, 3, 1-2.
[10] Hazavehei, S., Sharifirad, G. and Mohabi, S. (2007) The Effect of Educational Program Based on Health Belief Model on Diabetic Foot Care. International Journal of Diabetes in Developing Countries, 27, 82-90.
[11] Krichbaum, K., Aarestad, V. and Buethe, M. (2003) Exploring the Connection between Self-Efficacy and Effective Diabetes Self-Management. The Diabetes Educator, 29, 653-662.
[12] Whitley, E. and Ball, J. (2002) Statistics Review 4: Sample Size Calculations. Critical Care, 6, 335-341.
[13] Israel, G.D. (1992) Determining Sample Size: University of Florida Cooperative Extension Service, Institute of Food and Agriculture Sciences, EDIS.
[14] Given, C.W., Given, B.A., Gallin, R.S. and Condon, J.W. (1983) Development of Scales to Measure Beliefs of Diabetic Patients. Research in Nursing & Health, 6, 127-141.
[15] Gillibrand, R. and Stevenson, J. (2006) The Extended Health Belief Model Applied to the Experience of Diabetes in Young People. British Journal of Health Psychology, 11, 155-169.
[16] Zareban, I., Niknami, S., Hidarnia, A., Rakhshani, F., Shahrakipour, M. and Moshki, M. (2013) The Effect of Education Based on Health Belief Model on Reduction of HbA1c Level in Diabetes Type 2. Journal of Research & Health, 3, 370-378.
[17] Kloeblen, A.S. and Batish, S.S. (1999) Understanding the Intention to Permanently Follow a High Folate Diet among a Sample of Low-Income Pregnant Women According to the Health Belief Model. Health Education Research, 14, 327-338.
[18] Vosoghi Karkazloo, N., Abootalebi Daryasari, G., Farahani, B., Mohammadnezhad, E. and Sajjadi, A. (2012) The Study of Self-Care Agency in Patients with Diabetes (Ardabil). Modern Care Journal, 8, 197-204.
[19] Charron-Prochownik, D., Sereika, S.M., Becker, D., Jacober, S., Mansfield, J., White, N.H., et al. (2001) Reproductive Health Beliefs and Behaviors in Teens with Diabetes: Application of the Expanded Health Belief Model. Pediatric Diabetes, 2, 30-39.
[20] Morowatisharifabad, M. and Tonekaboni, N.R. (2009) Perceived Self-Efficacy in Self-Care Behaviors among Diabetic Patients Referring to Yazd Diabetes Research Center. Journal of Birjand University of Medical Sciences, 15, 91-99.
[21] Moghadamtabrizi, F., Mohadesi, H. and Babayee, H. (Eds.) (2002) The Survey of Need Educational Diabetes about Selfcare Referring to Taleghani Hospital Urmia. Abstract Second Public Health Congress, Kermanshah University of Medical Science.
[22] Baghyani-Moghadam, M., Shafiei, F., Haydarneia, A. and Afkhami, M. (2005) Efficacy of BASNEF Model in Controlling of Diabetic Patients in the City of Yazd, Iran. Indian Journal of Community Medicine, 30, 10-12.
[23] Mazloomy, S., Mirzaei, A., Afkhami Ardakani, M., Baghiani Moghadam, M. and Fallahzadeh, H. (2010) The Role of Health Beliefs in Preventive Behaviors of Individuals at High-Risk of Type 2 Diabetes Mellitus. The Journal of Shahid Sadoughi University of Medical Sciences, 18, 24-31.
[24] Asadzandi, M., Farsi, Z., Najafi Mehri, S. and Karimizarchi, A.A. (2006) Educational Intervention Focusing on Health Belief Model in Health Beliefs, Awareness and Behavior of Diabetic Patients. Iranian Journal of Diabetes and Lipid Disorders, 6, 169-176.
[25] Gh, S., Hazavehi, M., Baghianimoghadam, M. and Mohebi, S. (2007) The Effect of a Health Belief Model based education program for foot care in diabetic patients type II in Kermanshah, Iran (2005). International Journal of Endocrinology and Metabolism, 5, 82-90.
[26] Aljasem, L.I., Peyrot, M., Wissow, L. and Rubin, R.R. (2001) The Impact of Barriers and Self-Efficacy on Self-Care Behaviors in Type 2 Diabetes. The Diabetes Educator, 27, 393-404.
[27] Ayele, K., Tesfa, B., Abebe, L., Tilahun, T. and Girma, E. (2012) Self Care Behavior among Patients with Diabetes in Harari, Eastern Ethiopia: The Health Belief Model Perspective. PLoS ONE, 7, e35515.
[28] Whitford, D.L., McGee, H. and O’Sullivan, B. (2009) Reducing Health Risk in Family Members of Patients with Type 2 Diabetes: Views of First Degree Relatives. BMC Public Health, 9, 455.
[29] Polly, R.K. (1992) Diabetes Health Beliefs, Self-Care Behaviors, and Glycemic Control among Older Adults with Non-Insulin-Dependent Diabetes Mellitus. The Diabetes Educator, 18, 321-327.
[30] Shamsi, M., Sharifirad, G., Kachoyee, A. and Hassanzadeh, A. (2009)The Effect of Educational Program Walking Based on Health Belief Model on Control Sugar in Woman by Type 2 Diabetics. Iranian Journal of Endocrinology and Metabolism, 11, 490-499, 597.

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