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Iran Red Crescent Med J. 2018 December; 20(S1):e59800.
Published online 2018 April 16.
doi: 10.5812/ircmj.59800.
Research Article
Comparison of Multimedia and SMS Education on the Physical
Activity of Diabetic Patients: An Application of Health Promotion
Model
Hamideh Lari
1
, Azita Noroozi
1, 2, *
and Rahim Tahmasebi
2, 3
1
Department of Health, Bushehr University of Medical Sciences, Bushehr, Iran
2
The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
3
Department of Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran
*
Corresponding author: Associate Professor in Health Education, Department of Health, Bushehr University of Medical Sciences, Bushehr, Iran. Tel: +98-9177724605, E-mail:
azitanoroozi@yahoo.com
Received 2017 August 08; Revised 2017 October 10; Accepted 2017 November 18.
Abstract
Background: Physical activity is a vital element in diabetic patients and training of this behavior is important. Therefore, the
present study aims to compare the effect of multimedia and short message service (SMS) based on the health promotion model
on the physical activity of patients with Type 2 diabetes.
Methods: In this clinical trial study, 37 subjects in the SMS group and 40 subjects in the multimedia group were studied. Subjects in
the SMS group received training messages based on the health promotion model for 2 weeks, and the subjects of multimedia group
received a teaching CD based on the health promotion model. Both groups completed the questionnaires at the beginning of the
study, 2 weeks after training and 3 months after the 2nd stage.
Results: The participants in the 2 groups were similar in terms of demographic variables. The comparison of the 2 groups showed
that there was a significant difference between 2 groups in terms of the perceived self - efficacy (p = 0.032), benefits (p < 0.001), family
(p = 0.024), and friend support (p = 0.002), however, the perceived health status (p = 0.271) and barriers (p = 0.085) had no statistically
significant difference between 2 groups during the study. Additionally, 3 months after the education, the mean metabolic equivalent
of task (MET) increased to 2634.71 ± 502.01 and 2614.03 ± 592.45 in SMS and multimedia groups respectively; there was no significant
difference between the 2 groups (P = 0.662).
Conclusions: The results of this study showed more usefulness of multimedia rather than SMS education in changing the belief of
diabetic patients about the physical activity and also the effectiveness of both educational methods for promoting physical activity
of diabetic patients.
Keywords: Health Promotion Model, Physical Activity, Diabetes, Multimedia Learning, SMS Training, E - health Intervention
1. Background
Diabetes mellitus is a metabolic disorder. Type 2 dia-
betes includes 90% of the total number of diabetics (1). The
prevalence of Type 2 diabetes in Asia has risen and it has
been predicted that 77.6% of people with diabetes in the
2030s will be residents in developing countries (2), also in
Iran, the number of people with diabetes is expected to
triple in the next 15 years (3).
The cost of controlling diabetes is high and in many
countries, at least 10% of the total health care budget is
spent on diabetes (4).
The causes of Type 2 diabetes are mostly environmen-
tal factors as well as inappropriate nutritional habits. The
lack of physical activity are effective in developing of dia-
betes (5) and therefore, the American Diabetes Association
recommends that Type 2 diabetic patients perform at least
150 minutes of moderate exercise in a week (6).
Since the basis of diabetes control is self - care and the
main emphasis of the health promotion model is self - reg-
ulation, therefore, the health promotion model for chang-
ing the behavior in this group of people seems to be effec-
tive. This model includes 3 groups of concepts including
individual characteristics and experiences, behavioral spe-
cific cognition, and affects and behavioral outcomes. The
concept of individual characteristics and experiences in-
clude prior related behavior and personal factors and the
concept of behavioral specific cognition and affects includ-
ing constructs of perceived benefit and barrier, self - ef-
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