Determinants of Physical Activity among Patients with Cardiovascular Metabolic Risk Factors based on the Educational Factors of PRECEDE Model: A Mixed Method Study

Abstract

Background and objective: Physical activity (PA) is a multi-factorial behavior that is affected by intrapersonal, interpersonal, environmental and social factors. The aim of this study was to investigate determinants of PA among patients with cardiovascular (CV) metabolic risk factors based on the educational factors of PRECEDE Model. Materials and methods: This mix method study (qualitative and quantitative) was conducted in two consecutive phases. In the qualitative phase, the experiences of 50 patients with CV metabolic risk factors and 12 healthcare providers who worked in the Diabetes Units of Health Centers of Alborz University of Medical Sciences (ABZUMS) were explained based on the educational factors of PRECEDE Model. In the quantitative phase, the questionnaire of determinants of PA was developed and its validity and reliability were evaluated and confirmed and it was completed by 450 patients and the strongest determinants of PA using the Structural equation modeling (SEM) through AMOS 18 were identified. Results: Using path analysis the findings showed, self-efficacy (= 0.90) and perceived barriers (= -0.63) determinants of predisposing category, skill (= 0.38) determinant of enabling category, motivation comply (= 0.47), social support (= 0.23) and behavioral outcomes (= 0.17) determinants of reinforcing category were higher predictive power and they were significant.