Effect of Health Belief Model Based Nutrition Education on Dietary Habits of Secondary School Adolescent Girls in Sharkia Governorate

Background: Adolescents need much attention as they constitute one-fifth of the total
population and about 84% of this population live in developing countries. Also, they are
susceptible to poor nutritional status if they do not meet their increased nutritional needs
because of growth spurt, psychological and sexual maturity and cognitive development
occurring during this period. Objectives: To assess the dietary habits of secondary school
adolescent girls before and after an intervention nutrition education program. Methods:
an intervention study was conducted on 108 adolescent girls aged between 15-17 years
from one of female secondary governmental schools in Zagazig district at Sharkia
Governorate, Egypt from September 2015 to February 2016. The study was performed in
three stages; the 1st stage was assessment of dietary habits by a valid pretested dietary
questionnaire on food habits, eating behavior and nutritional knowledge that was modified
by adding a new section on Health Belief Model constructs, the 2nd stage was application
of Health Belief Model (HBM) based nutrition education program, and the 3rd stage was
reassessment of the same study participants with the same questionnaire to assess the
effectiveness of intervention. Results: Nutrition education has significantly improved the
consumption pattern of different foods where the percent of girls who followed the
servings of healthy food groups and avoid consumption of unhealthy foods (fast, fried,
canned foods), unhealthy drinks (carbonated and caffeinated drinks), and excess intake of
salt and sugar/sweet were significantly increased after nutrition education. The percent of
girls who followed recommended dietary, lifestyle and physical activity and food safety
and behavior in hygiene practices had statistically significantly increased after
intervention (P <0.05). After intervention there was an improvement in the mean of
nutrition knowledge score from (4.77± 2.7) to (6.2±2.1). The mean knowledge on healthy
and unhealthy lifestyle habits and foods was improved from (2.36±1.01) to (3.8±0.68).
The mean knowledge score on food safety was improved from (3.79±2.54) to (6.0±1.68),
all with (p <0.05). The mean scores of Health Belief Model constructs were significantly
improved. Conclusion and recommendation: Nutrition education based on HBM
brought significant improvements in not only nutritional knowledge of adolescent girls
but also translated some of them into action. HBM-based strategies can be recommended
as effective communication channels to improve dietary habits of female students.