extended parallel process model

Considering the global spread of the coronavirus and its adverse consequences, adoption of preventive behavior stratgies is a suitable solution to reduce the sequelae by this disease. Considering the effectiveness of the developed parallel process model in changing behavior, this study aimed to investigate the effect of the extended parallel process model on adoption of preventive behavior aginst coronavirus infection in young women.

This intervention (experimental) study was conducted in 2022. Using a multi-stage sampling method 222 young women were entered into the study. Data were collected using a researcher's questionnaire based on the extended parallel process model. The educational intervention was performed through 4 virtual sessions. Three months after the last session, the participants completed the questionnaire again. Using SPSS software version 26,  data were analyzed by descriptive and analytical statistical tests.

The results of the study showed that after the educational intervention, the mean scores of the model and behavior structures showed a significant difference between the two test and control groups (P<0.05). Before the training, 4.5% of the participants of the intervention group were in the risk control process, and after the training intervention, this figured reached 20.7%, which was statistically significant. After the educational intervention we found significant difference between the control and intervention groups in terms of the risk control process or fear control process (P=0.049).

Use of the developed parallel process model is effective in adopting preventive behaviors against the coronavirus in young women.

Adolescence coincides with the occurrence of risky behaviors. These high-risk behaviors lead to unpleasant and destructive physical, psychological, and social consequences. Based on an extended parallel process model, if people do not believe that they are at high risk for disease or health hazards. More to deal with it are more sensitive. Therefore, this study was conducted with the aim of the effect of the extended parallel process model on the risk of female adolescents in Aliabad Katoul in 2020.

This semi-experimental study was performed on 50 female students of Sama School in 2020 in AliAbad Katoul city in Golestan province, randomly divided into experimental and control groups. The data collection tool is the Iranian Adolescents Risk-Taking Scale (IARS). In the experimental group, 8  sessions (45-60) minutes were performed in groups of 6-7 people based on the extended parallel process model duration of 8 weeks. Data were collected in two experimental-control groups before and after the intervention

ANCOVA test showed a significant difference by removing the effect of pretest (p <0.01, Eta = 0.15). Also, the extended parallel process model affects all dimensions of risky behavior.

The results showed that the extended parallel process model reduces high-risk behaviors in adolescent girls. Therefore, nursing theories and health models can be used as a low-cost but effective educational method to increase awareness and prevent high-risk behaviors.

Due to the prevalence of coronavirus infection in Iran and the greater susceptibility of pregnant women to the disease, this study aimed to investigate the predictors of pregnant women's self-care behavior in coronavirus disease-2019 (COVID-19) epidemic using the Extended Parallel Process Model (EPPM).

This cross-sectional descriptive study was conducted on 309 pregnant women in Isfahan City, Iran. The samples were selected using two-stage cluster sampling method from 14 health centers in Isfahan City. In order to collect data, participants completed a researcher-made questionnaire based on EPPM constructs online. The collected data were analyzed using Spearman correlation coefficient and hierarchical linear regression tests via SPSS software.

The mean age of the participants was 29.00 ± 6.25 years. Overall, the four variables of “perceived sensitivity, perceived severity, self-efficacy, and response efficiency” constituted about 44% of the total variance of protective behaviors in pregnant women (adjusted R2 = 0.42%, P = 0.030). Among them, the constructs of self-efficacy (β = 0.41) and response efficiency (β = 0.15) had the greatest power in predicting self-care behavior (P < 0.050).

Self-efficacy and response efficiency constructs have been the main determinants of self-care behaviors of pregnant women during COVID-19 disease. Therefore, in order to promote self-care behaviors in pregnant women, more emphasis can be placed on strategies of improving the mentioned constructs.

Covid-19 preventive behaviors are essential, and designing messages that convey a sense of danger is essential to creating these behaviors. One of the most widely used models for designing danger messages is the Extended Parallel Process Model (EPPM). Therefore, the aim of this study was to determine the predictors of preventive behaviors based on EPPM. 

In this cross-sectional study, 1455 participants over 18 years old living in Bushehr province in cities of Bushehr, Genaveh, Tangestan, and Assaluyeh were selected by multi-stage sampling method. Data were collected online using valid and reliable questionnaires including demographic questions, constructs of the EPPM about individuals' perception of Covid-19, and preventive behaviors (hand washing and masking). Data were analyzed in SPSS software version 22. 

Out of 1455 participants, 877 (60.3%) had preventive behaviors. According to the results, the highest rate of hand disinfection by people after attending public places was 97.5% and the highest rate of wearing a mask was 98.7% in the presence of medical centers.  The constructs of perceived susceptibility, severity, and self-efficacy were predictors of preventive behaviors, and self-efficacy was the strongest predictor. Among the participants in the study, 914 (62.8%) were in the fear control process of preventive behavior, in which the highest defense response, has been about avoidance.

In order to promote preventive behaviors, people's perceptions of the threat of disease should be increased in health messages, and people's understanding of self-efficacy should be improved by using various methods, including verbal persuasion, modeling, step-by-step goal setting, and so on.

Skin cancer is one of the most common cancers, and the best way to prevent it is to protect yourself from the sun. The aim of this study was to determine the factors determining the protective behavior of skin cancer based on the extended parallel process model in medical students of Shahrekord Branch of Azad University in 2021.

This descriptive study was conducted on 196 students of Shahrekord Azad University School of Medical Sciences. Convenience (available) sampling was applied according to students' field. A questionnaire based on the extended parallel processes model was used to collect information, and data was analyzed using analysis of multiple linear regression.

The mean and standard deviation of age of participants were 21.84±4.19 years and 100 (51%) were female and 96 (49%) were male. According to the findings, the perceived intensity structure had the highest score among the model structures. Among the constructs of defensive avoidance model (β=0.445) and self-efficacy (β=0.424), the strongest predictor was behavioral intention (p<0.001), and behavioral intention (β=0.669) was the strongest predictor of skin cancer prevention behaviors (p<0.001).

The results showed that the structure of perceived self-efficacy and behavioral intention are the most effective factors on preventive behaviors of skin cancer. Therefore, it is recommended that in the field of development of educational interventions in the prevention of skin cancer, these structures should be considered more.

Diabetes is one of the most common chronic diseases in the elderly. Adherence to a medication regimen plays an important role in preventing and controlling the effects of this disease. Theory-based training programs have a vital role in changing behaviors. Therefore, the aim of this study was to investigate the effect of extended parallel process model (EPPM) on adherence to the medication regimen of the type 2 diabetic elderly.

This experimental study was performed on 60 diabetic elderly patients in two experimental and control groups in Gonbad City in 2019 via simple random sampling. The data were collected using Morisky Medication Adherence Scale (MMAS-8). In the experimental group, six 30-45-minute training sessions were held based on Kim Wittechr('39')s EPPM. The control group received routine care. Data were analyzed using SPSS 21 with descriptive statistics (table, mean and standard deviation) and inferential statistics (independent sample t-test, independent t-test and ANCOVA).

The results showed no significant difference in the experimental and control groups before the intervention (p=0.2), but no significant difference was observed after the intervention (p=0.04). Moreover, ANCOVA indicated a significant difference by removing the effect of pre-test (p=0.004, Eta=0.13) so that 13% of changes in adherence to the medication regimen could be developed based on the implementation of the EPPM.

The results suggested that the EPPM increased adherence to the medication regimen in diabetic elderly patients. Therefore, the findings of this study can be used as a low-cost but effective therapeutic intervention in the education and care of diabetic patients.

Skin cancer is one of the most common cancers with an increasing global rate. In preventing this disease, the most basic measure is sun protection behaviors. Given the importance of health for medical students as health ambassadors, the aim of this study was to investigate the effect of extended parallel process model on the skin cancer preventive behaviors in Yazd students.

This descriptive-analytical study was conducted on 280 students of Yazd universities in 2019. The participants were selected using the random sampling method. A questionnaire based on the extended parallel processes model was used to collect the information. After entering SPSS 18 software, the data were analyzed using appropriate parametric statistical tests including independent t-test, analysis of variance, Pearson correlation, and linear regression at the significance level of 0.05.

The participants’ mean age and standard deviation was 22.69±3.18 years within the range of 18 to 41 years. Among the participants, 62.5% were women. Application of hats and sunscreen was 15.7% and 30.9%, respectively. According to the findings, the perceived severity structural had the highest score among the model structures. Among the constructs of model, self-efficacy was the strongest predictor of behavioral intention (β = 0.376) and preventive behaviors of skin cancer (β = 0.109).

Due to the low level of protective behaviors and self-efficacy perceived construct, as the most effective factors on the preventive behaviors of skin cancer, it is recommended to consider educational interventions in this regard.

Adolescents often struggle with changes in blood sugar levels due to developing conditions. A major part of diabetes management is improving self-efficacy and increasing treatment-dependency. The education provided on theory-based approaches is considered one of the most basic methods of treatment and control of diseases. The extended parallel process model is also regarded as one of the healthcare training models. This study aimed to investigate the effect of the extended parallel process model on the self-efficacy of diabetic adolescents, Golestan Province, Iran, in 2019.

This classic interventional study with a pretest-posttest control group design was conducted on 50 diabetic adolescents in Golestan Province selected by simple random sampling method in 2019. The intervention group received an educational program based on the extended parallel process model in 5-6-people per group for 5 sessions of 45-60 min twice weekly. The required data were collected using a demographic form and the Self-Efficacy Questionnaire for Children. Data analysis was performed in SPSS software (version 23) using tables and mean scores for descriptive statistics and independent t-test, paired t-test, and ANOVA for inferential statistics.

The results of the ANOVA test, by removing the effect of the pretest, showed that teaching the extended parallel process model was effective on the self-efficacy of diabetic adolescents (Eta=0.63, P<0.01) predicting that 63% of posttest changes were attributed to the implementation of the intervention.

According to the findings, education based on the extended parallel process model and follow-ups after training sessions could increase the self-efficacy of adolescents with diabetes. Therefore, the findings of this study can be used to educate diabetic patients in clinics and medical centers.

The effectiveness of health education programs depends to a large extent on the correct use of existing theories and models. Extended Parallel Process Model is considered as one of the effective models in health education having influential structures in studies on health behaviours. Therefore, the present study set out to study the use of Extended Parallel Process Model in health related behaviours through a systematic approach.
Scoups, Springer, Google Scholar, Science Direct and Iranian databases including Iran Medes, SID, Magiran, etc were all considered in this study. Extended parallel process and Developed parallel process were used as two keywords in the searches. There were 25 papers in English and Persian, 22 of which were studied. Ethical issues were considered in all stages of the research, and there was no bias and confinement on the part of the researcher.
The findings of this study showed that through the use of all the structures of the parallel process model, especially the perceived self-efficacy construct, the effectiveness of training has been increased in conducted interventional studies. In cross-sectional studies, on the other hand, all structures, especially perceived self-efficacy and sensitivity of perception as well as perceived severity have been important predictors for intention and behaviour.
Our results revealed that Extended parallel process model can be used to prevent and control many risky behaviours before the subject exposed to risk factors.

Evidence shows that a considerable percentage of Iranian young men suffer from obesity and being overweight at the onset of military services. This study aimed to investigate the soldier's knowledge, attitude and practice about obesity and overweight management based on the Extended Parallel Processes Model.
This KAP (Knowledge, Attitude and Practice) study was conducted in two military centers in Yazd, Iran (in 2016). Through a multi-step sampling method, 94 subjects were recruited. The knowledge, attitude and practice level of soldiers were measured by valid and reliable researcher-made questionnaires. Data were analyzed by descriptive statistics and the Pearson correlation test using SPSS 18.0 software.
The mean±SD score was 8.30±1.34 for knowledge, 10.70±1.90 for perceived severity, 9.10±1.69 for susceptibility, 10.11±2.30 for response efficacy, 10.28±2.27 for self-efficacy and 19.70±5.84 for practice of obesity and overweight management. There was a significant direct correlation between the soldiers’ knowledge score and perceived severity (p=0.021). However, knowledge and perceived response efficacy had an inverse and significant correlation (p=0.04). Results also showed a direct significant correlation between perceived self-efficacy and practice (p Soldiers did not have ideal knowledge, attitude, and practice towards obesity management. Therefore, it is suggested to use proper educational intervention for improving these variables in soldiers who are overweight or obese during military service.

Pre-pregnancy obesity is an independent risk factor for adverse consequences of pregnancy. Increased awareness and sensitivity toward these consequences is the first step to promote preventive behaviors in this population. Extended parallel process model (EPPM) is known as a successful model in the prevention of health risky behaviors through raising awareness, sensitivity and self-efficacy of the people. Therefore, this study was performed with aim to compare traditional training (face to face) with Extended parallel process model (EPPM)-based Training on knowledge of obesity complications before pregnancy in women with high BMI.
This randomized clinical trial was performed with Multi-stage random sampling on 60 women referred to two health centers in Mashhad for pre-pregnancy counseling in 2015. For the experimental group, two training sessions were done by the researcher based on the model, and the control group received traditional training (face to face) by health care providers. Data collection tool was the questionnaire of concepts of model and knowledge of women from the risk of high weight before pregnancy which were completed before, two and four weeks after the intervention. Data were analyzed by SPSS software (version 16) and Independent T-test, Chi-square, Mann-Whitney and ANOVA with repeated data were used. P Before the intervention, there was no significant difference between the two groups in the mean score of knowledge (P>0.05). But after the intervention, significant increase was observed in the mean score of knowledge in the experimental group compared to the control group after two weeks (P Extended parallel process model-based training can act more successful than traditional training (face to face) in promoting the knowledge of women with high body mass index.

Since diabetes is a lifelong disease with no cure, this disease is a life-long self-care needs. Diabetic foot is a significant problem in patients with type II diabetes, which can be in some cases lead to amputation.
Material & This cross - sectional study was conducted on patients referred to the clinic diabetes in 2014 was a city of Sabzevar. Non-probability sampling method of sampling was available to collect data, a questionnaire developed parallel process model development and verification of the reliability and validity of the 400 patients (diabetics) were also used. Data analysis was performed using SPSS version 17 and regression testing
The mean age history of diabetes 45/11 ± 7/51, 65/6 ± 74/9 year knowledge score of 2/60 were a hundred. The perceived sensitivity of patients to the risk of diabetic foot and its consequences 67 percent, the perceived effectiveness of the strategies recommended to hygiene 1/72 of hundred variable The severity of diabetic foot infection 9/60 hundred 4/73 and 8/69 respectively performance and self-care variable and score a hundred
The results showed that the most influential factor in increasing severity of structural self-care behavior in patients with diabetes is to develop effective interventions to increase self-care behavior must be considered.

Objective (s): Iran is among countries with high road traffic accidents. The use of safety belts is known as the most effective in preventing severity of injuries and deaths caused by road accidents. However, many drivers do not wear seat belts while driving. To encourage drivers to use seat belts, providing appropriate messages based on scientific theories is very important. The purpose of this study was to use the extended parallel process model (EPPM) in developing an effective educational program to promote safety belt use among drivers in Tehran, Iran. This was a quasi-experimental study and conducted on drivers who were stopped by police officer because of driving without using seat belts. The site and participants of survey were selected by multistage random sampling. The message and educational intervention was developed after analyzing pre-test results. Among all 209 drivers, 80.4 percent were male and the mean age of participants was 41 (SD =1.3) years. Measuring the Risk Behavior Diagnosis Scale, based on EPPM, the findings showed that drivers were in fear control position indicating that they had a lower level of perceived efficacy comapired to perceived threat. Multiple regression analysis before educational intervention showed that perceived susceptibility and perceived self-efficacy were predictors of self-reporting use of seat belt among drivers (R2=0.38, P< 0.05(. After intervention, participants were moved to danger control position indicationg that they were in a position to adopt protective behavior. Self-reporting seat belt wearing increased about 24% after intervention. The findings suggest that focusing on messages with high efficacy contents; can promote seat belt wearing among drivers.