Al-Kandari FL, Vidal V. Correlation of the health-promoting lifestyle, enrollment level, and academic performance of college of nursing students in Kuwait. Nursing and Health Science. 2007; 9:(2)112-119

Arrish J, Yeatman H, Williamson M Midwives and nutrition education during pregnancy: a literature review. Women Birth. 2014; 27:22-28

Blum J, Beaudoin C, Caton-Lemos L Physical activity patterns and maternal well-being in postpartum women. Maternal and Child Health Journal. 2004; 8:(3)163-169

Bull F, Bauman A, Bellew B, Brown WMelbourne: National Public Health Partnership; 2004

Edrisi M, Khademloo M, Ghorban F. Self Report of health promoting behaviors of nurses working in the educational hospitals. (Persian). Journal of Mazandaran University of Medical Sciences. 2013; 23:(105)59-52

Emami S, Bagheri Nesami M, Nabinezhad Male F, Alitabar Malekshah R Health promotion beahaviors and its related factors in students of Mazandaran University of Medical Sciences. Tabari Journal of Preventive Medicine. 2015; 1:(3)25-32

Evenson K, Aytur S, Borodulin K Physical activity beliefs, barriers, and enablers among postpartum women. Journal of Women's Health. 2009; 18:(12)1925-1934

Together. Guide to creating a local healthy diets project for pregnant and breastfeeding women. 2016. (accessed 1 January 2020)

Investigate health promotion behaviors according to Pender model in Fasa teachers women in 2015-2016 academic year. 2016. (accessed 1 January 2020)

Hosseini M, Ashktorab T, Taghdisi MH Health promotion lifestyle in nursing students: a systematic review. (Persian). Journal of Health Promotion Management. 2012; 2:(1)66-79

Hosseinnejad M, Kalantarzadeh M Lifestyle among student of Islamic Azad University, Kerman BRANCH Based on Pender's health promotion model.(Persian). Journal of Education and Health Promotion. 2013; 1:(4)15-28

Kalisiak B, Spitznagle T What effect does an exercise program for healthy pregnant women have on the mother, fetus, and child?. PMR. 2009; 1:(3)261-266

Karimi M, Eshrati B Effect of health promotion model based on physical activity in students.(Persian). Journal of Kermanshah University of Medical Sciences. 2012; 16:(30)192-200

Karimi S, Javadi M, Jafarzadeh F Economic burden and costs of chronic diseases in Iran and the World. (Persian). Health Information Management. 2012; 8:(7)984-996

Kernot J, Olds T, Lewis L, Maher C Effectiveness of a Facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol. BMC Public Health. 2013; 13:(1)

Mansorian M, Qorbani M, Solaimani MA A survey of lifestyle and it's influential factors among the University Students Gorgan. (Persian). Jahrom University of Medical Sciences. 2009; 1:62-71

Mazloomi Mahmoodabad S, Fazelpour Sh, Askarshahi M Health-promoting behaviors and psychosocial well-being of University Shahid Sadoqi Yazd academic staff in Iran. (Persian). J Ilam Univ Med Sci. 2013; 21:(3)12-51

Norouzinia R, Aghabarari M, Kohan M, Karimi M Health promotion behaviors and its correlation with anxiety and some students demographic factors of Alborz University of Medical Science.(Persian). Journal of Health Promotion and Management. 2013; 2:(4)39-50

Saravanan P, Yajnik CS Role of maternal vitamin B12 on the metabolic health of the offspring: a contributor to the diabetes epidemic?. The British J Diabetes Vascular Disease. 2010; 10:(3)109-114

Streuling I, Beyerlein A, Rosenfeld E, Hofmann H, Schulz T, von Kries R Physical activity and gestational weight gain: a meta-analysis of intervention trials. BJOG. 2011; 118:(3)109-114

Symons Downs D, Hausenblas H Women's exercise beliefs and behaviours during their pregnancy and postpartum. JMWH. 2004; 49:(2)138-144

Tol A, Tavassoli E, Shariferad GR, Shojaeezadeh D Health-promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan university of medical sciences. Journal of Education and Health Promotion. 2013; 28:(2)

Walker SN, Sechrit KR, Pender NJ The health promoting lifestyle profile; development and psychometric characteristics. Nursing Research. 1987; 36:76-81

Investigating the effect of training on health behaviours of breastfeeding mothers in Iran

02 June 2021
11 min read



This article aims to investigate the effect of training based on Pender's model on health promotion behaviours in breastfeeding mothers.


In this quasi-experimental interventional study, 97 breastfeeding mothers referred to Fasa clinics were randomly studied in two case (n=48) and control (n=49) groups. To collect data, Walker et al's health promotion lifestyle questionnaire, including 52 questions, was used. After distributing the questionnaires in the first stage, the case group received five sessions of training. Data analysis was performed using SPSS20 software and independent t-test and paired t-test.


According to the results, the highest and lowest scores were related to the areas of spiritual growth (23.29±6.16 before training and 24.65±6.56 after training) and interpersonal relationships (4.70±1.57 before training and 1.57±1.76 after training), respectively. In all six areas, a significant increase was found in scores after the training in the case group or between the case and control groups.


With this small sample and just one month training, the researchers demonstrated that it is possible to make changes in all areas of health. This can not only have an immediate effect but also a ‘snowball effect’ down the generations, through mother-children transfer, as well as mother-to-other family members transfer.

New health paradigms suggest that being healthy depends on a number of factors. These can be social factors, awareness, and even personality traits. Similarly, quality of life includes all aspects of life, such as health. It can be, therefore, inferred that health promotion behaviours have positive effects on quality of life, and that people with healthy behaviours are generally healthier and will experience lower disease burden and disability (Hasheminasab, 2016). According to Pender's theory, health promotion behaviours refer to any action taken to increase or maintain the health or self-actualisation of an individual or group.

Health promotion behaviour indicates a person's desire for excellence, which leads to optimal wellbeing, individual development, and creative life. It is a multidimensional model of voluntary actions and perception leading to maintaining and enhancing the level of health, self-actualisation and success (Hosseini et al, 2013; Edrisi et al, 2013). Also, based on Walker's point of view, the health promotion model is a multidimensional model of self-efficacy, maintaining or improving the level of wellbeing and complete self-actualisation of individuals, so behaviours promoting the mental and social health and wellbeing of individuals are important determinants of health status (Mazloomi Mahmoodabad et al, 2013).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • Unlimited access to the latest news, blogs and video content

  • Monthly email newsletter