Kontakt X:X | DOI: 10.32725/kont.2025.039

Exploring the impact of health belief model-based nutrition education on promoting preventive nutritional behaviors in women with polycystic ovary syndrome in Jordan: a randomized controlled trialNursing - Original article

Mohammed O. Ibrahim
Mutah University, Faculty of Agriculture, Department of Nutrition and Food Technology, Karak 61710, Jordan

Background: Endocrinologists consider polycystic ovary syndrome (PCOS) the most complex disorder among women of reproductive age.

Objective: The purpose of the study was to explore the effect of a nutrition education intervention based on the Health Belief Model (HBM) in promoting preventive nutritional behaviors among women with PCOS.

Methods: A randomized controlled trial was conducted between February 2024 and August 2024. Participants were recruited from eight obstetrics and gynecology private clinics in Amman, Jordan. Participants were randomized into two groups: an intervention group (n = 58) and control group (n = 58). In addition to routine healthcare education, participants within the intervention group received a nutrition education program based on HBM.

Results: For all study variables, there was a significant improvement in the mean scores of HBM constructs, anthropometric measurements, and clinical features in the intervention group (P < 0.001). There was also a significant difference in the mean scores of HBM constructs, anthropometric measurements, and clinical features between the intervention group and the control group after three months of intervention (P < 0.001).

Conclusion: Providing nutrition education programs based on HBM improves preventive nutritional behaviors among women of reproductive age who suffer from PCOS. Such a model can be used as a framework for formulating advanced educational interventions for PCOS prevention.

Keywords: Health Belief Model; Jordan; Nutrition Education; Obstetrics and Gynecology; Polycystic Ovary Syndrome
Conflicts of interest:

Ethical aspects and conflict of interest The author has no conflict of interest to declare.

Received: April 12, 2025; Revised: July 29, 2025; Accepted: September 18, 2025; Prepublished online: September 19, 2025 

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    References

    1. Abdolahian S, Tehrani FR, Amiri M, Ghodsi D, Yarandi RB, Jafari M, et al. (2020). Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis. BMC Endocr Disord 20(1): 71. DOI: 10.1186/s12902-020-00552-1. Go to original source... Go to PubMed...
    2. Alomran S, Estrella ED (2023). Effect of Dietary Regimen on the Development of Polycystic Ovary Syndrome: A Narrative Review. Cureus 15(10): e47569. DOI: 10.7759/cureus.47569. Go to original source... Go to PubMed...
    3. Angin P, Yoldemir T, Atasayan K (2019). Quality of life among infertile PCOS patients. Arch Gynecol Obstet 300(2): 461-467. DOI: 10.1007/s00404-019-05202-z. Go to original source... Go to PubMed...
    4. Archer JS, Chang RJ (2004). Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 18(5): 737-754. DOI: 10.1016/j.bpobgyn.2004.05.007. Go to original source... Go to PubMed...
    5. Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO (2016). The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 31(12): 2841-2855. DOI: 10.1093/humrep/dew218. Go to original source... Go to PubMed...
    6. Cooney LG, Lee I, Sammel MD, Dokras A (2017). High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 32(5): 1075-1091. DOI: 10.1093/humrep/dex044. Go to original source... Go to PubMed...
    7. Diddana TZ, Kelkay GN, Dola AN, Sadore AA (2018). Effect of Nutrition Education Based on Health Belief Model on Nutritional Knowledge and Dietary Practice of Pregnant Women in Dessie Town, Northeast Ethiopia: A Cluster Randomized Control Trial. J Nutr Metab 2018: 6731815. DOI: 10.1155/2018/6731815. Go to original source... Go to PubMed...
    8. Doshi A, Zaheer A, Stiller MJ (1997). A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol 36(6): 416-418. DOI: 10.1046/j.1365-4362.1997.00099.x. Go to original source... Go to PubMed...
    9. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. (2012). Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 97(1): 28-38.e25. DOI: 10.1016/j.fertnstert.2011.09.024. Go to original source... Go to PubMed...
    10. Ferriman D, Gallwey JD (1961). Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 21: 1440-1447. DOI: 10.1210/jcem-21-11-1440. Go to original source... Go to PubMed...
    11. Gainder S, Sharma B (2019). Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian Dermatol Online J 10(2): 97-105. DOI: 10.4103/idoj.IDOJ_249_17. Go to original source... Go to PubMed...
    12. Ghaffari M, Niknami SH, Kasemnejad A, Mirzae E, Ghofranipour F (2007). Design and validity HIV/AIDS Questionnaire in Teen Kermanshah. J Kermanshah Univ Med Sci 11(1): e81863.
    13. Ghaffari M, Tavassoli E, Esmaillzadeh A, Hassanzadeh A (2012). Effect of Health Belief Model based intervention on promoting nutritional behaviors about osteoporosis prevention among students of female middle schools in Isfahan, Iran. J Educ Health Promot 1: 14. DOI: 10.4103/2277-9531.98572. Go to original source... Go to PubMed...
    14. Glanz KK, Rimer B, Viswanath K (Eds) (2008). Health Behavior and Health Education. 4th ed. Jossey-Bass: San Francisco, CA, USA, pp. 236-239. [online] [cit. 2025-01-22]. Available from: https://thehubedu-production.s3.amazonaws.com/uploads/3/18722973-f80f-4b55-8ffe-fafa44c21979/health_education.pdf
    15. Guvenc G, Akyuz A, Açikel CH (2011). Health Belief Model Scale for Cervical Cancer and Pap Smear Test: psychometric testing. J Adv Nurs 67(2): 428-437. DOI: 10.1111/j.1365-2648.2010.05450.x. Go to original source... Go to PubMed...
    16. Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A (2007). Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril 87(6): 1369-1376. DOI: 10.1016/j.fertnstert.2006.11.039. Go to original source... Go to PubMed...
    17. Huang Y, Wang T, Wang H, Zeng Y, Xie L (2025). Health beliefs mediates the association between the number of non-communicable diseases and preventive behaviors in middle-aged and older adults in southern China. Aging Clin Exp Res 37(1): 49. DOI: 10.1007/s40520-025-02939-3. Go to original source... Go to PubMed...
    18. Kaczmarek C, Haller DM, Yaron M (2016). Health-Related Quality of Life in Adolescents and Young Adults with Polycystic Ovary Syndrome: A Systematic Review. J Pediatr Adolesc Gynecol 29(6): 551-557. DOI: 10.1016/j.jpag.2016.05.006. Go to original source... Go to PubMed...
    19. Kishk DM, Hafeze FE, Alemam DS, Taref NN, Bauomy ES (2023). Adopting Health Belief Model to Improve Female Employees' Knowledge, Beliefs and Preventive Behaviors regarding Vitamin D Deficiency. Egypt J Health Care 14(4): 72-89. DOI: 10.21608/ejhc.2023.324832. Go to original source...
    20. Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, Brown JE (2019). Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis. Syst Rev 8(1): 51. DOI: 10.1186/s13643-019-0962-3. Go to original source... Go to PubMed...
    21. Łagowska K, Bajerska J, Pieczyńska-Zając JM (2024). Dietary Factors and the Risk of Depression among Women with Polycystic Ovary Syndrome. Nutrients 16(6): 763. DOI: 10.3390/nu16060763. Go to original source... Go to PubMed...
    22. Linton DN, Porteous J, Eatson H, Chepesiuk R, Long T, Inrig TM, et al. (2020). Educational booklet reinforces knowledge of osteoporosis and influences intentions to improve bone health in previously diagnosed and treated patients. Osteoporos Int 31(9): 1703-1711. DOI: 10.1007/s00198-020-05392-2. Go to original source... Go to PubMed...
    23. McPhee SJ, Papadakis M (2010). Polycystic ovarian syndrome. In: Current Medical Diagnosis and Treatment. 49th ed. McGraw-Hill Medical, 690 p.
    24. Moran LJ, Misso ML, Wild RA, Norman RJ (2010). Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 16(4): 347-363. DOI: 10.1093/humupd/dmq001. Go to original source... Go to PubMed...
    25. Nieman DC (2019). Nutritional Assessment. 7th ed. Nutritional Assessment: New York, USA: McGraw-Hill Education, 496 p.
    26. Rajbanshi I, Sharma VK, Tuladhar ET, Bhattarai A, Raut M, Dubey RK, et al. (2023). Metabolic and biochemical profile in women with polycystic ovarian syndrome attending tertiary care centre of central NEPAL. BMC Womens Health 23(1): 208. DOI: 10.1186/s12905-023-02379-z. Go to original source... Go to PubMed...
    27. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004). Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome. Fertil Steril 81(1): 19-25. DOI: 10.1016/j.fertnstert.2003.10.004. Go to original source... Go to PubMed...
    28. Saffari M, Sanaeinasab H, Jafarzadeh H, Sepandi M, O'Garo KN, Koenig HG, Pakpour AH (2020). Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran: A Quasi-experimental Study. J Prev Med Public Health 53(4): 275-284. DOI: 10.3961/jpmph.20.095. Go to original source... Go to PubMed...
    29. Sharifirad GR, Tol A, Mohebi S, Matlabi M, Shahnazi H, Shahsiah M (2013). The effectiveness of nutrition education program based on health belief model compared with traditional training. J Educ Health Promot 2: 15. DOI: 10.4103/2277-9531.112684. Go to original source... Go to PubMed...
    30. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril 110(3): 364-379. DOI: 10.1016/j.fertnstert.2018.05.004. Go to original source... Go to PubMed...
    31. Teede HJ, Misso ML, Deeks AA, Moran LJ, Stuckey BG, Wong JL, et al. (2011). Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline. The Med J Aust 195(6): S65-112. DOI: 10.5694/mja11.10915. Go to original source... Go to PubMed...
    32. Vaidya A, Yadav S, Vaidya A (2020). A Study on the Clinical and Hormonal Profile of Polycystic Ovarian Syndrome Patients Attending a Tertiary Care Hospital: A Descriptive Cross-sectional Study. J Nepal Med Assoc 58(231): 875-888. DOI: 10.31729/jnma.5694. Go to original source... Go to PubMed...
    33. Veltman-Verhulst SM, Boivin J, Eijkemans MJ, Fauser BJ (2012). Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies. Hum Reprod Update 18(6): 638-651. DOI: 10.1093/humupd/dms029. Go to original source... Go to PubMed...
    34. WHO (2003). Report of the Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. report of a joint WHO/FAO expert consultation, Geneva, 28 January - 1 February 2002. [online] [cit. 2025-01-22]. Available from: https://iris.who.int/handle/10665/42665
    35. Zhu M, Wang K, Feng J, Liu Y, Guan M, Wang Y, Wu X (2024). The waist-to-height ratio is a good predictor for insulin resistance in women with polycystic ovary syndrome. Front Endocrinol 15: 1502321. DOI: 10.3389/fendo.2024.1502321. Go to original source... Go to PubMed...

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