Application and Testing the PRECEDE Model for Health Promotion of Air Crew

Cho, Eui Young

Abstract

To define the factors related to health promotion behavior in aircrew of an airline, this study as a covariance structural analysis applied and tested PRECEDE model. In using the PRECEDE model, the purpose of this study was to assess by phase factors that influence health promotion of aircrews and to test the relationship between health promotion related factors and those of PRECEDE model. The data was collected for one month in April of 2001 using self-questionarire and medical records. The data of 218 subjects were analyzed. For general characteristics and each assessment SPSS 10.0 Win Program was used for analysis LISREL 8.12 Win Program was used to test model. 1. Application of PRECEDE model For health promotion of aircrew, PRECEDE model was applied. For epidemiological assessment, elevated serum total cholesterol was chosen. Smoking, drinking, exercise and diet were defined as behavior factor. Job stress and stress factors in aviation were defined as environmental factor. Predisposing factors were regular lifestyle habits(sleep time, dietary habits with three meals per day, breakfast and snack), health related self efficacy, perceived benefit, perceived barrier. Reinforcing factors, the social support network among peers was assessed. Duty depending on the type of work situation, either domestic or international and the number of days spent in a rural city or overseas were used as enabling factors. 2. Testing of the model The total of nine theoretical variable to test its validity was used. Exogenous variable were enabling factors of work situation. Endogenous variables were reinforcing factor of social support network, predisposing factor of regular lifestyle, self efficacy, perceived benefit and perceived barrier. Out of 16 hypothetical paths using such factors, only four were supported. In order to modify the model, 5 paths were added after eliminating of 4 and as a result 9 out of total 17 were supported. Direct Effects With the PROCEDE model, reinforcing factors had significant effect on predisposing factors [Regular lifestyle habits (beta21=8.728, t=2.742), self efficacy (beta31=7.461, t=2.947), perceived benefit (beta41=3.967, t=2.679), perceived barrier (beta51=-3.550, t=-2.955)]. Even after modifying the model in order to improve fitness reinforcing factors had significant direct effects on predisposing factors [Regular lifestyle habits (beta21=0.020, t=2.428), self efficacy (beta31=9.636, t=2.427), perceived benefit(beta41=4.425, t=2.229), perceived barrier (beta51=4.212, t=-2.451)]. Perceived barrier had significant direct effects on health problem (beta85=0.171, t=2.979). Perceived barrier had significant direct effects on environmental factor (beta75=0.035, t=2.257). Perceived benefit had significant direct effects on behavior factor (beta64=0.391, t=2.755). Indirect Effect Regular lifestyle habits had significant indirect effects on Endogenous variable [Self efficacy (effect coefficient=0.191, t=9.004), perceived benefit (effect coefficient=0.087, t=4.576), behavior factor (effect coefficient=1.108, t=2.703), perceived barrier (effect coefficient=-0.083, t=-5.130), environmental factor (effect coefficient=-0.007, t=-2.579), health problem (effect coefficient=-0.016, t=-3.138)]. Social support network had significant indirect effects on health problem (effect coefficient=-0.823, t=-2.083). In conclusion this study supports the PRECEDE model by Green (1980) and this was useful in health promotion model of aircrew. Therefore, in order to improve health problem related to hyperlipidemia in aircrew, behavior modification though peer support should be promoted initially and then, programs that emphasize increasing perceived benefit and decreased barrier should be promoted. Finally, modifying health behavior to promote regular lifestyle and decrease health problems is encouraged.