title: Behavioral determinants of cardiovascular diseases risk factors: A qualitative directed content analysis.
abstract: BACKGROUND
  The PRECEDE model is a useful tool for planers to assess health problems, the behavioral and environmental causes of the problems, and their determinants. This study aims to understand the experiences of patients and health care providers about the behavioral causes of cardiovascular diseases (CVDs) risk factors and their determinants.
  
  
  METHODS
  This qualitative study utilized content analysis approach based on the PRECEDE model. The study was conducted for over 6 months in 2012 at the diabetes units of health centers associated with Alborz University of Medical Sciences, which is located in Karaj, Iran. Data were collected using individual semi-structured interviews with 50 patients and 12 health care providers. Data analysis was performed simultaneously with data collection using the content analysis directed method.
  
  
  RESULTS
  Stress, unhealthy eating, and physical inactivity were the behaviors, which predict the risk factors for CVD. Most of the patients considered stress as the most important underlying cause of their illness. In this study, 110 of the primary codes were categorized into seven subcategories, including knowledge, attitude, perceived susceptibility, severity, perceived benefits, barriers, and self-efficacy, which were located in the predisposing category of the PRECEDE model. Among these determinants, perceived barriers and self-efficacy for the mentioned behaviors seemed to be of great importance.
  
  
  CONCLUSIONS
  Identifying behavioral determinants will help the planners design future programs and select the most appropriate methods and applications to address these determinants in order to reduce risky behaviors.
authors.affiliation: PhD Candidate, Department of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Sabzmakan
authors.affiliation: Associate Professor,Department of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Morowatisharifabad
authors.affiliation: Associate Professor, Department of Nursing, Tarbiat Modares University, Tehran, Iran.
authors.forename: Eesa
authors.initials: E
authors.lastname: Mohammadi
authors.affiliation: Professor, Department of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Seid Saied
authors.initials: SS
authors.lastname: Mazloomy-Mahmoodabad
authors.affiliation: PhD Candidate, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rabiei
authors.affiliation: Associate Professor, Department of Surgery, Baqiyatallah University of Medical Sciences, Tehran AND Department of Surgery, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Naseri
authors.affiliation: Assistant Professor, Department of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Shakibazadeh
authors.affiliation: Assistant Professor, Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Mirzaei
keywords: Behavior; Cardiovascular Diseases; Qualitative Research; Risk Factors