الفهرس 
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Abstract
Obesity has become an epidemic and affecting individuals of all ages. Adolescents are particularly susceptible to obesity due to their decrease in physical activity, as well as to the greater availability of foods void of nutritional value.
Adolescents’ impressionable natures and changing bodies also contribute to their increased weights. Obese adolescents are at a higher risk for cancer, liver disease, neurological issues, cardiovascular disease, asthma, sleep apnea, and orthopedic problems. Because the number of fat cells in a person is determined by late adolescence, many obese children face the consequences of adult obesity as well Fletcher et al.,( 2016).
Aim of the study:
The effect of application of health belief model among youth at high risk for obesity in West Bank ( Palestine) through:-
1. Assessing their knowledge and practice regarding of youth, BMI, nutritional status according to their belief.
2. Developing and implementing program for obese youth, according to their needs.
3. Evaluating the effectiveness of the health belief model on their improvement of knowledge and practice of youth .
Research Design:
A quasi experimental study design was used to explore the effect of the health belief model on improving the knowledge and practice of university youth, about obesity.
Technical Design:
The technical design includes; the setting, subject & tools were used in the study.
Setting:
The study was conducted at Faculty of Nursing /An-Najah National University which located in Nablus-West Bank- Palestine with a total capacity of around 23000 university students and IBN SINA College for Health Sciences /MOH, located in Nablus-West Bank Palestine with a total capacity of around 300 university students. These settings are considered the largest educational organizations and serve all governorates in the West Bank (Palestine) .
Sampling:Type:
A purposive sample was used in the study. The students were chosen as a total number of 185 (65 from IBN Sina and 120 from An-Najah), the study sample included 117 students, from both settings (45 from IBN Sina and 72 from An-Najah) according to inclusive criteria: university male and female students who enrolled in fourth academic years, and accepted to participate in the study & Excluded (50 students with normal weight according to BMI, also18 students as a pilot study sample)
Tools for data collection: Three tools were used for data collection.
First tool: A Self-Administered Questionnaire (appendix1):
It was developed by the researcher based on the recent related literature review and experts’ opinion. It included four parts:
Part One: Socio-demographic characteristics such as age, sex, marital status, place of residence, monthly income, number of family member and number of rooms (Q1-Q6).
Part two: Assessing university student’s knowledge (pre-post) application of health belief model (Q6-Q21) through asking question. It covered the following knowledge about obesity and nutritional habits, and its consequence.
Part three: Assessing university student’s practice (pre-post) application of health belief model (Q22-Q33) through asking question.It covered the following healthy food and regular exercises by using role play.
Part four: Assess the effects of obesity on student’s life style .
It was composed of 20 item regarding their Physical health, Self esteem and Social distress (pre-post) application of HBM(Q1-Q20).
Second tool: The HBM sub constructs which used in this study were include the Perceived threat scale consisted of tenth items about susceptibility (possibility of becoming obese) and severity of obesity (severity of disease resulting from obesity), the perceived benefits scale with 11 items, the perceived barriers scale with 12 items, the cues to action scale with 6 items, the perceived self-efficacy in dietary life scale with 16 items, and the perceived self-efficacy in exercise scale with 12 items (Appendix 11).
Third tool: Anthropometric measurement to detect body mass index DHSCDP,(2005) (Appendix III). Three variables were measured by the investigator, weight, height, and BMI, The height was recorded to the nearest 0.5 cm. The subject stood upright barefooted or in thin socks and bareheaded using a height scale measurement to take height .The Weight was recorded to the nearest 1 Kg using appropriate international standards scales, and 0.5kg standard weight for assessing and adjusting the scales were used. Weight was taken without shoes and with light clothing and body mass index (BMI) is a measure of body fatness. It was calculated by the equation: BMI = Weight in Kg / Height² in meters.
Pilot study:
It will be conducted for 10% (18) students to test the content, clarity and time needed to fill the tool as a pre-test. According to pilot study no modification done. So, the pilot study sample was excluded from the study sample.
The finding of the present study could be summarized as follows:
• Total number of the studied sample was 117, most of them aged ranged from 20 - 25 years old and more than two third were female .About more than half of the sample had resident at rural area.
• As regard body mass index the present study shows that less than half of them were obesity class1, more than one third were obesity class II, one tenth were obesity class III and only 4.3% of them were overweight.
• The total correct knowledge of university students related to nutritional habits reported 43.6% had correct knowledge pre program , while changed to 89.7% post program with highly statistically significant differences at P value <0.001,also there was a highly significant difference between student ’s practices regarding healthy food, exercises pre &post implementation of the program at P<0.001.
• In accordance to the total effect of obesity on their self stem and social distress the study reported there was a highly significant difference between pre, post application of HBM at P<0.001.
• It was found that there was highly significant relation between student’s practices regarding obesity and their sex, the female more practices than male.
• There was positive correlation between student’s practices and improvement their selected health belief model post program at P<0.001.
The finding of the present study, suggested the following recommendations:
1- Provide culturally appropriate health education programs for promoting physical activity especially among Palestinian students regarding nutritional habits, and its consequence, method of weight reduction & types of exercises, also continuously monitor the numbers of overweight and obese student with a national register for obesity.
2-Follow up periodically for overweight or obese student and continuous health education programs for them to enhance their life style practices to reduce the prognosis of the disease.
3-regarding the HBM also suggests that the benefits and barriers of changing health behavior must be taken into consideration, as those who perceive more benefits than barriers are more likely to take action. In addition, self-efficacy, or the belief in one’s ability to achieve a desired result, has recently been added to the HBM, as a significant amount of literature posits that individuals with higher self-efficacy are more likely to incorporate health behavior changes.
4-Finally it is important to explore whether measuring current Health Beliefs would impact different health behaviors. Eating healthy food and doing physical activity-the key components of this study-are easy and highly controllable behavior.
Further Researches on:
1. Investigate contributing factors of obesity to improve understanding and management.
2. Conduct experimental research on Nutritional therapy and physical activity to improve obesity management especially regarding adolescence stage.
3. Examine the relationship between body mass index and health related life style.
4. further research the impact of self-efficacy on training and guidance methods, goal setting practices and individualized training programs.
5. Applicate the study on large sample
6. Use of HBM in researches as in frame work.