The effect of training provided according to the health promotion model on premenstrual symptoms, emotional eating behavior, and perceived stress.

aimThis study aimed to determine the effect of training provided according to the health promotion model on premenstrual symptoms, emotional eating behavior, and perceived stress.

methodsThe study was conducted as a pretest-posttest randomized controlled trial between October 2023 and April 2024 with second- and third-year nursing and midwifery students at the Faculty of Health Sciences of a university in eastern Turkey. In the first stage, when students who took the Premenstrual Syndrome Scale scored 50% or more of the total scale score (220), PMS was classified as "present." Participants who scored 110 or higher on the Premenstrual Syndrome Scale were divided into three groups based on their PMS score levels. An equal number of individuals from each PMS score group were assigned to the intervention and control groups. The study was conducted using an open-label design, and the analysts were blinded during the data analysis process. The sample consisted of 86 students with PMS (42 in the intervention group and 44 in the control group). Data were collected using the "Personal Information Form," "Nutritional Habits During the Premenstrual Period," "Premenstrual Syndrome Scale (PMSS)," "Healthy Lifestyle Behaviors Scale (HLBS-II)," "Emotional Eating Scale (EES)," and "Perceived Stress Scale (PSS)." The intervention group received a training program using the health promotion model and the Phillips 66 technique. The posttest was administered to the intervention and control groups in the 8th week.

resultsIn the intervention group, statistically significant differences were found between the pretest and posttest in the consumption of milk and dairy products, refined grains, fast food, sweet foods, and packaged products (p < 0.05). The mean score of the intervention group in the posttest was lower than that of the control group in the total EES and PMSS scores, and the statistical difference was found to be significant (p < 0.05). No statistically significant difference was found between the groups in the pretest and posttest in terms of the total PSS and HLBS-II scores (p > 0.05). The group*time interaction of the total PMSS score was found to be statistically significant, while the total EES, PSS, and HLBS-II scores were found to be statistically insignificant (p > 0.05). In the intra-group comparison of the stress/distress subscale of the PSS, the mean score difference between the intervention and control groups was found to be statistically significant in favor of the control group (p = 0.045, d = 0.311). The group × time interaction for the fatigue (F = 5.813, p = 0.018, η²=0.065) and depressive thoughts (F = 8.926, p = 0.004, η²=0.096) subscales of the PMSS was found to be statistically significant. The group × time interaction for the total PMSS score was found to be statistically significant (F = 6.764, p = 0.011, η²=0.075). The group × time interaction for the EES score, as well as for the PSS and HLBS-II subscales and their total scores, was found to be statistically insignificant (p > 0.05).

conclusionThe training program led to positive changes in reducing PMS symptoms, and improving nutrition-related behaviors. This program did not prove to be effective over time in reducing emotional eating, alleviating perceived stress, or fostering healthy lifestyle behaviors; however, it did lead to positive changes in the scores. This training program is recommended within the scope of public health practices because it has been found useful in guiding toward a changeable lifestyle, identifying perceived barriers and benefits related to emotional eating behavior with PMS, and supporting healthy behaviors.

trial registrationThe protocol for this randomized controlled, open label, pretest-posttest design parallel-group clinical trial was registered on ClinicalTrials.gov on 2023/10/16 Registration No: NCT06105567; URL: https://clinicaltrials.gov/study/NCT06105567 .