The Development of a Health Behavior Modification Operating Manual for School-aged Children with Over Nutrition

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Pranee Insri
Piyanuch Jittanoon
Siriwan Piriyakoontorn


       This research aimed to develop a health behavior modification operating manual for school-aged children with over nutrition. The concepts of Transtheoretical Model (Prochaska & Diclemente, 1984) combined with dietary and exercise principles including research evidence were applied. The manual developing processes comprised four steps: 1) reviewing related theory, principles and research evidence, 2) developing the manual draft, 3) evaluating the applicability of the manual, and 4) revising and producing the final version. The newly developed manual was examined for its content validity by three experts and was assessed for its applicability by three teachers and two public health officers responsible for school health.

       The manual details comprised two operating steps: 1) the step of behavior assessment and identification of behavior changes, and 2) the step of behavior modification using activities suitable for  individual behavioral changes. In addition, work sheets and information inserts were provided for the users to help the children modify their dietary and exercise behaviors appropriately.

       The results of content validity examination by all experts revealed that the manual content was academically valid, in sequence, and precise. However, there were suggestions that the language used in the manual should be formal and pictures or symbols should be used instead of taking notes. After revising the manual according to the experts’ suggestion, the applicability of the manual was assessed. It was found that the manual was practical. Its content and steps of conducting activities were simple. The manual size was appropriate and its text and graphical illustrations were explicit and simple. In summary, the developed manual was applicable for behavior modification of school-aged children with over nutrition.


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Insri, P., Jittanoon, P., & Piriyakoontorn, S. (2015). The Development of a Health Behavior Modification Operating Manual for School-aged Children with Over Nutrition. Journal of Research in Nursing-Midwifery and Health Sciences, 35(2), 177–190. Retrieved from
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