Dean has it right. Also, check out the PhD thesis of Sarab Shaab (Leeds Beckett University); it addresses physical activity promotion among doctors and nurses in pre-civil war Syria. It has some sharp insights that move well beyond conventional, but deeply unhelpful, explanations about 'lack of motivation' and so on. It should be available online.

Behrooz - your findings are actually consistent with similar nursing-related behavioural studies internationally. There is a saying that 'knowledge can be dangerous'. It's too simple and assumption to think 'you are in a profession that teaches you what is healthy and what is not - therefore you should choose the healthy option'. Life is not like that. If your study highlights greater health discrepancy than others - might it be cultural? Most nurses in Iran, I assume, are female. Gender inequity, in Iran, is well documented internationally - but you would be in a far better position to comment on that.

Dean has it right. Also, check out the PhD thesis of Sarab Shaab (Leeds Beckett University); it addresses physical activity promotion among doctors and nurses in pre-civil war Syria. It has some sharp insights that move well beyond conventional, but deeply unhelpful, explanations about 'lack of motivation' and so on. It should be available online.

Dear Behrooz,

Looks like being a healthcare worker does not necessarily "immune" persons as to their individual health promoting behaviors. However, we have found that hands-on in-service HCW training (our program named "PHeeL-PHiNe") showed some optimistic outcomes regarding nutritional behaviors while physical activity improvements were less sustainable.

1. https://www.researchgate.net/publication/273325735_Public_Health_Nurses_Promoting_Healthy_Lifestyles_PHeeL-PHiNe_Methodology_and_Feasibility

2. https://www.researchgate.net/publication/325469414_Practice_What_You_Teach_Public_Health_Nurses_Promoting_Healthy_Lifestyles_PHeeL-PHiNe_Program_Evaluation

All the best,

Chen Stein-Zamir

There is a lot of health promotion literature that shows that knowledge does not result in behaviour change. If you apply the Ottawa Charter for Health Promotion you may identify factors in Iran that may impede someone's ability to adopt healthier behaviours despite having the knowledge. An earlier comment referring to gender inequalities may also shed some light on the reasons. I'm also not sure how well paid nurses are in Iran. If they are lower income then there may other factors based on socioeconomic status

that affect their health behaviours.

It is an important issue Beeroz. I focussed my four decades of medical work on the issues of wellness, recovery and flourishing. It was evident that these were not the focus of the training or the work around me each day - disease diagnosis and treatment interventions were the order of the day. This is vital and powerful stuff. Yet, as the epidemics of life-style and environmental illness arose, the severe limits of this medical map were slowly revealed. As I ran courses (TheWEL) to help people out of this impasse, it became evident that often the staff were no healthier than those they served. People need to know how to flourish in modern life, and the honest truth is that most staff do not know any better than their patients. In TheStaffWELs I then created, the levels of poor wellbeing and health were deeply worrying - and of course burnout is now rife among care staff. Staff share with the population the same root misunderstanding that health can be built or maintained with 'fix-it' approaches and without addressing self-care and life-nurture.

high knowledge does not indicate someone has a good attitude and practice towards something

lack of appropriate training may be a cause

Thank you for your ideas about my question. I agree with your responses. I think that the good knowledge about healthy behaviors not necessarily lead to positive attitude and finally doing better healthy behaviors. The predisposing factors and enabling factors have important roles in this regard ( you can see Precede-Proceed Model for more information).

Your results are consistent with many studies around the world where not only nurses but health professionals do not have disease preventive behaviors or health promoting behaviors. Cognitive factors such as cognitive distortions and low risk perception stand out. Then, health professionals do not consider themselves susceptible to illness or if they believe they would control the disease. Thus, the low perception of risk and cognitive distortions partially explain the behaviors observed in your study.

Dear Dr Cantero

Thank you for your response. I agree with you. Despite of enough konwledge,the health care providers have no attiude to performing heathy behaviors. This issue is due to several causes. Please share your ideas in this regard.

Thank you much.

Dear Cate Wood

Thank you for your response. I also think that this has different causes and that you have mentioned one of them well. In this regard, I agree with you, healthcare professionals often provide patients' care with a machine approach, which does not lead to quality and satisfactory care. However, they should follow a holistic and humanistic approach to health care delivery. But I think there are also other reasons that need more research.