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program based on Health Belief Model on preventive behaviors
of internet addiction :…
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ORIGINAL ARTICLE
Year : 2017 | Volume : 6 | Issue : 1 | Page : 63-
Assessing the effect of an educational intervention program
based on Health
Belief Model on preventive behaviors of internet addiction
Aghbabak Maheri, Azar Tol, Roya Sadeghi
Department of Health Education and Promotion, School of
Public Health, Tehran University of Medical Sciences, Tehran,
Iran
Correspondence Address:
Roya Sadeghi
Department of Health Education and Promotion, School of
Public Health, Tehran University of Medical Sciences, Tehran
Iran

Abstract
Introduction: Internet addiction refers to the excessive use of
the internet that causes mental, social, and physical problems.
According to the high prevalence of internet addiction among
university students, this study aimed to determine the effect of
an
educational intervention on preventive behaviors of internet
addiction among Tehran University of Medical Sciences
students.
Materials and Methods: This study was a quasi-experimental
study conducted among female college students who live in the
dormitories of Tehran University of Medical Sciences. Two-
stage cluster sampling was used for selection of eighty
participants in
each study groups; data were collected using “Young's Internet
Addiction” and unstructured questionnaire. Validity and
reliability of
unstructured questionnaire were evaluated by expert panel and
were reported as Cronbach's alpha. Information of study groups
before and 4 months after the intervention was compared using
statistical methods by SPSS 16. Results: After the intervention,
the mean scores of internet addiction, perceived barriers
construct, and the prevalence of internet addiction significantly
decreased
in the intervention group than that in the control group and the
mean scores of knowledge and Health Belief Model (HBM)
constructs (susceptibility, severity, benefits, self-efficacy)
significantly increased. Conclusions: Education based on the
HBM was
effective on the reduction and prevention of internet addiction
among female college students, and educational interventions in
this
field are highly recommended.

How to cite this article:
Maheri A, Tol A, Sadeghi R. Assessing the effect of an
educational intervention program based on Health Belief Model
on
preventive behaviors of internet addiction.J Edu Health Promot
2017;6:63-63
How to cite this URL:
Maheri A, Tol A, Sadeghi R. Assessing the effect of an
educational intervention program based on Health Belief Model
on
preventive behaviors of internet addiction. J Edu Health Promot
[serial online] 2017 [cited 2019 Apr 12 ];6:63-63
Available from:
http://www.jehp.net/text.asp?2017/6/1/63/212613
Full Text
Introduction
Internet is a means of neutralizing that can be used to search for
information.[1] Internet is a global computer network providing
a
variety of information and communication facilities, consisting
of interconnected networks using standardized communication

http://www.jehp.net/
Maheri 2/7
protocol.[2] The internet with its rapid expansion to individual
applications, training and research in the development of
inducing
and increase their knowledge and abilities of students and
universities by achieving rapid and inexpensive scientific
information is
undeniable benefits of internet access.[3] In 1969, the Defense
Department's Advanced Research Projects Agencies of America,
subsidized a network called ARPANET which was developed in
the 1970s and 1980s and renamed as Internet.[4] Many uses of
the internet and its attractiveness as a phenomenon are due to
the advent of internet Addiction.[5] Internet addiction refers to
the
excessive use of the internet or using the internet as
irrational.[6] Young believes that the term “addiction” was used
for internet
users because it has the same symptoms of the alcohol and
cigarettes addiction.[5] Holmes suggested that using internet
more
than 19 h per week is a sign of internet addiction; however,
Young) indicated that using internet about 38 h per week is a
sign of
addiction.[7],[8] In recent years, the number of internet users
had reached over 3 billion people worldwide compared with 360

million internet users in 2000.[9] Asian countries with 1.4
billion (45.6%) users are the first of ranking and China with 642
million
users is in first place.[10],[11] Iran currently has 46 million
users that include totally 57.2% of internet users at the entire
Middle
East.[11] International estimates of internet addiction widely
vary. The prevalence of internet addiction is reported from 1.5%
to
25% in different countries.[12] It is estimated that about 4.4–
4.7 million of Americans are affected by internet addiction.[13]
In Iran,
internet addiction is reported as approximately 11%, which is
higher than countries such as Italy, China, and Australia,
Internet
addiction in these countries are 5%, 4.4%, and 8.1%,
respectively.[12] According to Qasemzadeh study, the
prevalence rate of
internet addiction in Iran is 2%–80%.[14] Recent studies
reported that the highest prevalence of internet addiction is
among
adolescents of 15–19 years old.[14] The university students
have high vulnerability toward internet addiction disorder.
Internet
addiction is a global phenomenon with different levels and it
ranges from 5% to 25% in the US, China, South Korea,
England,
Australia, Taiwan, Japan, and other Eastern and Western
European countries students.[13] In Iran, 25.6% of students are
addicted
to the internet.[15] Another study reported the internet
addiction equal to 17.7% among university students in Iran.[16]
In Thailand,
5.9% of students are addicted to internet.[13] Various studies
indicated that the use of the internet is on the rise as well as the
incidence and prevalence of internet addiction.[17] Internet

addiction is a chronic, recurrent, and widespread problem which
may
contribute to financial, familial, and social difficulties.[18] The
personal and psychological problems such as depression,
anxiety,
social and physical damage resulting from internet addiction are
greater than other risks.[19],[20] Internet addicts lose their
sleep
due to being online and forget their nutrition and physical
activity.[21],[22] Reports of deaths due to heart attack during
use of the
internet, which can be due to physical disorders such as
insomnia, and lack of exercise.[23] On the other hand,
anonymous nature
of the internet makes people say things or do things on the
internet that they do not in a normal position. According to
some
studies, the students who experience extreme and pathological
use of the internet in comparison to those who have no such
experience, show more pathology and mental problems and
there is a relationship between the increase of working with
internet
experience and decrease of mental health rate.[13] Studies
showed that university students who are suffering from internet
addiction have no necessary skills in their social
communications.[24],[25] Prevention is the best solution for
addiction combating.
[26] Given the importance of prevention rather than treatment,
and given that internet addiction is a public health problem
among
young people and students community, design and
implementation of educational interventions about of how to use
the internet is
necessary among students. Most studies in the field of internet
addiction (in the world and Iran) are descriptive studies. These
studies examine factors affecting internet addiction and its

consequences.[27],[28],[29]
For example, Lashgarara et al. and Jafary Nodoushan et al.
investigated the factors affecting internet addiction and the
effect of
internet addiction on the general health of Medical Sciences
students.[29],[30] In addition, Kiany et al., in their study,
investigated
the internet addiction and its related factors among nursing
students in Tehran University of Medical Sciences. Based on
their
findings, 17.7% of the students have internet addiction and
there was statistically significant relationship between internet
addiction
and demographic variables including gender, status, personal
computers, science websites, personal blogs, personal websites,
Web chat (chat), listening to music, surfing the Web, making
friends, playing online games, blogging, duration of internet use
per
hours per day, time of the week, and time of internet use.[16]
Dadipoor et al., in their study entitled “Investigate internet
addiction
and effective factors among students in Hormozgan University
of Medical Sciences,” showed that there was significant relation
between variables such as gender, field of study, marital status,
age, educational level, and using internet with Internet
addiction.
However, the location was not significantly associated with
internet addiction.[31] Therefore, due to the lack of intervention
studies
in the field of internet addiction, design and implementation of
intervention studies in the field of internet addiction is
necessary.
Promotion of knowledge, attitude, and belief was a beset
approach to prevention of addictive behaviors.[26] Several

studies have
shown that based on the theory-driven approaches, educational
program is one of the most effective training programs for
preventing addiction.[32],[33] In health education field, certain
models help us explain the occurrence behavior and conduct
health
education program to view its effect on behavior.[34] Using
models and theories of behavior change, which increases the
possibility of increasing the effectiveness of health education
programs, helps identify the individual characteristics and
environment which may effect on behavior.[35],[36]
Effectiveness of health education programs depends on correct
theories and
models used in health education. Hence, today, using theories
and models of health behavior and health education is essential
for
health education and health promotion professionals.[37] One of
the health education models that are used in the prevention of
addictive behaviors is Health Belief Model (HBM).[26] HBM
states that health-related behaviors of people are based on their
perceived susceptibility (refers to one's perception of the risk or
the chances of contracting a health disease or condition),
perceived severity (a person's perception of the seriousness of
the consequences of contracting a disease), perceived benefit
(One's belief in the efficacy of the advised action to reduce risk
or seriousness of impact), perceived barrier (One's opinion of
tangible and psychological costs of the advised action), cues to
action (Strategies to activate “readiness”), and self-efficacy
(Confidence in one's ability to take action).[26] Based on search
in the internet, we have not found a study in the field of internet

Maheri 3/7
addiction that had been done using health education models
such as HBM, and therefore given the high prevalence of
internet
addiction among students and numerous complications
attributable and with regard to the importance of implementing
interventions such as educational interventions for the
prevention and reduction of internet addiction among students,
this study
aimed to determine the effect of an educational intervention on
preventive behaviors of internet addiction among Tehran
University
of Medical Sciences students.
Materials and Methods
This study was a quasi-experimental, case–control study. The
population of this study included female college students who
live in
the dormitories of Tehran University of Medical Sciences in
2014. According to research study, prevalence of internet
addiction
among medical students in dormitories of Tehran University of
Medical Sciences was about 30% and researchers believed that
with educational intervention based on the HBM, this problem
will decrease to 10%.[38] Therefore, sample size with a
confidence
interval of 0.95 and power of 0.80, determined 80 for each
group. In this study, two-stage cluster sampling method was

used. All
dormitories of female students of Tehran University of Medical
Sciences were selected and each dormitory was identified as a
cluster. After that, four dormitories were randomly selected and
divided into experimental and control groups, each group
included
two dormitories. Then, eighty students were randomly selected
from each group. Ethical considerations included the following:
This
study was approved by the Tehran University of Medical
Sciences and Iranian Registry of Clinical Trials. Informed
consent was
obtained from all participants and no personal identifier was
recorded on the questionnaires. The inclusion criteria for this
study
included being student, living in the dormitories of Tehran
University of Medical Sciences, and using the internet for at
least 3 h per
day. All students agreed to participate in this study. In this
study, the Internet Addiction Test (Young, 1998) was used to
assess
addiction to the internet.[39] This questionnaire has two
versions: 8 and 20 questions; however, in this study, 20-
questionnaire form
was used. In this study, scores 49 and <49 are considered as
normal internet use and scores 50 and >50 are considered as
addictive internet use. In this study, questionnaire developed by
the researcher was also used that was based on the HBM. This
questionnaire consisted of several parts including demographic
(9 questions), knowledge (7 questions), perceived susceptibility
(5
questions), perceived severity (6 questions), perceived barriers
(4 questions), perceived benefits (5 questions), cause to action
(5
questions), and self-efficacy (6 questions). This tool is a
grading scale of 5-1. In this tool for grading, Likert scale (agree

= 5,
relatively agree = 4, no comment = 3, relatively disagree = 2,
disagree = 1) was used. To determine the validity of qualitative
content, the questionnaire was given to eight health education
professionals. The reliability of the questionnaire was
calculated
using Cronbach's alpha. Based on data analysis, coefficient
alpha for the knowledge structures was 0.93, perceived
susceptibility
was 0.71, perceived severity was 0.6, perceived benefits was
0.83, perceived barriers was 0.65, cause to action was 0.64,
self-
efficacy was 0.7 and for the entire questionnaire was 0.83. The
pretest was used to measure the model constructs and determine
the prevalence rate of internet addiction (in intervention and
control groups). After the pretest, the educational intervention
was
designed and implemented for the experimental group during
the three sessions within 3 weeks. Control group received no
intervention. Two dormitories which were designated as the
intervention group, in terms of geographic, were far from two
dormitories which were designated as the control group, in this
way, was prevented from transmission of information among
two
groups. In this study education was based on active learning
methods which included group discussions, questions–answers,
and
lectures. In this study, educational intervention was designed
based on the HBM constructs, aimed of educational intervention
at
first session, was increasing knowledge of college students
about internet addiction. In this session, questions–answers and
lecture was about the addictive nature of the internet and side
effects of internet addiction. The second session intervention
was
implemented based on the constructs of perceived susceptibility

and perceived severity of the HBM, in this session, group
discussion was about the negative consequences of internet
addiction. Third session intervention was implemented based on
the
constructs of perceived benefits and perceived barriers of the
HBM in this session, group discussion was about the benefits of
adopting preventive behaviors of internet addiction and barriers
of adopting preventive behaviors of internet addiction. In this
study,
posters and pamphlets to be used as a cause to action and to
increase the self-efficacy of the intervention group, were used
reinforcing messages. Posttest, was taken 4 months after the
intervention. To determine the period of follow-up after the
intervention, interventional studies have been done on addictive
behaviors were investigated.[40],[41],[42],[43] These studies,
were
considered different time periods for follow-up, so, in this study
given the time taken to complete the project, start summer
vacation
of students under study and lack of access to them after 4
months, follow-up period were considered 4 months. The
collected data
were entered into the SPSS version 16 (SPSS, Inc., Chicago IL,
U.S.A.) and analyzed using the paired t-test, independent t-test,
Chi-square, Fisher exact test, McNemar test, analysis of
covariance (ANCOVA), and Kolmogorov–Smirnov; P< 0.05 was
considered statistically significant.
Results
This study involved two groups including of 80 participants in
case and 80 participants in control groups. The average age in
the

intervention group was 22 and that in the control group was
21.6. Majority (85%) of the intervention group and control
group (91%)
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were single. About 42.1% in the intervention group had
bachelor degree, followed by doctoral (40%), and master degree
(17.5%).
More than half (52.5%) of the respondents in the control group
had bachelor degree, 31.2% had doctoral, and 16.3% had master
degree. Before the intervention, demographic variables such as
age, marital status, employment, level of education and grade
point average there was no significant difference between the
intervention and control groups [Table 1].{Table 1}
Analyses by Fisher's Exact Test showed that before the
intervention, there was no significant difference between two
groups in
terms of hours of internet use during a day, but 4 months after
the intervention, this difference was statistically significant (P
<
0.001). Also, analyses by McNemar test showed that before and
after the intervention, in the control group, there was no
significant difference in terms of hours of internet use during a
day, but in the intervention group, this difference was
significant (P <

0.001) [Table 2].{Table 2}
[Table 3] represents the frequency distribution of the normal
and addicted internet user, before and 4 months after the
intervention.
According to Chi-squared test before the intervention, the
prevalence of internet addiction there was no significant
difference
between two groups, while after the intervention, the prevalence
of internet addiction was significantly reduced in the
intervention
group compared to the control group (P < 0.04). In addition,
McNemar test showed that before and after the intervention, the
prevalence of internet addiction there was no significant
difference in the control group, but in the intervention group
this difference
was statistically significant (P < 0.002), and after 4 month
follow-up, the prevalence of internet addiction was significantly
reduced
compared to the baseline [Table 3].{Table 3}
According to independent t-test before the intervention, the
mean scores of the HBM constructs (perceived susceptibility,
perceived
severity, perceived benefits, perceived barriers, self-efficacy
and internet addiction), there was no significant difference
between
two groups, but this difference was significant for mean score
of knowledge (P < 0.022). Based on ANCOVA test, after the
intervention, the mean scores of the HBM constructs (perceived
susceptibility [P < 0.001], perceived severity [P < 0.001],
perceived
benefits [P < 0.001], perceived barriers [P < 0.001], self-
efficacy [P < 0.001], internet addiction [P < 0.001]), and

knowledge (P <
0.04), there was significant difference between two groups. In
addition, paired t-test showed that before and after the
intervention,
in the control group, the mean scores of the HBM constructs and
knowledge there was no significant difference, but in the
intervention group this difference was significant [Table
4].{Table 4}
[Table 5] also shows that before the intervention, there was no
significant difference between two groups in terms of report of
radio
and TV, pamphlets and leaflets training, classroom training and
others as a cause to action, but this difference was significant
for
poster (P < 0.018). After the intervention, there was no
significant difference between two groups in terms of report of
radio and TV
and others as a cause to action, but after the intervention, there
was significant difference between two groups in terms of
report of
poster (P < 0.001), pamphlets and leaflets training (P < 0.001),
and classroom training (P < 0.001), as a cause to action.{Table
5}
Discussion
The results of this study showed that after the intervention, the
mean score of internet addiction and the prevalence of internet
addiction have significantly decreased in the intervention group
compared to the control group. Findings of this study support
the

effectiveness of education based on the HBM, to prevent and
reduce the prevalence of internet addiction. Many studies have
been
conducted using the HBM, indicating the effectiveness of this
model in improving the healthy behaviors of the
students.[44],[45]
Several studies have reported that educational interventions
based on the HBM are effective in the prevention of addictive
behaviors.[26],[46],[47] HBM is one of the broadest
frameworks for understanding health-related behavior. Hence,
the main focus
of this study is to promote preventive behaviors of internet
addiction based on the HBM. The result of this study showed
that after
the intervention, the mean scores of knowledge and HBM
constructs (perceived Susceptibility, perceived severity,
perceived
benefits, perceived self-efficacy), in the intervention group
compared to the control group, significantly increased and mean
score
of perceived barriers significantly reduced. According to
studies, knowledge is the introduction of behavior and increased
knowledge is essential for adopting healthy behavior such as
preventive behaviors of addiction.[40],[46] In this regard,
Shojaei
Zadeh et al. declared that knowledge about side effects of
addictive behaviors such as substance abuse can protect
adolescents
against addictive behaviors.[26] Thus, increasing the awareness
of college students about the addictive nature of the internet and
side effects of internet addiction is necessary. However, just
raising knowledge is not enough for adoption of health
behavior. It
seems that although educational intervention improves
knowledge, there is often a big gap between knowledge and
practice, for

correcting this gap, the needs and requests targeting the college
students as well as their primary knowledge, attitudes, and
behavioral patterns should be considered for the promotion of
health and internet addiction education programs. In this study,
an
education program based on the HBM appeared to have been
effective in increasing the perceived susceptibility and severity
of
Tehran University of Medical Sciences students about internet
addiction. Other studies have also stated that health education
based on the HBM can increase the perceived susceptibility and
severity of addictive behaviors.[26],[47] According to various
studies conducted, increasing perceived susceptibility and
perceived severity are predictive factors in adopting health
behaviors
such as preventive behaviors of addiction.[26],[47],[48],[49] It
is hoped that with the implementation of appropriate
educational
Maheri 5/7
interventions to increase the perceived susceptibility and
perceived severity about complications of internet addiction,
preventive
behaviors of internet addiction among college students to
promote. Another finding of current study, is to increase the
perceived
benefit and decrease the perceived barrier of preventive

behaviors of internet addiction among the intervention group,
after
educational intervention. Furthermore, other studies have also
stated that health education based on the HBM can increase the
perceived benefits and decrease the barrier of health
behavior.[26],[47] Consistent with our findings, Rakhshani et
al. reported that
educational program based on the HBM could increase the
perceived benefits of preventive behaviors and could be
effectiveness
on preventive behaviors of addiction.[50] Some of the
predictors of healthy behaviors such as preventive behaviors of
internet
addiction are perceived benefits and perceived barriers and
many studies showed that there are strong relationship between
the
increase perceived benefits and decrease perceived barriers,
with healthy behaviors.[51],[52],[53],[54],[55] Moreover,
according to
various studies conducted, increasing perceived benefits and
decreasing perceived barriers are predictive factors in adopting
health behaviors such as preventive behaviors of
addiction.[26],[47],[48],[49] Hence, results of this study
showed that design and
implementation of appropriate educational interventions are
necessary to accept the benefits of preventive behavior of
internet
addiction and overcome barriers of adopting preventive
behaviors of internet addiction among college students. In this
study, after
the intervention, the mean score of perceived self-efficacy for
adopting preventive behaviors of internet addiction significantly
increased in the intervention group compared to the control
group. Self-efficacy is one of the factors that influence on
healthy
behaviors and various studies show that increased self-efficacy

increased adopting healthy behavior.[26],[56] Hence, design
and
implementation of theory-based educational interventions are
necessary to increase self-efficacy to control anxiety and
depression
among college students. After the intervention, the hours of
internet use during a day significantly reduced in the
intervention group
compared to the control group. One of the factors affecting the
prevalence of internet addiction among college students is hours
of
internet use.[7],[8] Hence, design and implementation of
educational interventions based on the HBM to reduce the hours
of
internet use will decrease the prevalence of internet addiction
among college students. One of the strengths of this study was
that
for the first time, an educational intervention based on the HBM
designed and evaluated to reduce and prevent internet addiction
and this study due to lack of studies in this field can be used as
a guide for other studies. The limitation of this study is that due
to
the lack of studies designed based on the HBM to prevent
internet addiction, we have to compare our results with other
studies in
other fields that are designed based on the HBM. Another
limitation of this study is that the population of this study
included only
female college students who live in the dormitories of Tehran
University of Medical Sciences. College students who were not
living
in dormitories and male college students were excluded from
the study.
Conclusions

The results of this study showed the effectiveness of an
educational intervention based on the HBM structure in
improving the
knowledge, attitude, and practice relating to preventive
behaviors of internet addiction and reducing the prevalence of
internet
addiction among female college students living in dormitories
of Tehran University of Medical Sciences and educational
interventions in this field are highly recommended. Given that
educational intervention program based on the HBM was
effective on
preventive behaviors of internet addiction among female college
students who live in the dormitories, it is suggested that these
educational interventions are designed and implemented among
college students who were not living in dormitories and male
college students, and due to the lack of intervention studies
based on health education models in the field of internet
addiction,
suggested that educational interventions based on other health
education models such as Theory of Planned Behavior,
Transtheoretical model and PRECEDE-PROCEED model are
designed and implemented in the field of internet addiction.
Acknowledgment
The authors would like to thank all the participants who
dedicated their own invaluable time to participate in this study.
We are
grateful to Tehran University of Medical Sciences for
administration and cooperation and Iranian Registry of Clinical
Trials (IRCT

registration number: IRCT2013021312460N1).
Financial support and sponsorship
Tehran University of Medical Sciences supported this survey as
an original research. This study was granted by the Tehran
University of Medical Sciences.
Conflicts of interest
There are no conflicts of interest.
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CREATING A VISION
1
CREATING A VISION
14
CREATING A VISION
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Strategies for Change
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9 April 2019

Building the Team Strategies for Change
According to Kotter and Cohen, the second stage of
change; an organization should build a guiding team to bring
the right mastermind people with desired characters on board to
effect change within an organization (Hughes, 2016). All
employers working in a given organization have different
characters with different perception and ideas about change
about a specific issue. This stage allows leaders to integrate the
minds of all workers and create a team that will foster change
and leads it within the organization.
Building a team to address change
There are some ways through which leaders can build their
teams in preparation for a change in an organization. First,
employers should ensure that there is clarity of issues to the
team members team will readily embrace a change when they all
understand why, how, when, what and where the change is
expected. Also clarifying to the members that the change is
likely to affect the organization, employees, chains as well as
the customers will make them desire to work in line to effect
the change as expected by the management (Harrison, 2017).
Clarity is very critical in building teamwork as it addresses
“what if” situations enabling the team to plan well as act
effectively towards a change. Also, it allows team members to
analyze the risks and potential outcomes form a clear line of
thoughts and take a perfect path in making the anticipated
change a reality. Secondly, in building teams, leaders should
embrace thoughts from different members to cultivate the

diversity of thinking and acting through innovation. The
collaboration of ideas creates an environment where people can
connect, share and analyze situations concerning the desired and
anticipated change with an entity. Thirdly, the management
should encourage critical and strategic thinking in the run to
achieving or effecting change. Critical thinking builds strategies
since ideas are embraced (Hughes, 2016). The courageous
aspect of thinking allows team members to see opportunities in
various fields critically, anticipate for the unexpected risks,
unleash the hidden excellence pursuit, and work with the motive
of charitable purposes thus bringing the managerial change
desired by many(Harrison, 2017). Additionally, employers
should know the right composition of a team and the
aggressiveness of the members of the coalition team.
Showing enthusiasm and commitment to team members
Building a guiding coalition in bringing change to an
organization requires a high degree of enthusiasm and
commitment. To show enthusiasm and commitment leaders
should first consider the level of an organization and the weight
if the change anticipated. Through this, leaders may decide to
choose a group of 10, 20, or more members to a guiding
coalition. The team is called a guiding coalition since the
members are selected from various department and ideas are
embraced form each member with the aim of effecting the
desired change. A larger team with the right people in it acts as
a working engine as skills and ideas are collaborated to make
change happen in an organization. Skills such as leadership
skills among the team members stimulate high levels of urgency
to make things right in line with the coming change. Also
choosing guiding coalition members with different levels of
expertise from different fields or departments within an
organization will bring competitively and diversity of ideas thus
bringing moving power in bringing and adopting new change (
Hughes,2016)... Commitment will also enable an employer to
bring the right people together by identifying their passion,
desire, commitment as well as their experience in a specific area

at the workplace which is a very critical step in bringing
change.
Modeling trust and teamwork
Modeling trust and teamwork in fostering change in
organizations call for leaders to lead as an example by
demonstrating that they can trust other employees or their boss.
Team members learn cues from their leaders if there is no trust
they will also not cultivate trust to you and other employees
(Ryan, 2018). Also, as a leader, you need to communicate
openly and with clarity in an honest and meaningful way. Find
strategies to influence your team members also, to be honest,
and open when communicating change with other colleagues.
Leaders should consider building a working charter that defines
the role of each team members present it to the team and allow
them to ask questions and comment on their expectations.
Thirdly, organize and strategically plan for team building events
which will help team members to break ice and share freely
with the bosses or amongst themselves (Ryan, 2018). Another
way of creating trust is by ensuring that you know your team
members at a personal level. Also, creating an environment that
will allow o team members to share freely with other colleagues
about their lives families and hobbies will create a trust bond
and social life within the guiding coalition.
Structuring the team and ejecting energy
I will put my team into a functional structure which is
based on the team member’s functionality or expertise area. For
instance, I will group the team members into IT, marketing,
planning, finance and any other area of specialty (Harrison,
2017)... This structure will enable members from a similar
specialty to share experience and skills thus coming up with
ideas that will foster or embrace change. This structure will
have top management linked to small groups of specialty as
communication is effected from one department to the other.
Injecting energy into the team members will involve motivating

the team, giving them credit wherever they do a commendable
job, go easy on dress code (suggest one day within a week for
casual wear) as well as recommend days for social impact with
the organization.
Walmart Inc. is expected to implement proper changes to
their business operations. To compete with other companies in
the retail space and market, Walmart should invest in e-
commerce and improve the overall shopping experience.
Currently, the shopping experience is insufficient and the
employees lack proper motivation. To make the changes,
Walmart Inc. reported actions to bring about substantial changes
including investing in e-commerce and expanding he overall
shopping experience in the company. Making drastic changes is
important in increasing e-commerce presence is effective
(Hickman, & Silva, 2018). Walmart is expected to form proper
strategic partnerships to enhance the digital retail sales and
overall operations. For example, the company is expected to
form renovation into the shopping experience and the streaming
of the retail stores. Therefore, the strategies for implementing
change is important in promoting sales growth and long-term
performance.
Strategies for Change-Making Sense of Urgency
There are different strategies to implement proper changes in
the organization to increase the overall retail sales. Taking
advantage of the market opportunities is important to enhance
retail sales. One of the strategies is understanding customer-
interfacing employees effectively. Service employees are
critical in improving the customer reactions and encouraging
the managers to work effectively. Proper treatment of the
employees and responding to urgent questions is critical in
ensuring that the company is prepared for proper changes to the
adoption of e-commerce sites (Elnaga, &Shammari, 2016). The
organizational leaders should take proper actions to understand
the needs of the stakeholders. The leaders should also
understand the need for making proper changes to support long-
term online sales growth.

Some of the critical steps and actions for implementing sense of
urgency includes understanding severity of leadership
commitment to implementing proper changes, reviewing the bad
news of poor retail sales, demanding managers and employees
to respond directly to the unhappy customers, and other
stakeholders, sharing information to support change, and
ascertaining that the management actions are aligned with the
change communications to enhance online ecommerce sales. It
is impossible to implement urgency without proper and effective
communication with the work teams and employees. The leaders
demand clear communications that is critical in promoting
change efforts and programs. Understanding sense of urgency is
important in overcoming the status quo to improve change and
future productivity.
It is also recommendable for the managers of Walmart to
identify the specific tasks and reduce the potential confusion.
Sense of urgency is critical in making proper judgments about
the understanding the motivation of the employees.
Clarification of the organizational tasks is critical in promoting
communications for forming quality leader-follower
relationship. Clarifying the issues related to e-commerce
presence of Walmart is effective in understand the capabilities
of the employees effectively. The clarifying of the potential
consequences of e-commerce change is also important. It is
necessary for the teams to understand the actual consequences
of poor productivity and performance of Walmart Inc. Effective
organizational leaders should understand the effects of
challenges that impacts on the productivity of the organization.
Understanding the need for e-commerce change is good to
promote long-term actions and plans.
Most importantly, it is vital to set proper conditions and
guidelines for the work teams to ensure that they respond to the
urgent needs of the organization. The guidelines for the
implementation of online retail strategy for Walmart are
valuable to the long-term performance of the company. The
recognition of the employees is vital in responding to the sense

of urgency is important (Hickman, & Silva, 2018).Changing the
online sales strategy is critical in promoting success and
recognizing the teams effectively. The mastering of these online
strategies is critical in implementing proper changes to
Walmart’s proper actions.
It is recommendable for Walmart to support a blended shopping
experience and program to improve the implementation of the e-
commerce program. However, the company is making effort to
enhance the digital and the traditional shopping experiences for
Walmart. The integration of these retail shopping experiences is
important in improving the performance of the retail firms to
enhance the long-term sales expansion. For example, Walmart
Inc. should integrate relevant pickup discounts for specific
products purchased online (Elnaga, &Shammari, 2016).Some of
the online stores gives the customers the opportunity to
purchase the grocery products online. The empowerment of the
employees is critical to promote long-term online earnings.
Creating a Vision
The ability to influence change is one of the greatest qualities a
leader must possess. Such ability enables leaders to enhance
changes in their employees with improvements achieved in their
values, behavior, beliefs, and attitudes (Hao &
Yazdanifard, 2015). Poor leadership fails to influence these and
rather create conflicts that affect the achievement of the
objectives of the organization. An effective leader looks at
change through the vision of the organization as the driving
force through which the employees work to achieve the
objectives. In the following stage, the creation and
implementation of a vision for Walmart is executed as a
necessity considering it provides the organization with the
driving force through which change is possible and attainable.
The vision of Change Desired
The vision employed by Walmart is focused on saving
consumers money to enhance their living. The company seeks to
achieve this through providing the consumers with a wide range
of products through which it meets its needs and enables

consumers to attain their quest in the market. Attaining the
vision relates with the improvement of services offered and
products to ensure enhanced satisfaction of the consumers. The
company focuses on implementation of the emerging
technologies in their products and services as a means of
developing and maintaining their competitive advantage in the
field (Rowland, 2019, February 13). The company also focuses
only on those markets it is in a position to attain a positive
contribution influencing the lifestyles of its consumers and
generating customer satisfaction in all aspects of its products.
The company, therefore, desires to be the face of the retail
industry and provide highly innovative products and services
providing satisfaction not only today but also in the future.
Current Situation
Currently, Walmart remains one of the most competitive
company in the UK retail industry with products dominant in
the market. The company has attained dominance from the
quality of its products and services also creating customer
loyalty through constant satisfaction of the needs of the
consumers. However, Walmart seeks to create future dominance
and continue providing products that ensure customer
satisfaction. The company seeks to create corporate
sustainability and lasting competitive advantage. The future of
the company and the influence that constant changes in
technology will have on it is the focus of the current change
procedures implemented. Research and continued investment in
innovation is part of the processes favored that will contribute
towards the management of the change process to ensure the
vision of Walmart remains within sight. However, the
implementation of these changes is viewed differently by
employees and the outside world.
Views from Outsiders
The views from outsides are based on the nature of impact the
organization has in society and the level of customer
satisfaction attained. Organizations that fail to impress in
customer service and product quality are normally looked at as

failed with increasing difficulties in attracting customers. Such
companies are characterized by low sales and higher customer
turnover rates with reduced levels of customer loyalty. The
process of creating change, however, is measured by the
possibility of the impact the change process has on the
organization with improvement in processes and customer
service. The ability of the organization and its employees to
work towards customer satisfaction is viewed as a positive
influence of change. Such changes attract a growing number of
consumers and increased levels of customer loyalty. Positive
changes also increase the social status of the company brand
contributing to an enhanced market position.
Views from Employees and Team Members
The implementation of changes attracts varied opinions and
views from employees and work teams. To start with, the
support offered through the process by the employees and teams
is essential to determine the views after the implementation of
change. Also, the nature of the impact that employees see with
the change process is vital in determining their attitude towards
the change process. In cases where the change registered does
not provide sufficient improvement in the organizational
processes, the employees see a failure in change and develop
further resistance. According to Lawrence (1969, January 1), a
display of resistance to change may include behavior changes in
the employees with a reduction in output. An increase in the
labor turnover is also recorded as part of the resistance to
change with some employees requesting transfers from
departments and other areas of the organization. Conflicts in the
workplace are also a sign of resistance to change in addition to
increased hostility. However, success in attaining the change
process will lead to content in the employees with an increased
level of confidence in the process and participation. Positive
reaction after completion of change, therefore, indicates
confidence and contentment with the process while negative
reactions including defiance is a sign of the failure of the
change process and lack of support.

Indexes Useful in Measuring and Quantifying Change
Measuring change management and quantifying the results
enables an organization to identify the progress registered.
However, this process is challenging with many organizations
failing in measuring the change in place. A number of
approaches are identified that may help in measuring change.
These include performance improvements. In some change
situations, the target objective of the organization is to register
an improvement in performance. If the problem in the
organization is the turnover of employees, measuring the
performance of the organization by reviewing the turnover rate
after instituting change measures reveals progress. Project KPI
is also known to provide a means of measuring and quantifying
changes the organization achieves. The Key Performance
Indicators (KPIs) may include improvement in sales comparing
the previous year with the current year (Prosci Change
Management, n.d.). Other indexes for measuring and
quantifying changes include the improved adherence to
timelines by employees, enhanced speed of execution of
procedures and processes, realization of benefits and associated
Return on Investments and adherence to the project plan
established. In addition to the above, measuring individual
performance is also part of the process with each employee
assessed differently on their contribution towards change.
Approaches such as adoption metrics, adherence, and
compliance reports, employee feedbacks, proficiency measures,
errors log and proficiency measures may help identify changes
and improvements in the employees of Walmart.
Conclusion
In summary, Walmart Inc. should increase the sense of urgency
through the changing the traditional sales environment to an e-
commerce platform that promotes sales growth and
performance. The implementation of these change strategies
will be effective in promoting the long-term online sales

performance. For instance, the blending of shopping experience
is necessary to enhance sales performance as well as the e-
commerce program and initiatives. The implementation of the
shopping experience is useful in ensuring the integration of the
digital and traditional shopping experiences to improve sales
growth. Most importantly, effective communication between the
leaders and the work teams is also necessary. The collaboration
between the leaders and the work teams will help in promoting
the long-term performance of the company. Walmart will rely
on the sense of urgency strategies to implement a
comprehensive ecommerce strategy.
The vision of a company acts as its driving force and sense of
direction. The intentions of Walmart in attaining its vision have
seen the implementation of change strategies that contribute
towards customer satisfaction. Processes internally focused on
providing employees with a favorable environment have reduced
resistance to change allowing improvement in the quality of
services and products offered by the company. The end result of
these includes enhanced customer satisfaction and developed
brand loyalty that has maintained Walmart at the helm of the
retail industry for years. The attainment of future progress and
competitive advantage is part of the vision of the company
currently. The focus is on building an environment that ensures
continued innovation.

References
Elnaga, A. A., &Shammari, F. H. A. (2016). The impact of e-
commerce on business strategy: a literature review
approach. Journal of American Science, 12(5), 68-79.
Harrison, P. (2017). Communicating Change. In Exploring
Internal Communication (pp. 79-86). Routledge.
Hickman, C. R., & Silva, M. A. (2018). Creating excellence:
Managing corporate culture, strategy, and change in the new
age. London, UK: Routledge.
Hughes, M. (2016). Leading changes: Why transformation
explanations fail. Leadership, 12(4), 449-469.
Ryan, L. (2018, March 17). Ten Ways to Build Trust on Your
Team. Retrieved from
https://www.forbes.com/sites/lizryan/2018/03/17/ten-ways-
to-build-trust-on-your- team/#186e4b472445
Hao, M. J., & Yazdanifard, R. (2015). How Effective
Leadership can Facilitate Change in Organizations through
Improvement and Innovation. Global Journal of Management
and Business Research: A Administration and
Management, 15(9).
Lawrence, P. R. (1969, January 1). How to Deal With
Resistance to Change. Retrieved from
https://hbr.org/1969/01/how-to-deal-with-resistance-to-change
Prosci Change Management. (n.d.). Metrics for Measuring
Change Management. Retrieved from
https://www.prosci.com/resources/articles/measuring-change-
management-effectiveness-with-metrics

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