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Shahabi N, Shahbazi Sighaldeh S, Eshaghi Sani Kakhaki H, Mohseni S, Dadipoor S, El-Shahawy O. The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research. BMC Public Health 2024; 24:664. [PMID: 38429705 PMCID: PMC10908080 DOI: 10.1186/s12889-024-18169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women. METHODS The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant. RESULTS The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081). CONCLUSIONS The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.
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Affiliation(s)
- Nahid Shahabi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shirin Shahbazi Sighaldeh
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran Universities of Medical Sciences, Tehran, Iran
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Omar El-Shahawy
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Dadipoor S, Heydari G, Abu-Rmeileh NM, Mohseni S, Kakhaki HES, Aghamolaei T, Shahabi N. A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior. BMC Public Health 2023; 23:1151. [PMID: 37316841 DOI: 10.1186/s12889-023-16053-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). METHODS This cross-sectional analytical study was conducted in 2021-2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. RESULTS With an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively. CONCLUSIONS The present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women.
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Affiliation(s)
- Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gholamreza Heydari
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Eshaghi Sani Kakhaki
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Dehdari T, Mirzaei N, Taghdisi MH, Zare N. The use of the theory of planned behavior variables in predicting the intention of waterpipe tobacco smoking cessation among Iranian consumers. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1967475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tahereh Dehdari
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Mirzaei
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Hossein Taghdisi
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Najaf Zare
- Department of Biostatistics, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Karimian Z, Sadat Z, Afshar B, Hasani M, Araban M, Kafaei-Atrian M. Predictors of self-medication with herbal remedies during pregnancy based on the theory of planned behavior in Kashan, Iran. BMC Complement Med Ther 2021; 21:211. [PMID: 34404404 PMCID: PMC8369796 DOI: 10.1186/s12906-021-03353-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of application of medicinal herbs during pregnancy has increased significantly among women over the past years; however, the safety and efficacy of medicinal herbs during pregnancy are still unclear. The aim of the present study was to categorize the predictors of self-medication with herbal remedies during pregnancy based on the theory of planned behavior (TPB). METHODS The present descriptive-analytical study was conducted on 300 pregnant women referred to Kashan health center to receive prenatal care services in 2020. The study participants were randomly selected using stratified random sampling with proportional allocation. The data collection tool was a two-part researcher made questionnaire. The first part of the questionnaire included demographic information, midwifery information, and questions related to women's awareness about herbal medicine. The second part of the questionnaire was designed based on the theory of planned behavior including attitudes, perceived behavioral control, subjective norms, intention, and behavior performance. Data were analyzed using descriptive statistics, regression analysis, and SPSS version 18.0. RESULTS The mean age of participants was 28. 7±5.4 years (range, 15-45 years), the majority were housewives (88.3%) and had secondary education (39.3%). A total of 164 women (57. 1%) used medicinal herbs during pregnancy. The individual's attitude towards herbal medicines consumption, subjective norm, and perceived behavioral control was correlated with behavioral intention (P < 0.05). Similarly, subjective norms were the most predictor of using herbal medicine among pregnant women (P < 0.05). CONCLUSION The findings revealed that more than 50 % of pregnant women used medicinal herbs during pregnancy. The present study showed that the individual's attitude towards herbal medicines consumption, subjective norm, and perceived behavioral control was correlated with intention of herbal medicine use among pregnant women. Likewise, subjective norms were the most predictor of herbal medicine use among pregnant women. The TPB should be addressed in planning health education programs and modifying health behaviors, including self-medication, especially during pregnancy.
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Affiliation(s)
- Zahra Karimian
- Department of midwifery, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zohreh Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
| | - Bahareh Afshar
- Ms.c of midwifery counseling, Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Hasani
- Department of midwifery, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahbubeh Kafaei-Atrian
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.,Department of midwifery, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
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Snippe MHM, Peters GJY, Kok G. The operationalization of self-identity in reasoned action models: a systematic review of self-identity operationalizations in three decades of research. Health Psychol Behav Med 2021; 9:48-69. [PMID: 34104549 PMCID: PMC8158252 DOI: 10.1080/21642850.2020.1852086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background Self-identity has frequently been proposed as a useful addition to the Theory of Planned Behavior; yet Fishbein and Ajzen decided to not include self-identity when they published that theory's successor, the Reasoned Action Approach. One of their reasons for exclusion is the lack of clear conceptual independence, as manifested in self-identity operationalizations that often conflate the construct with attitudinal or normative measures. Therefore, establishing whether self-identity has added value in the Reasoned Action Approach first requires synthesis of the used operationalisations to develop an operationalization that captures self-identity but not attitude and perceived norm. Method In this systematic review we identified 153 articles through the PsycINFO database and descendency approach using Google Scholar. In total, 342 of the operationalisations of self-identity were identified in studies operationalizing it as a potential Reasoned Action Approach extension. Results and conclusions After analyzing the full item pool to eliminate duplicates and items that did not measure selfidentity, (also) measured attitudes or norms, did not allow tailoring formulations to target, action, context and time, were not applicable to a wide variety of behaviors, or were ambiguous, seven prototypical items remained. These items lend themselves well for further psychometric study to establish the conceptual independence of self-identity from other Reasoned Action Approach constructs such as attitude and perceived norms.
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Affiliation(s)
- Marwin H M Snippe
- Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
| | | | - Gerjo Kok
- Work and Social Psychology, Maastricht University, Maastricht, the Netherlands
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Robin RC, Noosorn N. Reducing Children's Exposure to Passive Smoking in Rural Communities of Bangladesh: An Application of the Theory of Planned Behavior. J Res Health Sci 2019; 19:e00463. [PMID: 32291362 PMCID: PMC7183560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 11/28/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Passive smoking prevalence is high in Bangladesh. We aimed to explore the association of the theory of planned behavior constructs to reduce the exposure of passive smoking among children in the rural area of Bangladesh. STUDY DESIGN Cross-sectional study. METHODS Overall, 410 adults had been taken at random following a self-administrative questionnaire. Data had been collected from six villages of Munshiganj district of Bangladesh from Jul to Oct 2018. Descriptive statistics were applied to describe socio-demographic characteristics. Inter correlations coefficient was done to observe the correlation, differences between demographic and dependent variables were assessed for significance using the Chi-square or Fisher's exact test as appropriate. Univariate and multivariate logistic regression models were used to investigate the association between the theory of planned behavior constructs and exposure of passive smoking among both smoker and nonsmoker groups. All results were presented as unadjusted and adjusted odds ratio (OR) with 95% confidence intervals (CIs). A P-value ≤0.05 was considered as statistically significant. RESULTS Attitude (OR 0.681, 95% CI: 0.498, 0.931) among smoker and intention (OR 0.226, 95% CI: 0.081, 0.633) was found statistically significant constructs (P<0.001) among non-smoker to reduce the exposure. Additionally, the prevalence of passive smoking exposure was found 36.6% (95% CI: 0.32%, 0.41%) on average 40% among males and 28.33% among females. CONCLUSION The theory of planned behavior constructs is useful to reduce the exposure of passive smoking among children, which may be useful in the future to design interventions of controlling passives smoking exposure.
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Affiliation(s)
- Rishad Choudhury Robin
- 1Doctoral Candidate, Faculty of Public Health, Naresuan University, Phitsanulok-65000, Thailand,Correspondence : Rishad Choudhury Robin (MPH) Tel: +8801843333000 E-mail:
| | - Narongsak Noosorn
- 2Dean and Associate Professor, Faculty of Public Health, Naresuan University, Phitsanulok-65000, Thailand
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Nurumal MS, Zain SHM, Mohamed MHN, Shorey S. Effectiveness of School-Based Smoking Prevention Education Program (SPEP) Among Nonsmoking Adolescents: A Quasi-Experimental Study. J Sch Nurs 2019; 37:333-342. [DOI: 10.1177/1059840519871641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Preventing smoking among adolescents is critical. This study evaluated the effectiveness of the Smoking Prevention Education Program among nonsmoking adolescents. A quasi-experimental study design was used. Data were collected from Year 5 students ( n = 140) from four government primary schools in the Kuantan and Pahang districts of Malaysia. The participating schools were randomly assigned into the intervention and control groups. Questionnaires and exhaled carbon monoxide (CO) levels were used to collect data at the baseline and at 3 months postintervention. At 3 months postintervention, the percentage of nonsmokers remained 100% in the intervention group, while 2.9% of the participants in the control group reported to have smoked in past 7 days. Comparatively, the mean scores of attitudes, subjective norms, and nonsmoking intentions of the intervention group improved significantly. The intervention was effective in preventing smoking initiations among Malaysian adolescents; however, further evaluation of this intervention is needed among varied populations.
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Affiliation(s)
- Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Malaysia
| | - Siti Hajar Mohd Zain
- Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Azizi N, Karimy M, Abedini R, Armoon B, Montazeri A. Development and Validation of the Health Literacy Scale for Workers. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:30-39. [PMID: 30685775 PMCID: PMC6522212 DOI: 10.15171/ijoem.2019.1498] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/29/2019] [Indexed: 12/03/2022]
Abstract
Background:
Health literacy has received growing attention in recent years to reduce health disparities. Health literate individuals can gain access, understand and use health information to maintain, improve and promote good health.
Objective: To develop and assess the psychometric properties of a tool for the measurement of health literacy among workers, the Health Literacy Scale for Workers (HELSW). Methods: 15 companies were selected from the factories of the industrial city of Saveh. 450 (400 male and 50 female) workers from Saveh, Iran, were selected through a multistage random sampling. The study had two stages—a qualitative and a quantitative stage. In the qualitative phase, the workers' beliefs were extracted based on 61 in-depth interviews. Content validity was assessed with the help of 12 experts in the field of health education, public health and occupational health. Also, face validity was evaluated through interviewing with 20 workers. In the quantitative phase, the reliability of the questionnaire was evaluated by measuring the internal consistency and test-retest reliability. The construct validity was assessed by the principal component analysis using varimax rotation. Results: In the exploratory factor analysis, six domains (ie, access, reading, understanding, assessment, decision making and applying health information, and self-efficacy) with 34 items were loaded; the model explained 64.3% of the total variance. Intraclass correlation coefficient and test-retest reliability ranged from 0.72 to 0.84 and 0.69 to 0.86, respectively. Conclusion: It seems that the developed Persian questionnaire, HELSW, is a reliable and valid measure of the health literacy in workers.
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Affiliation(s)
- Nemat Azizi
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rezvan Abedini
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Bahram Armoon
- Department of Public Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ali Montazeri
- Department Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Karimy M, Rezaee-Momtaz M, Tavousi M, Montazeri A, Araban M. Risk factors associated with self-medication among women in Iran. BMC Public Health 2019; 19:1033. [PMID: 31370891 PMCID: PMC6676788 DOI: 10.1186/s12889-019-7302-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/10/2019] [Indexed: 01/15/2023] Open
Abstract
Background Self-medication is a public health concern that may create several problems such as increase in drug resistance, raise in drug use per capita, and creating side effects. This study was conducted to determine predictors of self-medication based on the theory of planned behavior (TPB) among the Iranian women. Methods This was a cross sectional study. A sample of married women completed a validated, anonymous, self-administered questionnaire. The questionnaire included items on demographic variables, knowledge, and TPB structures, and the checklist of women’s self-medication practices. The study was conducted in six urban health centers of Shush and Zarandieh in Iran during January to July 2016. Data were analyzed using SPSS 23.0 applying t-test and logistic regression. Results A total of 360 women took part in the study. The results showed that 76% of women had a history of self-medication and 98.9% stored drugs at home. The most important reasons for self-medication were perceived self-medication harmless (41%), having history of a disease (35.5%), and availability of medications at home (34%). The most frequent diseases for self-medication were fatigue, weakness, and anxiety (24%), and fever (20%). The results obtained form logistic regression analysis indicated that age, place of residence, education level, health insurance status, as well as all constructs of the TPB were significant predictors for self-medication. Conclusion The findings indicated that the prevalence of self-medication among Iranian women was high. Since women have important role in shaping the family health, the issue of high prevalence among this population should be considered as a serious problem in Iran. In this regard, it is recommended to consider factors affecting self-medication among women to reduce this health threatening factors.
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Affiliation(s)
- Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Majed Rezaee-Momtaz
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Tavousi
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Yaghobi Z, Mohaddes Hakkak H, Tavakoli Ghoochani H, Joveini H, Maheri M, Taherpour M, Hosseini SH. Factors Affecting the Intention to Choose the Natural vaginal delivery based on the Theory of Planned Behavior among Primigravidae. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2019. [DOI: 10.29252/jech.6.3.169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Sabzmakan L, Ghasemi M, Asghari Jafarabadi M, Kamalikhah T, Chaleshgar Kordasiabi M. Factors Associated with Tobacco Use among Iranian Adolescents: An Application of Protection Motivation Theory. Subst Use Misuse 2018; 53:1511-1518. [PMID: 29313745 DOI: 10.1080/10826084.2017.1415356] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Tobacco use is a significant predisposing factor to many diseases. Protection motivation theory is a well-suited theory, since fear can motivate individuals to change their unhealthy behaviors. OBJECTIVE This study was conducted to examine the associations between the constructs of this theory with intention and tobacco use behavior. METHOD The present cross-sectional study was conducted in Noshahr, Iran. The participants were 440 high school boys selected using a stratified random sampling in 2016. A questionnaire about tobacco use based on protection motivation theory was developed and its validity and reliability were assessed. The questionnaire included the demographic information, the constructs of theory, and tobacco use behavior. Structural equation modeling was used to test the associations between the constructs with intention and tobacco use. RESULTS The variables of perceived vulnerability (β = 0/137, P < 0.001), fear (β = 0/149, P < 0.001), self-efficacy (β = 0/249, P < 0.001), perceived intrinsic reward (β = -0.285, P < 0.001), threat appraisal (β = -0.25, P < 0.001), and coping appraisal (β = 0.358, P < 0.001) had direct effect and are significant with intention. Moreover, perceived vulnerability (β = -0.158, P < 0.001), fear (β = -0.172, P < 0.001), self-efficacy (β = -0.288, P < 0.001), perceived intrinsic reward (β = 0.329, P < 0.001), threat appraisal (β = 0.265, P < 0.001), and coping appraisal (β = -0.379, P < 0.001) affected tobacco use indirectly through intention and were significantly associated with behavior. Also, intention had direct effect and is significant with tobacco use (β = -1.156, P < 0.001). CONCLUSIONS The protection motivation theory provides a useful framework for investigating factors of tobacco use among male students. Future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use.
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Affiliation(s)
- Leila Sabzmakan
- a Department of Health Education & Promotion , Alborz University of Medical Sciences , Karaj , Iran
| | - Mahmood Ghasemi
- a Department of Health Education & Promotion , Alborz University of Medical Sciences , Karaj , Iran
| | | | - Tahereh Kamalikhah
- c Department of Health Education & Promotion , Semnan University of Medical Sciences , Semnan , Iran
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Neppl TK, Dhalewadikar J, Lohman BJ. Harsh Parenting, Deviant Peers, Adolescent Risky Behavior: Understanding the Meditational Effect of Attitudes and Intentions. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2016; 26:538-551. [PMID: 28042227 PMCID: PMC5193236 DOI: 10.1111/jora.12212] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Although research supports the influence of parents and peers on adolescent risky behavior, less is known about mechanisms proposed to explain this relation. This study examined the influence of adolescent attitudes and intentions about such behaviors. Prospective, longitudinal data came from rural youth who participated throughout adolescence (n= 451). Observed harsh parenting and relationship with deviant peers was assessed in early adolescence, attitudes and intentions were measured during middle adolescence, and risky behavior was assessed in late adolescence. Results indicated that parenting and deviant peers was related to engagement in tobacco use, alcohol use, and risky sexual behaviors. Moreover, attitudes and intentions mediated this relationship even after parent use and adolescent early involvement in these behaviors were taken into account.
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Affiliation(s)
- Tricia K Neppl
- Dept. of Human Development and Family Studies, Iowa State University, 4389 Palmer Suite 2356, Ames, IA 50011; ; phone: 515-294-8502
| | - Jui Dhalewadikar
- Department of Human Development and Family Studies, Iowa State University;
| | - Brenda J Lohman
- Dept. of Human Development and Family Studies, Iowa State University, 4389 Palmer Suite 2356, Ames, IA 50011; ; phone: 515-294-6230
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Karimy M, Araban M, Zareban I, Taher M, Abedi A. Determinants of adherence to self-care behavior among women with type 2 diabetes: an explanation based on health belief model. Med J Islam Repub Iran 2016; 30:368. [PMID: 27493912 PMCID: PMC4972051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 09/12/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Self-care is an essential element in treating a person with diabetes; and managing diabetes is of prime importance. The aim of this study was to investigate the predictors of adherence to self-care behavior among women with Type 2 diabetes. METHODS This cross-sectional study was conducted on 210 female patients aged 30 to 60. Data collection tool was an anonymous valid and reliable questionnaire designed based on the Health Belief Model (HBM), which acquired information about the followings: Perceived susceptibility, severity, benefits, barriers, self-efficacy and diabetes self-care behavior. Data were analyzed by t-test, chisquare and regression analysis. RESULTS The multiple regression models revealed 59.9% of the variance of self-care behavior with self-efficacy, perceived barrier, benefit and susceptibility. Additionally, the highest weight for β (β=0.87) was found for self-efficacy. Self-care behavior was positively correlated with all HBM variables except for perceived barriers showing a negative correlation. CONCLUSION The Health Belief Model may be used as a framework to design intervention programs in an attempt to improve adherence to self-care behaviors of women with diabetes. In addition, the results indicated that self-efficacy might play a more crucial role in developing self-care behaviors than t other HBM components. Therefore, if the focus is placed on self-efficacy when developing educational programs, it may increase the likelihood of adherence to self-care behavior.
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Affiliation(s)
- Mahmood Karimy
- 1 Assistant Professor, Public Health Department, Faculty of Health, Saveh University of Medical Sciences, Saveh, Iran.
| | - Marzieh Araban
- 2 Assistant Professor, Public Health Department, Faculty of Health, Ahvaz University of Medical Sciences, Ahvaz, Iran.
| | - Iraj Zareban
- 3 Assistant Professor, Health education Department, Faculty of Health, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. ,(Corresponding author) Assistant Professor, Health education Department, Faculty of Health, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mohammad Taher
- 4 MSc, Nursing Department, Faculty of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
| | - Ahmadreza Abedi
- 5 Assistant Professor, Nursing Department, Faculty of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
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14
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Karimy M, Zareban I, Araban M, Montazeri A. An Extended Theory of Planned Behavior (TPB) Used to Predict Smoking Behavior Among a Sample of Iranian Medical Students. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2015; 4:e24715. [PMID: 26495261 PMCID: PMC4609501 DOI: 10.5812/ijhrba.24715] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/17/2015] [Accepted: 01/25/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Smoking among the youth is an important public health concern. Although several studies have investigated the correlates of smoking behavior, no theory-based study has particularly assessed this problem among medical students. OBJECTIVES This study aimed to evaluate the efficacy of the extended theory of planned behavior (TPB) to predict smoking behavior among a sample of Iranian medical students. PATIENTS AND METHODS This is a cross-sectional study carried out in Ahvaz, Iran, 2014. The data were collected through a self-administered questionnaire, which included items on demographics, smoking behavior, and components of the TPB model (attitude, subjective norms, perceived behavior control, and intention), and an added construct on smoking refusal skill. Data were analyzed using descriptive correlation, and linear regression statistics by SPSS, version 16. RESULTS One hundred and seventy medical students with a mean age of 21.25 (SD = 2.9) years were enrolled in the study. Of them, 24 (13.5%) students were smokers. All components of the TPB model and smoking refusal skill were statistically significant as to intention to smoke (P < 0.001). The TPB constructs with and without smoking refusal skill accounted for 77% (adjusted R2) and 78% of the variance observed for intention to smoke, respectively. The results also revealed the highest weight for perceived behavior control (β= -0.40). CONCLUSIONS The findings of this study indicated that all TPB variables are useful tools for prediction of the smoking behaviors among students. Particularly, students' perceived behavioral control and attitudes towards smoking were found to be important determinants of smoking intentions. Thus, the findings could be used for planning effective tobacco control programs targeting University students.
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Affiliation(s)
- Mahmood Karimy
- Department of Public Health, Faculty of Health, Saveh University of Medical Sciences, Saveh, IR Iran
| | - Iraj Zareban
- Department of Public Health, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Marzieh Araban
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Montazeri
- Department Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran
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15
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Barati M, Allahverdipour H, Hidarnia A, Niknami S, Bashirian S. Belief-based Tobacco Smoking Scale: Evaluating the Psychometric Properties of the Theory of Planned Behavior's Constructs. Health Promot Perspect 2015; 5:59-71. [PMID: 26000247 DOI: 10.15171/hpp.2015.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 01/21/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND At present, there are no comprehensive validated instruments for measuring adolescents' beliefs regarding tobacco smoking in the Iranian society. This study aimed to evaluate the validity, reliability and feasibility of the belief-based tobacco smoking scale using the Theory of Planned Behavior's (TPB) constructs as a theoretical framework. METHODS This cross-sectional validation study was carried out on 410 male adolescents of Hamadan, west of Iran, recruited through multi-stage random sampling method. Reliability was assessed by internal consistency and Intraclass Correlation Coefficient (ICC). In addition, Confirmatory Factor Analyses (CFA) and Exploratory Factor Analyses (EFA) were performed to test construct validity. Content validity was examined using Content Validity Index (CVI) and Content Validity Ratio (CVR). RESULTS RESULTS obtained from factor analysis showed that the data was fit to the model (X(2)=391.43, P<0.001) and TPB consisted of 22 items measuring seven components which explaining 69.7% of the common variance. The mean scores for the CVI and CVR were 0.89 and 0.80; respectively. Additional anal-yses indicated acceptable results for internal consistency reliability values ranging from 0.55 to 0.92. CONCLUSION The belief-based tobacco smoking questionnaire is a reliable and valid instrument and now is acceptable and suitable and can be used in future studies.
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Affiliation(s)
- Majid Barati
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Hamid Allahverdipour
- Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Hidarnia
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Shamsodin Niknami
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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16
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Karimy M, Niknami S, Heidarnia AR, Hajizadeh E, Shamsi M. Refusal self efficacy, self esteem, smoking refusal skills and water pipe (Hookah) smoking among iranian male adolescents. Asian Pac J Cancer Prev 2015; 14:7283-8. [PMID: 24460289 DOI: 10.7314/apjcp.2013.14.12.7283] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use among adolescents is a major public health concern, and identifying predictors of smoking is necessary for planning prevention programs. The present study examined the relationship between refusal self efficacy, self esteem, smoking refusal skills and water pipe (hookah) smoking among Iranian male adolescents. MATERIALS AND METHODS A cross-sectional study was conducted with 380 Iranian male adolescents aged between 15-19 years selected by multistage sampling. The participants completed an anonymous, voluntary, self-report questionnaire. Variables independently associated with water pipe (WP) smoking were identified by multiple logistic regression analysis. RESULTS The mean age of the participants was 16.7±1.3 years. The prevalence of WP smoking was 17.3%. Logistic regression analysis revealed that knowledge (OR=0.56; 95% CI: (0.37-0.79), attitude (OR=0.69; 95% CI: (0.52-0.89), self esteem (OR=0.67; 95% CI: (0.55-0.82), smoking refusal skills (OR=0.73; 95% CI: (0.55-0.87), and self efficacy (OR=.82; 95% CI: (0.61-0.93) were all signifcant prediting facotrs for adolescents WP smoking. CONCLUSIONS The findings have implications for public health interventions. Indeed, self efficacy and smoking refusal skills should be considered when developing tailored measures for the prevention of WP smoking among adolescents.
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Affiliation(s)
- Mahmood Karimy
- Department of Public Health, Faculty of Health, Saveh University of Medical Sciences, Saveh, Iran E-mail :
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17
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Predictors of Tobacco Smoking in Male Adolescents in Hamadan Based on the Theory of Planned Behavior. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2014. [DOI: 10.20286/jech-010364] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Huang YC, Ho CS, Lee SM, Gee MJ, Lan SJ, Hsieh YP. Intent to abuse addictive substances in regions with serious drug abuse among early adolescents. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.942399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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