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Zare S, Kazemnejad A, Hamta A, Raeesi Dehkordi F. The Intention of Waterpipe Tobacco Smoking by Women in the COVID-19 Pandemic and its Contributing Factors: a Nonparametric Path Analysis. Med J Islam Repub Iran 2023; 37:30. [PMID: 37180856 PMCID: PMC10167644 DOI: 10.47176/mjiri.37.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 05/16/2023] Open
Abstract
Background People with waterpipe tobacco smoking (WTS) seem to be more at risk for the serious complications of coronavirus disease 2019 (COVID-19). This study aimed at assessing the behavioral intention (BI) of WTS by women in the COVID-19 pandemic and its contributing factors. Methods This cross-sectional descriptive-correlational study was conducted in 2020 (ie, during the COVID-19 pandemic). Participants were 300 women randomly selected through multistage sampling from comprehensive healthcare centers in Khorramabad, Iran. Data collection instrument was a 42-item questionnaire with 4 main subscales, namely knowledge, attitude, differential association, and BI. Data were collected through both online and phone-based methods and were analyzed using non-parametirc path analysis. Results The prevalence of WTS among women was 13% (95% CI, 11.06-14.94) and the mean scores of attitude, differential association, and behavioral intention among participants with WTS were significantly higher than participants without WTS (P < 0.001). Moreover, 46.12% (95% CI, 38.12-54.08) of participants with WTS reported intention to quit WTS due to the COVID-19 pandemic and 43.6% (95% CI, 35.66-51.54) of women with WTS and 16.5% (95% CI, 14.20-18.80) of women without WTS believed in the protective effects of WTS against COVID-19. The path analysis model showed that the BI of WTS had a significant inverse relationship with knowledge and a significant direct relationship with attitude and differential association. Conclusion This study suggests the need for quality educational and counseling interventions for the general public to correct popular misconceptions about the protective effects of WTS against COVID-19.
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Affiliation(s)
- Soodabeh Zare
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Amir Hamta
- Department of Biostatistics, Faculty of Medical Sciences, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Raeesi Dehkordi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Khayat S, Navaee M, Fanaei H, Khojasteh F. Waterpipe Smoking in Pregnant Women of Zahedan City in 2020: Prevalence and Associated Factors. Int J Prev Med 2022; 13:128. [PMID: 36452469 PMCID: PMC9704486 DOI: 10.4103/ijpvm.ijpvm_703_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/09/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Waterpipe smoking is associated with maternal and fetal complications, and valid data contribute to evidence-based planning. This study was conducted to determine the prevalence and factors related with waterpipe smoking among pregnant women of Zahedan city in 2020. METHODS This cross-sectional study was conducted in 2020, and 400 pregnant women in the third trimester of pregnancy who lived in Zahedan participated in it by single stage randomized cluster sampling. A questionnaire was used to measure awareness of waterpipe complications, and another one investigated the status of waterpipe smoking to collect data. For data analysis, descriptive statistics and multiple logistic regression were used through SPSS 21. RESULTS The findings indicated that the prevalence of waterpipe smoking was 18.8%. In the waterpipe smoking group, 46.6% smoked every day, 89.3% had tried to reduce the smoking, and 64.8% reported fetal death as their main motivation to reduce smoking. Only 5.6% of subjects stated receiving training as the reason for reduction of their waterpipe smoking. The women's level of education, economic status, ethnicity, and awareness of the risks of waterpipe smoking were the predictors for waterpipe smoking (P < 0.05, P = 0.03, P = 0.006, and P < 0.001, respectively). CONCLUSIONS The results of this study show the high prevalence of waterpipe smoking in pregnant women of Zahedan. Further investigation and training in this regard are essential for pregnancy as well as pre-pregnancy care. Special attention should be paid to groups with better economic status and level of education, Baluch women, and those with low level of awareness.
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Affiliation(s)
- Samira Khayat
- Department of Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran,Address for correspondence: Dr. Samira Khayat, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. E-mail:
| | - Maryam Navaee
- Department of Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamed Fanaei
- Department of Physiology, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farnoosh Khojasteh
- Department of Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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de Carvalho Guimarães GL, Belo IS, Siqueira LFR, Ribeiro MTL, de Castro LL, de Oliveira GJPL, de Castro LA. Hookah Smoking among Brazilian University Students: An Exploratory Survey on the Prevalence and Perceptions of Addiction and its Harmfulness. ADDICTION & HEALTH 2022; 14:166-174. [PMID: 36544976 PMCID: PMC9743827 DOI: 10.34172/ahj.2022.1354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/12/2022] [Indexed: 11/29/2022]
Abstract
Background This study aimed to determine the prevalence, beliefs, attitudes, and perceptions of hookah use in a population of undergraduate students at a large public university in Brazil. Methods The sample consisted of 1348 undergraduate students aged over 18-year-old. They completed structured questionnaires on demographic information and close-ended questions on the past and current experiences of smoking hookah. The data underwent descriptive analysis and binary logistic regression. Findings Finally, 1298 valid survey forms were obtained from printed and digital questionnaires. More than half (53.9%) of participants reported having tried hookah at least once, however, only 10.8% reported they had experienced it within the last 30 days. The majority of the studied population presented acceptable beliefs about the harmfulness and addictive capacity of hookah smoking. However, when comparing the perceptions of those who had smoked and those who had never smoked hookah, and also, the perceptions of users and non-users, significant differences were observed. Students who were users or had already tried hookah showed a tendency to underestimate the deleterious effects of this type of smoking. Conclusion It could be concluded that hookah smoking was common among Brazilian university students. In addition, preoccupying misperceptions of hookah's harmfulness and addictive capacity were found. The results showed that the epidemic of hookah smoking, especially among young people, has spread far beyond the Arab world and the Persians. Accordingly, preventive measures must be taken if this population is to be protected from addiction and other serious health problems.
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Affiliation(s)
| | - Iara Silva Belo
- School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | | | | | | | | | - Luciano Alberto de Castro
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil,Corresponding Author: Luciano Alberto de Castro, DDS, MSc, PhD; Assistant Professor at the Department of Stomatological Sciences, Faculty of Dentistry, Federal University of Goiás, Campus 1, Sem número, Praça Universitária, Goiânia, Brazil. Postal code: 74605-020, Tel/Fax: 55 62-3209- 6230,
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Kalan ME, Ghobadi H, Taleb ZB, Adham D, Cobb CO, Ward KD, Behaleh R, Fazlzadeh M. COVID-19 and beliefs about tobacco use: an online cross-sectional study in Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:40346-40354. [PMID: 33029777 PMCID: PMC7541093 DOI: 10.1007/s11356-020-11038-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 09/28/2020] [Indexed: 05/02/2023]
Abstract
There is mixed evidence surrounding the relationship between tobacco use and COVID-19 infection/progression. The current study investigates beliefs and tobacco use behaviors and COVID-19 infection among a sample of smokers and never-smokers. Data were collected using an online survey distributed through Telegram, a cloud-based social media networking application in Iran from April 1 to May 31, 2020. The study participants included never-smokers (n = 511), current (past-month) waterpipe smokers (n = 89), current cigarette smokers (n = 158), and ex-smokers (n = 172). Multinomial logistic regression was used to compare tobacco use groups with never- smokers on beliefs, controlling for potential confounders. The study participants (n = 944) was mostly male (64%), had > high school education (76%), and lived in an urban area (91%), with mean ± SD age of 35.3 ± 10.8. Key findings of this study are that compared with never-smokers: (1) cigarette smokers were less likely to believe that smoking cigarette can lead to spreading COVID-19; (2) waterpipe smokers were more likely to believe that smoking waterpipe at home was a safe practice, that waterpipe protects against COVID-19, and smoking waterpipe may lead to a more rapid recovery from COVID-19; (3) both waterpipe and cigarette smokers believed that using e-cigarettes in public places was a safe practice during the COVID-19 pandemic; and (4) more than half of the ex-smokers stopped smoking due to COVID-19 and most of them planned to continue abstaining from smoking after the pandemic. Our findings underscore the need to raise awareness about the unsupported claims of a lower hazard of using tobacco products or possible protective effects against COVID-19 and to promote cessation programs.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Hassan Ghobadi
- Department of Internal Medicine, Pulmonary Division, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Mehdi Fazlzadeh
- Department of Environmental Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
- Department of Environmental Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran.
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Pahlavanzadeh B, Naghibi SA, Berdi-Ozounidavaji R, Zarghami F, Shahbazi-Sighaldeh S, Mohammadinia A, Hosseini MS, Mirkarimi K, Rahimi A, Shoaib-Hamrah M, Paul E, Charkazi A. Evaluation of the Psychometric Properties of the Lebanon Waterpipe Dependence Scale in a Sample of Iranian Waterpipe Smokers. ADDICTION & HEALTH 2021; 12:287-293. [PMID: 33623648 PMCID: PMC7878004 DOI: 10.22122/ahj.v12i4.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Waterpipe tobacco smoking (WTS) has recently increased in Iran. There is no valid instrument to measure the level of nicotine dependence among its consumers. This study was aimed to investigate the validity and reliability of the Lebanon Waterpipe Dependence Scale-11 (LWDS-11). Methods A cross-sectional study was conducted in the year 2017 whereby 367 waterpipe smokers were recruited from Golestan Province of Iran. LWDS-11 scale is composed of 4 subscales: 1) nicotine dependence, 2) negative reinforcement, 3) psychological craving, and 4) positive reinforcement. The validity of the questionnaire was examined using construct validity. Reliability of this scale was examined using test-retest reliability and internal consistency. Findings The four-factor model for LWDS [comparative fit index (CFI) = 0.985, Tucker-Lewis index (TLI) = 0.979, standardised root mean residual (SRMR) = 0.059, root mean square error of approximation (RMSEA) = 0.049 (0.031, 0.061)] demonstrated good fit to this data. Cronbach’s α was 0.825 for total scale and it was 0.818, 0.746, 0.624, and 0.670 for each individual subscale. The test-retest reliability of the scale was 0.925. Conclusion All goodness of fit indices (GFIs) represented a good fit of model. The LWDS-11 scale had an appropriate remarkable validity and reliability for waterpipe consumers to measure the level of nicotine dependence and it appeared to be likely useful for utilizing in the clinical and epidemiological studies.
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Affiliation(s)
- Bagher Pahlavanzadeh
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Abolhassan Naghibi
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rahman Berdi-Ozounidavaji
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Zarghami
- Department of Health Education and Health Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Shahbazi-Sighaldeh
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadinia
- Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahdieh Sadat Hosseini
- Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Kamal Mirkarimi
- Health Management and Social Development Research Center AND Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Amangholi Rahimi
- Gonbad-e-Qabus Health Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Shoaib-Hamrah
- Center for Rural Health, School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - Edwin Paul
- Center for Rural Health, School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - Abdurrahman Charkazi
- Environmental Health Research Center AND Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
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Aghdam FB, Alizadeh N, Nadrian H, Augner C, Mohammadpoorasl A. Effects of a multi-level intervention on hookah smoking frequency and duration among Iranian adolescents and adults: an application of socio-ecological model. BMC Public Health 2021; 21:184. [PMID: 33478456 PMCID: PMC7818729 DOI: 10.1186/s12889-021-10219-8] [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: 07/11/2020] [Accepted: 01/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background The present study aimed to investigate the effects of a multi-level intervention on hookah smoking frequency and duration among Iranian adolescents and adults. Methods In this study, two comparable cities in Iran were selected to participate in an intervention program based on a social-ecological model (SEM). In each city, 133 hookah smokers in coffee houses were selected. Environmental changes in coffee houses such as serving light foods and games were conducted. A virtual group named “no hookah” was established on the Telegram application to train participants in the intervention group. Messages, pictures, and short videos were sent to the participants through that virtual network. The frequency and duration of hookah consumption were assessed in both groups at baseline and after the intervention. Results The frequency of hookah consumption decreased in 72.6% of participants in the intervention group (vs. 6.3% in the control group), and the duration of hookah consumption per session decreased in 39.5% of participants in the intervention group (vs. 5.5% in the control group). Conclusions Using multi-level interventions through a social-ecological model can reduce hookah consumption in adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10219-8.
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Affiliation(s)
- Fatemeh Bakhtari Aghdam
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nader Alizadeh
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Christoph Augner
- Institute for Human Resources Research in Health Care, University Clinics of the Paracelsus Medical University, Salzburg, Austria
| | - Asghar Mohammadpoorasl
- Department of Biostatistics and Epidemiology & Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Kalan ME, Behaleh R, DiFranza JR, Bursac Z, Taleb ZB, Tleis M, Asfar T, Nakkash R, Ward KD, Eissenberg T, Maziak W. Natural Course of Nicotine Dependence Among Adolescent Waterpipe and Cigarette Smokers. J Adolesc Health 2020; 67:859-867. [PMID: 32622925 PMCID: PMC7683372 DOI: 10.1016/j.jadohealth.2020.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Waterpipe (WP) smoking patterns and setting can result in a unique trajectory of nicotine dependence (ND) compared with cigarette smoking. This longitudinal study compared the development of ND symptoms among adolescent WP and cigarette smokers. METHODS A cohort of 647 eighth and ninth graders in Lebanon were followed over 5 years. This study was based on 283 current exclusive WP and 146 current exclusive cigarette smokers. Kaplan-Meier survival analyses were conducted to evaluate 50% cumulative probability for the development of initial Hooked on Nicotine Checklist symptoms and the International Classification of Diseases, 10th revision (ICD-10) ND. RESULTS An initial Hooked on Nicotine Checklist symptom was endorsed by 59% of WP and 50% of cigarette smokers after smoking onset. Among those, 50% of both WP and cigarette smokers did so within 9.7 and 18.5 months, respectively. Approximately 28% of WP smokers and 22% of cigarette smokers developed ICD-10 ND. Among those, 50% of both WP and cigarette smokers did so within 15 and 22 months, respectively. The most common first to fourth ICD-10 criteria reported by WP smokers were "a strong desire to use tobacco," "difficulties in controlling tobacco taking behavior," "neglect of alternative pleasure," and "use despite harm." The most common first to fourth ICD-10 criteria reported by cigarette smokers were "a strong desire to use tobacco," "difficulties in controlling tobacco taking behavior," "withdrawal," and "tolerance". CONCLUSIONS Compared with adolescent cigarette smokers, initial ND symptoms and ICD-10 ND can develop sooner after starting to smoke and progress more rapidly among adolescent WP smokers. Developing, implementing, and evaluating intervention programs with adolescent WP smokers should be guided by the WP-specific trajectory of ND.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Malak Tleis
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA,Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Rima Nakkash
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria,School of Public Health, University of Memphis, Memphis, TN, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria,Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida; Syrian Center for Tobacco Studies, Aleppo, Syria.
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Mirzaei N, Dehdari T, Taghdisi MH, Zare N. Development of an instrument based on the theory of planned behavior variables to measure factors influencing Iranian adults' intention to quit waterpipe tobacco smoking. Psychol Res Behav Manag 2019; 12:901-912. [PMID: 31576183 PMCID: PMC6767482 DOI: 10.2147/prbm.s196417] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022] Open
Abstract
Background Theory of planned behavior (TPB) is one of the most widely used theoretical frameworks to explain addictive behaviors, such as tobacco smoking. The aim of this study is to develop and validate an instrument based on TPB variables to measure factors influencing Iranian rural adults’ intention to quit waterpipe tobacco smoking. Methods This study was performed on a sample of rural adult waterpipe consumers living in two villages in Shiraz, Southern Iran. In the beginning, the initial items of instrument were extracted from the literature review and interviews with 20 waterpipe consumers. After that, face validity and qualitative content validity of the items were appraised. To measure quantitative content validity index (CVI) and the content validity ratio (CVR), a panel of experts reviewed the items. In addition, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to characterize the construct validity of the instrument. Finally, Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) were computed. Results CVI and CVR of items were within the ranges of 0.89–0.95 and 0.85–0.96, respectively. EFA indicated the Kaiser-Meyer-Olkin (=0.71) and Bartlett’s test of sphericity was significant (=912.36, df=105, p<0.0001). Principal component analysis revealed that 15 items could be grouped into four subscales that accounted for 64.97% of the variance. Based on CFA, two items were deleted. CFA results showed that the remained data were fit to the model. The Cronbach’s alpha and ICC of subscales were, respectively, in the ranges of 0.72–0.87 and 0.64–0.82. Finally, a 13-item instrument with four subscales was confirmed. Conclusions The findings reveal that the developed TPB instrument is a reliable and valid scale to identify the determinants of the intention to quit waterpipe smoking among Iranian rural adults.
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Affiliation(s)
- Nasim Mirzaei
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad 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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9
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Dehdari T, Mirzaei N, Taghdisi MH, Khosropour A, Zare N. Psychometric Properties of the Iranian Brief Version of the Transtheoretical Model Instrument in Terms of Hookah Tobacco Smoking Cessation. ADDICTION & HEALTH 2019; 10:102-111. [PMID: 31069034 PMCID: PMC6494985 DOI: 10.22122/ahj.v10i2.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Transtheoretical model (TTM) has been recognized as a common theoretical model in researches in terms of addictive behaviors. The aim of this study was to examine the psychometric properties of the Persian brief version of the TTM for hookah tobacco smoking cessation in a sample of Iranian rural adults who were in the preparation stage for hookah cessation. Methods This was a validation study on Iranian rural adult hookah smokers by the TTM instrument. First, to translate the questionnaire items from English to Persian, backward-forward procedure was used. Face and content validity of the instrument items were assessed. Confirmatory factor analysis (CFA) was performed to determine the construct validity of the instrument. For this aim, 300 participants completed the instrument. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were calculated to examine the internal consistency and reliability of the subscales of the instrument. Findings The content validity index (CVI) and content validity ratio (CVR) of the items were ≥ 0.80 and ≥ 0.60, respectively. Based on CFA, the data fitted the TTM model. root mean square error of approximation (RMSEA), the goodness of fit index (GFI), adjusted GFI, and comparative fit index (CFI) were 0.037, 0.960, 0.910, and 0.950, respectively. At this stage, 6 items were deleted. The ICC and Cronbach's alpha of the subscales ranged between 0.60-0.74 and 0.71-0.86, respectively. The final instrument with 29 items was confirmed. Conclusion The findings suggest that translating Persian brief version of the TTM instrument was a reliable and valid tool to identify the determinants of hookah smoking cessation among Iranian rural adults.
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Affiliation(s)
- Tahereh Dehdari
- Assistant Professor, Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Mirzaei
- PhD Student, Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Hossein Taghdisi
- Professor, Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ashkan Khosropour
- Department of Mathematics, School of Mathematics, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran
| | - Najaf Zare
- Professor, Department of Biostatistics, School of Medicine AND Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kalan ME, Ben Taleb Z. Waterpipe tobacco smoking: A reality or hidden iceberg for Iranian women. Health Promot Perspect 2018; 8:252-254. [PMID: 30479977 PMCID: PMC6249491 DOI: 10.15171/hpp.2018.35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/20/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Florida, USA
| | - Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Florida, USA
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