1
|
Adegboyega A, Kang J, Aroh A, Williams LB. Perceived Barriers to Pap Screening Influence Adherence to Screening Recommendations Among Black Women. J Womens Health (Larchmt) 2024. [PMID: 38837184 DOI: 10.1089/jwh.2023.1024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Objectives: The aim of this study was to determine the Health Belief Model (HBM) constructs associated with Pap screening adherence among a sample of African American and sub-Saharan African immigrant women in the United States. Methods: A descriptive cross-sectional study was conducted via an online survey. Participants were recruited from central Kentucky counties. Ninety-one eligible women participated (mean age 38 ± 12 years), 49.5% identified as African American. Twenty-nine percent indicated never being screened or not being up-to-date. Self-reported demographic data, HBM constructs for Pap screening, and Pap screening history were collected. Bivariate and logistic regressions were performed. Results: There was a significant negative association between perceived barriers and being up-to-date. For every one-point increase in perceived barriers, the odds of being up-to-date decreased by 81%, (p = 0.004; CI: 0.06-0.60), findings from further evaluation of the barrier construct showed that barriers significantly associated with screening include items related to lack of knowledge about where to get a Pap screening, lack of time to attend the screening, screening-associated shame and pain, negligence, and age. There were no other significant HBM constructs associated with up-to-date Pap screening status. There was no difference in perceived barriers between African American and sub-Saharan African women. Conclusions: Despite public health efforts to decrease screening barriers, a perception of barriers exists among Black women. Continued efforts to address screening barriers as well as the perception of barriers are warranted among Black women.
Collapse
Affiliation(s)
| | - JungHee Kang
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Adaeze Aroh
- College of Public Health, Slippery Rock University, Slippery Rock, Pennsylvania, USA
| | | |
Collapse
|
2
|
Dadipoor S, Alavi A, Kader Z, Mohseni S, Eshaghi Sani Kakhaki H, Shahabi N. Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran. BMC Cancer 2023; 23:730. [PMID: 37553636 PMCID: PMC10408223 DOI: 10.1186/s12885-023-11240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs. METHODS A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15-49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant. RESULTS A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants' age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior. CONCLUSIONS The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.
Collapse
Affiliation(s)
- Sara Dadipoor
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zainab Kader
- The Centre for Interdisciplinary Studies of Children, Families and Society, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - 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
| | - Nahid Shahabi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| |
Collapse
|
3
|
Bas-Sarmiento P, Lamas-Toranzo MJ, Fernández-Gutiérrez M, Poza-Méndez M. Health Literacy, Misinformation, Self-Perceived Risk and Fear, and Preventive Measures Related to COVID-19 in Spanish University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15370. [PMID: 36430094 PMCID: PMC9690779 DOI: 10.3390/ijerph192215370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The "infodemic" is one of the main obstacles in the fight against the COVID-19 pandemic. In order to face it, health literacy (HL) is essential since it allows for knowledge about COVID-19 and the practice of preventive measures to be fostered. This is especially relevant in university students due to their idiosyncrasy. This study aims to evaluate the level of HL related to COVID-19 (HLC), risk perception, misinformation, and the attitudes and behaviors adopted to prevent the spread of coronavirus in Spanish university students. An online questionnaire was administered to 499 Spanish university students. The HLC index presented a mean of 33.89 out of 50; a total of 63.8% had an inadequate level of HLC. They practiced a mean of 7.54 out of 9 preventive behaviors, and the mean knowledge score was 10.40 out of 13. The HLC showed significantly different scores for the degree, the practice of preventive measures, and some sources of information. The level of HL correlates with the adoption of preventive measures. The higher the severity and perceived susceptibility, the more preventive measures are taken by the students. Therefore, there is a need to strengthen the HL skills of university students and address the dissemination of misinformation. Although caution should be taken when generalizing these results due to the limitations inherent within a cross-sectional study and the convenience sampling, our results can guide the establishment of health education strategies and policies for the management of the infodemic in pandemic situations, according to this target population.
Collapse
Affiliation(s)
- Pilar Bas-Sarmiento
- Department of Nursing and Physiotherapy, University of Cadiz, University Institute of Research in Social Sustainable Development (INDESS), Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz, INiBICA, 11009 Cadiz, Spain
| | | | - Martina Fernández-Gutiérrez
- Department of Nursing and Physiotherapy, University of Cadiz, University Institute of Research in Social Sustainable Development (INDESS), Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz, INiBICA, 11009 Cadiz, Spain
| | - Miriam Poza-Méndez
- Department of Nursing and Physiotherapy, University of Cadiz, University Institute of Research in Social Sustainable Development (INDESS), 11009 Cadiz, Spain
| |
Collapse
|
4
|
Hosseini Z, Najafi P, Mohseni S, Aghamolaei T, Dadipoor S. The effect of a theory-based educational program on southern Iranian prisoners' HIV preventive behaviors: a quasi-experimental research. BMC Public Health 2022; 22:1342. [PMID: 35836148 PMCID: PMC9281156 DOI: 10.1186/s12889-022-13763-z] [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: 12/18/2021] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background The present research explored the effect of an educational program based on the health belief model (HBM) on prisoners’ HIV preventive behaviors in the south of Iran. Methods The present quasi-experimental research was conducted in 2019–20 on 280 prisoners, 140 in the control group (CG) and 140 in the intervention group (IG). The sampling was simple randomized. The data were collected using a questionnaire in two parts, one exploring the demographic information and the other the HBM constructs. The final follow-up was completed 3 months after the educational intervention (8 sessions long) in November 2020. Results After the intervention, statistically significant between-group differences were found in the healthy behavior score and all HBM constructs except for the perceived barriers (p < 0.001). Perceived severity and susceptibility were found to be the strongest predictors of HIV preventive behaviors. Conclusion The educational intervention showed to positively affect the adoption of preventive behaviors mediated by the HBM constructs. To remove barriers to HIV preventive behaviors or any other healthy behavior, researchers are suggested to develop multi-level interventions (beyond the personal level) to gain better findings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13763-z.
Collapse
Affiliation(s)
- Zahra Hosseini
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Pirdad Najafi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sara Dadipoor
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| |
Collapse
|
5
|
Sun X, Wang L, Shen X, Huang C, Wei Z, Su L, Wang S, Liu X, Zhen X. Correlates of Adherence of Multimodal Non-pharmacological Interventions in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study. Front Psychiatry 2022; 13:833767. [PMID: 35747098 PMCID: PMC9210931 DOI: 10.3389/fpsyt.2022.833767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-pharmacological interventions are promising for delaying cognitive decline in older adults with mild cognitive impairment (MCI). Although some studies have demonstrated adherence rates and factors influencing participation in single modality non-pharmacological interventions, little is known about the level and correlates of adherence to multimodal non-pharmacological interventions (MNPIs) in older adults with MCI. Objective This study aimed to explore the adherence level and the correlates of adherence to MNPIs in older adults with MCI. Methods A cross-sectional design was employed. Community-dwelling older adults aged 60 years and over were recruited from senior community centers and healthcare centers in Huzhou from March 2019 to December 2020. Data were collected by a general information questionnaire and the adherence scale of cognitive dysfunction management (AS-CDM) in older adults with MCI. Hierarchical regression analyses were applied to explore the correlates of adherence to MNPIs. Results A total of 216 completed questionnaires were finally analyzed. Of these, 68.52% were female, and 45.4% of the participants had no less than 6 years of education. The overall mean score for adherence was 117.58 (SD = 10.51) out of 160, equivalent to 73.49 in the hundred-mark system, indicating a medium-level adherence to MNPIs in older adults with MCI. Of the five dimensions of adherence (AS-CDM), self-efficacy scored the highest, and the lowest was perceived barriers. The univariate analysis showed that the factors associated with the adherence to MNPIs were: regular physical exercise, meat-vegetable balance, absence of multimorbidity, high level of education, living alone, and living in urban (p < 0.05). In the hierarchical regression analysis, the final model explained 18.8% of variance in overall adherence (p < 0.01), which high school (Beta = 0.161, p < 0.05), college and above more (Beta = 0.171, p < 0.05), meat-vegetarian balance (Beta = 0.228, p < 0.05), regular physical exercise (Beta = 0.234, p < 0.05), and presence of multimorbidity (Beta = -0.128, p < 0.05) significantly contributed to adherence. In addition, nearly 80% of older adults with MCI preferred MNPIs. Conclusion Early assessment and management of adherence to MNPIs were essential in older adults with MCI. Furthermore, the findings shed light on several critical areas of intervention to improve adherence to MNPIs in older adults with MCI. Clinical Trial Registration http://www.chictr.org.cn/showproj.aspx?proj=35363, ChiCTR1900020950 (Registered on January 23, 2019).
Collapse
Affiliation(s)
- Xue Sun
- School of Medicine, Huzhou University, Huzhou, China
| | - Lina Wang
- School of Medicine, Huzhou University, Huzhou, China
| | - Xinhua Shen
- Department of Neurosis and Psychosomatic Diseases, Third People's Hospital of Huzhou, Huzhou, China
| | - Cheng Huang
- School of Medicine, Huzhou University, Huzhou, China
| | - Zhuqin Wei
- School of Medicine, Huzhou University, Huzhou, China
| | - Liming Su
- School of Medicine, Huzhou University, Huzhou, China
| | - Simeng Wang
- School of Medicine, Huzhou University, Huzhou, China
| | - Xiaoshen Liu
- Department of Orthopedics, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueting Zhen
- School of Medicine, Tongxiang City Health School, Jiaxing, China
| |
Collapse
|
6
|
Shahsavari S, Alavi A, Razmjoue P, Mohseni S, Ranae V, Hosseini Z, Dadipoor S. A predictive model of genital warts preventive behaviors among women in the south of Iran: application of health belief model. BMC Womens Health 2022; 22:63. [PMID: 35260143 PMCID: PMC8903721 DOI: 10.1186/s12905-022-01649-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genital wart (GW) is known as an infectious disease. Besides the infection, it is associated with a higher risk of cervical neoplasia and cancer in the infected population. The present research aimed to explore the predictors of GW preventive behaviors based on the health belief model (HBM). METHODS The present analytical and cross-sectional research was conducted in 2019 among 720 women between 15 and 49 years of age in Bandar Abbas in the south of Iran. The sample was selected in a multi-stratified clustering method. The participants responded to a reliable and valid researcher-made questionnaire which explored demographic information, knowledge-related items and the model constructs. A multivariate linear regression analysis was run to determine the predictors of adopting GW preventive behaviors. A path analysis was also run to test the direct and indirect effects of the model constructs on the dependent variable. RESULTS The mean and standard deviation of participants' age was 30.43 ± 8.697 years. As Pearson's correlation coefficients showed, knowledge (r = 0.197, p < 0.001), perceived susceptibility (r = 0.434, p < 0.001), severity (r = 0.463, p < 0.001) and self-efficacy (r = 0.434, p < 0.001) were significantly correlated with the adoption of GWs preventive behaviors. Multiple linear regression analysis showed that self-efficacy (B = - 0.010, p < 0.001), perceived susceptibility (B = 0.070, p < 0.001) and severity (B = 0.078, p < 0.001) were the predictors of GW preventive behaviors. Path analysis showed that perceived susceptibility, severity and self-efficacy directly affected healthy behaviors while perceived benefits and barriers indirectly affected the preventive behaviors. CONCLUSIONS The present findings help to promote knowledge of the predictors of GW preventive behaviors. HBM can be a useful theoretical framework to evaluate the preventive behavior of the disease and help to reduce the rate of sexually-transmitted infections including GW.
Collapse
Affiliation(s)
- Saeideh Shahsavari
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Parisa Razmjoue
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shokrollah Mohseni
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Vahid Ranae
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Hosseini
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| |
Collapse
|
7
|
Eche MT, Vermaak K. Knowledge, attitude and practice of female university students regarding human papillomavirus and self-sampling in KwaZulu-Natal, South Africa: a cross-sectional survey. BMC Womens Health 2022; 22:58. [PMID: 35246111 PMCID: PMC8895517 DOI: 10.1186/s12905-022-01634-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Human papillomavirus (HPV) infection remains a major cause of cervical cancer. Screening practice in South Africa has remained persistently low, with the invasiveness of pelvic examination as a major barrier to screening. This occasions the need to assess women’s knowledge, attitude, and practice regarding HPV testing and self-sampling. Method This is a cross-sectional quantitative study which enrolled 386 female students between the ages of 18 and 65 years at the University of KwaZulu-Natal, South Africa. Data was collected through a self-administered structured questionnaire, from February to March 2020. Data on participants’ socio-demographic characteristics, knowledge, attitudes and practices regarding HPV, HPV testing and self-sampling were obtained. Results Out of the 386 respondents, 30.6% were unaware that HPV can be transmitted through unprotected sex, only 25.1% knew about the availability of HPV vaccines in South Africa, 16.1% knew that the vaccines are accessible for free, while 79.0% were oblivious to the asymptomatic nature of HPV infection. Furthermore, a vast majority (95.8%) had never heard about self-sampling while only 1.0% had undergone HPV testing prior to this study. Although 52.9% knew that HPV testing could prevent cervical cancer, it did not positively impact screening practice. However, 57.7% of participants were willing to undergo future screening if allowed to self-sample. Conclusion Self-sampling is a more acceptable means of sample collection compared to pelvic examination. Therefore, encouraging self-sampling and providing self-sampling kits will aid increased screening participation and address certain barriers associated with HPV testing. Awareness and educational campaigns about HPV and its causative relationship with cervical cancer will occasion better attitude towards screening participation.
Collapse
Affiliation(s)
- Miracle Tamaraebi Eche
- School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa.
| | - Kerry Vermaak
- School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
8
|
Hosseini Z, Seyrafi N, Aghamolaei T, Mohseni S, Alavi A, Dadipoor S. The effectiveness of a model-based health education program on genital warts preventive behaviors: a quasi-experimental study. Infect Agent Cancer 2021; 16:68. [PMID: 34895298 PMCID: PMC8666010 DOI: 10.1186/s13027-021-00408-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Genital warts (GWs) are highly prevalent among Iranian women. GWs are not only highly infectious but are also followed by severe adverse effects, including the development of cervical cancer. Therefore, the present study aimed to explore the effect of an educational intervention based on the health belief model (HBM) on the adoption of GWs preventive behaviors by married women in Bandar Abbas, a city in the south of Iran. METHODS A quasi-experimental intervention was conducted between 2019 and 2020 among 150 women participants (75 as the intervention and 75 as the control group). The sampling method was multi-stage clustering. The required data was collected using a reliable and valid tripartite questionnaire which explored demographic information, awareness, and HBM constructs. A total number of 15 educational sessions were held, each 90 min long. The control group received only one 90-min session. The final follow-up was completed three months after the intervention in November 2020. RESULTS The two research groups had no statistically significant differences in terms of awareness, perceived susceptibility, severity, benefits, barriers, and self-efficacy before the intervention (in the pre-test) (p > .05). After the educational intervention, the two groups showed statistically significant differences in all constructs except for the perceived benefits (p < .001). In the intervention group, in the pretest (before the intervention), the behavior score was 2.77 ± 2.59, which was increased to 3.73 ± .52 after the intervention (p < .001). In the control group, however, the difference was not statistically significant (p = 0.227). CONCLUSION The present findings showed that the educational intervention based on the HBM can improve the prevalence of GWs preventive behaviors in women. This education should be provided by experts at regular intervals in all healthcare centers.
Collapse
Affiliation(s)
- Zahra Hosseini
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Niloofar Seyrafi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| |
Collapse
|
9
|
Factors Affecting Motivation among Key Populations to Engage with Tuberculosis Screening and Testing Services in Northwest Tanzania: A Mixed-Methods Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189654. [PMID: 34574579 PMCID: PMC8469176 DOI: 10.3390/ijerph18189654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 12/02/2022]
Abstract
In northwest Tanzania, many artisanal small-scale miners (ASMs) and female sex workers (FSWs) live in informal communities surrounding mines where tuberculosis (TB) is highly prevalent. An active case finding (ACF) intervention to increase TB case notification was undertaken in two districts. Alongside this, a study was implemented to understand engagement with the intervention through: (1) quantitative questionnaires to 128 ASMs and FSWs, who either engaged or did not engage in the ACF intervention, to assess their views on TB; (2) qualitative interviews with 41 ASMs and FSWs, 36 community health workers (CHWs) and 30 community stakeholders. The mean perceived severity of TB score was higher in the engaged than in the non-engaged group (p = 0.01). Thematic analysis showed that health-seeking behaviour was similar across both groups but that individuals in the non-engaged group were more reluctant to give sputum samples, often because they did not understand the purpose. CHWs feared contracting TB on the job, and many noted that mining areas were difficult to access without transportation. Community stakeholders provided various recommendations to increase engagement. This study highlights reasons for engagement with a large-scale ACF intervention targeting key populations and presents insights from implementers and stakeholders on the implementation of the intervention.
Collapse
|
10
|
Mahindarathne MGPP. Assessing COVID-19 preventive behaviours using the health belief model: A Sri Lankan study. J Taibah Univ Med Sci 2021; 16:914-919. [PMID: 34393699 PMCID: PMC8353659 DOI: 10.1016/j.jtumed.2021.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/14/2021] [Accepted: 07/08/2021] [Indexed: 11/21/2022] Open
Abstract
Objective The novel coronavirus (COVID-19) is turning out to be one of the most severe public health crises in recent history. Promoting preventive behaviour among the public is of paramount importance to effectively contain the disease. Hence, this research attempts to identify factors that affect preventive behaviour against COVID-19. Methods The Health Belief Model (HBM), which outlines how perceived susceptibility, severity, benefits, barriers, and health motivation affect individuals’ health behaviour, served as the theoretical basis of the study. As the outcome measure of the study was cues to action against COVID-19, a regression analysis was conducted to explore how the aforementioned HBM constructs influence the cues to action. The data were collected using an online survey with a total of 307 respondents. Results The results revealed that perceived benefits (0.395, p < 0.001), self-efficacy (0.405, p < 0.001), and general health motivation (0.313, p < 0.001) had significant positive impacts on the cues to action taken to prevent COVID-19, whereas perceived barriers (−0.097, p < 0.05) had a significant negative impact. The statistical analysis further revealed that the cues to action taken to prevent COVID-19 were not significantly influenced by perceived susceptibility and perceived severity. Conclusion The study reinstates the usability of the HBM in exploring health behaviour. Importantly, the study findings suggest that by informing the public of the benefits of prevention and general health motivation, and by encouraging self-efficacy and eliminating the barriers to prevention, preventive actions against COVID-19 can be effectively promoted.
Collapse
|
11
|
Shahnazi H, Araban M, Karimy M, Basiri M, Ghazvini A, Stein LAR. A quasi-experimental study to improve health service quality: implementing communication and self-efficacy skills training to primary healthcare workers in two counties in Iran. BMC MEDICAL EDUCATION 2021; 21:369. [PMID: 34229675 PMCID: PMC8258999 DOI: 10.1186/s12909-021-02796-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Service satisfaction ratings from clients are a good indicator of service quality. The present study aimed to investigate the impact of communication skills and self-efficacy training for healthcare workers on clients' satisfaction. METHODS A quasi-experimental study was conducted in health centers of Saveh University of Medical Science in Iran. Primary Healthcare (PHC; N = 105) workers and service recipients (N = 364) were randomly assigned to intervention and control groups. The intervention group received four 90-min training sessions consisting of lecture, film screening, role-playing, and discussion group. Before and 3 months after the intervention, a multi-part questionnaire (including demographics, self-efficacy and communication skills in PHC workers; and satisfaction questionnaire in service recipients) was completed by participants in both intervention and control groups. RESULTS PHC worker mean scores of self-efficacy and communication skills after the educational program were increased in the intervention group compared to the control group (p < 0.05). Also, mean satisfaction scores for service recipients of the intervention group (PHC workers) generally significantly increased compared to the control group (p < 0.001). CONCLUSIONS The educational program improved the self-efficacy, and communication skills in health workers and improved client satisfaction overall. Our results support the application of self-efficacy and communication skills training for other medical groups who wish to improve clients satisfaction as an important health services outcome.
Collapse
Affiliation(s)
- Hossein Shahnazi
- Department of Health Education and Promotion, Social Determinants of Health Research center, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Social Determinants of Health Research Center, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmood Karimy
- Department of Public Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mansooreh Basiri
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ali Ghazvini
- Chemical Injuries Research Center, System Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - LAR Stein
- Psychology Department, University of RI, Kingston, RI USA
- Behavioral & Social Sciences Department, Brown University School of Public Health, Providence, RI USA
- Rhode Island Training School, Department of Children, Youth & Families, Cranston, RI USA
- Center for Prisoner Health & Human Rights, Brown University Medical School, Providence, RI USA
| |
Collapse
|
12
|
Habibi H, Sedighi B, Jahani Y, Hasani M, Iranpour A. Self-Care Practices and Related Factors in Patients with Multiple Sclerosis (MS) Based on the Health Belief Model. J Caring Sci 2021; 10:77-83. [PMID: 34222116 PMCID: PMC8242295 DOI: 10.34172/jcs.2021.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 01/26/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.
Collapse
Affiliation(s)
- Hajar Habibi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Sedighi
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Marziyeh Hasani
- Department of Health Education and Promotion, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abedin Iranpour
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
13
|
Haghi R, Ashouri A, Karimy M, Rouhani-Tonekaboni N, Kasmaei P, Pakdaman F, Zareban I. The role of correlated factors based on Pender health promotion model in brushing behavior in the 13-16 years old students of Guilan, Iran. Ital J Pediatr 2021; 47:111. [PMID: 33980275 PMCID: PMC8117318 DOI: 10.1186/s13052-021-01063-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
Background Tooth decay is one of the diseases that is closely related to people’s behaviors and it can have adverse effects on their performance and their success in the future. Brushing twice a day is the simplest and most effective way to reduce tooth decay. The study aim was to determining the roles of correlational factors based on the Pender’s health promotion model in brushing behavior of ninth grade students at urban public schools of Guilan province during the academic year 2019. Methods The present study was cross-sectional and had a descriptive-analytical type. We performed the multi-stage random sampling on 761 ninth-grade students (374 girls and 387 boys) at urban public schools of six counties (ten cities) of Guilan province in 2019. The primary tool was a questionnaire on oral health behaviors focusing on brushing behavior. In the present study, which was conducted only on brushing behavior, we revised and changed the initial questionnaire during the sessions of the research team, and then confirmed its validity and reliability. The questionnaire consisted of three parts, demographic characteristics, constructs of health promotion model, and brushing behavior. We analyzed data in SPSS 21 using regression models. Results 20.1% of students brushed their teeth at least twice a day. Optimal behavior had a statistically significant relationship with parents’ education level, and gender. Based on the regression model, the health promotion model constructs described 58% of the variance of the commitment to plan of action. Perceived self-efficacy, situational influences, and perceived barriers of action had significantly stronger relationships with commitment to plan of action respectively. Multiple logistic regression analysis indicated that one-unit increase in scores of commitment to plan of action and self-efficacy increased the chance of desired behavior by 12 and 14% respectively. Conclusion Due to the low rate of brushing behavior in the students and the predictive power of the health promotion model in brushing behavior, we suggest planning and implementation of educational interventions for this group with an emphasis on influencing the commitment to plan of action, self-efficacy, and also the level of knowledge. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-021-01063-y.
Collapse
Affiliation(s)
- Robabeh Haghi
- Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Asieh Ashouri
- Department of Cardiology, Cardiovascular Diseases Research CenterHeshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Nooshin Rouhani-Tonekaboni
- Department of Health Education and Promotion, Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, 41857-33411, Realat St., Rasht, Iran
| | - Parisa Kasmaei
- Department of Health Education and Promotion, Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, 41857-33411, Realat St., Rasht, Iran.
| | - Farahnaz Pakdaman
- Department of Elderly and Middle-aged Health, Vice-chancellor of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Iraj Zareban
- Health Promotion Research Center, Zahedan University of Medical Science, Zahedan, Iran
| |
Collapse
|
14
|
Simbar M, Ghazanfarpour M, Abdolahian S. Effects of training based on the health belief model on Iranian women's performance about cervical screening: A systematic review and meta-analysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:179. [PMID: 32953907 PMCID: PMC7482640 DOI: 10.4103/jehp.jehp_684_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/29/2020] [Indexed: 05/27/2023]
Abstract
CONTEXT Pap smear test is one of the most important actions in preventing cervical cancer. This study aimed to perform a meta-analysis on all related literature about the effects of health belief model (HBM)-based training on Pap smear screening test performance of Iranian women. METHODS The search was performed in Scopus, PubMed, and Web of Science. Eligibility criteria were limited to English and Persian language articles with experimental or semi-experimental methods until October 2019 that evaluated the effect of HBM-based training on Iranian women's performance of Pap smear test. We excluded studies that used both cervical and breast cancer screening together. RESULTS Twelve studies were performed on totally 1605 participants. This meta-analysis showed that all of Health Belief Model (HBM) constructs improved significantly among HBM-based trained women, perceived susceptibility (standard mean division [SMD] =0.785; P = 0.002; confidence interval [CI] = 0.005 to 1.56; Heterogeneity; P = 0.013; I 2 = 97%)., perceived severity (SMD = 1.14; P = 0.001; CI = 0.66-1.62; heterogeneity; P < 0.001; I 2 = 92%), perceived benefits (SMD = 1.25; P = 0.001; CI = 0.545-0.135 heterogeneity; P = 0.003; I 2 = 97%), perceived barrier (SMD = 0.20; P = 0.001; CI = 0.44-1.24; heterogeneity; P < 0.001; I 2 = 92%) and perceived self-efficacy (SMD = 0.638; P < 0.001; CI =1.76-0.426; heterogeneity; P < 0.001; I 2 = 97%). CONCLUSION Cervical screening education program based on the HBM can be effective on Iranian women's performance in their perceived susceptibility, perceived severity, perceived barrier, and perceived self-efficacy about Pap smear test.
Collapse
Affiliation(s)
- Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masumeh Ghazanfarpour
- Department of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Abdolahian
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Eghbal SB, Karimy M, Kasmaei P, Roshan ZA, Valipour R, Attari SM. Evaluating the effect of an educational program on increasing cervical cancer screening behavior among rural women in Guilan, Iran. BMC WOMENS HEALTH 2020; 20:149. [PMID: 32689993 PMCID: PMC7372794 DOI: 10.1186/s12905-020-01020-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cervical cancer is one of the major health problems and the third prevalent cancer in women all around the world. As a simple, inexpensive, and with no side-effects, Pap test is a reliable way to screen cervical cancer. This study aimed to investigate, the effects of educational intervention based on the Health Belief Model (HBM) on doing Pap smear tests among the rural women of the north of Iran. METHODS In a quasi-experimental study, 160 rural women were randomly divided into control and experimental groups to experience a three-session intervention. The experimental group received the usual educational programs of rural health center and educational programs based on the HBM constructs through personal consultation, asking/answering questions, and an educational pamphlet. The control group, received the usual educational programs of rural health center. The post-test data were collected 2 months after the intervention and analyzed in SPSS-18. RESULTS Before the intervention, there was no significant difference between the control and experimental groups regarding the mean score of knowledge, performance and constructs of the HBM. After the intervention, however, there was a significant difference in the mean scores of knowledge performance and all constructs of the HBM in two groups (p < 0.001). Rate of doing the Pap smear test in the experimental group increased from 18.7 to 78.7% in the intervention group. CONCLUSION These findings support the effectiveness of cervical cancer prevention programs based on the HBM. Therefore, conducting similar programs in other regions is recommended.
Collapse
Affiliation(s)
- Sedighe Bab Eghbal
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahmood Karimy
- Department of public health, faculty of health, Social Determinants of Health Research Center, Saveh University of medical sciences, Saveh, Iran
| | - Parisa Kasmaei
- Department of Health Education and Promotion, Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
| | - Zahra Atrkar Roshan
- Department of Social Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Roghieh Valipour
- Department of public health, Mazandaran Training & Education Organization, Babol, Iran
| | - Seyedeh Maryam Attari
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
16
|
Baharum NN, Ariffin F, Isa MR, Tin ST. Health Literacy, Knowledge on Cervical Cancer and Pap Smear and Its Influence on Pre-Marital Malay Muslim Women Attitude towards Pap Smear. Asian Pac J Cancer Prev 2020; 21:2021-2028. [PMID: 32711428 PMCID: PMC7573396 DOI: 10.31557/apjcp.2020.21.7.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Cervical cancer is preventable. In Malaysia, women are found to have good awareness of the disease and yet, the Pap smear uptake is still poor. Measuring health literacy level could explain this discrepancy. This study aims to determine the relationship between health literacy, level of knowledge of cervical cancer and Pap smear with attitude towards Pap smear among women attending pre-marital course. Methods: A cross sectional study was performed in three randomly selected centres that organised pre-marital courses. All Malay Muslim women participants aged 18 to 40 years old were recruited while non-Malaysian, illiterate, and had hysterectomy were excluded. Validated self-administered questionnaires used were European Health Literacy Questionnaire (HLS-EU-Q16 Malay) and Knowledge and attitude towards Cervical Cancer and Pap Smear Questionnaire. The mean percentage score (mean± SD) was calculated, with higher scores showed better outcomes. Multiple linear regression was used to measure the relationship of independent variables with attitude towards Pap smear. Results: A total of 417 participants were recruited with a mean age of 24.9 ± 3.56 years old. Prevalence of awareness of cervical cancer was 91.6% (n=382, 95% CI: 89.0%, 94.2%) and mean percentage score was 74.7%±7.6. Prevalence of awareness of Pap smear was 59.0% (n=246, 95% CI: 54.2%, 63.8%) and mean percentage score was 80.2% ± 6.5. The health literacy mean score was 13.3±3.6, with minimum score 0 and maximum score 16. The mean percentage score of attitudes towards Pap smear was 64.8%±9.3. Multiple linear regression analysis demonstrated significant relationship between health literacy (p=0.047) and knowledge of Pap smear (p<0.001) with attitude towards Pap smear. Conclusion: A higher health literacy with high knowledge of Pap smear improves the attitude towards Pap smear. Pre-marital course is an opportunistic platform to disseminate information to improve health literacy and knowledge of cervical cancer and Pap smear screening.
Collapse
Affiliation(s)
- Nurul Nadia Baharum
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, 68100 Selayang, Selangor, Malaysia
| | - Farnaza Ariffin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, 68100 Selayang, Selangor, Malaysia.,The Maternofetal and Embryo Research Group (MatE), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia
| | - Mohamad Rodi Isa
- The Maternofetal and Embryo Research Group (MatE), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia.,Department of Population Health and Preventive Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor, Malaysia
| | - Su Tin Tin
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,South East Asia Community Observatory (SEACO), Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia
| |
Collapse
|
17
|
Shirazi Zadeh Mehraban S, Namdar A, Naghizadeh MM. Assessment of Preventive Behavior for Cervical Cancer with the Health Belief Model. Asian Pac J Cancer Prev 2018; 19:2155-2163. [PMID: 30139219 PMCID: PMC6171406 DOI: 10.22034/apjcp.2018.19.8.2155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction: Cervical cancer is a leading cause of death in developing countries. However, taking regular Pap smears screening, one of the most effective screening tests, can reduce chance of cervical cancer remarkably. The first step in health education is choosing the right model, one of the best known being the Health Belief Model (HBM). Here, we evaluated different HBM factors with regard to cervical cancer preventive behavior in Fasa, Iran. Materials and methods: This cross-sectional study included 200 married women between the ages of 17 and 64 in Fasa during 2013. Participants were selected through stratified sampling from urban health centers. The questionnaire of the HBM included four sections and was filled out by interview. Data analysis was with SPSS 21, ANOVA and t-tests and Internal correlations between components of model were analyzed in terms of the Spearman Pearson correlation coefficient. Results: The mean age of the participants was 35.6±9.89 years. Some 52% had undergone a Pap test. The percentage values for participants’ knowledge and perceived susceptibility were 49.5% and 46%, respectively, considered as moderate. Perceived severity and benefits were good at 56.5% and 73%, respectively, while perceived barriers was moderate (46.5%). Also, 57.1% demonstrated a good self-efficacy and 61% good behavior. Discussion: We found that the most predictable factors for knowledge and behavior were age, income level, perceived benefits, perceived severity and self-efficacy according to the HBM. These factors should be taken into account for achieving acceptable preventive behaviors in health programs.
Collapse
|