Development and psychometric properties of the Hookah Smoking Initiation for Women Questionnaire (HIWQ)

The aims of this study were to design the Hookah Smoking Initiation for Women Questionnaire (HIWQ) and determine its psychometric properties. This was a sequential exploratory mixed-methods design consisting of qualitative and quantitative phases. This study was conducted from August 2012 to July 2013 in Tehran. In the qualitative phase, semi-structured interviews were held with 36 Iranian women for developing a preliminary item pool. Consequently, during the quantitative phase, the psychometric properties of the questionnaire were determined with the collaboration of 323 women living in various geographical locations in Tehran, Iran. Content validity of the questionnaire was examined by a panel of experts. The questionnaire's construct validity was assessed using exploratory factor analysis and confirmatory factor analyses. The Cronbach's alpha coefficient was calculated to check the questionnaire's internal consistency reliability. Moreover, its stability was tested using the test-retest method. Exploratory factor analysis indicated that the HIQW could best be explained by a six-factor solution: 'drawing the attention of other people', the need to having fun and being relaxed, 'hookah smoking in the family', 'availability of hookah', 'curiosity' and 'having a positive attitude toward hookah'. It also was found that the construct and content validity, and the reliability of the questionnaire were satisfactory (α = 0.83, ICC = 0.94). The HIQW was valid and reliable. Therefore, healthcare professionals can use it for evaluating the hookah smoking initiation in women. Future studies are required to refine this questionnaire and assess its applicability in different cultures and contexts.

Prevalence and factors associated with exclusive breastfeeding at 6 months of life in Tehran: a population-based study

Exclusive breastfeeding is the best form of nutrition for infants in the first 6 months of life. The aim of this study was to determine the prevalence of exclusive breastfeeding in Tehran, Islamic Republic of Iran in the first 6 months of life, and the factors that influence it. In a population-based, cross-sectional study 538 mothers with children aged 6-24 months completed an interview questionnaire. Only 46.5% of mothers exclusively breastfed their infant in the first 6 months of life. In multivariate analysis formula supplementation in the hospital (OR = 0.41, 95% CI: 0.17-0.95) and mother receiving conflicting infant feeding advice (OR = 0.53, 95% CI: 0.37-0.78) had a negative effect on exclusive breastfeeding. Mother's intention to exclusively breastfeed (OR = 5.85, 95% CI: 2.88-11.9) and infant having first breast contact 6-30 minutes after delivery (OR = 2.35, 95% CI: 1.17-4.72) had positive effects on exclusive breastfeeding.

Lifetime and current waterpipe use among adolescents in Tehran, Islamic Republic of Iran

Waterpipe use among Iranian adolescents has become a matter for concern. A descriptive, cross-sectional community-based survey was performed in 2010 to determine the prevalence of waterpipe use and associated factors among Iranian adolescents in Tehran, Islamic Republic of Iran. After multi-stage, random cluster sampling 1201 adolescents aged 15-18 years old responded to a questionnaire based on the Youth Risk Behavior Surveillance. The prevalence of current waterpipe smoking (at least once in the previous 30 days) was 28.0%, significantly higher among males (34.8%) than females (21.4%). A total of 45.1% of adolescents reported lifetime use (ever use) of waterpipes and 34.2% had ever shared a waterpipe. In multivariate logistic regression analysis the significant correlates of current waterpipe use for both males and females were having smokers among friends and family members, while for males, older age and educational failure were also risk factors.

Determining appropriate strategies for improving women's health promoting behaviours: using the nominal group technique

Women's health constitutes a major aspect of development in societies and is considered a health-related priority. The aim of the present study was to determine appropriate strategies for improving health promoting behaviours in women of reproductive age in the Islamic Republic of Iran. Using the nominal group technique, a panel discussion was held in October 2011 with 12 health specialists who were selected through purposive sampling. In the first round, panel members generated 81 strategies; after eliminating irrelevant items and merging items with similar concepts, 44 strategies remained. After group discussion and voting, the following 4 items had the highest scores: improving physical activity, with a social support approach; empowering women; promoting and improving men's role in women's health; and promoting social support. The strategies presented in this study may be utilized by policy-makers, managers and health care providers to improve women's health promoting behaviours, and thus contribute to their wellbeing.

Psychometric properties of the persian version of the youth risk behavior survey questionnaire

BACKGROUND

Adolescents may get involved in high-risk behaviors. Surveys are the primary, and sometimes the sole source of data collection for many high-risk health behaviours. We examined the reliability and validity of the psychometric properties of the self-administered Persian version of the 2009 Youth Risk Behavior Surveillance System (YRBSS) questionnaire.

METHODS

In a methodological study in summer 2010, 100 Iranian adolescents aged 15-18 years were recruited through convenience sampling. The face and content validity were used for the questionnaire validity. In order to evaluate the questionnaire's reliability, the Intraclass Correlation Coefficient (ICC) and Cronbach's α were calculated for domains and 89 items.

RESULTS

Among 89 items, the ICC values were below 0.4 (weak reliability) for 2 items (2.25%), 0.4-0.6 (moderate reliability) for 10 items (11.24%), 0.6-0.8 (good reliability) for 32 items (35.96%) and 0.8-1 (excellent reliability) for 45 items (50.56%). The prevalence of most high-risk behaviors was constant in the first and second survey. The value of Cronbach's α was 0.73 for intentional and unintentional injuries, 0.77 for tobacco use, 0.86 for alcohol and other drug use, and 0.79 for unsafe sexual behaviors. No domain had a mean ICC of below 0.6. Furthermore, 97.75% of the items had moderate to excellent reliability. Thus, the Persian YRBSS questionnaire had an acceptable reliability.

CONCLUSION

Over the 2-week period, sexual behaviors were reported with less consistency compared to other behaviors. In any case, researchers must be aware of the limitation of the data collected through this questionnaire, particularly in comparison to the domain of sexual behaviors. Overall, 97.75% of the items had moderate to excellent reliability. Thus, the Persian YRBSS questionnaire had an acceptable reliability.

Relation of assertiveness and anxiety among Iranian University students

ACCESSIBLE SUMMARY

• The findings from the present study revealed that less than 30% of nursing and midwifery students have high assertiveness and only half of them have low anxiety. • Assertiveness and anxiety have negative correlations in nursing and midwifery students and affect the mental health and educational and occupational performance of the students. • Many factors such as years of education and working while studying influence the level of assertiveness in the students. • The anxiety in students had a significant relation with the father's level of education, family income, etc.

ABSTRACT

The simultaneous existence of low assertiveness and high anxiety in nursing and midwifery students leads to the disruption of study performance. There exists little information concerning their assertiveness. The purpose of this study was to determine the relation of assertiveness and anxiety in nursing and midwifery students. In this correlational, cross-sectional study, 173 nursing students (68 males and 105 females) and 77 midwifery students were recruited from the Tehran University of Medical Sciences in Iran. Data were collected using a questionnaire including personal-social factors, the Spielberger Trait Anxiety Inventory and the Assertion Inventory of Gambrill and Richey. More than half of the nursing and midwifery students (59.5% and 59.7%, respectively) had moderate assertiveness. Also, 43.3% and 36.4% of them had moderate and high levels of anxiety. Pearson correlation test revealed that assertiveness and anxiety had negative correlations in nursing (r=-0.51, P < 0.001) and midwifery (r=-0.449, P < 0.001) students. Some demographic variables had significant correlations with assertiveness and anxiety among the students. Considering the relation of assertiveness and anxiety and its effects on mental health and educational and occupational performance, students should be informed of the required skills for positive interaction with others and to increase assertiveness and decrease anxiety.