Design and Validation of a Health Literacy Assessment Tool for COVID-19 Among Iranian Workers

BACKGROUND

The workforce is an organization's most important asset, and ensuring their health and safety is crucial for achieving the organization's mission and goals.

OBJECTIVE

The objective of this study was to design and validate a health literacy tool for COVID-19 among Iranian workers.

METHODS

This cross-sectional study involved a total of 201 participants. A personal information questionnaire was administered, and The Health Literacy Assessment (HLA) Tool was used to collect data specifically related to COVID-19. The HLA for COVID-19 was designed and developed, and the validity of the tool was evaluated through face, content, convergent, and construct validity analyses. To examine convergent validity, the Perceived Stress Scale was used. The reliability of the questionnaire was assessed using internal consistency measures, such as Cronbach's alpha coefficient.

KEY RESULTS

The mean content validity index was 0.93, indicating high content validity. Confirmatory factor analysis results supported the five-dimensional structure of the tool. Significant correlations were found between the HLA for COVID-19 and perceived stress levels. The Cronbach's alpha coefficient for all items was 0.84, indicating high internal consistency.

CONCLUSION

The HLA for COVID-19 is a concise, reliable tool for measuring health literacy related to COVID-19 among Iranian workers. Assessing COVID-19 health literacy in this population can be useful in evaluating the effectiveness of government officials, the media, and the medical and scientific community in providing necessary information. [HLRP: Health Literacy Research and Practice. 2024;8(2):e62-e68.].

The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors

INTRODUCTION

Breast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran.

METHODS

This quasi-experimental study was conducted on 162 women aged 30-69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22.

RESULTS

The intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group.

CONCLUSION

Overall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.

Training of Pelvic Floor Muscle Training Improves the Severity and Quality of Urine Incontinence and Increases Social Participation of Older Women in Southern Iran

BACKGROUND

Aging and gender are risk factors for urine incontinence, which can lead to psychological, physical, and social complications.

OBJECTIVE

This community-based study investigates the effectiveness of pelvic floor muscle training on the severity and quality of urine incontinence and social participation of older women.

METHODS

This quasi-experimental community-based study was performed with the participation of 60 older women referring to the Public Health Center in Kerman City, southern Iran. The experiment group was trained with pelvic floor muscle training in 7 training sessions with distance health education in the second half of 2021. Before and after the intervention, data were collected based on: demographic, severity and quality of urine incontinence, and social participation inventories. Data were analyzed using a t-test and ANOVA (P ≤ 0.05).

RESULTS

The mean scores of severity and quality of urine incontinence and social participation in the experiment and control groups before receiving the intervention were not statistically significant (P ≥ 0.05). But after that, a statistically significant difference was observed between the groups (P <0.05), which showed an improvement in the severity and quality of urine incontinence scores as well as SP in the experiment group.

CONCLUSIONS

Tele-training of the Kegel exercise, even during the pandemic, can play an important role in improving incontinence and social participation in older women. Therefore, this training can be used to prevent and improve urine incontinence in public health centers in the community.

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Predictors of musculoskeletal disorders and job satisfaction among office workers of an oil company: A cross-sectional study in Iran

BACKGROUND

Musculoskeletal disorders are among the significant causes of disabilities and occupational injuries all over the world and can reduce the quality of life and job satisfaction. These disorders prevail among the office workers of the Iranian Oil Company, though research on the involved factors is limited.

OBJECTIVE

The present study investigated the incidence and risk factors of musculoskeletal disorders and their association with job satisfaction among the office workers of the Iranian Oil Company.

METHODS

The present research was a cross-sectional descriptive-analytical study on 210 male office workers of the Iranian Oil Company. The prevalence of musculoskeletal disorders and the rate of job satisfaction were measured by Nordic Musculoskeletal and Minnesota job Satisfaction Questionnaires, respectively. The relationship between the variables was analyzed by the SPSS 28 software.

RESULTS

The most prevalent musculoskeletal disorders among office workers in the past 12 months were associated with the neck, waist, and knee organs, with 45.70, 41, and 38.10 percentages. Smoking, second jobs, and physical injury histories were identified as three risk factors connected to musculoskeletal disorders (p <  0.05). Forty-one percent of the participants were moderately satisfied with their jobs, and this number was significantly related to musculoskeletal disorders in the shoulders, elbows, back, waist, and knees (p <  0.05).

CONCLUSION

The results of this study indicate that second jobs, smoking, and physical injury histories are three risk factors for musculoskeletal disorders among office workers of the Iranian Oil Company. Thus, it is imperative to identify at-risk office workers and train and encourage them to take preventive actions and employ ergonomic job equipment.

Validation of the Persian version of the 9-item Berg Balance Scale Among Older Iranians

Objectives

Old age is often associated with a progressive decline in the capacity of individuals to maintain dynamic and static balance, leading to falls and fear of falling. This study aimed to validate the 9-item Berg Balance Scale (BBS-9) for the older Iranian population.

Methods

The current psychometric study involved translation of the BBS-9 to Persian language and its validation among a cohort of Persian-speaking elderly people. Confirmatory factor analysis, exploratory factor analysis, internal consistency, construct validity, test-retest reliability, receiver operating characteristic analysis, inter-rater, and convergent validity of the BBS-9 (Persian) were investigated and statistically analyzed.

Results

The participants were 9117 Iranians with an average age of 64.3±2.45 years. The cohort was 54.1% female. Nearly three quarters of the subjects (72.4%) lived alone, 92.9% needed help with activities of daily living, and 93.0% sustained falls in the previous two years. Internal consistency was confirmed using intraclass correlation coefficient and McDonald's Omega (≥ 0.75). The receiver operating characteristic analysis represented the exact cut-off values for male and female and with or without fear of falling with good specificity and sensitivity. Analysis of variance revealed that fear of falling was significantly related to age, Aging in Place, loneliness, hospitalization rate, frailty, and sense of anxiety (effect size ≥ 0.130, p ≤ 0.050).

Conclusions

The Persian version of BBS-9, a psychometrically sound self-reported measure of fear of falling, retained the original's satisfactory psychometric properties. It has the potential to be used among older Iranians in community-based and clinical settings.

A health communication campaign for prevention of osteoporosis in rural elderly women

BACKGROUND

Osteoporosis, as the most common metabolic disease and the leading cause of death among older people, affects more than 200 million women throughout the world. This study aimed to evaluate the effect of a health communication campaign on knowledge, attitude, and practice of older women towards prevention and control of osteoporosis.

METHODS

In this multi-stage mixed methods study, 30 days' health communication campaign for prevention of osteoporosis was conducted on 60- 75-year-old women, in rural areas of Fasa, Iran. Subjects were divided into two groups, control (n = 103) and intervention (n = 98). Data were collected using a researcher-made questionnaire and analyzed by SPSS 25.0. The significance level was set at < 0.05.

RESULTS

Inter-group group analysis revealed that the mean scores of knowledge, attitude, and practice were not significantly different between the two groups before the intervention, but after the intervention, unlike the behavior (P = 0.569), mean scores of knowledge (p < 0.001) and attitude (p < 0.001) of the intervention group were significantly more than the control group. Intra-group comparisons showed that, unlike the control group, the mean scores of knowledge (p < 0.001), attitudes (p < 0.001), and behavior (P < 0.001) increased significantly in the intervention group.

CONCLUSIONS

Health communication campaign is an effective way to change the knowledge and attitude and to a lesser extent the practice of the eldery toward prevention and control of osteoporosis.

The impact of family social support on postpartum quality of life among Iranian women: structural equation modelling

OBJECTIVE

To assess the impact of family social support (FSS) on postpartum quality of life (PQOL).

METHODS

This analytical cross-sectional study enrolled postpartum women and asked them to complete the PQOL and FSS questionnaire (FSSQ) between October 2021 and February 2022 in three urban health centres in Shiraz, Iran. Pearson correlation coefficient analysis and multiple regression were used to determine the relationship between the FSS and PQOL variables. Structural equation modelling was used to determine the relationship pathways of the impact of FSS on PQOL.

RESULTS

A total of 240 women were enrolled in the study. The mean ± SD scores of PQOL and FSSQ were 61.63 ± 9.59 and 69.80 ± 11.19, respectively. Family support seeking (7.95) and emotional support seeking (-6.80) were two factors affecting PQOL.

CONCLUSION

Women should be empowered to seek support through education and actions from health workers, especially nurses and midwives, during routine regular prenatal care.

Effectiveness of Otago Exercise Program on Successful Aging within Older Women with Migrant Children Referring to Public Health Centers in Shiraz City, Iran

Background: Successful aging (SA) is considered an indicator of satisfaction of older people. This study aimed to evaluate the effectiveness of the Otago Exercise Program (OEP) on SA among older women. Materials and Methods: quasi-experimental research with a control group was conducted in 2021 on 120 older women in Shiraz city, south Iran. Eligible samples were selected by a three-stage cluster sampling method and were classified into two equal intervention and control groups. Eight training sessions (exercises) were conducted for the intervention group using the OEP. SA questionnaire was completed at the beginning and 2 months after the intervention. The data were analyzed using the IBM-SPSS version 26, and the effect sizes were extracted. Results: The mean age of samples in the intervention and control groups was 69.71 + 59.59 and 68.83 + 5.08 years, respectively. Although there was no significant difference in the mean scores of SA between the two groups at the beginning of the study, 2 months after the intervention implementation, the mean scores of SA increased significantly in the intervention group (t = 8.57, p ≤ .001). Conclusion: It seems that OEP is an effective strategy for supporting SA in older people.

Psychometric Validation and Setting Cutoff Point for Persian Version of World Health Organization Quality of Life-Old Questionnaire

Health professionals assume the quality of life (QOL) as a main outcome of health care activities, especially in the elderly. Thus, they need valid tools for evaluating the effectiveness of their interventions. This study aimed to investigate the psychometric properties of the Persian version of the World Health Organization quality of life-old questionnaire (WHOQOL-OLD). The questionnaire was translated into Persian by standard translate/back-translate procedure. The Cronbach's alpha and intra-class correlation (ICC) coefficients were estimated to assess the internal validity and reliability. Confirmatory factor analyses (CFA) in a sample of 300 Persian-speaking elderly in Shiraz, Iran, were used for construct validity assessment. ROC curve analysis was used to determine the cutoff point for poor or good QOL. All the analyses were conducted using SPSS 24 and IBM AMOS 24. The internal consistency and reliability indices of the Persian version of WHOQOL-OLD were acceptable (Cronbach's alpha: 0.66-0.95; ICC: 0.71-0.91). CFA confirmed the WHOQOL-OLD six-domain structure (CMIN/df = 3.12, p < .001; CFI = 0.93; NFI = 0.89; RMSEA = 0.08). The ROC curve indicated 71.5 as the best cutoff point, with a sensitivity of 82.3% and specificity of 61.8%. The Persian version of the WHOQOL-OLD is valid and can be used for investigating the QOL in Persian-speaking elderly.

Effectiveness of resilience training intervention on psychological capital of the underprivileged widowed women of Fasa City, Iran

Introduction

Women heads of households (widows or divorcees) are vulnerable groups in society who face various psychological problems and have less resilience than other women. Therefore, the present study was conducted to determine the effectiveness of resilience educational intervention on the psychological capital of poor widows in Fasa city, south Iran.

Materials and Methods

In this quasi-experimental study, 120 widows covered by Imam Khomeini Relief Foundation were selected by a simple random sampling method based on a random Efron algorithm (Efron coin) and randomly assigned into two interventions and control groups (60 people each) in the second half of 2021. About 8 training sessions on resilience and psychological capital were held for the experimental group through training clips, audio transmissions, and podcasts. Data were collected using demographic characteristics forms, widowers' resilience assessment questionnaires, and Luten's psychological capital scale for testing and control before and two months after the intervention. Data were analyzed with Chi-square test, independent and paired t-test using SPSS V. 26 software.

Results

There were differences between the two groups at pretest in demographic variables and psychological capital and its subscales, and resilience and its subscales (P ≥ 0.05).. But two months after the educational intervention, a statistically significant increase was observed in the experimental group in these variables compared to the control group (p < 0.05). It indicates that there was an improvement in the outcomes from pretest to post-test within the intervention and no change in the outcomes over time within the control group.

Discussion and Conclusion

Using a resilience-based educational approach as a novelty of this research to promote psychological capital and resilience can increase resilience and psychological capital in widows. Then, considering the positive effect of this educational approach and the low cost of this intervention, it seems that the implementation of such interventions should be included in the plans related to widows.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-022-01886-9.

Design and psychometric evaluation of the breast cancer screening behaviors scale based on the health action model (HAM)

Background

Breast cancer is known as the most common cancer and the first-rank malignancy among women. Screening plays a crucial role in early diagnosis and timely treatment. This paper presents the results of design, evaluation and analysis of a questionnaire based on the health action model to investigate breast cancer screening behaviors and their relevant factors.

Methods

The study is based on using a combination of quantitative and qualitative approaches for optimal design and development of research tools. In order to design the structure of the health action model and screening behaviors related factors, both qualitative methods such as semi-structured interviews and quantitative approaches studied. Psychometric properties of the research tool were investigated through literature review. The research population consisted of 210 30–69 years old females based in Kashan who were selected through simple random sampling. The relative and content validity indexes were calculated to judge the content of the tool. Also, the confirmatory factor analysis was used to evaluate the construct validity. Additionally, intra-class correlation coefficient and Cornbrash’s alpha coefficient were calculated to evaluate the reliability of the instrument. The data were analyzed using the SPSS 22 and AMOS 22 software packages.

Results

The mean age of the participants was 43 ± 9.82 Years old. The final version of the questionnaire was prepared in four sections, namely demographic factors (15 items), knowledge (12 items), constructs of the health action model or the factors related to breast cancer screening behaviors (67 items), and behavior (6 items). Factor analysis confirmed that the health action model fits in measuring breast cancer screening behaviors.

Conclusion

The tool designed for measuring breast cancer screening behaviors showed acceptable psychometric properties amongst females and can be used as a valid tool in conducting research in health studies.

Alleviating work-family conflict for female employees in Iran: The effect of a multimedia educational intervention

Work-family conflict can lead to irreparable losses to individuals, families and organizations. This matter is especially important for married working women who cannot eschew home responsibilities. To consider an appropriate intervention for this issue, we investigated the effect of a one-month intervention on support from the workplace and the family, individual characteristics and work-family conflict. This quasi-experimental longitudinal study includes an intervention group and a control group, and uses a pre-test, post-test and 6-months follow up design. Participants were 120 married women working in healthcare services, recruited from two cities in South Iran. The web-based multimedia educational program comprised four modules: one for each of the women participants, their spouses, their co-workers, and their workplace supervisors. Data collection tools included a demographic information form, and co-worker support, supervisor social support, spouse support, core self-evaluation and work-family conflict questionnaires. The effect of the intervention was examined at two post-intervention time points. A comparison of changes in mean scores between the intervention and control groups indicated that scores of supervisor support, spouse support, core self-evaluation and work-family conflict in the intervention group one month and six months after the intervention were all significantly improved compared to before the intervention. There was no benefit of the intervention in terms of a change in co-worker support. There was no significant difference across the three time points in the control group. These results confirm that online educational methods can enable health promotion professionals to reduce work-family conflict to the benefit of both employees and organizations.

Patient Health Engagement Model as the Predictor of Social Support, Self-efficacy, and Quality of Life in Breast Cancer Patients

Background: Patient health engagement (PHE) is a dynamic and evolutionary process that involves improving health; however, little information is available on the PHE model. This study aimed to investigate health engagement and its relationship with social support, self-efficacy, and the quality of life in women with breast cancer. Methods: This cross-sectional study was conducted on 129 breast cancer patients who were referred to a specialized medical clinic and met the inclusion criteria. Data were collected using the EORTC QLQ-br23 questionnaire, Communication and Attitudinal Self-efficacy Scale for Cancer (19-item), Perceived Social Support Scale, NCCN Distress Thermometer, and PHE Scale. The statistical methods used in this study were linear regression, ANOVA, CATREG (Categorical regression with optimal scaling using alternating least squares), and descriptive statistics. Results: The most commonly reported problem was tingling in hands and/or feet (43.3%). The median PHE score was 2. Additionally, 29.45% and 16.27% of the patients reported moderate and severe distress, respectively. The results of regression analysis showed that the PHE scale could predict social support, self-efficacy, quality of life and all of its dimensions (P<0.001). However, it is the strongest predictor of understanding and participating in care (P<0.001, r=0.485). Conclusion: Given that the model can predict factors effective in improving cancer and interventions based on this model have not been performed in Iran, it is recommended that health interventions based on this model should be designed and implemented.

Developing strategies to improve the community readiness level to prevent drug abuse in adolescents: Based on the community readiness model, Eghlid City, Iran, 2019

The aim of this study was to investigate the level of readiness of Eghlid city community for adolescents' substance abuse prevention programs, and to develop strategies to improve community readiness levels based on the community readiness model (CRM). In this two-stage qualitative study, a 36-item semi-structured CRM questionnaire, was used to interview 11 key informants in Eghlid city, Iran, 2019. The interviews were analyzed and scored by two independent researchers. Strategies for increasing the level of readiness were developed and prioritized by participants using the nominal group method. The readiness levels to prevent substance abuse in community efforts and leadership dimensions were at stabilization and preparation stage. In terms of community awareness of efforts, community space, and public awareness of the issue, the readiness level was at the pre-planning stage, and in the resources for prevention efforts dimension, it was at the vague awareness level. In the strategy development section, the key participants focused on using traditional methods such as holding face-to-face training programs and festivals, using IRIB platform, local media, and lectures. The general level of readiness is at a moderate level. It seems necessary to focus on resources and areas related to public information.

What Are the Determinants of a Workplace Health Promotion? Application of a Social Marketing Model in Identifying Determinants of Physical Activity in the Workplace (a Qualitative Study)

Background and objective: Physical activity is an important behavior to reduce the risk of non-communicable diseases. Providing the context for physical activity in the workplace in addition to promoting the employees' physical and mental health has significant economic benefits for organizations. We conducted the present study using a social marketing model to explain the determinants of a Workplace Health Promotion in promoting physical activity among employees of government organizations in Yasuj, Iran. Materials and methods: The present study was qualitative research with directed content analysis based on the social marketing model. Thirty-three employees of government organizations in Yasuj were included in the study using the purposive sampling method. The data collection method included semi-structured interviews and observation. Data analysis was performed manually and by the qualitative content analysis method. The implementation data were systematically sorted and analyzed and classified into five steps. Results: Organizational structure, organizational policies, and a supportive interpersonal climate were extracted and categorized as characteristics of workplace health promotion programs from participant interviews. In addition to participants' emphasis on receiving information from reputable sources, virtual communication networks such as WhatsApp and real communication networks such as physicians and specialists were their preferred media for education and information. Conclusion: Due to the complexity of workplace, diversity, and multiplicity of factors and determinants of physical activity, the findings of the present study will be a basis for designing an appropriate and effective intervention and organizational changes to promote physical activities among employees in the future.

Association between parents and peer attachment with health locus of control: a cross-sectional study among Iranian adolescents

INTRODUCTION

Evidence suggests that the quality of family relationships is associated with health locus of control in family members. The present study aimed to determine the correlation between the health locus of control and adolescent-parent attachment.

MATERIALS AND METHODS

In this descriptive, analytical cross-sectional study, at each of these 10 schools, 40 students aged 14 and 15, will be randomly selected among Behbahan middle schools. 400 students were selected. Rotters Locus of Control Scale and the Inventory of Parent and Peer Attachment (IPPA) were used for data collection. Data were analyzed using SPSS software and Pearson correlation coefficient, t-test and ANOVA statistical techniques.

RESULTS

Findings showed that the mean and standard deviation of attachment level to father (95.97±19.66), mother (99.62±15.60) friends (93.78±17.59) were all high. Between source of health control (intrinsic, affective, and luck), parental attachment and peers have predictive power (beta=0.263, p≤0.001).

CONCLUSION

According to the findings, to increase attachment to parents, it is better that Intervention should also be carried out on the father and the mother and health Locus control will be increased.

Development and validation of dust exposure prevention questionnaire for cardiovascular patients based on the health belief model

BACKGROUND

Many cardiovascular patients suffer from respiratory failure. Environmental conditions can exacerbate symptomatology. It is necessary to prevent exposure to dust by taking educational steps to identify and modify patient behavior. This study aimed to develop and validate a dust exposure behavior questionnaire based on the Health Belief Model.

METHODS

A mixture of qualitative and quantitative methods was employed to design and develop the desired tool. Qualitative methods were used to identify the preventive behaviors needed by cardiovascular patients at risk of dust exposure using the opinions of two expert panels and a literature review. The quantitative phase of the research was performed to evaluate the psychometric properties of the research tool. The research population comprised 417 people with cardiovascular disease referred to a heart hospital in Bushehr, Iran in 2018. Consenting participants entered the study through consecutive sampling.

RESULTS

The final version of the questionnaire included 27 items across six domains, namely perceived susceptibility, perceived barriers, perceived severity, perceived benefits, cues to action, and self-efficacy. The mean values of the content validity ratio and content validity index were 0.93 and 0.9, respectively. In addition, all items had a good correlation with the total score of their parent domain (P < 0.01). The model fit was initially unsuitable, according to the related indices. Hence, to achieve a better model fit, the model was improved by releasing some parameters based on the modifications suggested by the AMOS software. The modified model featured an acceptable fit (χ2/df = 2.2, P < 0.001). Cronbach's alpha coefficients also confirmed appropriate reliability for all six domains.

CONCLUSION

The Dust Exposure Prevention questionnaire has desirable psychometric properties and appropriate validity to determine the behavioral factors involved in harm from dust exposure among cardiovascular disease patients. This marks an effective step toward evaluating the factors effective in preventing complications related to dust exposure among such patients.

High-risk behaviors and demographic features: a cross-sectional study among Iranian adolescents

BACKGROUND AND OBJECTIVES

High-risk behaviors are considered to be a serious threat among adolescents. This study aimed to investigate the frequency of unhealthy and high-risk behaviors and their relationship with demographic features in adolescents living in Shiraz, Iran.

MATERIALS AND METHODS

The present descriptive, cross-sectional study was conducted on 483 students in the 10th grade of high school. The data were collected using a demographic information form and a modified adolescents high-risk behaviors questionnaire. The reliability of the questionnaire was assessed using the test-retest method. Afterwards, the data were entered into the SPSS statistical software (IBM), version 22 and were analyzed using the chi-square (χ²) test, logistic regression analysis and one-way analysis of variance (ANOVA).

RESULTS

High-risk health behaviors were significantly correlated to adolescents' gender, parents' occupations and education levels, length of residency in Shiraz and talking about important things with one's parents (p < 0.03). Gender predicted 52% of variance of bullying behaviors at school [Exp(B) = 0.502, p < 0.03, 95% confidence interval (CI) = 0.261-0.996]. In fact, most high-risk behaviors were associated with gender (p < 0.001). Indeed, bullying was mostly reported in boys, while being hopeless or sad, suicide attempts and appropriate weight loss behaviors were mostly reported among girls. Additionally, the frequency of smoking cigarettes and using hookahs was higher among girls compared to boys (23.1% for smoking cigarettes and 39.6% for using hookahs). However, no significant correlation was observed between gender and smoking cigarettes and using hookahs (p > 0.704 for smoking cigarettes and p > 0.118 for using hookahs). The most prevalent high-risk behaviors were physical fighting (51.1%), being sad or hopeless (35.2%), alcohol abuse (26.7%), overweight (14.7%) and obesity (8.1%) in both genders. Based on the results, only 26.5% of the adolescents had sufficient physical activity. Besides, the adolescents' weight scores were significantly correlated to eating green salads (p < 0.01), which was seen more among overweight adolescents.

CONCLUSION

The findings indicated that adolescents' gender and their parents' roles should be taken into consideration in designing health promotion programs, such as mental health and its related skills. This would eventually result in the prevention and reduction of unhealthy habits.

Malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, south of Iran: interventional design based on PRECEDE model

Suburban areas suffer from unfavorable conditions as a result of poor health standards, low income, illness, and slight levels of education. One of the most important components in malaria elimination programs is health education. Bandar-Abbas is a malaria endemic city. Therefore, this study aimed to promote malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, Iran, through a PRECEDE model-based intervention program. This quasi-experimental study was carried out on 172 housewives under the coverage of four healthcare centers in Bandar-Abbas in 2016. The participants were randomly divided into two experimental and control groups, based on the inclusion criteria. The data collection tools included ademographic questionnaire, aresearcher-made questionnaire based on the educational phase of the PRECEDE model and achecklist for assessing malaria preventive behaviors. After the pre-test, the educational intervention was implemented on the intervention group at the first stage and the same questionnaire was administered as the post-test for both groups two months after the intervention. In this study, after implementing the intervention using the PRECEDE educational program, asignificant difference was found between the intervention and control groups in the mean scores for predisposing factors (knowledge and attitude) (P< 0.001), enabling factors (P< 0.001) and reinforcing factors (P< 0.001), which contributed to the improvement of preventive behaviors (P< 0.001). The PRECEDE model-based health education was effective in increasing knowledge and attitude, enabling and reinforcing factors, and promoting malaria preventive behaviors in the studied endemic areas.

Socio-Demographic Determinants of Quality of Life among Older People, a Population-Based Study

Introduction: Social participation is considered one dimension and also determinant of quality of life. The level of social participation of the elderly is influenced by various components such as socio-economic and demographic factors. The present study aimed to assess the relationship between social participation, quality of life, and some socio- economic factors in community dwelling elderly in Kerman, Iran. Methods: This cross-sectional study was conducted on 250 communities dwelling old people in Kerman in 2017 selected through random sampling. The data were collected using researcher-made Social Participation questionnaire and WHOQOL-BREF questionnaires. The data were analyzed using Pearson’s correlation coefficient, t-test, one-way ANOVA, and linear regression analysis. Results: The results revealed the participants’ mean score of social participation was above fifty. Social participation was significantly associated with age (p < 0.001), marital status (p = 0.004), education level (p < 0.001), and occupation (p = 0.021). A significant direct correlation was also observed between social participation and quality of life (p < 0.001), and social participation determined 21 % of variance of life quality score (p < 0.001). Conclusion: With the increase in social participation of the elderly, their quality of life improves. Establishing nongovernmental organizations, charities, and associations for retirement and aging can increase the level of social participation of the elderly.

Data on hepatitis B, C signs, and HIV-aids among middle-aged and older IDUs in Southwest Iran

Presented data was gathered from a local rehabilitation & caring center in Ahwaz city, southwest Iran end-2017. Data was classified in the six sections upon two predictors i.e. years of imprisonments and Injecting Drug Users (IDUs) to predict three blood infectious diseases i.e. HIV-Aids, Hepatitis B Virus (HBV), & Hepatitis C Virus (HCV). Each section jointly includes the following: tables of raw data, input data concerning false & true positive fractions (18 tables), scatter graph concerning false positive fractions (FPF) & true positive fractions (TPF) (6 graphs), and six ROC curves. The full access to data set is available at Mendeley data repository via doi:10.17632/6s9yzm7hr7.1.

Self-Care Education Programs Based on a Trans-Theoretical Model in Women Referring to Health Centers: Breast Self-Examination Behavior in Iran

Background:

Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran. This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country.

Materials and Methods:

This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05).

Results:

The results showed an increase in the intervention group’s mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001).

Conclusion:

The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women’s health and reduce deaths due to breast cancer.

Validation of Perceived Wellness Survey (PWS) in a Sample of Iranian Population

The individual's perception of health, when health is understood to include many dimensions of life, is considered the basis for any improvement in health status. Therefore, the present study aimed to assess the reliability and validity of the Persian version of the Perceived Wellness Scale (PWS) by applying it to employees of the Shiraz University of Medical Sciences. This cross-sectional study was conducted with 180 staff members of the university selected by convenience sampling. The study instrument was a Persian version of the PWS prepared through a translation and back-translation process. The reliability and validity of the instrument were assessed by using confirmatory factor analysis (CFA) and Cronbach's alpha coefficient. A total of 180 employees participated in the study. The mean age of the participants was 32.29 years (SD = 7.39) and 78.1% of the participants were women. The results showed that the Persian version of the PWS is acceptable. Cronbach's alpha coefficient was 0.87 for the whole scale, ranging from 0.68 to 0.85 on different dimensions of the scale. The results of split-half reliability and CFA indicated that the reliability and validity of the PWS are acceptable. The PWS is therefore an effective tool for evaluating the different dimensions of perceived wellness in the Iranian population.

Investigation of the Role of Training Health Volunteers in Promoting Pap Smear Test Use among Iranian Women Based on the Protection Motivation Theory

BACKGROUND

Cervical cancer is known as one of the most prevalent types of cancers and a major public health problem in developing countries which can be detected by Pap test, prevented, and treated. Despite the effective role of Pap test in decreasing the incidence and mortality due to cervical cancer, it is still one the most common causes of cancer-related deaths among women, especially in developing countries. Thus, this study aimed to examine the effect of educational interventions implemented by health volunteers based on protection motivation theory (PMT) on promoting Pap test use among women.

MATERIALS AND METHODS

This quasi-experimental study was conducted on 60 health volunteers and 420 women. The study participants were divided into an intervention and a control group. Data were collected using a valid self-reported questionnaire including demographic variables and PMT constructs which was completed by both groups before and 2 months after the intervention. Then, the data were entered into the SPSS statistical software, version 19 and were analyzed using Chi-square test, independent T-test, and descriptive statistical methods. P<0.05 was considered as statistically significant.

RESULTS

The findings of this study showed that the mean scores of PMT constructs (i.e. perceived vulnerability, perceived severity, fear, response-costs, self-efficacy, and intention) increased in the intervention group after the intervention (P<0.001). However, no significant difference was found between the two groups regarding response efficacy after the intervention (P=0.06). The rate of Pap test use also increased by about 62.9% among the study women.

CONCLUSIONS

This study showed a significant positive relationship between PMT-based training and Pap test use. The results also revealed the successful contribution of health volunteers to training cervical cancer screening. Thus, training interventions based on PMT are suggested to be designed and implemented and health volunteers are recommended to be employed for educational purposes and promoting the community's, especially women's, health.

The effects of a peer-led training program on female students' self-esteem in public secondary schools in Shiraz

INTRODUCTION

Low self-esteem in adolescence is one of the risk factors for negative outcomes in important domains of adulthood life. Due to the lack of trials based on modern methods of teaching in the field of self-esteem, this study aimed to investigate the effects of a peer-led training program on female second graders' self-esteem in public secondary schools in Shiraz.

METHODS

The present study is an educational controlled trial. 223 public school female students in the second grade were selected with the Multi-stage random cluster sampling method. The selected Schools were assigned randomly to experimental and control groups. The data were collected before, one and six weeks after an intervention in the control and experimental group, using Pope's 5-scale test of self-esteem with Cronbach's alpha reliability of 0.85. The educational intervention in the experimental group was a peer-led approach, using discussion techniques in small groups (the group work, role play and group play) and a 5-volume training manual. The data were analyzed through SPSS, version 14, using Mann-Whitney test, Chi-square test, Wilcoxon and repeated measure Analysis of Variance (ANOVA).

RESULTS

The results showed that the mean of total self-esteem scores and the sub-scales (except for family self-esteem) in the experimental groups compared to that in the control groups, one and six weeks after the peer-led based approach intervention was significantly different (p<0.001). Before the intervention, the mean for self-esteem in the experimental groups was 51.80±13.91 but in the first post-test and second post-test the mean increased to 73.72±12.94, and 69.48±12.63, respectively. Before the educational intervention, the frequency distribution of females' self-esteem in the experimental and control groups did not differ significantly from each other (p=0.337). But during one and six weeks after the intervention, a significant increase was observed between the two groups (p<0.001).

CONCLUSION

The results of this study suggest that peer education is an effective way to promote self-esteem in adolescents. Providing opportunities such as a peer-led approach can help adolescents to acquire practical ways to increase their self-esteem.

Effect of health education based on the protection motivation theory on malaria preventive behaviors in rural households of kerman, iran

BACKGROUND

Malaria is one of the most serious diseases in pregnant women as well as children less than 5 years around the world. The present study aimed to investigate the effect of health education based on the protection motivation theory on malaria preventive behaviors in the households of Ghale Ganj, Kerman, Iran in 2011.

METHODS

The present quasi-experimental study was conducted on 144 households covered by 8 health centers of Ghale Ganj, Kerman. The study samples were selected through systematic random sampling and the study data were collected using a questionnaire including demographic information, the constructs of the protection motivation theory, and a checklist for assessing the malaria preventive behaviors. After the pre-test, the intervention group underwent an educational intervention and after two months, the post-test was performed through the same questionnaire. Then, the data were entered into the SPSS statistical software (v. 18) and analyzed using Chi-square and Wilcoxon non-parametric tests. Besides, P < 0.05 was considered as statistically significant.

RESULTS

Before the intervention, no significant difference was found between the two study groups regarding perceived vulnerability, perceived severity, response costs, self-efficacy, response efficacy, and malaria preventive behaviors. After the intervention, however, a significant increase was observed in the intervention group's mean scores of all the constructs of the protection motivation theory as well as malaria preventive behaviors (P < 0.01).

CONCLUSIONS

According to the findings of the study, educational intervention based on the protection motivation theory is highly effective in promoting malaria preventive behaviors.

Effect of a parenting education program on girls' life satisfaction in governmental guidance schools of Shiraz

INTRODUCTION

One of the main determinants of adolescents' life satisfaction is parenting skills. Due to the lack of educational trials in this field, this research was done to evaluate the effect of a parenting education program on girls' life satisfaction in governmental guidance schools of Shiraz. 

METHODS

This study is an educational randomized controlled trial. At first, 152 female students in 2nd grade of governmental guidance schools and 304 parents (152 mother and 152 father) were selected by multistage random cluster sampling method. Then, they were categorized into experimental and control groups. Before and after the intervention, data were collected from two groups using multidimensional students' life satisfaction scale with stability (Cronbach's alpha=0.89), test-retest and correlation coefficient (r=0.70). Educational intervention for parents was performed in the experimental group through presentations with question and answer, discussion in small groups and distribution of educational booklets in 5 volumes. Finally, the data were analyzed using SPSS 14 and through Mann-Whitney test, Chi-square test, Fisher's Exact test, Wilcoxon test.

RESULTS

Before the intervention, the experimental and control groups did not show a statistically significant difference based on the demographic variables. Thetotal of life satisfaction scores and also its subscales in the experimental and controlgroup, before and six weeks afterthe educational interventiondid showstatisticallysignificant difference (p<0.001). The scores of differences (pre-test/post-test) in total life satisfaction between the experimental and control groups were statistically significant difference (p<0.001).

CONCLUSION

According to low scores of the students in the pre-test, especially in the control group which didn't undergo any educational program, holding scheduled educational intervention is necessary. This study not only supports the effectiveness of educational intervention but also recommends further educational research to develop knowledge regarding patterns of parenting education.

The prediction of physical activity intention and behavior in elderly male residents of a nursing home: a comparison of two behavioral theories

BACKGROUND

Regular physical activity is ranked as a leading health indicator. Despite the extensive benefits of physical activity, elder people are much less active than desired. Using Theory of Planned Behavior (TPB) and the self-efficacy construct, this study examined the prediction of physical activity intention and behavior in a sample of elderly male resident of a nursing home.

METHODS

In a cross-sectional study of the residents of Kahrizak Nursing Home in Tehran, Iran, elderly men who were 60 years or older, capable of independent living, mobility, and verbal communication were asked to complete measures of the TPB, self-efficacy and physical activity behavior.

RESULTS

A hierarchical step-wise multiple regression analysis indicated that affective/instrumental attitude, subjective norm, and perceived behavioral control (PBC) explained 32.8% of the variance in physical activity intention, and self-efficacy provided an additional 2.7%. In a reverse step regression, the TPB variables explained an additional 12.2% of physical activity intention. In a multiple regression analysis on physical activity behavior, affective/instrumental attitude, subjective norm, perceived behavioral control (PBC) and intention explained 15.7% of the variance in physical activity behavior while self-efficacy contributed an additional 5.6%. In the reverse step regression, TPB predictors contributed an additional 3.0% in explaining the variance in physical activity behavior.

CONCLUSION

The results indicate that in addition to the TPB, self-efficacy may also play an important role in the prediction of behavior, and should be included in the design of physical activity programs for elderly men of nursing home residents.