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BACKGROUND: The high use of media among adolescents is involved in negative social and health consequences. Therefore, it is critical that adolescents acquire the skills to interact with media content in a healthy way. This study aimed to identify the dimensions and concept of media health literacy (MHL) among adolescents.MATERIALS AND METHODS: In this qualitative study, specialists (n = 19) in the field of health education and promotion, as well as a wide range of activists in the field of media and communication and adolescents (n = 20), who met the inclusion criteria were participated in this study. Participants were recruited by purposive sampling. Exploratory, open-ended, and face-to-face interviews based on the interview guide were used to elicit participants' perspectives from October 2021 to May 2022 in Tehran, Iran. The interviews were analyzed by content analysis using the inductive method and MAXQDA 2020.RESULTS: A total of eight health education and promotion specialists (20.51%), nine media and communication specialists (23.07%), two software and programming instructors (5.12%), and 20 adolescents (51.28%) were included in the study. Analysis of qualitative data led to the identification of five categories (media literacy (ML), health literacy (HL), media reference, interactive communication literacy, and basic literacy (BL)) and 25 subcategories.CONCLUSIONS: Our findings provide a deep understanding of the concept and domains of MHL. Based on the results, MHL can be defined as a set of knowledge and individual skills needed in the fields of ML, HL, interactive communication literacy, media reference, and BL, which help achieve the appropriate state of MHL among adolescents and its improvement. It is hoped that these findings are used to guide the development of interventions for MHL.

BACKGROUND: Skill Training Intervention Based on the Healthy Lifestyle Counselling Module (5As model) in the Ira PEN Program. MATERIALS AND METHODS: This study was a randomized controlled trial in Iran. Participants were 184 health workers and 184 clients (92 in each study group). The training program entailed an online training course, educational video, and clip. The behavior related to a healthy lifestyle in clients was also followed-up 2 months later. Data were analyzed using SPSS 22 software. RESULTS: Based on the observations, significant improvement in lifestyle counseling skills among health workers in the intervention group compared to the control group in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), smoking cessation (P = 0.03), and withdrawal of alcohol consumption (P < 0.001) was observed. Also, lifestyle-related behaviors among clients in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), and withdrawal smoking (P < 0.001) increased significantly. Furthermore, waist circumference (P < 0.024) and BMI (P < 0.001) among clients were significantly reduced. CONCLUSION: The training program for health personnel in healthy lifestyle has a more effective role in changing people's behavior and prevention of noncommunicable risk factors. Healthy life style counselling in primary health cares may lead to control risk factors for Noncommunicable disease.

BACKGROUND AND AIM: Given the complexities of the health care system and the importance of the subject and effects of health literacy in all aspects of care, defining specific health literacy in this context seems necessary. The purpose of this research was to explain the concept of hospital health literacy (HHL), its definition, and the related dimensions using the qualitative research method. MATERIALS AND METHODS: An exploratory qualitative design was used. Exploratory, open-ended, and face-to-face interviews based on the interview guide were used to elicit participants' perspectives between July 2021 and January 2022. By using the content analysis method, researchers coded transcripts and collated these codes into sub-categories and then merged them into the main category and explored the dimensions of the concept. RESULTS: A total of 23 service providers and 25 service recipients were included in the study. Analysis of qualitative data led to the identification of 6 categories and 25 sub-categories including cognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, media literacy, and emotional literacy. CONCLUSION: The findings of the present study provide a deep understanding of the concept of HHL that could be applied to develop valid and reliable measurement tools for assessing HHL among a variety of populations. Also, it is hoped that the present attempt can be useful to guide future research and interventions as well as to provide a clear base for planning, implementing, and evaluating interventions aimed at promoting individuals' health literacy in health settings.

BACKGROUND: During the last two decades, several reports have indicated an increase in the number of type-2 diabetes among adolescents. Therefore, an assessment of adolescents' awareness of this disease deserves serious consideration. This study aims at designing a psychometric tool for assessing adolescents' awareness of type-2 diabetes. METHODS AND MATERIAL: In this methodological research, 770 students attending 10 middle schools (five girls “schools and five boys” schools) from Tehran participated in the study. The questionnaire was designed by examining the relevant literature and the existing questionnaires, as well as considering the research team's comments, and the initial pool of items with 57 questions was designed. Face validity, content validity, and construct validity were calculated to determine the validity of the instrument. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured with Cronbach Alpha. SPSS 16 was used for data analysis. RESULTS: The questionnaire was initially designed with 57 items. Based on the results of CVR and CVI, five questions were removed. The average CVR and CVI were 0.75 and 0.82, respectively. Following exploratory factor analysis, the 30 questions in the questionnaire were categorized into five dimensions: public awareness, symptoms, behavioral risk factors, long-term effects, and medium-term effects. The internal reliability was calculated for the whole questionnaire—ICC = 0.87 with a Cronbach alpha coefficient of 0.80. CONCLUSIONS: The resulting questionnaire on adolescents' awareness of type-2 diabetes, with 30 questions in five dimensions, can be employed by researchers for its high factor loading in factor analysis and its standard psychometric properties.

BACKGROUND: The cancer is uncontrolled growth and spread of cells that affect almost all parts of the body. One of the most prevalent cancers in the female genital system is cervical cancer. The aim of present study was to determine the effect of educational intervention using the Precaution Adoption Process Model (PAPM) on cervical cancer screening behavior (Pap smear test) among women. MATERIALS AND METHODS: In this interventional study that was done in Karaj health centers (2016), women (aged 15-49 years) were in the third stage of behavior change process based on PAPM randomly assigned to experimental and control groups. The data collection tool was a PAPM-based questionnaire whose validity and reliability were confirmed. Gathered data were analyzed using statistical software SPSS 16 and statistical tests (t-test, repeated measures analysis of variance, and Wilcoxon, Chi-squared, Fisher's exact, and Mann-Whitney tests). RESULTS: The result showed that the stages of the decision-making process between the two groups were significantly different at the time immediately and 2 months after the intervention (P > 0.001). Also the results of the intervention based on the health belief model health belief model (HBM) components, regarding variables of knowledge, perceived susceptibility, perceived benefits, perceived barriers, and subjective norms, the mean scores in the experimental group were significantly different between the three sections before, immediately, and 2 months after the intervention (P > 0.001). CONCLUSIONS: This study provides hints how persons could be influenced to move from the “Deciding about action” positions into to the stages of decided to act, adoption, and maintenance for promoting cervical cancer screening behavior.

BACKGROUND: The Iran Package for Essential Noncommunicable Disease (Ira-PEN) program has been established since 2018 with the aim of controlling and caring of noncommunicable diseases (NCDs) as well as their underlying causes in Iran. In this study protocol, a healthy lifestyle module will be used for the first time in Iran, which was recommended in 2018 by the World Health Organization to train health workers. This module relies on the 5As model, a training intervention design, then, implement, evaluate, and present the results to the managers and decision makers of the Ira-PEN program. MATERIALS AND METHODS: This study will be performed in 2 stages, including 2 steps per stage. The first stage involves designing the 2 steps and validation of the healthy lifestyle counseling skills tool. The tool will encompass a health counseling evaluation checklist and a counseling assessment questionnaire according to the counseling recipients. The second stage also entails 2 steps; designing a training program for health workers in the field of healthy lifestyle counseling based on the Oles-Cement model followed by implementation and evaluation. CONCLUSIONS: The training program and the results obtained in this study will be presented to the managers and decision makers of both the Ira-PEN program and NCDs control in Iran, and it is suggested to enhance the training program, network, and educational curriculum of health workers in providing healthy lifestyle counseling to play a more effective role in changing the public behavior toward a healthy lifestyle and preventing the risk factors of NCDs.

BACKGROUND: Healthy nutrition in childhood and adolescence is important for growth and development. Breakfast is the most important meal during a day, and many studies have linked eating breakfast to good health. The aim of the present study was to evaluate the subjective norms and perceived behavioural control of Iranian teenage girls about breakfast consumption and its related factors in 2018. MATERIALS AND METHODS: In this descriptive-analytical study, 320 female students were enrolled using a multistage sampling method. Data were collected using a questionnaire, the validity and reliability of which were evaluated. Data analysis was carried out using SPSS16 software and ANOVA and t independent tests. RESULTS: There was a significant relationship between students' sleep duration and the people with whom they eat breakfast with the Motivation to Comply (P = 0.009), (P = 0.001) and subjective norms (P = 0.004), (P = 0.001) as well as between the people with whom they eat breakfast and normative beliefs (P = 0.05). There was a significant relationship between father's job and control beliefs (P = 0.03) and perceived behavioural control (P = 0.04), between household size with perceived behavioural control (P = 0.05), between sleep duration and perceived power (P < 0.001), and perceived behavioural control (P = 0.03), between the people with whom they eat breakfast with control beliefs (P < 0.001), perceived power (P < 0.001), and perceived behavioural control (P < 0.001). CONCLUSION: Considering the importance of sleep duration for adolescent girls as well as eating breakfast with other family members, health policymakers are recommended to pay special attention to these two factors while designing educational interventions.

BACKGROUND: The phenomenon of Internet addiction has increased due to the delay between Internet technology and the culture of using it. According to the high prevalence of Internet addiction among students and its associated complications, the present study was conducted to determine the effect of education based on the health belief model on Internet addiction status among students in Tehran, Iran. MATERIALS AND METHODS: In this interventional study, two dormitories were divided into two groups of control and intervention in a completely random manner using the random cluster sampling method from a total of eight dormitories. Then 134 girls in each group answer two questionnaires of Young (about Internet addiction) and health belief model-based scale. After the need assessments of the primary results, intervention was performed in the experimental group in a way that a textbook based on the health belief model and ten educational text messages were sent to the students' E-mail. Two months later, questionnaires were again given to both groups. The results were analyzed with the help of independent t-test, Chi-square test, Fisher's exact test, Mann–Whitney test, analysis of covariance, and logistic regression with repetitive measures with GEE approach. RESULTS: The average scores of knowledge (P < 0.001), perceived susceptibility (P < 0.001), perceived severity (P = 0.006), perceived barriers (P < 0.001), and self-efficacy (P = 0.002) between the two groups, had a significant difference after the intervention. The average scores of perceived benefits (P = 0.6), Internet addiction behavior (P = 0.11), and the frequency of Internet addiction (P = 0.63) after intervention did not have a significant difference in the two groups. CONCLUSIONS: The results of this study show the effectiveness of educational intervention design based on the structures of health belief model on reducing the frequency of Internet addiction and adopting preventive behaviors.

BACKGROUND: Approximately one third of the food produced in the world for human consumption was wasted. OBJECTIVES: This study aimed to determine the effect of intervention on behavior of food consumption and waste production in the restaurants of Shahid Beheshti University of Medical Sciences. MATERIALS AND METHODS: In this quasi-experimental study, 233 students of public health school were selected as intervention group, and 233 students of medical school were selected as control group. The food wastage was weighed in both “Sabz” and “Medical” restaurants for a week. Based on training needs of the samples, teaching methods and programs were implemented in the intervention group for a month. The clients of both restaurants were followed 4 weeks after the intervention. The food waste was weighed after 4 weeks. Data were analyzed using SPSS software version 16 and statistical tests (Wilcoxon, Chi-squared, McNemar, and Mann–Whitney tests). RESULTS: The results obtained from Wilcoxon test showed that, the means of awareness, attitude, and behavior were significantly improved after the intervention in the intervention and control groups (P < 0.001). After the intervention, according to the number of served foods, it was expected that the weight of food wastage to be 341.37 kg/week, but this figure was reduced to 224.98 kg/week after the intervention. CONCLUSIONS: This study has confirmed the effectiveness of implementation of interventions on enhancement of knowledge, attitude, and behavior of people about consumption of food and amount of wastage. The authors suggest that to investigate sustainability of effect of intervention on behavior of food consumption and wastage production, this study could be implemented in different and longer time intervals after the end of project.

BACKGROUND: A proper measurement instrument is selected based on the suggested use of the instrument, the target concept of measurement, and features of measurement (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability). Concerning the design and features of measurement, there are not any adequately specific standards for instrumentation to measure oral health literacy (OHL). The present study proposes a protocol that attempts to fill this gap by introducing the psychometrics of a standard questionnaire which measures OHL. MATERIALS AND METHODS: The present research employs a methodological design and is carried out in Tehran, with data collected through interviews that are held face to face. The data collection procedure involves a review of the related literature, cognitive interviews, fuzzy Delphi Method, and focal groups with participants with OHL work experience for item generation. The target participants of this research are the Iranian adult population and experts working professionally in different health domains. For qualitative data analysis, the content analysis strategy and in the instrument Psychometrics COSMIN checklist will use. CONCLUSIONS: Achievement of the present research will be used to evaluate the capability of the Iranian adult population in searching, processing, and deciding on healthcare services. This instrument will focus on evaluating both clinical and nonclinical settings. The present research can vastly improve our knowledge of the state of OHL in the Iranian adult population.

INTRODUCTION: Aging and chronic diseases associated with nutrition are increasing in the world; therefore, access to a tool for assessing nutritional literacy in the elderly is necessary. Therefore, the present study was carried out with the aim of psychometric evaluation of nutritional literacy in the elderly. MATERIALS AND METHODS: This study was carried out to psychometric testing of the Nutrition Literacy Scale (NLS), through the validity and reliability of the tool in 280 elderly people (60 years of age and older) in Tehran. The validity of this tool was determined through the methods of translation, face and content and reliability of the tool through the methods of test–retest and internal consistency. Finally, the tool was analyzed using SPSS software version 16. RESULTS: In this study, content validity index (CVI) was calculated for each item; CVI average was 0.86.5. To determine the reliability of the tool, interclass correlation coefficient was calculated by measuring the instrument's stability, and it was 0.92. Exploratory factor analysis confirmed the existence of six factors in the questionnaire, which was named nutritional information, healthy nutrition, calorie intake, organic foods, saturated fats, and unit size, which explains 43% of the total variance. Furthermore, in the internal consistency assessment, the questionnaire was completed by 280 elderly people, and the Cronbach's α coefficient was 0.80. CONCLUSION: Based on the results obtained in the reliability and validity assessment, NLS in Iranian elderly has a desirable reliability and validity. This questionnaire has been translated into Persian for the first time. The results of this study provide a standard tool for assessing nutritional literacy status in Persian language communities.