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Background: The Iranian National Blood Pressure Measurement Campaign (INBPMC) was conducted all over the country to raise awareness in different groups of people regarding the importance of blood pressure and persuading them to manage their blood pressure. The present research aimed at assessing the process and output of this campaign. Methods: For process evaluation, 31 universities/faculties were selected. Experts from the Ministry of Health and Medical Education assessed the documentation of the campaign implementation using the designed checklist. The output was assessed by including 8274 people and through a telephone survey using the designed instructions. Results: The response rate of the telephone interviews was 82.74% (8274 people). It was found that 79% of the selected groups were aware of the INBPMC. Among them, 64% remembered the messages, 99% of the participants who remembered the messages agreed with those messages, and 89% of the participants who agree with the messages went for a measurement of their blood pressure. In the telephone interviews, 30% of the participants stated that they were diagnosed with hypertension, 97% of these participants received the required consultations for subsequent care, and 86% of them went to the health service centers to receive care. The process evaluation of the INBPMC indicated that the universities of medical sciences obtained 97% of the score of the checklist. Conclusion: The INBPMC was successful and accomplished its objectives.

This study examined effects of a social marketing intervention to encourage people to donate blood in a southwest city of Iran. To design the intervention, the constructs of theory of planned behavior in 170 consistent blood donors were measured. Persuasive messages were developed, and some printed materials were prepared to transfer the message to the target segment. The trend of the percentage of consistent blood donors was measured during the first four months after the intervention. The percentage of consistent blood donors was increased significantly. The findings showed the effectiveness of the social marketing interventions for blood donation.

Coronavirus disease 2019 (COVID-19), is an infectious disease caused by SARS-CoV-2 virus, a newly discovered coronavirus, the best strategy to deal with the infection is prevention aimed at reducing transmission in the community. This article aimed to using effective behavior change strategies are needed to control COVID-19. Social marketing facilitates the acceptance, rejection, modification, abandonment, or maintenance of particular behaviors by groups of individuals, often referred to as the target audience. The six-benchmark criteria for social marketing interventions include Behavior change, Customer research, Audience segmentation Marketing mix, Exchange, Competition. Social marketing can promote healthy behaviors. Perceived benefits of the preventive behaviors can be considered. Besides, media, advertising, and other methods to reach out to the consumers to inform and encourage them should be considered. For this purpose, a slogan and a logo should be designed and installed in all educational interventions and media such as posters, pamphlets, face-to-face training sessions, group discussion sessions, telephone counseling, and videos. Advertising using celebrities covering their faces with masks can persuade people to wear face mask. To promote health behaviors, professionals should pay attention to the segmentation of the target audience before providing any service. All plans should be piloted before implementation. Besides, information sources should be organized, and media that should be used to inform the target audience should be identified.

A reliable and valid tool to assess hearing health literacy in Iranian young people is lacking.This study aimed to develop a tool to assess the hearing health literacy of young people in the Islamic Republic of Iran and to use the tool to determine the hearing health literacy of a sample of Iranians aged 12-25 years.A questionnaire was designed with three skill sections: obtaining health information, evaluating this information and applying it to benefit health. The validity and reliability of the tool were determined. Cluster sampling was used to select 50 urban clusters across the country from which 5000 Iranians aged between 12-25 years old were selected to complete the questionnaire.The final questionnaire had 22 items with scores ranging from 22 to 44. The Cronbach alpha was 0.65, and content validity ratio and index were 0.92 and 0.82, respectively. Of the 5000 questionnaires completed, 4890 were included in the analysis. The mean (standard deviation (SD)) age of the participants was 17 (SD 3) years and 45.9% were males. The mean score on the tool was 30.81 (SD 3.75), indicating inadequate health literacy (score 22-36). Only 137 (2.8%) participants had adequate health literacy (score 37-44). Statistically significant differences in mean hearing health literacy were seen for sex, age, years of education, occupation, marital status and income (P0.05).Given the low level of hearing health literacy in Iranian young people, programmes to improve the ear and hearing health literacy are urgently needed.إعداد واستخدام أداة لقياس مدى الوعي بصحة السمْع في صفوف الشباب بجمهورية إيران الإسلامية.سعيد محموديان، سعيد فرهدي، علي رضا هضاوه، مصطفى مالكي، صديقة شريعتنيا، محسن شمس.لا تتوافر أداة موثوقة وصالحة لتقييم الوعي بصحة السمع في صفوف الشباب الإيراني.هدفت هذه الدراسة إلى إعداد أداة لتقييم مستوى الوعي بصحة السمع لدى فئة الشباب في جمهورية إيران الإسلامية، واستخدام هذه الأداة لتحديد مستوى الوعي بصحة السمع لدى عينة من الإيرانيين الذين تتراوح أعمارهم بين 12 و 25 عاماً.صُمِّم استبيان يتألف من ثلاثة أقسام للمهارات، هي: الحصول على المعلومات الصحية، وتقييم تلك المعلومات، وتطبيقها بما يعود بالنفع على الصحة. وحُددت صلاحية الأداة وموثوقيتها. واستُخدمت عينة عنقودية لاختيار 50 مجموعة حضرية من جميع أنحاء البلاد، واختير من تلك العينة 5000 إيراني تتراوح أعمارهم بين 12 و 25 عاماً لاستكمال الاستبيان.اشتمل الاستبيان الأخير على 22 بنداً تراوحت درجاتها بين 22 و44. وبلغت قيمة ألفا كرونباخ 0.65، وكان معدل صلاحية المحتوى ومؤشره 0.92 و0.82 على التوالي. ومن بين 5000 استبيان مُسْتَكمل، أُدرِجَ 4890 استبياناً في التحليل. وبلغ متوسط عمر المشاركين 17 عاماً (بانحراف معياري يساوي 3) وكان 45.9٪ منهم من الذكور. وكان متوسط الدرجة المحرزة باستخدام الأداة 30.81 (بانحراف معياري يساوي 3.75)، مما يشير إلى عدم كفاية المعلومات الصحية (القياسات 22 – 36) واتضح أن 137 مشاركاً وحسب (2.8٪) لديهم وعي صحي كافٍ (القياسات 37 – 44). وشوهدت فروق ذات دلالة إحصائية في متوسط الوعي بصحة السمع وفقاً للجنس، والسن، وسنوات التعليم، والمهنة، والحالة الاجتماعية، والدخل (0.05P).بالنظر إلى انخفاض مستوى الوعي بصحة السمع في صفوف الشباب الإيراني، فهناك حاجة ماسة إلى وضع برامج لتحسين الوعي بصحة الأذن والسمع.Mise au point et application d’un outil destiné à mesurer les connaissances en santé auditive des jeunes en République islamique d’Iran.Il n’existe pas d’outil fiable et valable pour évaluer les connaissances en matière de santé auditive des jeunes Iraniens.La présente étude avait pour objectif de mettre au point un outil permettant d’évaluer les connaissances en matière de santé auditive des jeunes en République islamique d’Iran et d’utiliser cet outil pour déterminer ces connaissances dans un échantillon d’Iraniens âgés de 12 à 25 ans.Un questionnaire a été conçu avec trois sections de compétences : obtenir des informations sur la santé, évaluer ces informations et les appliquer pour améliorer la santé. La validité et la fiabilité de l’outil ont été déterminées. Un échantillonnage en grappes a été utilisé pour sélectionner 50 grappes urbaines à travers le pays parmi lesquelles 500 Iraniens âgés de 12 à 25 ans ont été choisis pour remplir le questionnaire.Le questionnaire final comportait 22 items avec des scores compris entre 22 et 44. L’alpha de Cronbach était de 0,65 ; le ratio et l’indice de validité du contenu étaient respectivement de 0,92 et 0,82. Sur les 5000 questionnaires remplis, 4890 ont été inclus dans l’analyse. L’âge moyen (écart type (ET)) des participants était de 17 ans (ET 3) et 45,9 % étaient des hommes. Le score moyen pour l’outil était de 30,81 (ET 3,75), signe d’une littératie en santé insuffisante (score 22 à 36). Seuls 137 (2,8 %) des participants possédaient une littératie en santé adéquate (score 37-44). Des différences statistiquement significatives dans les connaissances moyennes en matière de santé auditive ont été observées eu égard au sexe, à l’âge, aux années d’études, à la profession, au statut marital et aux revenus (p0,05).Étant donné le faible niveau de connaissances en santé auditive des jeunes Iraniens, des programmes visant à améliorer ce domaine sont nécessaires de toute urgence.

With the lack of social supports, divorce has many negative psychological impacts on women. This study aimed at determining the social support in divorced women in Iran. In this cross-sectional sur...

Introduction: Teachers, by creating a culture of health within their classrooms, are agents of change and have an important role during students’ formative years. This study aimed to investigate the effect of an educational intervention on the nutrition literacy of primary school teachers in Yasuj. Methods: In this quasiexperimental study, 110 primary school teachers in Yasuj, who were randomly selected from two areas of the city (intervention and comparison groups), were included in the study. Nutrition literacy was measured by using a validated tool for the Iranian society. After analysing the data, the educational content and structure were developed to improve nutrition literacy. The intervention consisted of two training sessions, provision of educational pamphlets and sending of two SMS messages. Data were analysed before and three months after the intervention by using SPSS16 software. Results: Before the intervention, the mean ± standard deviation of nutrition literacy in the comparison and intervention groups were 27.04±3.15 and 27.25±3.27, respectively. According to repeated measures ANOVA, nutrition literacy score improved significantly three months after the intervention (p time = 0.001). Besides, there was a significant difference between the two groups (p group = 0.03). The interaction between time and group was also significant (p time × group = 0.001). Conclusion: The educational intervention led to an improvement in the nutrition literacy of primary school teachers in Yasuj.

The Polycyclic Aromatic Hydrocarbons (PAHs) bound to ambient fine Particular Matter (PMThe online version contains supplementary material available at 10.1007/s40201-022-00821-2.

Road traffic crashes are among the leading causes of death and disability in the world, particularly in low and middle-income countries. This study aimed at to conduct a social marketing formative research to inform the development of a campaign to manage driving speed on the intercity roads of Iran.To carry out the social marketing formative research, a qualitative and quantitative study were conducted. Also, a literature review of the speed management strategies was carried out and an analysis of traffic accident data and speeding violations was performed in selected provinces during 2019 and 2020.Based on the findings of the qualitative study, perceived sense of lack of speed control, poor monitoring system, and law enforcement are the main reasons drivers exceed the speed limit. They mostly suggest using punitive levers and more stringent law enforcement practices for speed management. Literature reviews also confirm that to successfully develop an effective speed management plan a set of measures should be implemented together, including road safety engineering, raising awareness, social marketing strategies, and finally strict law enforcement. The overriding findings of the formative research revealed that to persuade Iranian drivers to respect the speed limit, the messages of the campaign should focus on strict law enforcement in the selected corridors.In the minds of the Iranian audience, strict law enforcement is of paramount importance for a speed management strategy to work; hence it should be taken into consideration when tailoring the campaign messages. From the findings of the present study, it can be concluded that to manage speed on intercity routes in Iran, a social marketing campaign is needed to encourage compliance with speed limits.

PURPOSE This study aims to compare the effectiveness of uphill walking and physical therapy versus physical therapy alone on knee pain, excursion ranges, stride length, and walking speed in individuals with knee osteoarthritis. METHODS In this randomized clinical trial, 30 patients with knee osteoarthritis participated. Both control and intervention groups received 10-session physical therapy. Moreover, the intervention group received an 8-degree treadmill walking at a speed of 1.1 m/s for 30 min in each session. Outcome measures, including pain, excursion ranges, stride length, and walking speed, were measured at baseline, post-treatment, and a 20-day follow-up. RESULTS Significant improvements in stride length and walking speed were observed just in the intervention group from baseline to post-treatment (p ≤ 0.001) and from baseline to follow-up (p ≤ 0.001). Furthermore, significant improvement in excursion ranges was observed just in the intervention group from baseline to follow-up (p

Introduction: Self-medication is one of the challenging health issues among women throughout the world and Iran. Considering the main role of mothers in promoting health within the families, women play a key role in this regard. This study aimed at determining the effect of an educational intervention based on the Health Belief Model (HBM) to change the women's self-medication behavior about consuming Prescription-Only Medicines (POM) in Yasuj City, Iran. Methods: This quasi-experimental study was conducted with a pre-test/post-test design over 192 women under the coverage of urban healthcare centers. These participants were selected by random sampling method and divided into the intervention and control groups. After measuring the constructs of HBM, a tailored intervention was designed and implemented in four weeks. The intervention program consisted of instructional sessions, pamphlet delivery, and short messages (SMS). After three months, educational contends were reevaluated and the results were compared with the pre-intervention data for both groups. Results: No significant difference was observed between the interventional and control groups before and after the intervention (p> 0.05). Comparison of the data collected from the questionnaires administered before and three months after the intervention showed a significant difference between the two groups regarding the perceived susceptibility construct (P = 0.001). Conclusion: Based on the results, the HBM was effective in changing women's self-medication behavior considering the prescription-only medicines. Self-medication can be reduced by increasing the women's perceived susceptibility to medication.

Purpose: This study aimed to compare the effectiveness of physiotherapy with uphill walking versus physiotherapy alone on the disability of patients with knee osteoarthritis. Methods: This study was a randomized clinical trial carried out on 30 patients (5 males and 25 females) with moderate knee osteoarthritis aged between 40 and 65 years. They were assigned to the intervention and control groups. Both groups received 10-session routine physiotherapy, and the intervention group received an 8-degree treadmill walking at a speed of 1.1m/s for 30 minutes in each session. The participants’ disability was measured before, immediately after, and 20 days after the 10-session treatment by the Persian version of Knee injury and Osteoarthritis Outcome Score (KOOS). The data were analyzed through the repeated measures analysis of variance in SPSS V. 22. The significant level was set at 0.05. Results: Statistical analysis showed significant improvements in the activity of daily living (P≤0.01) and quality of life (P

Background: Sexuality education is one of the most important educational needs for adolescents. Parents play a significant role in shaping sexuality health in adolescents. There is little evidence in Iran about sexuality education for empowering adolescences. Objectives: This study aimed at developing, implementing, and evaluating a training program for mothers to educate sexuality matters to their adolescent girls in Mahshahr, Iran. Materials and Methods: This field trial was conducted among 140 mothers with 12- to 18-year-old adolescent girls in Mahshahr. The multi-stratified sampling method was performed for determining the study participants. Data was collected by using “Parent-Child Relationship: Mother” and “Knowledge and Attitude About Sexuality Education to Adolescents” questionnaires. Based on the baseline results, an educational intervention for mothers was designed and implemented. Data were collected, analyzed, and compared before and three months after the intervention implementation. Means and standard deviations were calculated, and statistical analysis was performed using a paired t-test. A confidence interval of 95% with significance at P < 0.05 was used. Results: Compared with the pre-intervention phase, mothers’ awareness of sexual issues significantly increased from 30.00 to 36.50 (P < 0.001). While the mean score of attitudes towards sexuality education significantly increased from 46.65 to 48.57 (P < 0.001), no significant difference was observed between mothers’ communication skills before and after the educational intervention (P = 0.98). Conclusions: The designed educational program was an effective tool to improve the knowledge and attitudes toward sexuality matters in mothers. Thus, continuous and regular programs are required to improve communication skills in mothers.

Self-medication is a serious health problem in Iran. In this quasi-experimental study with a control group, four healthcare facilities were selected and divided into intervention and control groups. Based on the health files of women in healthcare facilities, 192 women were selected randomly and completed a self-reported questionnaire to measure Health Belief Model constructs and self-medication. After analyzing the data, perceived susceptibility was found as the main predictive factor for self-medication, and an intervention was developed to increase it. The intervention consisted of lectures and group discussions, along with distributing pamphlets and sending short messages for four weeks. Three months later, the data was collected again and analyzed. Perceived susceptibility was improved, and self-reported behavior was reduced significantly in intervention groups compared to the control groups.

Background Iran has a low incidence but higher rate of death from cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies show high dropout in continued testing among eligible women. This qualitative study aimed to explore women’s awareness regarding CC and CC testing and the role of knowledge, perceived risk, and cues to action in this process. Method Through a qualitative study based on the Framework Method, we recruited 81 women aged 25–65 who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran. The interviewees were selected purposefully during January to May 2015 from households belonging to different socioeconomic classes until data saturation. The data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%). Results The coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action, and perceived risks regarding CC and screening. The results showed that women had limited and unspecified knowledge about CC and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients and within communities on subjects related to CC and screening. The perceived risk of getting CC was low because of overestimating the role of hereditary factors for CC, difficulty in differentiating between cancer and sexually transmitted infections (STI), and the absence of visible symptoms. Conclusion The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women’s social environment in order to prevent misconceptions being communicated to women.

Introduction. In Iran, the rate of cesarean section is three times more than the acceptable rate considered by the World Health Organization. This study aimed at reducing the selection of cesarean section by primigravida through an intervention based on social marketing in Boyer-Ahmad County, Iran, 2015. Methods. In this field trial, 39 of primigravida women were identified and selected as a target group. Formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix. The tailored intervention was developed based on the findings of formative research. The intervention was implemented for one month for pregnant women who had cesarean section intention. Their intention for the cesarean section was studied again one month after the implementation of the intervention. The effectiveness of the intervention was evaluated by the proportion test. Results. The average age of the women was 25.82. All of the women 38.5 percent had a diploma degree and lower than and 61.5 percent had a university degree. Before the intervention, 39 women intended to do Cesarean. The intention of 30 pregnant women was changed significantly one month after the intervention. Conclusion. The study showed the effectiveness of an intervention based on consumer-oriented social marketing theory and could be used to reduce Cesarean intention. More studies about related factors of vaginal delivery selection especially from behavioral intention up to behavior are suggested.

Introduction: Although performing cesarean section in specific condition can save life of mother and neonate, but has considerable complications. Reducing cesarean among primigravida is one of the best strategies to reduce cesarean. Therefore, this study was performed with aim to develop a tailored intervention to promote normal vaginal delivery (NVD) among primigravida women. Methods: This formative research was done to develop an intervention based on assessment tools pattern and social marketing response to reduce cesarean section among primigravida women in Boyer-Ahmad city in 2015. The qualitative data were collected through individual interviews and focused group discussions. The quantitative data were collected by a questionnaire based on the constructs of Theory of Planned Behavior. Data was analyzed by SPSS software (version 16). The qualitative data were analyzed by content analysis method as manual and the quantitative data by routine descriptive statistics, logistic regression, Chi-Square and Mann-Whitney tests. Results: In qualitative part, the most important barriers for selecting NVD were: maternity being unpleasant, fear, others' recommendations, and negative experiences of referring to maternity and low level of knowledge among women. The main interventions recommended for increasing NVD were: education, counseling, making the process of NVD more pleasant. In the quantitative survey, we found that 25.2 of the women were intended to do cesarean. In quantitative part, 39 women (25.2) had intention to perform cesarean section. The median and interquartile range of attitude was 18±4, subjective norms 16.5±3, and perceived control behavior 16±3. Attitude, subjective norms, place of residence, and the spouse's job were the main predictors in selecting the mode of delivery. Conclusion: To design an effective tailored intervention to promote NVD among primigravida women, their wants and needs should be considered. Education, offering telephone counseling, and implement of brief interventions by physicians and midwives in health centers are the main elements of the tailored intervention.

Introduction: Sexuality education is one of the most important educational needs for adolescents, and mothers may have the key role in educating these issues to their daughters. This study aimed at developing, implementing and evaluating of a training program for mothers to educate sexuality matters to their adolescent girls in Mahshahr, Iran. Methods: This field trial was conducted on 140 mothers having 12 to18-year girls from September to March 2012. Data was collected by two validated questionnaires. The first one assessed the “Parent-Child Relationship: Mother" questionnaire which indirectly measures the level of communication skills for mothers completed by the girls, and the second one measured "Knowledge and attitude about sexuality education to adolescents" questionnaire completed for mothers. Based on the results, an educational intervention for mothers consisted of three training sessions was designed and established. Before and three-month later data were analyzed and compared. Results: Three months after the intervention, the mean scores of mothers’ knowledge and attitude scores toward sexuality matters, was increased significantly (P

Background and aim In social marketing, at the center of the program is consumer perception. The objective of this study was to explore the viewpoints of Iranian women for tailoring interventions so as to increase physical activity. Methods The social marketing model served as the framework of the study. Qualitative data were collected via six semi-structured focus group discussions (FGDs), in 2014 in Iran. Participants were 51 women, 20 to 60 years old, selected by purposive sampling, with a maximum diversity. Qualitative content analysis of the data was conducted by researchers. Results After data analysis and extracting initial codes, they were all categorized in four predefined categories of social marketing model (product, price, place and promotion) and related sub-categories. Most of the participants were inactive. Price was addressed by women as the dominant category of this study. The majority of participants emphasized the benefits of prevention of chronic diseases, fitness, staying young, and improving family relations. Most women preferred to do physical activity in a secure and enclosed female environment. And the majority of participants considered radio, television, face to face training, texting, and advertising billboards as promotional strategies. Conclusion This study provides a unique insight into consumers' values and motivations that affect consumers' decisions to adopt physical activity, in Iran. It could also help researchers to design and implement intervention programs to increase physical activity.

Background and Purpose: The World Health Organization declared violence against women a top priority for health and emphasized the importance of the world's attention to the prevention and control programs. This study was conducted aimed to identify the training needs of married women referring to health centers in Ahvaz with the objective of enabling the design of a program to prevent violence. Methodology: This sectional study consisted of two qualitative and quantitative studies. In qualitative study, the opinions of 30 married women residing in Ahvaz were collected and analyzed in four focus group discussions. using a validated and reliable questionnaire, the knowledge, attitude, self-efficacy and performance of 320 married women in area of domestic violence were identified Findings: 79% of the women surveyed had adequate awareness about violence against women. 34% of the target group in the field of domestic violence against women has had the right attitude and more than 80% of them stated that violence by men is considered inevitable and natural. 89% of the target group expressed lack of efficacy for the prevention of domestic violence against women. The findings also suggest that there is significant relationship between education and early marriage with violent behavior. Conclusion: providing proper education and awareness to women and group discussion and clarification in order to change attitudes and increase efficacy in abused women against domestic violence are the necessary strategies which result in changing attitudes of women and increasing empowerment of women against domestic violence.

Background Iran has a low incidence of, but a higher rate of death from, cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies show high drop-out in continued testing among eligible women. This qualitative study aimed to explore women’s awareness regarding CC and CC testing, and the role of knowledge, perceived risk and cues to action in this process. Methods We recruited 81 women aged between 25-65 years, who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran, the capital of Iran. Data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%). Results Coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action and perceived risks regarding cervical cancer and screening. Results showed that women had inadequate and unspecified knowledge about cervical cancer and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients, and within communities on subjects related to cervical cancer and screening. Perceived risk of getting CC was low due to insufficient knowledge regarding the causes of cancer, difficulty in differentiating between cancer and sexually transmitted infections, and the absence of visible symptoms. Conclusions The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC, through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women’s social environment in order to prevent misconceptions being communicated to women.

Marketing, besides education and enforcement, is a strategy to change behaviors. The most important question for commercial marketers is: "What can we do to persuade people to buy our products?" They try to use commercial marketing principles such as exchange theory, consumer orientation, competition, audience segmentation, and marketing mix, to influence customers and sell their products and services. Health is considered as an important market, and people have to pay tangible and intangible costs to buy health products, services, and behaviors. So, health professionals must know about marketing key concepts and designing programs to promote health products and changing health behavior. "Social marketing" is an approach to persuade people to accept ideas and attitudes, perform healthy behaviors, refer to health facilities, and receive health products. In this chapter, the theoretical considerations and practical steps for planning, implementing, and evaluating the interventions based on the social marketing approach will be discussed. At the end of the chapter, we will study four researches designed and implemented based on the social marketing model.

To determine the effect of an educational program based on the PRECEDE model to improve sexual function among women with hysterectomy.The present randomized trial, conducted in Iran during 2014, included 48 women with hysterectomy who were selected through convenience sampling and randomly divided into two equal groups. Women in the experimental group received an educational program based on constructs of the PRECEDE model. The control group received only routine interventions. Before the interventions, the women completed two questionnaires: one that measured the PRECEDE model constructs and the Rosen Female Sexual Function Index. The questionnaires were repeated 4 weeks after the intervention and the results were compared within and between groups.In each group, a significant improvement in sexual function was demonstrated after the intervention (P0.001). The mean sexual function score increased to a greater extent in the experimental group (difference 16.95±6.33) than in the control group (difference 4.35±1.94; P0.001).The findings confirm the effectiveness of an educational program based on the PRECEDE model in terms of improving sexual function among women with hysterectomy. Iranian Registry of Clinical Trials: IRCT2014122220401N1.

To study the effects of an intervention based on social marketing to persuade workers to use personal protective equipment (PPE) in constructing subway stations in Isfahan, Iran. This was a quasi-experimental study. Two stations were selected as intervention and control groups. Intervention was designed based on results of a formative research. A free package containing a safety helmet with a tailored message affixed to it, mask and gloves and an educational pamphlet was delivered to the intervention group. After 6 weeks, behaviours in the intervention and control stations were measured using an observational checklist. After the intervention, the percentage of workers who used PPE at the intervention station increased significantly. OR for helmet and mask usage was 7.009 and 2.235, respectively, in the intervention group. Social marketing can be used to persuade workers to use PPE in the workplace.

Background: Theory of planned behavior (TPB) has not been adequately addressed in the field of physical activity among Iranian women. Objectives: This study aimed to determine factors affecting physical activity behavior among women based on the theory of planned behavior. Methods: This cross-sectional study was conducted on 398 women in Kerman, Iran. The women were selected through the multi-stage random sampling method. Data were collected using the international physical activity questionnaire (IPAQ) and a researcher-made questionnaire based on the constructs of the theory of planned behavior and analyzed using structural equation modeling (SEM). Results: The mean age (SD) of participants was 36.9 (9.9). Perceived behavioral control (β = 0. 16, P = 0. 013) and behavioral intention (β = 0.16, P = 0.005) had a significant positive direct effect on physical activity behavior. Moreover, instrumental attitude (β = 0.04, P = 0.003), subjective norms (β = 0.04, P = 0.003) and perceived behavioral control (β = 0.03, P = 0.002) had a significant positive indirect effect on physical activity behavior. Behavioral intention and perceived behavioral control constructs predicted 6% of variance of physical activity behavior. Conclusions: Given that the constructs of behavioral intention and perceived behavioral control could predict physical activity behavior, health promotion interventions should be designed with an emphasis on these factors in order to promote physical activity in women.

Background Despite recommendations, many middle-age adults neglect to check their blood cholesterol levels. Short message service (SMS, also known as texting) has been seldom studied for preventive education. We estimated how SMS can be a cost-effective method in encouraging people to check their blood cholesterol levels. Methods In a field trial, 3600 cell phone users (age > 30) were randomly assigned to the intervention (N: 1200) and the control groups (N: 2400). An SMS was sent to the intervention group for five rounds every two weeks, which targeted the cognitive and affective learning and finally advised the blood cholesterol level to be checked, if not checked during the past twelve months. Two weeks after the last round, both groups were asked for the time/level of their latest blood cholesterol, family history of early cardiac death and having a family member with coronary heart disease (CHD), and to report their attitude about whether annual blood sampling is worth the cost and time to prevent CHD. Moreover, the intervention group was asked if they remembered the SMS content. The cost-effectiveness was evaluated by estimating the “number needed to treat” (NNT) and calculating the cost of sending SMS to that number of people. Results In the intervention group, 629 individuals (72.0%) recalled the SMS content. The factors associated with cholesterol screening during the past two years were older age, diabetes, family history of coronary disease, higher education, female gender and being non-smoker. In both groups, women were significantly more aware of their blood cholesterol level (68.7% vs. 53.6%). The relative frequency of respondents who believed it was not worth checking their cholesterol annually was significantly lower in the intervention group (P

Background Given that mothers play a role in the sexual education of their daughters, it is important to understand their views of sexual health and related programs. This study was aimed at exploring mothers’ perspectives regarding sexual health education for their adolescent daughters in Mahshahr, Iran. Methods In this qualitative study, in-depth interviews with ten key informants and five focus group discussions involving 28 mothers with daughters aged 12–18 were conducted. All the discussions were audio-recorded and later transcribed. The data were classified, after which the main themes and sub-themes were manually extracted and analyzed. Results The five main themes determined were: the necessity of sexual health education for adolescent girls, the sources of information that mothers use, barriers to sexual health education, the need to empower mothers to provide sexual education to their daughters, and recommendations for developing special training programs for mothers. Most participants believed in limiting sexual health education for adolescent girls; nevertheless, they stated that trained mothers were best equipped to educate their daughters. The major barriers identified by the mothers were their own insufficient knowledge about sexual issues, embarrassment surrounding discussions of this issue with their daughters, fear of the arrogance and curiosity of girls, and a lack of skills for effective communication. Conclusion The results showed that empowering mothers to provide sexual health education is important. Tailored educational programs, based on mothers’ views, should be developed and implemented.

Cervical cancer is the fourth common cancer among women worldwide. Pap smear screening has resulted in deceasing incidence of cervical cancer in developed countries but low uptake of Pap smear screening among women in developing countries is still a public health challenge. The aim of this cross-sectional study was to assess the relationship between self-efficacy and timely uptake of Pap smear among Iranian women. A total of 580 married women referred to primary health care centers covered administratively by Shahid Beheshti University of Medical Sciences in Tehran were administered a questionnaire by trained staff. Data were analyzed with SPSS (version 16) software, using univariate and multivariate logistic regression. The mean age for participants was 33.1±8.8 years. There was a significant association between self-efficacy and Pap smear screening (P