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Background: Hypertension is a crucial general health issue. Severe and acute hypertension needs urgent medical intervention. Self-care behaviors can help patients with hypertension in controlling blood pressure and preventing hypertensive emergencies. This study aimed to determine the perception of hypertension towards self-care behaviors using constructs of the theory of planned behavior (TPB) in critically ill patients with hypertension to prevent hypertensive emergencies.

Background: The present study aimed to determine the effect of an intervention based on Pender's health promotion model (HPM) on treatment adherence in patients with type 2 diabetes (T2D). Methods: The present quasi-experimental study with a 3-month follow-up was conducted in Bandar Abbas, a city in the south of Iran in 2023. The intervention group (IG) with a total number of 95 T2D patients was selected from Hormuz diabetes clinic and the control group (CG) with 95 T2D patients was selected from comprehensive health centers through a clustering sampling method. The educational intervention was implemented in 10 sessions to improve patients' treatment adherence. The teaching methods in training sessions were lectures, joint discussions, Q&A, role-play and peer training. The participants were evaluated using a researcher-made questionnaire including the constructs of Pender's HPM about T2D treatment adherence, hemoglobin A1C (HbA1C), and BMI. Independent-samples t-test, paired-samples t-test, covariance analysis and stepwise regression analysis were used. Data analysis was done in SPSS 26. Findings: Three months after the intervention, in comparison to the CG, the mean and standard deviation of treatment adherence benefits (p = 0.002), treatment adherence self-efficacy (p = 0.010), treatment adherence related affect (p = 0.001), interpersonal influences (p = 0.012), commitment to plan of action (p < 0.001), treatment adherence behavior (p = 0.022), treatment adherence experiences (p = 0.001) was higher in the IG. The mean and standard deviation of situational influences (p < 0.001), immediate competing demands and preferences (p = 0.018) were lower than the CG. The results obtained from the analysis of covariance proved the effectiveness of the intervention in the constructs of Pender's HPM and HbA1C in participants of the IG (p < 0.001). The regression analysis showed, after the intervention, for every 1 unit of change in commitment to behavior planning, action related affect and perceived self-efficacy, compared to before the intervention, there were 0.22 units, 0.16 units and 0.26 units of change in the behavior score in the IG. Conclusion: The findings proved the effectiveness of the educational intervention in improving the constructs in Pender's HPM and the blood sugar level of T2D patients. As the results of the educational intervention showed, the use of a suitable educational approach as well as the development of appropriate educational content for the target population can significantly improve the treatment adherence behavior. Trial registration: This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1: https://www.irct.ir/trial/61741) and first release date of 17th March 2022. [ABSTRACT FROM AUTHOR]

Hookah smoking does not only transmit COVID-19 but also intensifies the symptoms of the disease. Thus, the present research aimed to explore the association between COVID-19 and hookah cessation among female smokers. The institutional-based cross-sectional study was conducted nine months after the onset of the COVID-19 pandemic. Face-to-face interviews were held between November 2020 and January 2021 to explore the pattern of hookah smoking among 561 female hookah smokers in Bandar Abbas in the south of Iran. The daily, weekly and monthly rates of hookah smoking showed a statistically significant decrease in the during COVID-19 era (p <.001). Thirteen percent of women managed to cease hookah smoking successfully during the pandemic. The odds ratio of hookah cessation was higher in single women (95% CI 1.09-5.23) as well as women with a high socioeconomic status (SES) (95% CI 4.28-24.01). It was also higher among women who initiated hookah smoking at an older age (95% CI 29-68) and among those with no hookah smoking family member (95% CI 301- 943). Fear of COVID-19 infection was the leading factor involved in hookah cessation or reduction. Entertainment was the leading barrier to successful hookah cessation behavior. It is believed that COVID-19 has directly and indirectly contributed to the reduced or ceased hookah smoking behavior. One of the reasons for the reduction of hookah smoking was the fear of aggravated symptoms and reasons for cessation included closure of coffee shops and removal of all hookahs from the city. [ABSTRACT FROM AUTHOR]

Background and Aims: Coronary artery disease (CAD) is the most common cardiovascular disease worldwide. Nutrition and physical activity are recognized as the major lifestyle‐related behaviors to reduce the risk of noncommunicable diseases. It is essential to explain personal cognitive factors to identify potential ways to increase physical activity and improve nutritional behavior. Therefore, the present study aimed to explain the personal cognitive factors affecting physical activity and nutritional behavior in the middle‐aged population at risk of a CAD. Methods: The present qualitative study was conducted with a directed content analysis approach. A purposive sampling was used with maximum variety of sex, age, education, marital status, job, and risk factors of CAD. The data were collected through semistructured interviews with 20 middle‐aged participants at the risk of CAD visiting comprehensive health centers in Bandar Abbas city. The interviews continued until data saturation. Results: The present findings led to the identification of 4 main categories (i.e., self‐efficacy, collective efficacy, outcome expectations, knowledge) and 10 subcategories. Conclusion: It seems that to increase the self‐efficacy, attention should be paid to individuals' past experiences, self‐efficacy of action and maintenance and successful middle‐aged peers. Measures should be taken to improve and strengthen it. Peer support, networking, forming online groups (in social networks), and a comprehensive use of social media can help increase collective efficacy. Expectations of positive and negative outcomes and the public knowledge can also be modified through accurate and appropriate information provided in different campaigns for awareness‐raising. [ABSTRACT FROM AUTHOR]

Background and Aims: The human immunodeficiency virus (HIV) infection, also known as acquired immunodeficiency syndrome (AIDS), is spreading rapidly in the world, especially in developing countries, and is considered a serious health threat. This study aimed to assess the relationship of adherence antiretroviral therapy (ART) and self‐efficacy among people living with HIV. Methods: This cross‐sectional study was conducted in March–July 2022 at the Center for Behavioral Diseases in Bandar Abbas. A total number of 208 HIV patients treated with ART entered the study after voluntarily signing an informed letter of consent. The data collection instrument was the adherence to ART questionnaire with the six subscales and the General Self‐Efficacy Scale‐17 (GSE‐17) general self‐efficacy questionnaire. Multivariate regression analysis was used to test the relationship among the variables. Results: The participants' mean age was 41.7 ± 8.2 years. Self‐efficacy was positively correlated with adherence ART. With every one score of increased self‐efficacy, MA increased for 0.85 score (p < 0.001) and medical challenges have the strongest correlation (r = 0.27) with self‐efficacy. The multivariable regression analysis showed that moderate and high socioeconomic status (SES) each improved MA for 18 and 22 units, respectively, compared to poor SES. Alcohol consumption reduced MA for 11 units. Conclusion: This study proved the positive relationship of self‐efficacy in adherence to ART in HIV patients. The insights offered by this research can help develop a systematic and effective intervention to promote MA in HIV patients. SES and alcohol consumption significantly affect MA. [ABSTRACT FROM AUTHOR]

Adherence to the treatment of type 2 diabetes (T2D), which includes the use of prescribed drugs, following a healthy diet, and adopting a physically active lifestyle, is important to control the disease and improve the patients' quality of life. The present study aimed to explain the determinants of adherence to treatment in patients with T2D based on Pender's Health Promotion Model (HPM). The present research used a qualitative content analysis and was based on Pender's HPM. The data were collected through in-depth semi-structured interviews with 20 T2D patients using a purposive sampling in Bandar Abbas, southern Iran. Maximum variation was considered in terms of gender, age, history of diabetes, type of drug used, education, and occupation. The data collection continued until data saturation. At the same time, the collected data were analyzed using the directed content analysis. MAXQDA 10 was used to manage codes and facilitate data analysis. The data analysis led to the extraction of 10 categories and 19 subcategories as the determinants of adherence to the treatment of T2D patients. The participants shared their experiences about personal characteristics and their ecological environment, specific cognition and emotions, and the behavioral results and experience as the determinants of adherence to T2D treatment. The categories extracted from this study in the form of HPM constructs provided a framework to explain treatment adherence. This information can help policy makers and planners in designing future programs. [ABSTRACT FROM AUTHOR]

Background: Avoiding smoking behavior is an important area of focus for health care professionals because of the destructive consequences of tobacco use. The present research aimed to explore the predictors of cigarette smoking preventive behaviors according to an extended parallel process model (EPPM). Methods: This analysis was done among 343 medical sciences students. A linear and multivariate regression analysis and structural equation modeling (SEM) were used to examine the relationship between model structures and preventive smoking behaviors. Data were collected using a 3-part questionnaire, including demographic information, awareness, EPPM structures. Results: According to SEM results, EPPM predicted 68% of the behavioral changes. SEM showed all model constructs have a significant relationship to smoking-preventive behaviors; the perceived susceptibility to smoking is influenced by perceived self-efficacy and perceived response efficacy is a stronger predictor of behavior. Conclusion: The present findings can raise awareness of the main predictors of cigarette smoking among university students. EPPM can be a useful instrument for health policy-makers and can act as the theoretical background for behavior assessment, reduction or prevention of cigarette smoking. It can probably be used as a guideline for developing effective standards and strategies or goal-oriented interventions to cut down on the rate of cigarette smoking. [ABSTRACT FROM AUTHOR]

This research explored factors associated with knowledge, attitude and practice of hookah smoking cessation during the Covid-19 pandemic. The participants were 650 women over 15. The data were collected by face-to-face interviews and structured questionnaires in multi-stage sampling. The results showed 63.5%, 56.3%, and 34.8% of the participants had a good knowledge, positive attitude, and a good practice. The age below 20 (AOR=1.134), college education (AOR=13.227), good economic status (AOR=2.153), holding a job (AOR=1.299), initiation age of hookah use>30years (AOR=3.956) were significantly associated with good knowledge. College education (AOR=1.215), and the initiation age of >30years (AOR= 1.350) were significantly associated with positive attitude. Besides, the initiation age of >30years, (AOR=2.513), history of HS< 5 years (AOR=1.884), no history of HS in family (AOR=1.678), the mere use of fruit tobacco, (AOR=2.131), good knowledge (AOR=9.264) and positive attitude (AOR=2.641) were significantly correlated with a good practice Based on the results, besides knowledge and attitude, a set of influential internal and external factors should be considered to eliminate HS habit during the pandemic. COVID-19: Coronavirus Disease-2019, HS: hookah smoking, HSC: hookah smoking cessation, TU: tobacco use, SES: socio-economic-status [ABSTRACT FROM AUTHOR]

Background: Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). Methods: This cross-sectional analytical study was conducted in 2021–2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. Results: With an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively. Conclusions: The present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women. [ABSTRACT FROM AUTHOR]