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Abstract Background This study addresses the determination of educational intervention—based on the Theory of Planned Behavior (TPB)—effectiveness on continued breastfeeding among Iranian mothers attending health centers, considering low researchers’ attention to the continued breastfeeding index despite its important impact on children’s health. Methods The present study was conducted among 230 mothers with exclusively breastfed infant (115 in the intervention group and 115 in the control group). Sampling starts with randomly selecting 12 health centers among all health centers in Karaj, Alborz province, and allocating them randomly into two equal groups of intervention and control. A study-specific questionnaire, designed in alignment with TPB, was the primary data collection tool. The intervention group received peer education, and optional additional education through a social network. Data were collected in 4 stages, including before the intervention, immediately, 3 months, and 6 months after the intervention. Data were analyzed using SPSS-16 and Independent t-test, Chi-square RMANOVA, ANCOVA, Cochran and McNemar tests. Results There was a significant increase in the mean scores of attitude, subjective norms and perceived behavioral control constructs in the intervention group and a significant decrease of those constructs was observed in the control group (p 0.05). There was also a significant decrease in breastfeeding and an increase in the usage of powdered milk in mothers of the control group (p

Abstract Background and aim Given the rapid technological advancements and increased usage of digital tools, understanding older people's attitudes toward technology is vital. Assessing their views can help identify barriers and facilitators to adoption. This understanding is essential for developing effective educational strategies and user-friendly technologies that enhance seniors' quality of life. Therefore, the present study aimed to psychometrically evaluate the scale for measuring attitudes—both willingness and anxiety—toward technology (TechPH) in Iranian older adults. Methods This methodological study was conducted on 420 older individuals (aged 60 and above) in Tehran in 2024 to perform a psychometric test of the attitudes toward technology scale (TechPH). Validation was carried out using translation validity methods, including translation-back translation with bilingual experts (n = 2), face validity with a sample of the older population (n = 10), content validity with a panel of 11 experts, and construct validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) (n = 420). Instrument reliability was determined through test–retest and internal consistency (Cronbach's alpha) methods with a sample of older individuals (n = 30). Data analysis was performed using SPSS version 16 and EQS 6.4 software. Results A comparison of Persian and English translations revealed acceptable translation validity and cultural adaptability for the scale. Each item's Content Validity Index (CVI) and Content Validity Ratio (CVR) were determined, with a total average CVI of 0.95. The results of EFA indicated that the sample size was adequate, as shown by the KMO value of 0.754. Additionally, Bartlett's sphericity test demonstrated a significant correlation between the items (χ2 = 221.819, df = 15, P

Background: It is necessary to enhance understanding and attitudes towards puberty and reproductive health within the framework of the culture and beliefs of the community. The aim of this study was to investigate the effect of school-based education compared with family-based education on puberty health behaviors in teenage girls.Methods: In 2018, an experimental field study was conducted on 272 high school girl students who were selected through multi-stage sampling method. A questionnaire was used for collecting the data. Face and content validity of the questionnaire was determined by nine health and fertility education experts. Content validity ratio and index were calculated by Lawshe and Walts and Basel methods. The test-retest method and Cronbach’s alpha coefficient were used for checking the reliability of the questionnaire. The Cronbach’s alpha for knowledge, attitude and behavior was 0.81, 0.92, and 0.73, respectively; also, ICC for all questions was 0.81. The students completed the questionnaire in two stages. Interventions were conducted for mothers, teachers and students through lecture and group discussion. The collected data were analyzed using SPSS version 16. Chi-Square, Paired T-test, ANOVA and ANCOVA were used for data analysis.Results: The results showed that after the intervention, knowledge, attitude and behavior scores were significantly higher, and the increase in the school-centered group was more than the family-centered group. Also, there was no significant difference in the mean scores in the control group.Conclusions: School engagement allows for the implementation of effective interventions to enhance menstrual management, ultimately leading to a decrease in negative psychosocial outcomes through improved interactions in the classroom.

Unhealthy eating habits and a high intake of energy, salt, sugar, fat and trans-fatty acids are introduced as dietary risk factors for non-communicable diseases (NCDs). Since one of the key strategies to combat high-risk food behaviors in families is the establishment of healthy eating habits by mothers, this study aims to investigate the effect of nutrition traffic light (TL) education on mothers’ knowledge, attitude and practice. This semi-experimental intervention was conducted among 84 mothers covered by the health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran. The participants were randomly divided into the intervention and control groups (42 participants in each group). Data were collected through a standard questionnaire at three points (before, one week after, and one month after the intervention) across 12 sessions from June 15 to August 15, 2022. The data were analyzed using repeated measures ANOVA, t-test, and chi-square test through SPSS software, version 21. After education, the mean scores of knowledge, attitude and practice improved from 8.61±1.36, 25±2.81 and 22.61±8.6 to 11.71±0.63, 28.04±2.52 and 28.38±4.74, respectively. A comparison of the two groups revealed a significant increase in the scores of knowledge, attitude and practice in the intervention group compared to the control group (P

BackgroundFatigue is a prevalent issue among cancer patients. Cognitive behavioral therapy (CBT) is an individualized intervention that empowers patients and caregivers to actively participate in the treatment process. A recent systematic review and meta-analysis examined the impact of CBT on fatigue in cancer patients.MethodsArticles published up to April 2023 were systematically searched in Scopus, PubMed, and the Web of Science using relevant keywords. All randomized clinical trials (RCTs) investigating the effects of CBT on fatigue in cancer patients were included. Statistical analyses were conducted using Stata version 14, with a significance level set at a p-value of

زمینه و اهداف: با توجه به اینکه کارکنان و عوامل اجرایی پسماند در بیمارستان در معرض خطرات ناشی از پسماند هستند، هدف این مطالعه بررسی سلامت و ایمنی کارکنان پسماند در بیمارستان‌های تحت پوشش دانشگاه علوم پزشکی کرمان و شناخت مهمترین عوامل تاثیر‌گذار بر سلامت آنها است. مواد و روش‌ها: مطالعه‌ی حاضر از نوع توصیفی- تحلیلی بوده که درطی سالهای 1401 و 1402 انجام شد. برای بررسی سلامت و ایمنی کارکنان پسماند از پرسشنامه استفاده شد و با استفاده از نرم‌افزاز SPSS16 داده‌ها تجزیه و تحلیل شدند. با استفاده از مدل معادلات ساختاری در نرم‌افزار SmartPLS v2 مهمترین عامل تاثیر‌گذار بر سلامت شاغلین پسماند بررسی شد. تمام مراحل این تحقیق با رعایت موازین اخلاقی و پژوهشی انجام شد. یافته‌ها: نتایج نشان داد 76% کارکنان پسماند در یکسال گذشته احساس درد داشتند و غالبا از مشکلات عضلانی (64/3%) رنج می‌برند. برای اعتبار و پایایی مدل معادلات ساختاری از دو شاخص میانگین واریانس استخراج شده و پایایی مرکب استفاده شد که هر دو شاخص برای تمام اجزای مدل دارای مقادیر قابل قبول بودند. مدل معادلات ساختاری نشان داد، نوع بیمارستان (0/001>P) از مهمترین عوامل تاثیر‌گذار بر سلامت کارکنان پسماند است. بیشترین اختلاف بین بیمارستان‌ها مربوط به بیماری تنفسی کارکنان بود (0/05>P). نتیجه‌گیری: درصد بالای کمر درد و نیدل استیک در بین کارکنان پسماند، نیاز به تحقیقات بیشتر در این بخش را نمایان می‌کند. با افزایش سابقه کار احتمال بیماری‌های تنفسی در بین کارکنان پسماند افزایش یافته بود؛ بنابراین تجهیزات فردی کارکنان پسماند در بیمارستان‌های تحت نظر دانشگاه علوم پزشکی کرمان خصوصا بیمارستان‌های دولتی باید بهبود یابند.

Background : This study conducted an empirical evaluation of an intervention derived from the theory of planned behavior (TPB) aimed at implementing a health campaign among medical students at Shahid Beheshti University of Medical Sciences. Methods : In this interventional study, a valid and reliable TPB-based questionnaire was administered before launching a health campaign titled “Organ Donation=Life Donation” among 260 medical students. The campaign was structured around nine steps: situation analysis, goal identification, target audience identification, strategy development, tactics establishment, media selection, timetable creation, budget planning, and program evaluation. Two months after the campaign, participants completed a posttest and were offered an organ donation card. Data analysis was conducted using SPSS ver. 16, employing descriptive statistics (frequency and percentage) and tests such as the Kolmogorov-Smirnov test and the paired-samples t-test. Results : All participants adopted more prodonation stances across all constructs measured, both immediately and 2 months after exposure to the health campaign, compared to their pretest scores. These results indicate that the health campaign had a significant impact on psychological variables such as attitudes (P

Abstract Background Type 2 diabetes is a chronic but preventable disease that is on the rise among adolescents. Evaluating adolescents’ behavior and planning to prevent it require a valid and reliable instrument. This study aims at designing a psychometric instrument to measure adolescents’ behavior with respect to type-2 diabetes. Research Design and methods In this methodological research, 770 students (adolescent boys and girls aged 13–15 years) participated through multistage sampling. The Inclusion criteria were: junior high school students, students’ willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by examining the relevant literature and the existing questionnaires as well as considering the research team’s comments. The validity of the study was determined through face validity and content validity both quantitatively and qualitatively. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via intraclass consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and Eq. 6.1 were used for data analysis. Results At first, a list of 47 initial items was designed and compiled, and after by removing similar (10 questions) or inappropriate sentences (12 questions), a draft questionnaire with 25 questions was designed. No items were removed in the face validity phase. Based on exploratory factor analysis, the number of items in the questionnaire was reduced to 20 items and was categorized in five dimensions of stress management, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.70 with ICC = 0.80. Conclusion The questionnaire designed has standard psychometric properties to assess adolescents’ behavior with respect to type-2 diabetes prevention. The reliability and the validity of the questionnaire as well as its general structure were confirmed.

Abstract Background Adolescence is a critical stage for the development of self-care. Many adolescents use mobile apps to monitor and improve their health. Health information technology plays a significant role in the field of self-care. This article provides a protocol for a study to design and evaluate mobile applications for adolescent self-care. Methods The present research is a combination of applied development study, methodological, and intervention experimental. This study will be done in three stages: The first stage is the design and evaluation of a mobile application for adolescent self-care. The second stage is, designing and evaluating the psychometric properties of the “Questionnaire for Measuring Adolescent Self-Care Performance.” This questionnaire will be used before and after using the application in the third stage. The third stage is determining the effectiveness of self-care interventions based on mobile applications among adolescents. The target group will be adolescents aged 10–19 from the schools of Amol City. In the first stage, the opinions of 30 people adolescents, parents, and experts will be used. In the second stage, the number of samples will be 10 times the number of items in the questionnaire. In the third stage, 50 people will be in the intervention group and 50 people will be in the control group. Descriptive statistics will be used for data analysis. Between-group and intra-group comparisons will be calculated about quantitative variables, independent t-test and paired t-test, and analysis of variance. The chi-square test and Fisher’s exact test will be used in SPSS 16 software to test the homogeneity of qualitative variables between the two groups. Discussion In the first stage, based on the opinions received from the target group, a user-centered educational application for self-care of adolescents will be designed. In the second stage, after determining the validity and reliability, a questionnaire will be designed to measure the self-care performance of adolescents. In the third stage, using an intervention study for 3 months, the effectiveness of the training will be determined through the designed application. Our findings are scheduled for a full analysis, with expectations that analyses will be completed by September 2023.

Abstract Background Mobile phones can be an ideal platform to engage adolescents to maintain, improve, and promote self-care. Therefore, the current study aims to design and evaluate the usability of a mobile application for self-care in adolescents with a user-centered approach. Methods The current applied developmental study was done in four steps. The first step, polling and examining opinions was conducted through in-depth semi-structured interviews, with the aim of user-centered mobile application design with the involvement of 30 participants. The second step, extracting and compiling the educational content related to the main themes of the self-care app, was obtained from national and international guidelines and instructions, including the World Health Organization, the Center for Disease Control and Prevention, the Ministry of Health and Medical Education, etc. In the third step, the initial version of the mobile application was developed. In the fourth step, app usability was evaluated by 30 participants from the target group, 2 weeks after using the app, using the MAUQ questionnaire. Results In the first step, 789 codes, 12 sub-categories, and 3 categories were extracted. These codes were used in the design of the mobile application. In the second step, educational information was prepared and arranged in 5 sections (physical activity, nutrition, personal hygiene, risky behaviors and safety and events) in the form of text, images and short videos. In the third step, the mobile application was designed based on step 1 and 2. This application operates in online mode and under the Android operating system. the initial version of the mobile application was developed using JavaScript and Typescript programming languages in a Visual Studio Code environment. In the fourth step, the participants the overall level of usability of the application as very good with an average of 6.28 ± 0.55. The highest average score was given to the user interface and satisfaction with an average score of 6.43 ± 0.58. Conclusions The "My-Care" app is a collaboratively designed smartphone app for adolescents that targets 5 dimensions of physical self-care. This app has the potential to teach, assess, and promote self-care among adolescents.

Objectives The increase in the aged population, associated with various diseases and problems that threaten physical and mental health, as well as the social and economic developments and changes in individual and family lifestyles, have caused inappropriate emotional responses such as stress, anxiety and depression in the elderly in Iran. The present study aims to determine the relationship of perceived social support with sleep quality and mental health in elderly people referred to health centers in Tehran, Iran. Methods & Materials This is a descriptive-analytical study with a cross-sectional design that was conducted on 420 elderly people referred to health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran in 2021, who were selected by a multi-stage random sampling method. A demographic form, the pittsburgh sleep quality index (PSQI), the depression anxiety stress scale-21 (DASS-21), and the multidimensional scale of perceived social support (MSPSS) were used to collect information. Data analysis was done using Pearson’s correlation test and descriptive statistics (frequency, percentage, mean, standard deviation, skewness, and kurtosis) in SPSS software version 25 and path analysis in EQS software, version 6.4. Results The findings indicated that 54.5% of the elderly had depression, 64% had anxiety, 49.3% had stress, and 91.4% had sleep disorders. A negative and significant correlation was found between perceived social support and mental health components (depression, anxiety, and stress) in the elderly (P

Abstract This study aimed to develop and rigorously evaluate the Test of Oral Health Literacy in Adults (TOHLA) for the Iranian population, addressing the limitations of existing oral health literacy (OHL) measurement instruments and contributing to the literature on OHL assessment. The development of the TOHLA involved a qualitative approach, which included a comprehensive literature review and semi-structured interviews with a panel of 15 experts from diverse fields and 22 Iranian adults aged 18 to 64 years. The instrument was designed with 48 items categorized into four domains: cognitive skill, communication skill, media skill, and functional skill. Content validity was established through expert input and content validation indices. Construct validity was supported by factor analysis, and concurrent validity was assessed by comparing TOHLA scores with demographic variables. Internal consistency and test-retest reliability analyses were performed to assess the instrument’s reliability. The psychometric evaluation of the TOHLA demonstrated strong content validity, construct validity, concurrent validity, internal consistency, and test-retest reliability. The instrument exhibited a high level of internal consistency, with a Cronbach’s alpha coefficient of 0.81 for the entire scale. Test-retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.83. Concurrent validity analysis showed statistically significant associations between OHL scores and demographic variables, supporting the instrument’s overall performance. The TOHLA overcomes the weaknesses observed in existing instruments and offers a comprehensive tool with strong psychometric properties to assess the OHL of the Iranian adult population. Researchers, policymakers, and healthcare providers can utilize the TOHLA to address oral health challenges and enhance overall oral health outcomes among Iranian adults.

Abstract Background Several reports have shown an increase in the number of type-2 diabetics among adolescents creating an extra burden for this age group. However, there is no instrument assessing adolescents’ attitude toward this disease. This study aims at designing a psychometric tool for assessing adolescents’ health beliefs regarding type-2 diabetes. Research design and methods In this methodological research, 770 boy and girl adolescents (between 13 and 15) from Tehran participated through multistage sampling. The Inclusion criteria were: junior high school students, students’ willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by extensive literature review and the related existing questionnaires, as well as considering the research team’s comments. The validity of the questionnaire was determined through face and content validity. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and EQS6.1 were used for data analysis. Results The pool of questions had 57 items, and by removing similar (23 questions) or inappropriate sentences (8 questions), a draft questionnaire with 26 questions was designed. No items were removed in the face validity phase. Based on the results of CVR and CVI, six items and 4 items in the exploratory factor analysis were removed. Finally, a questionnaire with 16 items in 4 dimensions of perceived self-efficacy, behavioral beliefs, perceived susceptibility and perceived severity was obtained. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.78 and ICC = 0.73. Conclusion The questionnaire designed can be employed as a reliable and valid instrument to assess the psychological perceptions and health beliefs of adolescents with respect to type-2 diabetes.

Abstract Background Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education. Methods This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model. Results Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components. Conclusion This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.

زمینه و اهداف: غفلت از نيازهاي تغذيه‌اي سالمندي، زمينه را براي بروز بسياري از بيماري‌ها مساعد مي‌کند. اندازه‌گيري آگاهي‌، نگرش‌ها و رفتارهای تغذیه‌ای به عنوان يک نيازسنجي از گام‌هاي اوليه برنامه‌ ریزی مداخلات است. مطالعه‌ي حاضر باهدف بررسي آگاهي‌، نگرش‌ و رفتارهاي تغذيه‌اي سالمندان شهرکرج اجرا شد. مواد و روش‌ها: در اين مطالعه مقطعي که به صورت توصيفي-تحليلي انجام شد، 393 نفر از سالمندان مراجعه‌کننده به مراكز بهداشتي درماني شهر كرج با استفاده از روش نمونه‌گيري چند مرحله‌اي شركت كرده بودند. ابزار گردآوري داده‌ها، پرسشنامه‌اي شامل اطلاعات جمعیت‌شناختی و سؤالات آگاهي، نگرش و رفتار در خصوص تغذيه بود كه مراحل روايي و پايايي آن به تأييد رسيده بود. داده‌هاي جمع‌آوري شده با كمك نرم‌افزارSPSS16 و با استفاده از آمارتوصيفي و استنباطي تجزيه ‌وتحليل شدند. رعایت ملاحظات اخلاقی در تمام مراحل اجرای مطالعه درنظر گرفته شد. یافته‌ها: سالمندان داراي وضعيت ‌آگاهي متوسط، در بخش نگرش و رفتار نیز وضعيت خوبي داشتند. آگاهي، نگرش‌ها و رفتار سالمندان با تحصيلات و منطقه سکونت ارتباط معنادار داشت (P0/05). همچنین ارتباط معني‌دار بين امتیازات آگاهي افراد موردمطالعه با ساختار خانواده وجود داشت (P=0/038). نتیجه‌گیری: داشتن آگاهي، جهت ايجاد تغييرات مثبت در سلامت کافي نيست. مداخلات آموزشي و تأکيد بر عادات بهداشتي سالم، بايد آن‌قدر تکرار شود تا به‌طور واضح در نگرش و عملکرد افراد تغيير ايجاد شود و اثرات مثبت آن برسلامت ظاهر گردد. طراحي و اجراي برنامه‌هاي آموزشي تغذيه با هدف بهبود و اصلاح رژيم غذايي در سالمندان پيشنهاد مي‌گردد.

Background Injuries are increasing global public health problems, causing disability and death among children. This has considerable financial, emotional and social effects on families and society. This study aimed to investigate the behavioural and environmental factors leading to unintentional home injuries and attempts to highlight the pivotal role of mothers’ behaviour and performance to provide a safe place for children at home.Methods The current research is a qualitative study of a directed content analysis type. The data were gathered through semistructured interviews conducted in participants’ workplaces, namely universities, research centres and health centres. In some cases, telephone interviews were conducted within 3 months, from February 2021 to May 2021 in Tehran, Iran. The participants were selected through non-probability and purposive sampling. All the recorded interviews and notes were accurately evaluated, and data analysis was performed based on the content analysis. There were 29 interviews in total: 12 interviews with mothers, 9 with treatment and prevention specialists, and 8 with researchers.Results A total of 66 factors, 6 subcategories and 2 main categories were extracted after analysing the interviews. The main categories included environmental and behavioural factors. The subcategories included house infrastructure, house equipment/furniture, children’s equipment/furniture, provision of precarious conditions, access to hazardous substances and appliances, and unsafe arrangement of furniture.Conclusion Despite the existing obstacles such as the long-term implementation, financial difficulties and overcomplicated policy-making process, health interventions can make it possible for mothers of children under the age of seven to adopt preventive measures through appropriately designed instructions and optimal use of existing facilities.

Objectives The importance of self-care ability in the elderly to improve their physical and mental health has led to the most direct intervention in this regard to be the assessment of the status of self-care ability and its relationship with nutritional status. This study aims to determine the impact of self-care ability on the nutritional status of the elderly in Tehran City, Iran in 2019. Methods & Materials In this descriptive-analytical correlation study, 420 elderly people referred to the health centers of Shahid Beheshti University of Medical Sciences were studied by two-stage cluster sampling. The data collection tool in this study was a three-part questionnaire, including demographic information, a self-care ability scale for the elderly (SASE), including 40 questions, and a mini nutritional assessment (MNA), including 18 items. The inclusion criteria included a willingness to participate in the study, age 60 years and older, literacy, ability to communicate and collaborate in the study, no cognitive impairment, and the exclusion criteria included incomplete completion of the questionnaire. Data were analyzed by SPSS software version 16 using descriptive and inferential statistical tests of Spearman correlation and structural equation model via using model fit indices under EQS6/1 software. Results Among the elderly people, 65.7% were at the desired level in terms of self-care ability and 34.3% were at the middle level. In terms of nutrition, 65% of the elderly people were normal, and 26.4% were exposed to malnutrition. The highest mean and SD of nutritional status and self-care status were obtained in the elderly between the ages of 70-74 and 65-69 years (21.47±3.98) (87.51±6.64). The results obtained from structural equations showed that self-care with an intensity of 71% affected the nutritional status of elderly people. The indices obtained in the model RMR and RMSEA showed less than 0.08 and other fitting indices showed 0.90 and higher. Conclusion According to the findings, considering the appropriate level of self-care ability and nutritional status of the elderly and the impact of its socio-individual factors on self-care status, purposeful planning to improve quality of life, especially nutritional quality, and self-care, is essential.

Introduction Despite the emphasis on empowerment in interventions supporting women against domestic violence and ending spousal abuse, there is still no standard and accurate instrument to evaluate women’s empowerment in this field. This study proposes a protocol to fill this gap by developing and psychometrically testing a standardised instrument for assessing women’s empowerment in dealing with domestic violence (WEDDV).Methods and analysis This study will be conducted in Iran in a mixed method with a sequential exploratory design (qualitative–quantitative). In the first phase, qualitative methods will be used to generate items, rank and identify essential items for WEDDV conceptualisation. The data collection method in this phase includes semistructured face-to-face interviews with married women, a review of related literature, and a fuzzy Delphi method with participants with work experience and expertise about violence against women. Qualitative data analysis will be done using a content analysis strategy and MAXQDA 2020 software. In the second phase of the study, the psychometric properties of the instrument, including face, content and construct validity, and the instrument’s reliability will be evaluated. Also, the psychometric features of the COSMIN checklist will be used in the design of this instrument.Ethics and dissemination This study protocol has been approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences with code (IR.SBMU.PHNS.REC.1400.011). The findings will be published in prestigious journals and presented at national and international conferences. We hope that these results can provide a practical framework for planning and organising domestic violence interventions for policy-makers, researchers and women’s health and counselling service providers.

Background: Regular physical activity for adolescents has many health benefits, many of which also affect adulthood. Physical activity is a behavior that requires planning and choosing an appropriate educational method, model, or theory. However, mobile phone applications are known as a suitable method to increase physical activity according to the guidelines. This study aims to increase physical activity in female students based on the theory of planned behavior using mobile phone applications. Methods: This quasi-experimental study was implemented on 220 high school students (110 people in each group). The samples were selected by a multi-stage cluster method and their information was collected by the International Physical Activity Questionnaire (IPAQ) and the Theory of Planned Behavior (TPB) questionnaire whose validity and reliability were confirmed. The intervention group received 8 sessions of education through a mobile phone application that was designed by the constructs of the theory of planned behavior. The samples were evaluated in three stages, through a pre-test, post-test, and two-month follow-up. Results: The results showed a significant difference in the post-test and two months after the intervention between intervention and control groups in terms of attitude, perceived behavioral control, intention, and physical activity. There was a significant difference between intervention and control groups in subjective norms in the post-test, but there was no significant difference in the two-month follow-up compared to the post-test (P = 0.08). Conclusions: An educational intervention based on the theory of planned behavior using mobile phone applications led to an increase in the physical activity of girl high school students. However, to determine the full effectiveness of this study, it is recommended to implement this intervention in all schools.

Abstract Background In order to increase HPV vaccination, it is necessary to identify the factors influencing vaccination behavior among different cultures and the young adult populations. To evaluate the factors influencing HPV vaccine uptake behaviors, valid, reliable, and culture-compatible scales are required. This study was conducted with the aim of designing and psychometric assessment of the scale of factors influencing HPV vaccine uptake behaviors in Young Adults (FI(HPV)VUBYA) in Iran. Methods The present study was carried out in a mixed-method in two steps: (a) Generating items using a qualitative study and literature review and (b) Reducing items by psychometric assessment of the designed scale. The initial set of items (N = 80) was prepared based on a qualitative study and literature review. A total of 400 young adults participated in online data collection from November 2019 to February 2020. The validity (face, content, and construct) and reliability (internal consistency and stability) of the scale were evaluated. Results The exploratory factor analysis (EFA) revealed that the scale has 7 factors, explaining 57.84% of the total extracted variance. There was also a knowledge factor that EFA did not analyze, but its validity and reliability were evaluated with 7 other factors. The results of confirmatory factor analysis showed a good model fit. Convergent and divergent validity of the scale was accepted for all factors. Good reliability was also reported for the scale. Conclusion FI(HPV)VUBYA 8-factor scale has good validity and reliability among young Iranian adults. Due to its appropriate psychometric properties, this scale can be used on this population in future studies.

Healthy breakfast and snacks play an important role in students’ physical and mental health and education is one of the most effective strategies for improving the nutritional status of children. The aim of this study was to survey the effect of school-based educational intervention on mothers’ behavior with respect to healthy breakfast and snacks for children. In this experimental study, random sampling was conducted and 120 students were selected and divided into two experimental and control groups and their mothers were invited to participate in the study. Samples were examined in two stages through pre-test, and a delayed post-test with a questionnaire that consists of demographic information questions related to knowledge, attitude, perceived benefits, perceived barriers and behavior. Training, lectures and group discussion methods and question and answer with educational aids such as pamphlets were used. Data were analyzed by using SPSS16 and paired t-test, t-test and chi-square analyses were employed. The mean scores of knowledge (6.20±88.30), attitude (1.65±25.95) and perceived benefits (0.29 ±17.95), perceived barriers (2.71±34.70), and behavior of mothers (8.38± 115) in the experimental group significantly increased after intervention (P

Abstract Background Abuse against women causes great suffering for the victims and is an important health problem among women. To date, a few screening instruments for wife abuse exist for married women in Iran, but they only assess some of the wife abuse components. The aim of this study was to investigate the psychometric properties and factor structure of the Haj-Yahia’s Questionnaire in a sample of married women residing in Tehran. Materials and methods This is a cross-sectional study with a population consisting of married women in Tehran, among which 471 individuals were selected using convenience sampling method. Psychometric properties of the questionnaire were evaluated using face validity, content validity, construct validity, internal consistency, and stability. Confirmatory factor analysis was performed using the weighted least square mean and variance adjusted. We performed confirmatory factor analysis using Mplus version 8 software and for other calculations, we used STATA V14. Results The quantitative results of face validity and content validity indicated that all items of the questionnaire were in acceptable range, and were retained in the study. In CFA results, the model fit indices were acceptable (TLI = 0.986, CFI = 0.987, RMSEA = 0.039 and SRMR = 0.057). Cronbach’s alpha coefficient for psychological abuse, physical abuse, sexual abuse, and economic abuse were estimated 0.90, 0.93, 0.79, and 0.78 respectively, and an alpha of 0.95 was found for the total questionnaire. The intra-cluster correlation index was 0.98. Conclusions Findings showed that the Persian version of the questionnaire of violence against women made it possible to evaluate various dimensions of violence using 4 factors and showed good construct validity and internal reliability in the female population in Iran; therefore, it can be used in future studies.

Abstract Background The present study aimed to evaluate the results of a theory-based and systematic intervention on Hookah Tobacco Smoking (HTS) cessation in women local to Bandar Abbas, Iran. Methods In the present quasi-experimental research, we used an intervention mapping approach to develop, implement, and evaluate an education and training course as our intervention. Applying the results of a systematic review and two prior local qualitative studies, we identified six HTS determinants and set goals for the intervention. We selected 212 eligible women through systematic stratified random sampling and enrolled them in control and intervention groups. The course was presented to the intervention group in 17 sessions for four months. The educational material was developed to address the goals of the intervention, improve HTS determinants, and change the HTS behavior. We used a questionnaire to collect data on participants’ characteristics, HTS behavior, and detailed determinants of HTS in the control and intervention groups at the beginning of the study, at the end of the intervention, and at three- and six- months follow-up. All work done in the study was guided by ethical considerations. Results The results showed no significant difference between women enrolled in control and intervention groups regarding participants’ characteristics and HTS behavior. At baseline, there were no differences between groups for six determinants of HTS (knowledge, attitude, social norms, self-efficacy, habit, and intention). At the end of the intervention and at three and six months follow-up, the women in the intervention group had significantly better results in all six domains, compared with those in the control group. The rate of HTS abstinence at the end of the intervention and at the three- and six-month follow-ups was 61.3%, 48.5%, and 45.5% for the intervention and 16%, 14.4%, and 10% for the control groups, respectively. Conclusions HTS is a complicated behavior, and its cessation is hard. However, Intervention Mapping (IM) can be a powerful integrative, purposeful, theory-based, and participation-based method to reduce or cease HTS. This method should be tested in other settings. Trial registration: IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129

زمینه و اهداف: کاهش سلامت روان بهورزان تأثیرات سوئی بر روند ارائه خدمات در شرایط شیوع کرونا در جامعه خواهد داشت. لذا این مطالعه با هدف تعیین عوامل موثر بر سلامت روان و مولفه‌های آن در بهورزان استان‌های با وضعیت قرمز کووید-19 انجام گرفت. مواد و روش‌ها: مطالعه حاضر از نوع توصیفی- تحلیلی و به صورت مقطعی در سال 1399 روی 627 نفر از بهورزان شاغل در استان‌های با وضعیت قرمز کووید 19 که با روش نمونه گیری چند مرحله‌ای انتخاب شدند، انجام گرفت. داده‌ها با استفاده از پرسشنامه‌های سلامت عمومی به صورت آنلاین جمع آوری شد. تحلیل داده‌ها با استفاده از آزمون‌های آنالیز واریانس یک طرفه و آزمون تعقیبی LSD با SPSS16 انجام گرفت. سطح معناداری همه تحلیل ها برابر با 05/0 درنظر گرفته شد. یافته‌ها: در بهورزان شاغل در استان‌های با وضعیت قرمز کووید-19، اختلالات روانی مشاهده شد. اکثریت جمعیت مورد مطالعه دارای سلامت روان مطلوبی بودند. میان میانگین کل سلامت روان و متغیرهای جمعیت‌شناختی تفاوت معنی‌داری وجود داشت (05/0P

Abstract Background Patient education is a critical aspect of patient care and is considered a vital part of self-care (especially in patients with cardiovascular disease (CVD)) and health promotion. The literature supports incorporating the principles of the andragogy model (adult learning) into patient education. This study aimed to determine the concordance of the CVD patient education with the principles of the andragogy model. Methods This cross-sectional survey was conducted on 384 adult CVD patients from 2 selected hospitals of Tehran. The sampling method was convenient, and the data collection tool was a researcher-made questionnaire based on the principles of the andragogy model. Data were analyzed using SPSS16 statistical software. Results The mean age of the patients was 55.69 ± 13.01 years old. Frequency of distribution of the patients who, in total, selected the items of 4 or 5 for respecting the principles of andragogy model was as follows: 68.16% for the motivation, 66.29% for the need, 66.03% for the orientation, 54.16% for the experiences, 51.55% for the self-concept, and 44.65% for the readiness principle. Also, three principles of motivation (77.37) need (74.97), and orientation (74.78) had the highest mean, respectively, in terms of adhering to this model. But the most common problems in patient education were related to the principles of readiness (64.35), self-concept (68.19), and experiences (77.71) with the lowest mean. Conclusions The findings of this study provided valuable information on the flaws in patient education, including ignoring and disrespecting the principles of adult education. Correcting these detected defects and providing feedback to health professionals can improve the quality of patient education programs and patient satisfaction. Also, it empowers healthcare providers, patients, and families through effective education strategies.

Abstract Background & aim HIV/AIDS is one of the most dangerous viruses known in the world. In addition, considering its fatality rate and high cost of care, it is a serious threat to the health and economy of social communities. Adolescents are one of the high-risk groups. One of the most effective ways to prevent this disease is to promote healthcare, raise awareness, and change health-related beliefs and attitudes. This study aims at determining the effect of peer education, based on the health belief model, on the preventative measures against AIDS adopted by girls. Methods & materials In this empirical-interventionist study two schools were randomly selected, one of which was considered as the intervention group and the other as the control group. The classes were also randomly selected and 80 students from each school took part in the project following the entry criterion. A questionnaire with acceptable validity and reliability was used to collect data. In this study a few bright students were chosen as peer educators after being trained. The intervention group (N = 80) received 4 sessions of 60-min education through training, lectures, question and answer, and group discussion, But the control group received no instruction. The posttest was administered two months after the treatment. The data was fed into the SPSS 16. Finally, T-test, Chi-Square, and ANCOVA were employed to analyze the data. Results The average scores obtained from the intervention group and the control group were not significantly different in terms of awareness level, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, behavioral intention, and behavior in baseline (P>0.05). Two months after the intervention there was a significant increase in the average scores of all the variables in the experimental group (P > 0.05). However, there was no significant change in the scores of the control group (P > 0.05). Conclusion Following a health belief model focusing on peer eduaction among high school girls, the intervention eduaction can affect awareness level, susceptibility, severity, benefits, perceived barriers, perceived self-efficacy, behavioral intention, and finally avoidance of high-risk behavior.

Background and Objectives: The preparedness of petrochemical industries against disasters is important to control risks, reduce losses and possible damages. Studies have shown that preparedness is an important factor in the disaster response phase. This study aimed to explore the factors influencing industry preparedness in fire. Methods: This study was conducted from July 2020 to December 2021, with a qualitative case study design. The population included 22 people including 12 crisis managers, three Health, Safety, and Environment chief officers, two operational commanders in the fire department, two policymakers and three university professors. The data were collected through semi-structured interviews and purposeful sampling, which continued until saturating the data. The strategies recommended by Guba and Lincoln were used for evaluating the trustworthiness of the data. The data were analyzed using the conventional content analysis method according to the method suggested by Graneheim and Lundman. Results: The effective components of the petrochemical industry preparedness for fire were classified into six main categories and 16 subcategories. Categories and subcategories covered fire characteristics (nature and chain of fire), policy-making (regulations, incident information documentation, and incident insurance incentives), and management factors (commitment and leadership, incident command, communication and information, and planning). The others involved support factors (equipment supply, coordination and cooperation, and training and awareness), safety culture (risk management, monitoring and auditing, inherently safe design), and sanction consequence (software and hardware). Conclusions: Many factors affect the petrochemical industry's preparedness for fire. Adopting effective management and appropriate policy regarding preparedness with strategies for promoting and developing a safety culture can improve the preparedness of petrochemical industries in disasters.

Abstract Background Present study was conducted to determine the effect of training on coping efforts and stress moderators, based on transactional model of Lazarus and Folkman, in hemodialysis patients. Methods This is a randomized controlled clinical trial on 116 hemodialysis patients referred to dialysis centers in Tehran from May to August 2018. The patients were assigned to two experimental and control groups using a simple randomization method. The intervention included 6 training sessions in the form of coping efforts and moderators of transactional model. Data were collected before and 3 months after the intervention. Data were analyzed using SPSS 16. Results After 3 months training intervention, there was significant increase in the intervention group in the mean scores of coping efforts (P

زمینه و اهداف: تقویت و بهبود خودکارآمدی در میان کارکنان در ارتقا هر چه بیشتر سلامت روان و کاهش علایم روانشناختی در دروه‌ی شیوع بیماری کرونا موثر است. لذا این مطالعه با هدف ارتباط بین علائم روانشناختی و خود کارآمدی کارکنان ستاد وزارت بهداشت در پاندمی کووید -19 انجام گرفت. مواد و روش‌ها: این پژوهش ازنوع توصیفی- تحلیلی و به صورت مقطعی در سال 1399 در میان 330 نفر از کارکنان ستادی وزارت بهداشت انجام گرفت. نمونه‌گیری به صورت تصادفی طبقه‌ای انجام شد. داده‌ها با استفاده پرسشنامه سلامت عمومی و خودکارآمدی و به صورت آنلاین جمع آوری شدند. تحلیل داده‌ها با استفاده از SPSS16انجام شد. ملاحظات اخلاقی در تمام مراحل اجرای مطالعه رعایت شد. یافته‌ها: افسردگی (9/04 ± 10/39) بیشترین و ترس مرضی (3/75 ±3/20) کمترین نمره را در میان علایم روانی داشتند. وضعیت کارآمدی کارکنان خوب ارزیابی شد. میان علایم روانی با متغیرهای جنس، وضعیت تاهل، وضعیت استخدامی و تعداد فرزندان تفاوت معناداری وجود نداشت و با متغیرهای میزان درگیری با کرونا، سن، سطح تحصیلات و سابقه خدمت تفاوت معنادار بود. ارتباط همه علایم روانی با خود کارآمدی معنادار و معکوس بود. مدل رگرسیونی نشان داد، متغیرهای حساسیت در روابط متقابل، سن، افسردگی، پرخاشگری و ترس مرضی بر روی هم 38 درصد تغییرات خود کارآمدی را پیش‌بینی می‌کنند. نتیجه‌گیری: با توجه به همبستگی منفی میان خود کارآمدی با علایم روانی و پیش‌بینی کننده خود کارآمدی توسط علایم روانی، برگزاري کلاس‌هاي آموزشي، روش‌هاي مقابله‌اي و آموزش مهارت‌هاي خود کارآمدي می‌تواند در ارتقاء سلامت روان و خودکارآمدی کارکنان مفید واقع گردد.

Abstract Background Oral and dental health has a significant impact on public health as well as the quality of life among individuals and families. This study aims to design, implement, and evaluate an intervention based on the PRECEDE-PROCEED model for oral and dental health among primary school students in Rafsanjan city, Southern Iran. Methods According to the nature of the model and with the focus group discussion and interview methods, in phases 1 to 4 (PRECEDE), predisposing, enabling, and reinforcing factors related to oral health were identified. The training program was designed and consisted of six sessions for students (250 students) with a brushing session, three sessions for parents, and two sessions for teachers. Process evaluation and the effect of the program on behavioral and factors affecting oral health were evaluated (PROCEED). Results In the qualitative section, seven predisposing factors, five enabling factors, and two reinforcing factors were identified. A training program based on the PRECEDE-PROCEED model was found to be effective in increasing the mean scores of the above constructs and the students’ brushing behavior (P

زمینه و اهداف: نظریه رفتار برنامه‌ریزی شده مفیدترین نظریه، برای درک بهتر از پیش‌گویی کننده‌های مصرف مواد مخدر شناخته شده است. لذا این مطالعه با هدف بررسی عوامل پیش‌بینی کننده قصد سوء مصرف مواد مبتنی بر نظریه رفتار برنامه‌ریزی شده در زوجین مراجعه کننده به مرکز مشاوره قبل از ازدواج در مرکز بهداشت شرق اهواز در سال 1399 انجام گرفت. مواد و روش­ها: این مطالعه به صورت مقطعی– تحلیلی و از نوع همبستگی در میان کلیه زوجین مراجعه کننده به مرکز مشاوره انجام گرفت. 360 نفر از زوجین به صورت تصادفی سیستماتیک و از روی شماره پرونده زوجین انتخاب شدند. ابزار جمع‌آوری داده، پرسشنامه‌ای شامل مصرف مواد مخدر و نظریه رفتار برنامه‌ریزی شده بود. جهت تحلیل داده‌ها از آمار توصیفی و آزمون‌های استنباطی مانند رگرسیون چندگانه و لجستیک در نرم افزار آماری SPSS نسخه 16 استفاده شد. سطح معنی‌داری نیز 0/05 درنظر گرفته شد. در تمام مراحل، ملاحظات اخلاقی مد نظر قرار گرفت. یافته‌ها: میان میانگین سازه‌های نظریه رفتار برنامه‌ریزی شده و متغیرهای دموگرافیک تفاوت معناداری وجود داشت (P0/05). نتایج آزمون رگرسیون نشان داد کنترل رفتار درک شده و هنجارهای انتزاعی با هم تقریباً 37 درصد تغییرات قصد رفتاری را پیش‌بینی می‌کند. نتیجه­ گیری: نظریه رفتار برنامه‌ریزی شده پیش‌بینی کننده مناسبی برای مصرف مواد مخدر می‌باشد. پیشنهاد می‌شود از این نظریه در برنامه‌های آموزشی سطوح مختلف پیشگیری از مصرف مواد مخدر استفاده گردد.

Abstract Background The present research aimed to explore the association of self-efficacy and general health among nurses. Methods This was a descriptive-analytical. A total of 470 nurses were selected through the stratified sampling method. To collect the required data, GSE-10 and GHQ-28 were used. Independent-sample T-test, Pearson correlation coefficient, Chi-squared test, and regression were also used to analyze the obtained data. Results The results reveal a statistically significant correlation between general health and self-efficacy (t=-6.72, p

زمينه و اهداف: با توجه به اهمیت آموزش در پیشگیری از ابتلا به ایدز، مطالعه حاضر با هدف بررسی تاثیر مداخله مبتنی بر الگوی اعتقاد بهداشتی بر رفتارهای پیشگیری‌کننده از ایدز در میان زنان شهر تهران انجام شد. مواد و روش‌ها: این مطالعه نيمه تجربي در سال 1399 روی 100 نفر (دو گروه 50 نفره) از زنان که با روش نمونه‌گیري در دسترس انتخاب شدند، انجام شد. داده‌ها در دو مرحله (قبل و دو ماه بعد از مداخله) با استفاده از پرسشنامه مبتنی بر سازه‌های مدل اعتقاد بهداشتی جمع‌آوری گردید. براساس نتایج پیش‌آزمون، مداخله آموزشی طراحی و در 5 جلسه 1 ساعته برای گروه مداخله اجرا شد. داده‌ها با آزمون‌های آماری کای اسکوائر، تی‌مستقل و تی‌زوجی در نرم‌افزار ‏SPSS- 23‏ تحلیل شدند. در تمام مراحل، ملاحظات اخلاقی مد نظر قرار گرفت. يافته‌ها: متغیرهای جمعیت شناختی بین دو گروه کنترل و مداخله تفاوت معناداری نداشتند (p>0.05). قبل از مداخله سازه‌های مدل اعتقاد بهداشتی دو گروه تفاوت معناداری نداشتند (p>0.05)، اما پس از مداخله نمرات سازه‌های آگاهی (p=0.001)، حساسیت درک‌شده (p=0.02)، شدت درک‌شده (p=0.012)، منافع درک‌شده (p=0.03) و خودکارآمدی (p=0.001) در گروه مداخله افزایش و نمرات موانع درک‌شده (p=0.05) کاهش یافت، در حالیکه در گروه کنترل پس از مداخله نمرات هیچکدام از سازه‌ها تفاوت معناداری پیدا نکرد (p>0.05). نتيجه‌گيري: با افزایش آگاهی و حساسیت زنان نسبت به ایدز و شناخت موانع و منافع رفتارهای پیشگیری کننده، ضمن تلاش برای افزایش خودکارامدی، به این نتیجه می‌رسند که با انجام رفتارهای سالم و پیشگیری، از ابتلا به ایدز، حافظ سلامت خود باشند.

ObjectiveAs one of the health aspects, social health is less well-known than physical and mental aspects. In order to better understand this aspect and considering the importance of social context in its conceptualizing, the present study was performed aiming at explaining the social health and identification of its various aspects in the perspective of Iranian adults.MethodologyThe present study was conducted in 2021 with a qualitative approach and with the participation of Iranian adults and social health professionals. Data were collected through semi-structured interviews with 36 participants who were selected by purposive sampling. The obtained data were analyzed using qualitative (conventional) content analysis and Granheim and Lundman method in the MAXQDA-2020. Guba and Lincoln criteria were observed to evaluate the quality of research results.ResultsUsing data analysis, 3 main categories and 17 subcategories were obtained, including: (1) Conceptual scope of social health (social health as social capital, social health as mental health, social health as moral health), (2) Characteristics of social health (biologic, continual, acquired, evolutionary, relative), and (3) Social health dimensions (openness to interactions, social adaptability, social dutifulness, social self-esteem, mutual trust, communicational capability, social optimism, enjoying social support, public-oriented personality).ConclusionSince social health has a conceptual scope, it is important to try to strengthen and reproduce the dimensions of social health and at the same time use planning, policymaking and appropriate interventions to improve and to promote the dimensions of social health.

Background: Awareness of people about the risk factors of the disease and prevention strategies has a significant effect on the prevention and treatment of diseases. Considering the high prevalence of cancer in Iran, the present research was carried out to determine the awareness and health beliefs of staff of Shahid Beheshti University of Medical Sciences, Tehran, Iran, on colorectal cancer and related factors using Health Belief Model (HBM). Methods: In this cross-sectional study, 101 employees were selected from among 4 schools of Shahid Beheshti University of Medical Sciences through cluster sampling method. Data collection tool was a valid and reliable researcher-made questionnaire including demographic questions and health belief and behavior pattern items. Data were analyzed by independent t-test, one-way analysis of variance (ANOVA), and Pearson correlation coefficient using SPSS software. P-value less than 0.050 was considered as the significance level. Findings: The mean score of participants' knowledge was 66.80 ± 18.37; 48.5% of them had low, 28.7% had moderate, and the rest had high level of knowledge about colorectal cancer. Perceived benefits and perceived sensitivity had the highest and the lowest mean, respectively. Increasing age, family history of cancer, and education were factors that influenced employees' awareness of colorectal cancer. Conclusion: Considering that about half of the staff had low level of awareness about colorectal cancer, it is suggested that programs be conducted to change the behavior of individuals in order to prevent the onset of this cancer, so that in addition to increasing awareness and promoting health beliefs, an ever greater reduction in the incidence of this disease occurs.

The present research aims to systematically analyse Iranian university students’ awareness and attitude towards AIDS. We published human cross-sectional studies published in English and Persian between 1 January 1990 and 1 January 2018 in the following databases: MEDLINE, Embase Ovid, Scopus, Web of Science. The key terms searched were Student, HIV, AIDS, Iran, Knowledge, and Attitude. The operators used were AND, NOT, OR which led us to find related articles. The overall findings showed that about 30% of university students had a reasonable awareness of AIDS and 44% had an attitude towards AIDS. As the results showed, 37% of the medical students and 23% of the non-medical group had a good awareness of AIDS. This study showed the fact that despite the susceptibility of university students to high-risk behaviours, this population does not enjoy an adequate level of AIDS preventive programmes.

This paper attempts to assess the knowledge and attitude on HIV/AIDS among school students of Iran. The following data sources were searched for eligible studies: Medline, Science Direct, CINAHL, Scopus, Web of Science, SID, ISC, Magiran, and Google Scholar from 1990 to the end of 2016. The quality of the studies was evaluated using the 22-item STROBE checklist. The highest level of awareness belonged to sharing clothes (93.15) and blood transfusion, respectively (86.31), while the lowest level of awareness was related to transmitting HIV from mother to child (42.05). The study identified a substantial gap in the knowledge, negative attitude towards HIV/AIDS and its transmission among Iranian school students. Accordingly, schools should be regarded as one of the main focuses of activities in the strategies of AIDS risk reduction, and education of school students about all aspects of HIV/AIDS has to be considered seriously by the education policymakers.

Objectives: Health literacy is one of the most important social determinants of elderly health. This study aimed to determine the effectiveness of the educational intervention on knowledge, attitude, and nutritional behaviors of the elderly with adequate health literacy and inadequate health literacy. Methods & Materials: An experimental study was conducted with 192 people 60 years and older in Ilam Province, Iran, from May to September 2016. The elderly were assigned into four groups (48 subjects in each group), including two intervention groups with adequate and inadequate health literacy and two control groups with sufficient and insufficient health literacy. The elderly nutrition education program consisted of four lecture sessions with questions and answers, along with an elderly nutrition manual for the intervention group. The level of health literacy among the elderly was assessed using functional health literacy in adults. The level of knowledge, attitude, and nutritional behaviors was assessed using a researcher-made questionnaire in two stages before and two months after the educational intervention. The SPSS V. 21 was used for data analysis. Descriptive statistics and the Chi-square, paired t test, and Fisher exact test were used for data analysis. Results: The Mean±SD age of the men was 61.24±2.38 years, and the mean±SD age of women was 61.35±2.45 years. The majority of men with adequate health literacy were men (84.37%), while the proportion of men and women in those with inadequate health literacy was almost the same. All participants with adequate health literacy and 89.58% of those with inadequate health literacy were married. After the educational intervention, the mean scores of knowledge, attitude, and behavior in the intervention group with adequate health literacy increased significantly (P≤0.013, P≤0.015, and P0.05). Conclusion: According to the study Results, the effectiveness of the educational intervention in relation to nutrition of the elderly is significantly influenced by the level of health literacy.

Abstract Background The purpose of this study was to predict safe driving behaviors among taxi drivers of Tehran based on the constructs of health belief model. Methods This descriptive-analytical study was performed on 450 taxi drivers in Tehran using multi-stage sampling. Data were analyzed through SPSS software version 18 using Pearson correlation coefficient and multivariate regression analysis. The P

Abstract Background According to the WHO, most chronic diseases, including cancer, can be prevented by identifying their risk factors such as unhealthy diet, smoking and physical inactivity. This research examined the effectiveness of a theory-based educational intervention on colorectal cancer-related preventive nutritional behaviors among a sample of organizational staff. Methods In this interventional study, 110 employees of Shahid Beheshti University of Medical Sciences were randomly divided into two groups (intervention and control) with cluster sampling. The data gathering tool was a researcher-made questionnaire containing two parts of 10-dimensional information and health belief model constructs. The educational intervention was conducted for 1 month and in four sessions in the form of classroom lecture, pamphlet, educational text messages via mobile phones and educational pamphlets through the office automation system. Two groups were evaluated in two stages, pre-test and post-test. Data were analyzed using SPSS-18 software, analysis of Covariance (ANCOVA) and independent t-test (intergroup comparisons). Results Two groups were evaluated for variables such as age, sex, education level and family history of colorectal cancer, and there was no significant difference between the two groups (P 0.05). Conclusion Implementation of educational intervention based on health belief model was effective for the personnel, and can enhance the preventative nutritional behaviors related to colorectal cancer.

Abstract Background This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. Methods Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. Results After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of “poor”, 19 tools were in the category of “fair”, 20 tools were in the category of “good”, and 4 tools were in the category of “excellent” in at least one dimension. Conclusion The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.

Background and Objective: Healthy breakfast and snacks have important role to student thought and body health. The aim of this study was to survey the Behavior And perceptions of mothers about the benefits and barriers of preparation of healthy breakfast and snacks for school children. Materials and Methods: Descriptive-analytical study was conducted in 2017. 315 elementary school boys and girls selected by cluster random sampling and their mothers were invited to participate in the study. Data were collected using by questionnaires that included demographic characteristics, questions related perceived benefits, perceived barriers and behavior. Questionnaires Validity were assessed in two ways face and content validity. Test-retest method and internal consistency were used for questionnaires reliability. Data were collected and analyzed by SPSS 16 software and using T-tests and ANOVA. Results: The significant difference between the perceived benefits of mothers and their employment status (p0.05). There was a significant difference between mothers' behavior with age (P-value

Abstract Background Food safety manual was developed by the World Health Organization (WHO) to train professionals to reduce the burden of foodborne diseases as a global strategy. The present pioneering research aimed to explore the effectiveness of an intervention based on the manual of five keys to safer food by WHO in enhancing the knowledge, attitude and behavior of Iranian Female Community Health Volunteers (FCHVs). Methods In the present quasi-experimental research, FCHVs (n = 125) were selected and assigned to two groups, an intervention and a control. A modified version of the questionnaire based on WHO manual was used to measure knowledge, attitude and behavior of the sample. The questionnaire was first completed at the outset of the study (pre-test) and then once again in 2 months of the intervention (post-test). Face and content validity of the questionnaire was tested and confirmed. Cronbach’s alpha was used to test the reliability of the questionnaire along with the test-retest method of testing reliability. The data entered SPSS16 for statistical analysis. To this aim, Chi-squared test, dependent and independent samples T-test, ANOVA and ANCOVA were run. Partial population attributable risks were calculated and corresponding 95% confidence intervals (95% CIs) were estimated using a bootstrap method. Results The two groups showed no statistically significant difference in the pretest (p > .05). In the post-test, the mean scores for all variables was higher in the intervention group than the control, and this difference between the two research groups was statistically significant (p

Introduction: Early initiation of sex increases the risks of unprotected sex, multiple partners, and sexually transmitted infections. The effective factors of premarital sexual intercourse have not been widely studied. Objective: This study aimed at identifying environmental factors influencing premarital sexual intercoursefromthe Iranian youths’ perspective. Materials and Methods: Using a qualitative content analysis method, we carried out on students of the Payame Noor University of Shiraz, Iran. A total of 30 single male and female students were selected using a purposive sampling method. Semi-structured interviews were used to collect data. The obtained data were analyzed via thematic analysis. Participation in the study was voluntary with informed consent. Results: Seven teen subjects were male, and 13 were female. Analysis of the transcripts yielded 5 main categories: Culture, Cocio-economic status, Family, Media, and Friends, and Peers. The sub-categories were acculturation, cultural norms, economic problems, heavy dowry, availability of unhealthy options, family support, family values and norms, control and supervision, parent-child relationship, satellite, Internet, friends,and peer pressure, and lack of resistance to peer and friends’ influence. Conclusion:The educational programs and interventions should emphasize the role of cultural factors and family support and monitoring by families to help correct sexual orientation and healthy behaviors among adolescents. Furthermore, training programs should consider the negative impacts of western media and the effects of peer pressure on the formation and correction of premarital sexual behavior

Background and Objective: The elderly people, as one of the most groups at high risk for diseases, need to have a high level of health literacy to having an improved level of health. The aim of this study was to investigate the predictors of health literacy among elderly at health centers affiliated to Shahid Beheshti University of Medical Sciences. Materials and Methods: In this descriptive-analytic study, 270 elderly people were selected via cluster random sampling from health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran. To collect data, a short form of the S-TOHFLA standard questionnaire was used to measure health literacy. Data were analyzed by SPSS software version 16 via independent t-test, ANOVA, Kendall correlation and multiple regressions. Results: The mean (SD) age of participants was 67 (5/6). The health literacy of the elderly with university education with a mean (SD) 28.2 (7) and the age group of 60-65 years with a mean (SD) 32.6 (4.9), was significantly higher than the other groups (P

Abstract Background Hookah smoking is an emerging global health issue, especially in Eastern Mediterranean region; and accordingly, women are at the center of this issue as they have a more positive attitude towards hookah smoking. Also, the rate of hookah smoking is increasing at a faster rate among women compared to men. The aim of the present study will be systematically designing and implementing an educational intervention program for hookah smoking cessation among 15 years old women and older in the Iranian southern city of Bandar Abbas. Methods We will use intervention mapping methodology for designing the study. Due to the breadth of factors affecting hookah smoking and the complexity of hookah cessation, we will initially conceptualize hookah smoking cessation program as a set of purposeful activities designed to stop the hookah smoking. In the first step (need assessment), the environmental and behavioral factors related to hookah smoking/cessation and the determinants of these factors will be determined by systematic review and local qualitative study. Then, based on the results of the first step, the behavioral and environmental goals of hookah smoking cessation will be identified. In the second step, the practical goals will be determined for each of the behavioral and environmental outcomes; and then, the logic and matrix of change objectives will be designed using the determinants extracted from the previous step. The products of the second step will be the intervention goals. In the third step, theoretical and practical methods affecting each of the intervention goals will be identified. In the fourth step, contents of educational program for hookah cessation will be produced. The fifth step will be about planning to implement the program. In the sixth step, the effectiveness of designed program will be evaluated in a quasi-experimental intervention. Discussion Appropriate development and successful implementation of a hookah cessation intervention requires a systematic and theory-based approach. We believe that using Intervention Mapping (IM) as the guiding methodology will make it possible to address complexities of developing an intervention program. Also, reflections on the quasi-experimental research and describing the context and executed methods of implementation would contribute to the development of IM and the knowledge needed for the implementation of program. Trial registration IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129.

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 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.