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Tarbiat Modares University (TMU) is the owner of HEHP.
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About HEHP
indexed journal "Health Education & Health Promotion" (HEHP) is concerned with all elements of the health sciences, particularly new trends and developments. An open-access publication that publishes original, peer-reviewed academic works that improve the international knowledge and growth of health, both as a profession and as an academic field, is the goal of HEHP.Announcements
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Editor-in-Chief
Fazlollah Ghofranipour, PhD (Editor-in-Chief)
Professor, Tarbiat Modares University, Tehran, Iran
Fatemeh Zarei, PhD (Associate Editor)
Associate Professor, Tarbiat Modares University, Tehran, Iran
Scientific Supporters
Tarbiat Modares University
Articles
Effectiveness of the COM-B Model Application in Hypertension Management; a Systematic Review
A. Abidah, T. Sukartini, H. Mariyanti
Aims: This systematic review aims to identify the effectiveness of the COM-B-based intervention model on hypertension management behavior and to explore the barriers and facilitators of COM-B interventions in changing hypertension behavior.
Information & Methods: This systematic review uses the PRISMA guide. The databases of Scopus, PubMed, ProQuest, and Web of Science were searched from January 2015 to April 2025. The search strategy uses keywords and Boolean operators. The selection of articles is based on the research's inclusion and exclusion criteria. This study used the Joanna Briggs Institute Critical Appraisal Checklist to assess the quality of the included studies.
Findings: Twelve studies involving 1,961 participants from China, the United States, Uganda, Nepal, India, and Ghana were included. 5 quantitative articles showed that COM-B-based interventions had clinical significance in terms of blood pressure values and behavioral significance, including blood pressure control, self-management, dietary patterns, and others. 7 qualitative articles report on barriers and facilitators to behavior change, including low health literacy, medical costs, pill fatigue, and social factors. Meanwhile, facilitators of behavior change are family support, interactive education, and treatment facilities such as digital reminders.
Conclusion: The COM-B model is effectively used to evaluate barriers and facilitators to the performance of health behaviors. Identified barriers and facilitators can be used to develop COM-B-based behavior change interventions. Behavioral changes are evident in the results of COM-B-based intervention research, which significantly influence clinical outcomes.
View Abstract
Information & Methods: This systematic review uses the PRISMA guide. The databases of Scopus, PubMed, ProQuest, and Web of Science were searched from January 2015 to April 2025. The search strategy uses keywords and Boolean operators. The selection of articles is based on the research's inclusion and exclusion criteria. This study used the Joanna Briggs Institute Critical Appraisal Checklist to assess the quality of the included studies.
Findings: Twelve studies involving 1,961 participants from China, the United States, Uganda, Nepal, India, and Ghana were included. 5 quantitative articles showed that COM-B-based interventions had clinical significance in terms of blood pressure values and behavioral significance, including blood pressure control, self-management, dietary patterns, and others. 7 qualitative articles report on barriers and facilitators to behavior change, including low health literacy, medical costs, pill fatigue, and social factors. Meanwhile, facilitators of behavior change are family support, interactive education, and treatment facilities such as digital reminders.
Conclusion: The COM-B model is effectively used to evaluate barriers and facilitators to the performance of health behaviors. Identified barriers and facilitators can be used to develop COM-B-based behavior change interventions. Behavioral changes are evident in the results of COM-B-based intervention research, which significantly influence clinical outcomes.
Knowledge, Attitudes, and Practices of Nurturing Care in Indonesian Mothers of Acutely Ill Children Under Five Years Old
F. Haryanti, I. Parmawati, A. Sandhi, I. Rahmat, A.B. Agustin, C.I. Putri, T.M.N. Izati, A. Akhmadi
Aims Nurturing care during episodes of acute illness is essential to support optimal child development, yet the delivery remains poorly studied in Indonesia. The objective of this study was to determine maternal knowledge, attitudes and practices of nurturing care among mothers with acutely ill children under five years in Indonesia.
Instrument & Methods It is a descriptive cross-sectional research which was done in November 2024 at Banguntapan II PHC. One hundred and four mother-child pairs were studied using systematic random sampling. Information was gathered through validated questionnaires on knowledge, attitudes and practices. Descriptive statistics, Pearson correlation and ANOVA test was performed.
Findings The knowledge (M = 18.35, SD = 1.83) and attitudes (M = 95.64, SD = 3.36) of mothers were high regarding nurturing care. Practice scores, however, were significantly lower (M = 58.56, SD = 7.19), indicating a significant knowledge-practice disparity. Correlation analysis revealed a moderate positive relationship between knowledge and attitudes (r = 0.557), but no significant correlations were found between knowledge-practices or attitudes-practices. Notably, no statistically significant differences were observed across demographic factors such as age, occupation, education level, or family income.
Conclusion These results emphasize important areas for targeted interventions, specifically in relation to nutritional and early stimulation activities, and child safety practices during periods of illness for optimal development.
View Abstract
Instrument & Methods It is a descriptive cross-sectional research which was done in November 2024 at Banguntapan II PHC. One hundred and four mother-child pairs were studied using systematic random sampling. Information was gathered through validated questionnaires on knowledge, attitudes and practices. Descriptive statistics, Pearson correlation and ANOVA test was performed.
Findings The knowledge (M = 18.35, SD = 1.83) and attitudes (M = 95.64, SD = 3.36) of mothers were high regarding nurturing care. Practice scores, however, were significantly lower (M = 58.56, SD = 7.19), indicating a significant knowledge-practice disparity. Correlation analysis revealed a moderate positive relationship between knowledge and attitudes (r = 0.557), but no significant correlations were found between knowledge-practices or attitudes-practices. Notably, no statistically significant differences were observed across demographic factors such as age, occupation, education level, or family income.
Conclusion These results emphasize important areas for targeted interventions, specifically in relation to nutritional and early stimulation activities, and child safety practices during periods of illness for optimal development.
Validation of Mobile Application Usability Questionnaire for Evaluation of Usability of the Mommy-Be Application in Indonesia
A. Syam, F. Fadli, A. Syam, A.R. Amelia, A. Toaha
Aims: Mobile health [mHealth] applications have emerged as an effective approach to supporting maternal breastfeeding health. However, adopting these applications often faces challenges in terms of usability and user satisfaction. This study aims to adapt and validate the Malay language version of the Mobile Application Usability Questionnaire [MAUQ] instrument in the context of the Mommy-Be application in Indonesia.
Methods: This research method uses a descriptive quantitative design with a Confirmatory Factor Analysis [CFA] approach to test the validity of the instrument. Data was collected from 386 breastfeeding mothers from 400 invitations distributed via social media applications in each primary health service.
Findings: A total of 386 breastfeeding mothers in Makassar City, South Sulawesi, participated in a two-week application trial. The results of the first model test showed a CFI value of 0.548 and a TLI of 0.477, indicating a less-than-ideal model fit. After removing items with high Modification Indices [MI] values, the second model showed a significant improvement with a CFI of 0.972, a TLI of 0.966, and an RMSEA of 0.062.
Conclusion: These results highlight the importance of adapting instruments to the local context and technical conditions of the application. The results of this study are expected to support the development of health applications that are more in line with the needs of local users.
View Abstract
Methods: This research method uses a descriptive quantitative design with a Confirmatory Factor Analysis [CFA] approach to test the validity of the instrument. Data was collected from 386 breastfeeding mothers from 400 invitations distributed via social media applications in each primary health service.
Findings: A total of 386 breastfeeding mothers in Makassar City, South Sulawesi, participated in a two-week application trial. The results of the first model test showed a CFI value of 0.548 and a TLI of 0.477, indicating a less-than-ideal model fit. After removing items with high Modification Indices [MI] values, the second model showed a significant improvement with a CFI of 0.972, a TLI of 0.966, and an RMSEA of 0.062.
Conclusion: These results highlight the importance of adapting instruments to the local context and technical conditions of the application. The results of this study are expected to support the development of health applications that are more in line with the needs of local users.
Alcohol Misuse Prevention Campaign for Parents of 3-7 Years Old Children in Kerman Province, Iran
V.R. Borhaninejad, A. Iranpour, A. Bahramnejad, S. Alizadeh
Background: Childhood is considered the most appropriate stage for behavioral interventions, as children have not yet established stable behavioral patterns. Implementing educational interventions at this age can instill healthy behaviors and prevent risky behaviors in adulthood. Accordingly, the present study was conducted with the aim of implementing a campaign to prevent alcohol misuse among parents of children aged 3–7 years in Kerman Province, Iran.
Methods: This study was carried out on 500 participants in the pretest and 497 participants in the posttest between November 2023 and January 2024 in Kerman. Sampling was conducted randomly. An educational package was uploaded for 10 days on the domestic messaging platform Eitaa. Data were collected before and after the campaign using a researcher-designed questionnaire on knowledge and attitudes. Statistical analyses were performed using SPSS software.
Results: Most parents were in the age group of 29–59 years. After the campaign, the mean knowledge score of parents regarding alcohol misuse in children showed a significant improvement (P < 0.001), whereas the attitude score did not show a significant change.
Conclusion: The intervention increased parental knowledge about alcohol and substance misuse, but did not significantly change their attitudes. These findings suggest that sustainable change requires more comprehensive, interactive, and long-term educational programs.
View Abstract
Methods: This study was carried out on 500 participants in the pretest and 497 participants in the posttest between November 2023 and January 2024 in Kerman. Sampling was conducted randomly. An educational package was uploaded for 10 days on the domestic messaging platform Eitaa. Data were collected before and after the campaign using a researcher-designed questionnaire on knowledge and attitudes. Statistical analyses were performed using SPSS software.
Results: Most parents were in the age group of 29–59 years. After the campaign, the mean knowledge score of parents regarding alcohol misuse in children showed a significant improvement (P < 0.001), whereas the attitude score did not show a significant change.
Conclusion: The intervention increased parental knowledge about alcohol and substance misuse, but did not significantly change their attitudes. These findings suggest that sustainable change requires more comprehensive, interactive, and long-term educational programs.
Modeling a Job Demands-Resources Framework in Indonesian Primary Healthcare; a Structural Equation Modeling-Partial Least Squares Analysis
R. Rahman, P. Patwayati, L.H. La Hatani, S.W. Maharani
Aims: Primary health care requires personnel with strong psychological resources to maintain optimal performance. Grounded in the Job Demands–Resources model, this study examines the mediating role of work engagement in the relationship between personal resources—self-efficacy, resilience, and optimism—and healthcare professionals’ performance.
Materials and Methods: This study employed an explanatory cross-sectional design. Data were collected from 292 primary healthcare professionals using a Likert-scale questionnaire and proportional stratified random sampling. Structural relationships and mediation effects were analysed using Structural Equation Modeling–Partial Least Squares (SEM-PLS) with SmartPLS 4, assessing both measurement and structural models.
Finding: Personal resources significantly influenced work engagement, with optimism (β = 0.430), self-efficacy (β = 0.318), and resilience (β = 0.161) showing positive effects. Work engagement had a strong and significant effect on performance (β = 0.699). Direct effects of optimism and resilience on performance were not significant. However, mediation analysis revealed significant indirect effects of optimism (β = 0.301), self-efficacy (β = 0.222), and resilience (β = 0.113) on performance through work engagement.
Conclusion: The findings indicate that personal resources primarily enhance performance through work engagement. Strengthening psychological resources and fostering supportive work environments are essential strategies for improving performance in primary health care settings.
View Abstract
Materials and Methods: This study employed an explanatory cross-sectional design. Data were collected from 292 primary healthcare professionals using a Likert-scale questionnaire and proportional stratified random sampling. Structural relationships and mediation effects were analysed using Structural Equation Modeling–Partial Least Squares (SEM-PLS) with SmartPLS 4, assessing both measurement and structural models.
Finding: Personal resources significantly influenced work engagement, with optimism (β = 0.430), self-efficacy (β = 0.318), and resilience (β = 0.161) showing positive effects. Work engagement had a strong and significant effect on performance (β = 0.699). Direct effects of optimism and resilience on performance were not significant. However, mediation analysis revealed significant indirect effects of optimism (β = 0.301), self-efficacy (β = 0.222), and resilience (β = 0.113) on performance through work engagement.
Conclusion: The findings indicate that personal resources primarily enhance performance through work engagement. Strengthening psychological resources and fostering supportive work environments are essential strategies for improving performance in primary health care settings.
Influence of Patient Conditions and Health Service Providers on Indonesian Patients' Experience
Riana Ingrid Suranto, Syahrir A. Pasinringi, Fridawaty Rivai, Herlina A. Hamzah, Irwandy Irwandy
AIMS: Patient experience is a key indicator for assessing hospital service quality. Although Primaya Inco Sorowako Hospital has achieved an A-level accreditation with a patient satisfaction rate above 90%, several complaints persist regarding long waiting times, unclear explanations from staff, and complicated administrative procedures. These issues indicate the need to evaluate factors influencing patient experience.
To analyze the influence of patient conditions and healthcare service providers on patient experience at Primaya Inco Sorowako Hospital, both directly and through the mediation of healthcare service providers
METHODS: Employed a quantitative approach with a cross-sectional design. The population consisted of 3,771 outpatients, and a total of 349 respondents were selected using a proportional stratified random sampling technique. Data were collected using a closed-ended questionnaire with a 4-point Likert scale and analyzed using univariate, bivariate, and multivariate methods
RESULTS: The findings revealed that patient conditions and healthcare service providers significantly affect patient experience. The most influential factors were healthcare responsiveness and quality, emphasizing the importance of timeliness, effective communication, and provider attentiveness to patient needs
CONCLUSION: The Lived Experience of Illness variable has a significant negative effect on Patient Experience
View Abstract
To analyze the influence of patient conditions and healthcare service providers on patient experience at Primaya Inco Sorowako Hospital, both directly and through the mediation of healthcare service providers
METHODS: Employed a quantitative approach with a cross-sectional design. The population consisted of 3,771 outpatients, and a total of 349 respondents were selected using a proportional stratified random sampling technique. Data were collected using a closed-ended questionnaire with a 4-point Likert scale and analyzed using univariate, bivariate, and multivariate methods
RESULTS: The findings revealed that patient conditions and healthcare service providers significantly affect patient experience. The most influential factors were healthcare responsiveness and quality, emphasizing the importance of timeliness, effective communication, and provider attentiveness to patient needs
CONCLUSION: The Lived Experience of Illness variable has a significant negative effect on Patient Experience
Effects of Nature-Based Educational Therapy on Treatment Adherence and Exercise Capacity in Ischemic Heart Disease Patients
, E. Karazhian, N. Davoudi Hasanabad, S.A. Ebrahimi, S. Nazemi, S.R. Mazlom
Aims: This study evaluated the effect of nature-based therapy on treatment adherence and exercise capacity in patients with ischemic heart disease.
Materials & Methods: This randomized controlled clinical trial was conducted on 58 patients who were randomly assigned to the intervention and control group (n=29 per group). The intervention group participated in a structured nature-based educational program that included guided walking, group discussions, relaxation techniques, and exercise sessions conducted in a natural environment. The control group received routine face-to-face education. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale, and exercise capacity was evaluated using the six-minute walk test before and after the intervention. Secondary physiological outcomes, including blood pressure, heart rate, respiratory rate, and oxygen saturation, were also measured. Analysis of covariance was used to compare post-intervention outcomes between groups while adjusting for baseline values.
Findings: After adjusting for covariates, treatment adherence was significantly higher in the intervention group than in the control group (p<0.01). Exercise capacity was also significantly greater in the intervention group than in the control group (p<0.001). Furthermore, the intervention group showed significant improvements in physiological parameters, including lower systolic and diastolic blood pressure, reduced heart rate, and improved oxygen saturation compared with the control group (p<0.05).
Conclusion: Nature-based therapy significantly improves treatment adherence, exercise capacity, and physiological outcomes in patients with ischemic heart disease in the short term.
Effect of COVID-19 Pandemic-Related Post-Traumatic Stress Disorder on the Quality of Nurses’ Work Life
F. Hosseini, F. Hashemi, A. Shafiei, A. Salavatian
Aims: Post-traumatic stress disorder is a psychological condition that can affect individuals during large-scale crises, such as the coronavirus pandemic. This study aimed to investigate the effect of COVID-19-related post-traumatic stress disorder on the quality of nurses’ work life.
Instrument & Methods: This cross-sectional descriptive-analytical study was conducted between September 2022 and March 2023 among nurses working in hospitals affiliated with Qazvin University of Medical Sciences, located in northwest Iran. Through convenience sampling, 261 nurses were enrolled. Data were collected using the demographic and professional characteristics form, the Post-Traumatic Stress Disorder Symptoms Scale, and the Quality of Nurses’ Work Life (QNWL) questionnaire. Data analysis was performed using SPSS 20, applying descriptive statistics and inferential tests, including the Mann-Whitney U test, Kruskal-Wallis test, analysis of variance, and Spearman’s correlation coefficient. A significance level of p<0.05 was considered.
Findings: The mean age of the participants was 35.19±7.75 years. The mean post-traumatic stress disorder score was 45.96±20.21, and the mean quality of nurses’ work-life score was 128.17±27.73. Significant relationships were observed between employment status and work shift with the quality of nurses’ work life (p<0.05). Additionally, gender and marital status were significantly associated with post-traumatic stress disorder scores (p<0.05).
Conclusion: Both post-traumatic stress disorder symptoms and the quality of nurses’ work life are at moderate levels among the nurses.
View Abstract
Instrument & Methods: This cross-sectional descriptive-analytical study was conducted between September 2022 and March 2023 among nurses working in hospitals affiliated with Qazvin University of Medical Sciences, located in northwest Iran. Through convenience sampling, 261 nurses were enrolled. Data were collected using the demographic and professional characteristics form, the Post-Traumatic Stress Disorder Symptoms Scale, and the Quality of Nurses’ Work Life (QNWL) questionnaire. Data analysis was performed using SPSS 20, applying descriptive statistics and inferential tests, including the Mann-Whitney U test, Kruskal-Wallis test, analysis of variance, and Spearman’s correlation coefficient. A significance level of p<0.05 was considered.
Findings: The mean age of the participants was 35.19±7.75 years. The mean post-traumatic stress disorder score was 45.96±20.21, and the mean quality of nurses’ work-life score was 128.17±27.73. Significant relationships were observed between employment status and work shift with the quality of nurses’ work life (p<0.05). Additionally, gender and marital status were significantly associated with post-traumatic stress disorder scores (p<0.05).
Conclusion: Both post-traumatic stress disorder symptoms and the quality of nurses’ work life are at moderate levels among the nurses.
Effect of Self-Efficacy-Based Intervention on Stress, Anxiety, Depression, and Quality of Life in Heart Failure Patients
A. Asri, A. SUSWANI, S. Safruddin, M. Muriyati, A. AB
Aims: Heart failure is a major global public health problem. This study aimed to assess the effect of a self-efficacy-based nursing intervention on stress, anxiety, depression, and quality of life in patients with heart failure.
Materials & Methods: This quasi-experimental study was conducted involving 252 participants, with 126 assigned to the intervention group and 126 to the control group, at community cardiology centers in South Sulawesi, Indonesia. The intervention group participated in a twelve-week structured program centered on knowledge, motivation, and self-monitoring, based on Bandura’s self-efficacy theory. Psychological distress, quality of life, and functional independence were evaluated at baseline and during the intervention.
Findings: Participants in the intervention group showed significant reductions in stress (p=0.001), anxiety (p<0.001), and depression (p=0.001) compared to the control group. Quality of life improved in physical (median=63.00), psychological (median=69.00), and social (median=69.00) domains. Functional independence showed a significant increase (p=0.002).
Conclusion: The self-efficacy-based nursing intervention significantly decreases psychological distress and improves quality of life in patients with heart failure.
View Abstract
Materials & Methods: This quasi-experimental study was conducted involving 252 participants, with 126 assigned to the intervention group and 126 to the control group, at community cardiology centers in South Sulawesi, Indonesia. The intervention group participated in a twelve-week structured program centered on knowledge, motivation, and self-monitoring, based on Bandura’s self-efficacy theory. Psychological distress, quality of life, and functional independence were evaluated at baseline and during the intervention.
Findings: Participants in the intervention group showed significant reductions in stress (p=0.001), anxiety (p<0.001), and depression (p=0.001) compared to the control group. Quality of life improved in physical (median=63.00), psychological (median=69.00), and social (median=69.00) domains. Functional independence showed a significant increase (p=0.002).
Conclusion: The self-efficacy-based nursing intervention significantly decreases psychological distress and improves quality of life in patients with heart failure.
Digital Literacy and Health Service Effectiveness in Kendari City
J. Jumakil, S. Suhadi, L.A. Kalza, M.B. Yahya, M. Wahida, M.J. Ihsani
Aims: The optimization of services, such as online registration and virtual consultations, is hampered by low levels of digital literacy. The purpose of this study was to investigate how digital literacy affects the community health center’s ability to provide quality medical care.
Instrument & Methods: This quantitative, explanatory study was conducted using 224 samples. Purposive sampling was used at the community health centers, whereas proportionate random sampling was used at the research location to determine the number of respondents at each community health center. A questionnaire was used to gather data, which was then administered to Kendari City health center officers.
Findings: The effectiveness of healthcare was positively and significantly affected by digital literacy (p=0.0001). Community health center policies had a positive and significant impact on digital literacy (p=0.011), while digital infrastructure had a positive and significant impact (p=0.016).
Conclusion: Digital literacy significantly improves service effectiveness.
View Abstract
Instrument & Methods: This quantitative, explanatory study was conducted using 224 samples. Purposive sampling was used at the community health centers, whereas proportionate random sampling was used at the research location to determine the number of respondents at each community health center. A questionnaire was used to gather data, which was then administered to Kendari City health center officers.
Findings: The effectiveness of healthcare was positively and significantly affected by digital literacy (p=0.0001). Community health center policies had a positive and significant impact on digital literacy (p=0.011), while digital infrastructure had a positive and significant impact (p=0.016).
Conclusion: Digital literacy significantly improves service effectiveness.
E-Health Literacy and Its Relationship with Self-Care Behaviors among Iranian Hypertensive Patients
Sh. Shirzadi, Z. Arab Borzu, M. Taziki, S. Safari, N. Golghandashti, Sh. Jahanfar
Aims: E-health literacy is correlated with health-related behaviors, suggesting it can act as a mediator in the process by which health-related information leads to changes in health-related behaviors. This study aimed to investigate e-health literacy and to examine its relationship with self-care behaviors in hypertensive patients.
Instrument & Methods: This cross-sectional study was conducted in 2024 among 240 hypertensive patients covered by the healthcare centers of Neyshabur City, Iran. Participants were selected using a stratified random sampling method. Data were gathered using a demographic characteristics questionnaire, the Hypertension Self-Care Profile, and the Electronic Health Literacy Scale. The collected data were analyzed using multiple linear regression with SPSS 22.
Findings: The mean age of the respondents was 41.10±5.69 years. The mean of diabetes self-care activities was 47.1±8.5, and the mean e-health literacy was 21.3±6.6. Most diabetics had low e-health literacy, with 179 (74.6%) falling into this category. After adjusting for having a blood pressure measuring device at home and sleep status, e-health literacy (B=0.313, SE=0.092, p<0.05) was the statistically significant independent factor associated with self-care activities of hypertensive patients.
Conclusion: Implementing educational programs focused on promoting e-health literacy increases the self-care activities of hypertensive patients, thereby enhancing the patient’s overall quality of life.
View Abstract
Instrument & Methods: This cross-sectional study was conducted in 2024 among 240 hypertensive patients covered by the healthcare centers of Neyshabur City, Iran. Participants were selected using a stratified random sampling method. Data were gathered using a demographic characteristics questionnaire, the Hypertension Self-Care Profile, and the Electronic Health Literacy Scale. The collected data were analyzed using multiple linear regression with SPSS 22.
Findings: The mean age of the respondents was 41.10±5.69 years. The mean of diabetes self-care activities was 47.1±8.5, and the mean e-health literacy was 21.3±6.6. Most diabetics had low e-health literacy, with 179 (74.6%) falling into this category. After adjusting for having a blood pressure measuring device at home and sleep status, e-health literacy (B=0.313, SE=0.092, p<0.05) was the statistically significant independent factor associated with self-care activities of hypertensive patients.
Conclusion: Implementing educational programs focused on promoting e-health literacy increases the self-care activities of hypertensive patients, thereby enhancing the patient’s overall quality of life.
Relationship between Fertility Knowledge, General Health Literacy, and Reproductive Health Literacy among Iranian Medical Students
M. Rostami Varnousfaderani, Z. Khoshnazar, F. Mohammadjani, F. Fotovvati, F. Ghafori, K. Hosseini, P. Hosseini Koukamari
Aims: This study aimed to examine the association between fertility knowledge, general health literacy, and reproductive health literacy among female students at Saveh University of Medical Sciences.
Instrument & Methods: This descriptive-analytical cross-sectional study was conducted in 2025 on 208 female medical sciences students. Data collection tools included the Cardiff Fertility Knowledge Scale, the Short Form Health Literacy for Iranian Adults, and the Women’s
Reproductive Health Literacy Questionnaire. Data were analyzed using SPSS 24. For inferential analysis, Spearman’s correlation and backward linear regression were employed.
Findings: The mean age of participants was 22.34±3.27 years. The mean fertility knowledge score was 7.68 out of 13, while the mean scores for general health literacy and reproductive health literacy were 74.07 and 73.54 out of 100, respectively. A significant positive correlation was observed between fertility knowledge and both general health literacy (r=0.401; p<0.001) and reproductive health literacy (r=0.386; p<0.001). Regression analysis revealed that general health literacy (p=0.003) and reproductive health literacy (p=0.007) were significant positive predictors of fertility knowledge.
Conclusion: Fertility knowledge among female university students is moderate and influenced by both general and reproductive health literacy.
View Abstract
Instrument & Methods: This descriptive-analytical cross-sectional study was conducted in 2025 on 208 female medical sciences students. Data collection tools included the Cardiff Fertility Knowledge Scale, the Short Form Health Literacy for Iranian Adults, and the Women’s
Reproductive Health Literacy Questionnaire. Data were analyzed using SPSS 24. For inferential analysis, Spearman’s correlation and backward linear regression were employed.
Findings: The mean age of participants was 22.34±3.27 years. The mean fertility knowledge score was 7.68 out of 13, while the mean scores for general health literacy and reproductive health literacy were 74.07 and 73.54 out of 100, respectively. A significant positive correlation was observed between fertility knowledge and both general health literacy (r=0.401; p<0.001) and reproductive health literacy (r=0.386; p<0.001). Regression analysis revealed that general health literacy (p=0.003) and reproductive health literacy (p=0.007) were significant positive predictors of fertility knowledge.
Conclusion: Fertility knowledge among female university students is moderate and influenced by both general and reproductive health literacy.
Impact of the Teach-Back Method on Self-Care Behaviors in Hemodialysis Patients in Indonesia
W. Trisnaningtyas, N. Kurnia Wulandari, S. Metasari, S. Sawab
Aims: Self-care is essential for improving clinical outcomes among hemodialysis patients. However, limited health literacy often hinders patients’ ability to meet treatment demands. This research aimed to examine the efficacy of the teach-back technique as a health education strategy in promoting self-care behaviors among individuals receiving hemodialysis treatment in Indonesia.
Materials & Methods: This quasi-experimental study was conducted with 158 hemodialysis patients recruited from two tertiary hospitals in 2025. Participants were assigned to the intervention and control groups (79 per group). Data were collected through a researcher-constructed questionnaire assessing sociodemographic and clinical characteristics, along with the established Self-Care Agency Scale (SCAS). Statistical analyses were performed using SPSS 21, applying the Chi-square test and independent t-tests.
Findings: No notable disparities were observed between the groups at the initial assessment (p>0.05). Following a two-month period, the experimental group exhibited markedly elevated self-care scores across all domains—namely, medication adherence (p=0.007), self-monitoring (p=0.0001), dietary management (p=0.0001), personal hygiene (p=0.009), and psychological well-being (p=0.0001)—compared with the control group.
Conclusion: The teach-back technique is effective in bolstering self-care abilities among individuals receiving hemodialysis.
Effect of Life Skills Education on Preventing Household Tuberculosis Transmission in North Sumatra
Asriwati Amirah, Teguh Suharto, Nur Aini, Rara Jaka Desy, Neni Ekowati, Krisna Dona BR Sembiring, Azniah Syam, Melyana Malik
Aims: Pulmonary tuberculosis disproportionately affects the productive age group and has a tendency to spread to household contacts, especially vulnerable populations like children from low socioeconomic backgrounds. This study aimed to develop a life skills education model for tuberculosis patients, employing an effective life skills education strategy to prevent tuberculosis transmission, particularly among household contacts.
Materials & Methods: This quantitative quasi-experimental study used a two-group pre-test and post-test design. The study population comprised all tuberculosis patients in the North Sumatra region. The sample included 127 patients from urban areas and 126 patients from rural areas assigned to the intervention and control groups. The non-parametric Friedman test was used to examine changes in knowledge, attitudes, and practices regarding the prevention of tuberculosis transmission among household contacts. Concurrently, the Mann-Whitney test was applied to compare scores between the groups.
Findings: Post-intervention analysis revealed significant changes in attitudes for both urban and rural groups (p=0.0001), with no significant difference in the magnitude of these changes between the two areas (p>0.05). While practice scores improved significantly following the intervention (p<0.05), no significant difference in changes in practice scores was found between rural and urban areas when comparing the first and third tests (p>0.05).
Conclusion: Health education delivered via the lecture method, incorporating the life skills education module, effectively improves knowledge, attitudes, and actions in both urban and rural settings.
View Abstract
Materials & Methods: This quantitative quasi-experimental study used a two-group pre-test and post-test design. The study population comprised all tuberculosis patients in the North Sumatra region. The sample included 127 patients from urban areas and 126 patients from rural areas assigned to the intervention and control groups. The non-parametric Friedman test was used to examine changes in knowledge, attitudes, and practices regarding the prevention of tuberculosis transmission among household contacts. Concurrently, the Mann-Whitney test was applied to compare scores between the groups.
Findings: Post-intervention analysis revealed significant changes in attitudes for both urban and rural groups (p=0.0001), with no significant difference in the magnitude of these changes between the two areas (p>0.05). While practice scores improved significantly following the intervention (p<0.05), no significant difference in changes in practice scores was found between rural and urban areas when comparing the first and third tests (p>0.05).
Conclusion: Health education delivered via the lecture method, incorporating the life skills education module, effectively improves knowledge, attitudes, and actions in both urban and rural settings.
Regulatory Pressure and Perceived Threats in Indonesian Electronic Medical Records Adoption
M. Ghozali, C.K. Dewi
Aims: This study explored the dynamics of electronic medical records adoption and use in primary healthcare facilities in Indonesia, specifically examining the role of regulatory pressure and perceived technological threats within the framework of mandatory national health policies.
Instrument & Methods: This multisite cross-sectional survey was conducted among 688 healthcare workers from 27 community health centers in Bantul Regency, Indonesia. An analytical framework was used to examine regulatory pressure, perceived threat, performance expectancy, effort expectancy, facilitating conditions, behavioral intention, and actual use, with the latter analyzed through structural equation modeling.
Findings: Perceptions of utility, ease of use, and organizational support played a vital role in shaping the intention to adopt electronic medical records. Regulatory pressure emerged as a primary driver shaping facility readiness and practitioners’ psychological response, directly strengthening behavioral intention. Notably, actual system usage was driven by the synergy between regulatory mandates and institutional readiness.
Conclusion: Successful digital transformation in primary healthcare requires coherence among regulatory enforcement, institutional readiness, and healthcare workers' adaptive responses to technological change.
Faculty Members’ Perspectives on Using Artificial Intelligence Chatbots in Medical Education and Research
R. Abjar, Z. Nouri Khaneghah, L. Sadati, S.M. Hosseini, Gh. Ramezani
Aims: The effective adoption of artificial intelligence in medical academia depends critically on the perspectives of faculty members as the primary stakeholders. Therefore, this study aimed to elucidate faculty perspectives regarding the use of artificial intelligence chatbots in medical education and research.
Participants & Methods: This qualitative study employed conventional content analysis. Data were collected through semi-structured interviews with 18 faculty members. Participants were recruited through purposive and snowball sampling until data saturation was reached. Interviews were analyzed using the conventional content analysis method developed by Graneheim & Lundman, and the rigor of the findings was ensured in accordance with Lincoln & Guba’s criteria.
Findings: Three main categories were obtained, including “practical application domains of artificial intelligence tools,” which included the sub-categories of content creation and instructional design, academic research support and production, and therapeutic application, “identified benefits and challenges of artificial intelligence tools,” comprising sub-categories of ethical and security concerns, educational and pedagogical concerns regarding student learning, technical and infrastructural limitations, and perceived advantages and opportunities, and prerequisites and enablers for effective artificial intelligence tools use, covering the sub-categories of competency development, foundational attitudes, and systemic support.
Conclusion: Faculty members widely utilize chatbots for content creation, article writing, and disease diagnosis, noting that these tools can help accelerate educational and research processes.
Mindset to Action: Predicting Medical Students' Safety Practices in Clinical Environments via Protection Motivation Theory
Aims: Occupational hazards in healthcare settings threaten the safety of medical students, whose protective behaviors during clinical training are vital for their well-being and patient care. This study applied Protection Motivation Theory (PMT) to identify key determinants of protective behaviors among medical students.
Methods: A descriptive–analytical (cross-sectional) study was conducted in 2025 among 420 medical students at Shahid Beheshti University of Medical Sciences, Tehran, Iran, selected through multistage cluster sampling. Data were collected using demographic and PMT-based questionnaires. Pearson correlation and linear regression analyses were performed in SPSS version 18, with a significance level of p < 0.05.
Findings: Participants had a mean age of 22.45 ± 3.9 years; 61% of the participants were female. Regression analysis showed that perceived susceptibility (p = 0.003), intention (p < 0.001), and behavior (p = 0.002) significantly predicted protection motivation. Self-efficacy (p = 0.001), intention (p = 0.001), and protection motivation (p = 0.002) significantly predicted protective behaviors.
Conclusion: Self-efficacy, intention, and protection motivation were the strongest determinants of students’ safety behaviors. PMT-based educational interventions may improve protective practices and reduce occupational risks in clinical environments.
Toward Technology Attitudinal Research among Iranian Older Adults: Are They Technophile or Technophobe?
Objective: Older adults’ attitudes toward technology are a key determinant of its acceptance or rejection, directly impacting the effectiveness of health interventions. The present study aimed to investigate and measure older adults’ attitudes toward technology and to examine factors associated with these attitudes among individuals attending comprehensive health centers in Iran.
Methods: In this cross-sectional study, 420 participants were selected using multi-stage random sampling. The P.TechPH scale was employed to assess both technophilia and technophobia. Data were analyzed using SPSS version 16.
Results: The mean TechPH score (3.59 ± 0.40) indicated generally positive technophilic attitudes among the participants. Higher levels of technophilia were observed in individuals aged 60–65, those with higher socioeconomic status, employed participants, and those with higher educational attainment. Daily Internet users and individuals with greater proficiency in using phones or tablets also exhibited significantly higher technophilia levels (P < 0.05).
Conclusion: These findings highlight the need for targeted interventions to foster positive attitudes toward technology among older adults, taking into account individual beliefs and relevant sociodemographic factors.
Electronic Health Literacy in Predicting Health-Promoting Lifestyle Behaviors (HPLB): A Cross-Sectional Study among College Students
Aims: This study aimed to investigate the role of electronic health literacy in adopting health-promoting lifestyle behaviors (HPLB) among students of Qazvin University of Medical Sciences in Iran.
Methods: In this cross-sectional study, 376 students were selected in 2023-2024 using proportionate stratified sampling. Participants completed questionnaires on demographic characteristics, eHEALS, and HPLP-II. Data were analyzed using SPSSv22 software, employing descriptive and analytical tests including independent t-tests, Pearson’s correlation and multiple regression analysis, at a significance level of p < 0.05.
Findings: Of the 376 participants, 79.78% were under 22 years of age. The mean and standard deviation of the total HPLB and eHealth literacy scores were (127.5 ± 18.8) and (25.04 ± 5.63), respectively. The highest score among the HPLB dimensions was observed in spiritual growth and self-actualization, while the lowest was in physical activity. A significant relationship was found between eHealth literacy and students’ HPLB, indicating that students with higher levels of eHealth literacy were more likely to engage in healthy behaviors. Multiple regression analysis revealed that age, gender, economic status, place of residence, and eHealth literacy together explained 32% of the variance in nutrition (R² = 0.235), 26% in interpersonal relationships (R² = 0.261), 20% in spiritual growth (R² = 0.202), 18% in health responsibility (R² = 0.183), 16% in stress management (R² = 0.162), and 11% in physical activity (R² = 0.115).
Conclusion: It is recommended that eHealth literacy concepts be integrated into university curricula to enhance students’ skills in using information technology for adopting health-promoting behaviors.
Dental Prosthetic Status, Needs, and Oral Frailty in Aging Population: Insights from a Cross-Sectional Study
Aims This study’s objective is to evaluate the current status of dental prosthetics, identify prosthetic needs, and the prevalence of oral frailty within the geriatric population in Egypt.
Instrument & Methods The study recruited 258 community-dwelling adults aged 60 years or older from residential homes in Al-Sharkia Governorate, Egypt. Collected data included demographic information, medical history, oral hygiene, prosthetic status and needs, and scores on the Oral Frailty Index-8 (OFI-8). Statistical analyses, including chi-square tests, t-tests, and multinomial logistic regression, were utilized to evaluate the associations among prosthetic status, prosthetic needs, and oral frailty.
Findings The analysis revealed that a very high percentage (79.8%) of participants were at an elevated risk for oral frailty. More than half the participants needed prosthetic rehabilitation, but many did not have access to suitable dental care. Factors including advanced age, chronic diseases, cigarette smoking, and poor oral hygiene were significantly linked to increased prosthetic needs. In contrast, place of residence and income level were not found to be significant predictors.
Conclusion This study underscores the high prevalence of oral frailty and substantial unmet prosthetic needs among older adults in Egypt. The findings emphasize the need for comprehensive geriatric dental care that incorporates prosthetic treatment. Such interventions are vital for preventing the progression of oral frailty and preserving quality of life in this aging population.
The Health Belief Model’s Application in the Development of Health Behaviors
N. Daniati, G. Widjaja, M. Olalla Gracìa, P. Chaudhary, M. Nader Shalaby, S. Chupradit, Y. Fakri Mustafa
Introduction: As part of any program, it is essential to identify the multiple factors influencing behavior. In the present study, an attempt has been made to overview this model's concepts and mention some strategies for developing health behaviors using this model. The health belief model is one of the first models to introduce theories from behavioral sciences into the field of health to solve health problems. A group of psychologists first developed this model in the 1950s to help explain why people do not use health services such as chest x-rays for tuberculosis screening and smallpox immunization.
Conclusion: People are afraid of the disease, and the degree of fear or the perceived threat encourages people to take health practices. The Health Belief Model was used to develop messages that motivate people to make decisions. This model helps to identify behaviors, identify points where behavioral changes need to be made, and make decisions easier.
Conclusion: People are afraid of the disease, and the degree of fear or the perceived threat encourages people to take health practices. The Health Belief Model was used to develop messages that motivate people to make decisions. This model helps to identify behaviors, identify points where behavioral changes need to be made, and make decisions easier.
A Survey on the Effects of the Pender's Health Promotion Model on Prediction of the Employees' Physical Activity
Mohammad Vahedian-Shahroodi, Farkhondeh Amin-Shokravi, Alireza Hidarnia, Hadi Jabbari Nooghabid
Aims: Most of the world population who is at work and production age does not have appropriate and regular physical activity for various reasons. Accordingly, the researchers tried to evaluate the effect of physical activity predictors of employees through the path analysis based on the Pender's Health Promotion Model (HPM). Methods and Materials: We conducted this study on 359 employees of the milk and milk powder production factories in Mashhad. A questionnaire consisted of items related to the structure of the Pender's Health Promotion Model (Perceived Benefits, Perceived Barriers, Prior Related Behavior, Perceived Self-Efficacy, Activity Related Affect, Personal Factors, Interpersonal Influences and Situational Influences) and the IPAQ standard questionnaire related to the physical activity were designed and applied in interviews as data collection instruments. Findings: One fourth of the employees had proper physical activity. Generally, structures of the Pender's Health Promotion Model predicted 34.8 % of the physical activity behavior variance. Regression analysis has shown that the predictability of Prior Related Behavior, Perceived Self-Efficacy, Personal Factors, Activity Related Affect and Interpersonal Influences are significant and Situational Influences are nearly significant. Prior Related Behavior (β = 0.45, P < 0.000) and Self-Efficacy (β = 0.17, PConclusions: The findings of the study revealed that HPM is efficient in identifying and predicting the physical activity behavior. This pattern can be used as a framework for planning and implementing educational interventions in order to improve the physical activity of the adult employees.
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Effects of the BASNEF Model-Based Educational Programs on Blood Sugar Control, (Type 2 Diabetes)
Ali Khani Jeihooni, Seyyd Mansour Kashfi, Seyyd Mohammad Mehdi Hazavehei
Aims: Complication of diabetes mellitus (DM) is the most important impediment resulted from uncontrolled blood sugar. The patients should be educated on controlling their blood sugar and promoting their preventive behaviors, in order to reduce complications. The aim of the present study is to determine the effects of the BASNEF Model-based educational programs on Blood sugar Control (Diabetes Type 2), in Nader Kazemi Clinic, Shiraz-Iran.rnMethods and Materials: This is a perspective and quasi-experimental intervention study, the research population is type 2 diabetics of 40-65 years diagnosed over 5 years. 100 patients fulfilling the inclusion criteria participated in the study. They were randomly divided into experimental and control groups. The instruments for data collection were: a questionnaire established based on the BASNEF Model (Belief, Attitude, Subjective Norm and Enabling Factors), a self reporting checklist related to the patient practice and a checklist for recording the patients' HbA1c and Fasting Blood Sugar (FBS) levels. Content validity method was used to evaluate the questionnaire's scientific validity. The questionnaires were completed by 20 type 2 diabetics to measure reliability (other than those who participated in the study). The faulty ones were removed and the results checked with %95 reliability (Cronbach's ά Coefficient was 84%).rnBoth groups completed the questionnaires and checklists; the results were documented before and three months after intervention.rnThe patients of the experimental group participated in 6- session educational classes in the first month of intervention and once more two months after, with 2-session meeting classes as the intervention follow up. Data analysis was conducted using SPSS software, chi square-test, T-test for independent samples, matched T-test, and repeated measures ANOVA.rnFindings: concerning the mean scores of age, T-test for independent samples showed no significant difference between the experimental group (SD=7.52, Mean=54.40) and control group (SD=6.72, Mean=54.24).rnThe findings indicated that the mean scores of BASNEF Model variables were significantly increased in the experimental group compared to the control group, after intervention. Also, behavioral control of blood sugar, HbA1c rate (8.65% before intervention and 7.47% after three months) and FBS levels (207.08 before intervention and 124.2 after three months) improved significantly among the experimental group, compared to control group.rnConclusions: Applying the BASNEF Model is very effective in developing an educational program for diabetics, in order to control their blood sugar and enhance behavioral controlling blood sugar. Besides, follow up education on controlling and monitoring is highly recommended.
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Homesickness and Coping Strategies among International Students Studying in University Technology Malaysia
Faezeh Mozafarinia, Sedigheh Sadat Tavafian
Aims: Nowadays, one of the most frequent problems that international students face is homesickness. The purpose of this study was investigation of homesickness and coping strategies among the University Technology Malaysia) UTM (international students and finding new research topics for future educational planning research. Methods: This descriptive study was done in August 2010 among the students studying in University Technology Malaysia (UTM). The respondents were international students from different courses in UTM. Fifty questionnaires were randomly distributed among the students at various faculties and residential colleges of the university. The questionnaire included 11 questions, which was developed by the researcher through literature review. Findings: Totally, 50 international students including 24 (48%) female and 26 (52%) male students took part in the study. There were different reported causes of homesickness by the respondents that were classified into four aspects: social, psychological, physical and academic”. The findings showed the most important reason for homesickness has been cultural differences between the countries. Accordingly, 75% of the respondents (n=38) reported social customs as the first reason for international students' homesickness. Conclusion: The research results indicated that missing family was the most important factor that influenced international students to feel homesick. According to this study, the best and effective way to manage homesickness was to call family and friend(s).
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A Study on the Relationship between Quality of Life, Emotional Intelligence and Life Satisfaction among Students
naemeh Alibabaie
Aim: Happiness is a very important issue in the life of every human, which is influenced by many closely-related variables. The purpose of the present study is to explore the relationship of quality of life, emotional intelligence and life satisfaction among the students of Zahedan University, Iran. Methods: This descriptive-analytic study was done on 204 students (101 males & 103 females) by using census method. Research tools were quality of life, emotional intelligence and life satisfaction scales. These are valid and reliable scales for use in psychological studies. Data were analyzed using Pearson’s correlation and T-tests in SPSS software. Findings: The research findings showed that emotional intelligence had a significant positive correlation with quality of life (r=.454, p<.001) but emotional intelligence was not associated with life satisfaction. Also quality of life had a significant correlation with life satisfaction (r=.402, p<.001). The results of t-test revealed that female students showed higher mean scores in quality of life and life satisfaction in comparison to their male student counterparts; however, there was no significant difference between the two groups in emotional intelligence scores. Conclusion: The results indicated that the higher scores of students’ emotional intelligence show the better quality of life they will have. Also quality of life is a variable that increasing students’ satisfaction of life. In order to raise the level of mental health, it is necessary to pay attention to the mentioned variables and educating people.
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The Theory-Based Substance Abuse Prevention Program for Adolescents
Saeid Bashirian, Alireza Hidarnia, Hamid Allahverdipour, Ebrahim Hajizadeh
Aims: Adolescence is one the most precarious periods of life, concerning the drug abuse. The social cost of the drug abuse and injury among adolescents is extraordinary and requires intervention. The theory of planned behavior (TPB) is perhaps the most influential theory for prediction of social and health behaviors including drug abuse. This study aimed at designing and implementing a curriculum based on the TPB for preventing adolescents from drug abuse. Methods and Materials: This quasi-experimental study was conducted in Hamadan, west Iran. We recruited 140 male high school students from randomly selected schools: they were divided into experimental group, n = 70 and control group, n = 70. The experimental group received 20 hours educational program based on the TPB. The control group receives no intervention. Findings: Compared to the control group, experimental group have significantly elevated post test scores for attitude (19.07 vs. 15.28, p < .001), subjective norm (18.08 vs. 16.45, p < .001), perceived behavioral control (51.67 vs. 54.82, p < .001); and their intention to use drug significantly decreased(p = 0.082) Conclusions: The TPB-based educational program may be effective in prevention of substance abuse among adolescents.
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Is Information- Motivation - Behavioral Skills Model Appropriate for Interventions on Health Education and Promotion?
Masoumeh Ebrahimi Tavani, Fazlollah Ghofranipour
One of the newest and the most comprehensive models for the behavior change is Information- Motivation- Behavioral skills (IMB) model. It is both simple and economic, and is of proper efficacy in the studies. IMB model as a health behavior change model is based on integration of the theories in social psychology and health education and promotion, emphasizing on information, motivation and behavioral skills as the basic determinants of the health-related behaviors The purpose of this article is to introduce the IMB model and by review of some studies based on this model; suitability of the model for health education and promotion interventions to be discussed. Iranian and foreign studies conducted using this model reveal the model's effectiveness in various health education disciplines. Although the IMB model has restrictions and disadvantages as any other health education and promotion model, IMB model-based interventions' advantages show that it is an applied model for changing health behavior.
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Reliability and Validity of the Champion's Health Belief Model Scale for Mammography among Iranian Women with Family History of Breast Cancer
Masoumeh Hashemian, Farkhondeh Amin Shokravi, Minoor Lamyian, Kazem Hassanpour, Arash Akaberi
Aims: The presence of a patient with breast cancer in the family can be considered as a guidance for further prevention and increase the susceptibility of people against this disease. Champion's health belief model scale is translated and tested in different countries, but few attempts have been made to measure this scale in women with history of breast cancer. Methods: After the standard Champion's Health Belief Model Scale was translated, 28 items were extracted with the help of panel of experts (n=13) and focus group (n=42) in four subscales. The eligible women were selected randomly (n=200) and took part in this study. The participants filled in the questionnaire through interviews. To test the construct validity of the data, the confirmatory factor analysis (CFA) was applied using AMOS software, moreover, test of internal consistency and test of reliability were applied by retesting (n=30). Findings: The confirmatory factor analysis, which, was repeated after omitting these two items for the subscale of perceived barriers and shows the proper fit of its structural model. Cronbach 'alpha coefficients were 0.72 (susceptibility), 0.75 (seriousness), 0.82 (benefits) and 0.76 (barriers). Internal consistency ranged from 0 .64 to 0 .79 and test-retest reliability correlation were from 0 .67 to 0.92. Conclusions: The Persian version of the Champion's Health Belief Model Scale can be a reliable and valid measure in Iranian women with family history of breast cancer.
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The Effect of Educational Program on Increasing Oral Health Behavior among Pregnant Women: Applying Health Belief Model
Mohsen Shamsi, Alireza Hidarnia, Shamsaddin Niknami, Mohammad Rafiee, Iraj Zareban, Mahmood Karimy
Aims: The oral health is one of the most of public health problems and women with pregnancy have high risk for dental caries and need more attention. The purpose of this study was to assess the effectiveness of a health education intervention based on the Health Belief Model (HBM) on oral health behavior in pregnant women. Methods: This is a quasi-experimental study carried out on 130 pregnant women selected with random sampling method from health centers in Arak in 2011 (case and control groups each of 65 women). Data collection with questionnaire was based on construct HBM, as well as their knowledge and performance about oral health. The women of the case group participated during the two month of intervention and again two month after، with 2 session meeting classes as the follow up after intervention. The data were collected 3 months after intervention and analyzed. Findings: Our findings indicated that mean scores of HBM Model variables, i.e susceptibility, severity, benefit and barriers perceived, were significantly increased in the case group compared to the controls after intervention. Also, oral health care (before intervention 45 ±9.2, after three months 77±9.7) improved significantly among the case group, compared to the controls (p<0/001). Conclusion: Applying the HBM Model is very effective for developing an educational program for oral health in pregnant women. Besides such programs, follow up education on controlling and monitoring is highly recommended.
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Identifying, Assessment and Prioritization of the Existing or Potential Hazards in the Automotive Industry by Combining Three Methods: FMEA, Wiliam Fine and AHP
Saeed Baesmat, Mohammad Reza Ghotbi Ravandi, Faezeh Abbasi Balochkhaneh, fateme golkhani, Ali Doost Mohammadi, Maryam Saadati, Somaye Dashti Rahmat Abadi
Aim: Every year, a huge number of incidents of irreparable damage to personnel and industries occur, most of which are predictable with identifying hazards as well as risk assessment and control. Therefore, in order to prevent occupational accidents, the automotive industry is one of the top priorities for evaluating and identifying the hazards.
Methods: The purpose of this study is to identify, control and rank the hazards of actions and processes in the hazardous automotive industry. This descriptive-analytical study was carried out in 2017 in one unit of Iran Khodro Company by using FMEA method. Also to accurately assess the health risks and make decisions for corrective actions to prioritize hazard risks, Wiliam Fine and AHP (Analytical Hierarchy Process) methods were used, respectively.
Findings: In this research, a list of 301 risks in 7 units including cutting line, assembly line, prototyping and modification, manufacturing, packaging, quality control, laboratory, and repair and maintenance were provided. The results of FMEA method indicated that the highest risk priority number (RPN) is related to the risks of particle swirling in grinding operations (336). Moreover, based on the results of William Fine method, the exposure to noise in the Kissing & Wessich Sersim Strandbauft operation was rated at 540 and 500, respectively, with the highest risk of evaluation. The risk of exposure to noise (Kicking operation) with a relative weight of 0/1904 was ranked the first.
Conclusion: The results of the hazard analysis showed that the effect of noise pollution that leads to hearing impairment in the staff is very high.
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Methods: The purpose of this study is to identify, control and rank the hazards of actions and processes in the hazardous automotive industry. This descriptive-analytical study was carried out in 2017 in one unit of Iran Khodro Company by using FMEA method. Also to accurately assess the health risks and make decisions for corrective actions to prioritize hazard risks, Wiliam Fine and AHP (Analytical Hierarchy Process) methods were used, respectively.
Findings: In this research, a list of 301 risks in 7 units including cutting line, assembly line, prototyping and modification, manufacturing, packaging, quality control, laboratory, and repair and maintenance were provided. The results of FMEA method indicated that the highest risk priority number (RPN) is related to the risks of particle swirling in grinding operations (336). Moreover, based on the results of William Fine method, the exposure to noise in the Kissing & Wessich Sersim Strandbauft operation was rated at 540 and 500, respectively, with the highest risk of evaluation. The risk of exposure to noise (Kicking operation) with a relative weight of 0/1904 was ranked the first.
Conclusion: The results of the hazard analysis showed that the effect of noise pollution that leads to hearing impairment in the staff is very high.
The Effect of Self Efficacy Education Program on Reducing Blood Sugar Levels in Patients with Type 2 Diabetes
Iraj zareban, Shamsaddin Niknami, Fatemeh Rakhshani
Aims: Diabetes as the most common diseases caused by metabolic disorders is an important global challenge. This is a disease that requires lifelong self-care; because the self-care and improvement of the life quality is cost effective .The aim of this study is to determine the effects of the self-Efficacy education program on reducing blood sugar levels among the type 2 diabetic patients. It was conducted in Zahedan. Methods and Materials: 138 diabetic type 2 patients were selected in Zahedan Diabetic Center and divided randomly into control groups (n=69) and test group (n=69); and special checklist and health belief model questionnaire were applied as data collection instruments. Reliability and validity of the questionnaire was evaluated and confirmed. The data collected before intervention was analyzed, then educational design method executed 3 and 6 months after intervention and the collected data was analyzed using SPSS software. Findings: According to the results, there is a significant statistical difference in average number of models before and after educational intervention (pConclusions: Self-efficacy training in striation improves knowledge, attitude and self-care behaviours performance of the subjects and the related average of HbA1c and FB. The training seems to increase the learners' active participation in caring themselves, because they have experienced the results of the training program and they are motivated to enhance their better self-care behaviours.
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Determining the Most Important Hazards in the Cement Industry with a Cost Reduction and Process Optimization Approach
Faezeh Abbasi Balochkhaneh, mohamad reza ghotbi ravandi, Fatemeh Golkhani, Saeed Baesmat, zahra hasan pour sodrejani
Aim: Occupational health with the goals of providing, maintaining and enhancing the physical, psychological and social health of employees and preventing harmful factors is important.
One of the ways of preventing occupational hazards is to identify them in the workplace. So the purpose of this research is to identify hazards and risk assessment in order to provide the necessary information to help make the decisions required to reduce the occupation-related risks.
Methods: In this study, we used a combination of FMEA and AHP methods to assess the occupational risks of the cement industry.
Findings: In this study, eight hazards were first examined by the FMEA method, which was the highest risk priority number for occupational hazards. Then the hierarchical analysis process technique was used to evaluate and rank the hazards, with the risk of working at an elevated level with a relative weight of 0.2234 in the first place and the dangers of working with machinery with a relative weight of 0.20864.
Conclusion: The manufacturing activities in this industry are required to work in different conditions such as high altitude, work and contact with dangerous rotating and moving equipment, and high-risk manufacturing processes that provide suitable safety controls and structures for the protection of human capital and even upgrading machines. Therefore, the health of the staff and the work environment is necessary.
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One of the ways of preventing occupational hazards is to identify them in the workplace. So the purpose of this research is to identify hazards and risk assessment in order to provide the necessary information to help make the decisions required to reduce the occupation-related risks.
Methods: In this study, we used a combination of FMEA and AHP methods to assess the occupational risks of the cement industry.
Findings: In this study, eight hazards were first examined by the FMEA method, which was the highest risk priority number for occupational hazards. Then the hierarchical analysis process technique was used to evaluate and rank the hazards, with the risk of working at an elevated level with a relative weight of 0.2234 in the first place and the dangers of working with machinery with a relative weight of 0.20864.
Conclusion: The manufacturing activities in this industry are required to work in different conditions such as high altitude, work and contact with dangerous rotating and moving equipment, and high-risk manufacturing processes that provide suitable safety controls and structures for the protection of human capital and even upgrading machines. Therefore, the health of the staff and the work environment is necessary.
Application of Planned Behaviour Theory to Predict Salt Consumption in the Rural Women of Chabahar
Rabea Agh Atabay, Iraj Zareban, Mahnaz Shahrakipoor, Farzane Montazerifar
Aim: There is conclusive scientific evidence of the adverse effect of excessive salt consumption on health, particularly on blood pressure, leading to cardiovascular disease (CVD), gastric cancer, osteoporosis, cataracts, kidney stones, diabetes and obesity. We investigated the determinants of salt consumption among the rural women in Chabahar (Iran) by applying the theory of planned behavior. Methods: Rural native Chabahari women (n =230), aged 12-75 years old, were selected by multistage sampling via native assistants. Data were gathered through a questionnaire with acceptable validity and reliability consisting of TBP constructs (intention, attitude, subjective norms, and perceived behavioral control), as well as demographic characteristics. Bivariate correlations and stepwise regression analyses of TBP model were performed with the SPSS software. Findings: The results showed a significant direct asociation between attitude, subjective norms, percieved behavioral control and intention, and salt consuming behavior, also between attitude (sig.<0.001), subjective norms (sig.<0.01), perceived behavioral control (sig.<0.01), the intention to reduce salt consumption. Subjective norms, attitude and intention together predicted 10.9% of salt consuming behavior. Attitude and perceived behavioral control together predicted approximately 9% of the intention to reduce salt consumption. Conclusion: This study indicated that the theory of planned behavior can be used to predict the salt consuming behavior and the intention of Chabahari rural women. Focus on the family- and community-based educational programs to change attitude, subjective norms, and perceived behavioral control is necessary to make women reduce salt consumption.
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The Use of Failure Mode Effects Analysis (FMEA) and Analytic Hierarchy Process (AHP) Methods to Determine the Most Important Safety Hazards
F. Golkhani, M.R. Ghotbi Ravandi, S. Baesmat, F. Abasi Balochkhane
Aims: Since the occurrence of hazards in the steel industry has often been multiple and complex, the aim of this study was to identify the risk assessment in this industry in order to study the roots and realities of the risks and the causes of their occurrence, as well as to find solutions to reduce these risks.
Instruments & Methods: This descriptive-analytical research was conducted in the cement industry in Khorasan Razavi in 2017. FMEA and AHP methods were used to determine the most important safety hazards. The Risk Priority Number (RPN) was obtained from the multiplication of 3 factors including severity, probability of occurrence, and probability of discovery. Risk tolerance was used for the acceptable and unacceptable risks in the FMEA method.
Findings: The fluctuation of the flange and its breakage due to excessive water pressure in the furnace and lack of lighting for installation of the equipment in the furnace had a high risk. In the AHP method, the risk of breaking the flange was due to excessive water pressure in the furnace and lack of lighting to install the equipment in the furnace, which had a higher weight than the other hazards.
Conclusion: Although in the developing countries, the use of risk analysis methods with a preventive approach is not common, these problems have been resolved by communicating with the industry by recent studies.
It also emphasizes the use of decision-making methods to minimize the impact of judgments on risk assessment.
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Instruments & Methods: This descriptive-analytical research was conducted in the cement industry in Khorasan Razavi in 2017. FMEA and AHP methods were used to determine the most important safety hazards. The Risk Priority Number (RPN) was obtained from the multiplication of 3 factors including severity, probability of occurrence, and probability of discovery. Risk tolerance was used for the acceptable and unacceptable risks in the FMEA method.
Findings: The fluctuation of the flange and its breakage due to excessive water pressure in the furnace and lack of lighting for installation of the equipment in the furnace had a high risk. In the AHP method, the risk of breaking the flange was due to excessive water pressure in the furnace and lack of lighting to install the equipment in the furnace, which had a higher weight than the other hazards.
Conclusion: Although in the developing countries, the use of risk analysis methods with a preventive approach is not common, these problems have been resolved by communicating with the industry by recent studies.
It also emphasizes the use of decision-making methods to minimize the impact of judgments on risk assessment.
The Survey of Osteoporosis Prevention Behaviors in Women Based on Health Belief Model
Ali Khani Jeihooni, Mohammad Hossein Kaveh, Ebrahim Hajizadeh, Alireza Askari
Aim: Investigating factors affecting the adoption of preventive behaviors in women with osteoporosis is necessary. This study aims at determining the preventive treatment of osteoporosis in women in Fasa using the Health Belief Model (HBM) during 2014. Method: In this cross-sectional study, 401 women (aged 30-50 years) covered by the health centers in Fasa city were randomly chosen. Construct of HBM and the function of feeding and walking were determined to prevent osteoporosis in women. Findings: The mean age of women was 40/9±6/2 years. The variables of perceived susceptibility (p=0.007), motivation (p=0.009) for walking behavior and variables of perceived sensitivity (p=0.020) for feeding behavior were predicted. Conclusions: This study confirmed the power of HBM in predicting feeding and walking behavior for prevention of osteoporosis. Hence, this model can be used as a framework for designing and implementing educational interventions for prevention of osteoporosis in women.
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Effectiveness of Drug Abuse Preventative Intervention among Iranian Medical College Students Based on the Theory of Planned Behavior
Mehdi Mirzaei Alavijeh, Farzad Jalilian, Fazel Zinat Motlagh, Saeid Mazloomy Mahmodabad, Razieh Zolghadr, Naser Hatamzadeh
Aims: Drug abuse among college students continues as a major public-health concern. Theory-driven research is necessary to address and find causes. The current research investigates the utility of Theory of Planned Behavior (TPB) in designing and implementing a drug abuse educational prevention program among medical college students. Methods: This quasi-experimental study was conducted among 120 college students in two groups: experimental and control, who were randomly enrolled at the baseline survey. We used a questionnaire, which included three sections of background data (11 questions), knowledge about the side effects of drug abuse questionnaire (16 questions), and TPB-based questionnaire (20 questions). Educational planning was based on active learning with using group discussion, printed leaflet, and audio-visual CD. The participants were followed up after 2-month intervention. Data were analyzed by the SPSS software version 16 using appropriate statistical tests such as stepwise multiple logistic regressions and t-test. Findings: Almost 6.7% of the participants had a history of drug abuse. The three predictors of 1) attitude, 2) subjective norms, and 3) perceived behavioral control accounted for 48 % of the variation in the outcome measure of the intention to drug abuse. There was a significant improvement in average response for knowledge about the side effects of drug abuse and TPB variables among the students who were under intervention (P < 0.05). Conclusions: Designing intervention to reduce positive attitude and subjective norms toward drug abuse among college students could be useful to substance abuse prevention.
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The Internet Addiction and Related Factors among Students of Yazd Universities
Seyyed Saeid Mazloomy Mahmoudabad, Mohammad Hassan Lotfi, Nahid Ardian, Sajad Saleh Manshadi, Soheila Bazm
Aim: Nowadays, the Internet is considered as an appropriate means of transferring knowledge in education and research processes. However, overusing the Internet may cause addiction. This problem may increase as the Internet usage increases. This paper attempted to study the Internet addiction among the students of Yazd universities. Methods: This research was a cross-sectional study conducted among 238 students of Yazd University Medical Sciences and 245 students of Yazd Payam-e-Noor University. The data were collected using the Internet Addiction Questionnaire introduced by Young. To analyze data, several statistical operations were conducted, including mean, percentage, Chi-square, Spearman’s correlation coefficient, Chi-two, and linear regression. Findings: Among the addicted students, 51% were from Payam-e-Noor University and 49% were from the University of Medical Sciences. Descriptive statistics also revealed that 51% of the addicted students were female and 67% of them were unmarried. Getting news and using e-mail services were mostly reported the Internet usages. Conclusion: Comparing with the previous studies, the Internet addiction has increased among the students of Yazd universities. This problem needs more concise investigation, and educational and counseling planning to reduce the Internet abuse.
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Socio-demographic Factors and Fruit and Vegetable Consumption among Tehranian Adolescents: A Cross-sectional Study
Sakineh Rakhshanderou, Ali Ramezankhani, Mohtasham Ghaffari, Yadollah Mehrabi
Aim: Evidence indicates that demographic factors such as age, gender, and mother's literacy are important predictors of fruit and vegetable consumption among adolescents. So, this study was conducted in order to survey the relation between socio-demographic factors and fruit and vegetable consumption among Tehranian adolescents in 2013. Methods: This cross-sectional study (descriptive-analytic) was carried out for surveying Tehranian adolescents, socio-demographic factors and fruit and vegetable consumption. The total of 500 adolescents (11-14 years old) was included in the study using multistage random sampling method. Being at the age of 11-14 years, giving informed consent, and voluntary participation were criteria for students' selection. Data were gathered using questionnaire encompass socio-demographic characteristics (11 items) and Frequent Fruit and Vegetable Questionnaire (FFQ). Data were analyzed using statistical software SPSS 18 (descriptive statistics, and tests of independent t and one way ANOVA). Findings: There was no relationship between age, gender, family size, parent’s job, and fruit and vegetable consumption. Based on one way ANOVA test, there was a significant relation between vegetable consumption and mother’s and father’s literacy, as well as between home size and fruit and vegetable consumption. Conclusion: The finding that economic factors and parent’s education level have a strong association with the adolescents’ intake of fruits and vegetables in this sample concurs with other research findings regarding the importance of family environment to promote healthy eating behaviors among adolescents.
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What Is “Meaningful Change” When Working with Transtheoretical Model (TTM)?
Fazlollah Ghofranipour, Saeideh Ghaffarifar
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Effect of Emotional Intelligence Training on the Communication Skills of Final-year Nursing Students
Shahla Ayoubi Mahani, Shayesteh Salehi
Aim: Effective communication has a key role in nursing profession. Furthermore, controlling emotions as a part of communication skills has an important role in initiating and maintaining healthy social communications. The meaning of emotional intelligence is also effected considerably by the importance of this aspect of social communications. The aim of this study was to determine the effect of emotional intelligence training on the communication skills of final-year nursing students of Islamic Azad University, Isfahan branch (Khorasgan) in 2014. Methods: This quasi-experimental study was done with semester 7 and 8 undergraduate (nursing) 77 students. Data were collected by Bar-On Emotional Intelligence Test and Queen-Dom Communication Skills Test. Initially, the questionnaires were completed by the students; then the emotional intelligence workshop was held in 6 sessions’ each took 45 minutes. After a month, again both questionnaires were completed by the students. Analysis of results was performed by descriptive statistics (frequency, mean, middle and standard deviation) and analytic statistics (Kolmogorov-Smirnov test, Wilcoxon and Spearman correlation coefficient) in the SPSS software (version 19). Findings: Difference of communication skills’ scores before and after the intervention had a significant level (p=0.001), and the scores increased after the intervention significantly. Conclusion: Emotional intelligence training has a positive impact on communication skills of nursing students. So holding emotional intelligence workshops in one of the university alternatively annually for nursing students is recommended.
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