Health Education and Health Promotion

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Aims: The Electronic Health Record is a collection of medical information about a person's health status. The development of electronic health records has occurred worldwide, and developing countries, including Iran, have been no exception and have tried to take action in this regard. Therefore, this study aimed to review the types of Electronic Health Records designed in Iran.
Information & Methods: This systematic review was conducted without any time limitation until 12 June 2022 by searching the keywords Electronic Health Record, and Iran, and their synonyms in the Web of Science, PubMed, Scopus, SID, and Magiran databases, and Google Scholar search engine. Published articles on the development or design of electronic health records in Iran were reviewed.
Findings: Among 28 papers, 11, 6, and 11 records were designed in Electronic Health Record, Electronic Medical Record, and Personal Electronic Record formats, respectively. Approximately 46% of the studies only designed electronic records but never implemented them, and the rest (54%) had completed the electronic record development. Among 15 implemented records, 7, 4, and 4 were in Personal Electronic Record, Electronic Health Record, and Electronic Medical Records formats, respectively. In addition, implementation platforms for records were in the form of web-based, mobile-based, and windows-based applications. Most of the minimum data set in the designed records were demographic data, medical history, therapeutic procedures, and laboratory tests.
Conclusion: Designing various Electronic Health Record systems for different diseases and clinical conditions can be an effective step toward developing a national Electronic Health Record.