Health Education and Health Promotion

Abstract Aim: Oral hygiene must start at a young age. Childhood is the perfect time to start the conversion of knowledge into creative thinking and subsequent health care activity. This study aimed to measure the constructs of the Health Belief Model (HBM) in relation to the oral health practice of female students in Tehran.
Methods: A cross-sectional descriptive study was conducted on 416 grade five female students of elementary schools in the school year of 2016-2017 in Tehran, Iran. Data were collected using an author-designed questionnaire based on the constructs of the HBM. The validity of the questionnaire was confirmed using face validity while its reliability was approved using Cronbach’s alpha statistics. Data were analyzed using Pearson's correlation and regression analysis at 0.05 level of significance.
Findings: According to the findings, the mean age of the participants was 10.88±0.628 years. Pearson's correlation showed that four the HBM constructs of Self-efficacy, Cues to action, Perceived benefits, Perceived barriers were significant predictors for oral health practices (P < 0.05). In addition, the variables of knowledge and socio– economic conditions (mother's educational level, father's educational level, mother's job, father's job and family income) had significant relationship with performance (P < 0.05).
Conclusion: Our study shows that for improving the beliefs related with oral health behaviors, designing educational programs with emphasis on increasing self-efficacy and perceived benefits, and overcoming the barriers to promote oral health behaviors is essential.

Abstract

Abstract Aim: The most important factor underlying the mortality of patients with diabetes is the lack of self-care. This study aimed to determine the effect of education via mobile text messaging on the self-care of patients with type 2 diabetes.
Methods: This semi-experimental controlled study was carried out on 74 patients with diabetes in Chabahar, Iran. They were selected using convenience sampling in the health care centers, and were randomized into two control and intervention groups of 37 subjects each. The tools to collect data were questionnaires containing demographic profiles and self-care questionnaire. For each group, the questionnaires were completed, and educational SMS (short message service) was sent to the intervention group for four weeks. The post-test questionnaire was completed by both groups two months after educational intervention. Data were analyzed using SPSS16 and appropriate statistical tests.
Findings: Before the intervention, the mean scores of all self-care dimensions between the two groups did not differ significantly but after that, the mean of total scores of self-care and some of its dimensions (adherence to diet, blood glucose self-monitoring and foot care) were positive, and significantly increased in the intervention group versus the control group regularly after intervention were not different significantly between the two groups (P>0.05).
Conclusion: Considering the effectiveness of sending SMS educational method (SSEM) in improving the self-care of patients, it is necessary to further consider and use this method.

Abstract Aim: Hypertension (HTN) is considered to be the most important modifiable risk factor for cardiovascular morbidity and mortality. Although lifestyle modifications such as increase in physical activity (PA) are effective for lowering blood pressure (BP), it can often be difficult for hypertensive (HTN) individuals to modify their lifestyle and maintain such modification. So this study aimed at assessing the effectiveness of trans-theoretical model (TTM)-based intervention on PA in HTN patients.
Methods: This randomized controlled trial was conducted on 78 hypertensive patients (39 in the experimental group (EG) and 39 in the control group (CG)) from January 2015 to September 2015 in the city of Shiraz in southern Iran. The EG received TTM-based intervention about PA for four weeks. The study outcomes included PA stages of change, processes of change, exercise self-efficacy (ESE), decisional balance and PA, which were measured at the onset and at one week post-intervention. The data were analyzed using SPSS 16 software.
Findings: At one week post-intervention, PA increased significantly in the EG (1218.35±917.95) compared to the CG (810.28±785.21) (p=0.04). A significantly larger percentage of the EG (80.6%, n= 25) progressed to the stage of action compared with the CG (16.1%, n=5). Also one week post-intervention, the EG demonstrated higher ESE (p=0.004), higher decisional balance (p<0.001), and greater process of change (p=0.001) compared with the CG.
Conclusion: The present study showed that the TTM-based intervention effectively increased PA. So the use of TTM-based interventions can be effective in increasing the commitment to PA in HTN patients.

Abstract Aim: The aim of this study was to design a tool and to assess its validity and reliability based on native culture characterization to evaluate the health belief model (HBF) constructs about prenatal care.
Methods: 215 pregnant women covered by the health centers of Iranshahr in the age group of 18-35 years and the least ability of reading and writing participated in this cross-sectional study. After reviewing the literature, the tool was designed, and its validity and reliability were approved based on psychometric data of the target group and the view of a panel of experts through calculating the content validity ratio, content validity index, exploratory factor analysis, and internal consistency.
Findings: The validity of 42 items was assessed through calculating the index score of the item effect above 1.5, content validity ratio more than 0.80, and content validity index higher than 0.79. By using exploratory factor analysis with a special value greater than 1, six factors and 35 items remained that were classified into six categories based on the literature review and content items, which were able to predict 77.095 % of the total variance of the tool. The reliability of the research tool was calculated using Cronbach’s alpha equal to 0.816.
Conclusion: The results of this study provide proper evidence about the strength of structural factors and the reliability of the assessment tool for the structures of HBM about prenatal care. It can be considered by the researchers in developing a tool for research, education and action.

Abstract Aim: Insufficient physical activity in women exposes them to problems such as overweight, diabetes, depression and cardiovascular diseases on top. In between, employees have minimum physical activity due to type of their job. The goal of this study was determining psychological factors effective on the physical activity of women working in University of Tehran based on the theory of planned behavior. Methods: The research population included female office workers from the University of Tehran, who were selected through a call at this university in 2014 for this descriptive analytical cross-sectional study. For data gathering, a questionnaire was used with acceptable validity and reliability including demographic information and constructs of the Theory of Planned Behavior (TPB) as well as International Physical Activity Questionnaire (IPAQ). Data were analyzed using SPSS21. The statistical bivariate correlation test and stepwise regression test were employed at the significance level of 0.05. Findings: In this study, behavioral intention had a positive and significant relation with perceived behavioral control (P=0.000) and attitude (P=0.042). Also behavioral intention had a positive and significant relation with physical activity (P=0.000). Stepwise regression analysis was used to evaluate important factors effective on prediction of behavior and intention; it determined 40% of intention variance (R2= 0.408). Conclusion: The results of the study showed that constructs such as attitude and perceived behavioral control can be effective on the behavioral intention and physical behavior of female employees; therefore, these factors must be seriously considered in educational planning for this group of the society.

Abstract 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.

Abstract Aim: Tobacco use is one of the major causes of death worldwide and the most preventable risk factor of the coronary heart disease. The purpose of this study was to determine attitudes, risk perception and perceived vulnerability toward to water pipe (WP) smoking among male students in Zarandieh city of Iran. Methods: This cross-sectional descriptive study was carried out on 400 male adolescents in 2011-2012. A multiple-stage sampling protocol was used. The participants completed a self-report questionnaire about demographics, knowledge, attitude and beliefs about WP smoking and their tobacco use background. Data were analyzed by SPSS16. Findings: The prevalence of WP smoking was 72 (18%). Also 50% of participants believed water pipe smoking is less harmful compared to cigarettes. The mean score of knowledge, attitude, and risk perception for non smokers was higher from smokers (knowledge 4.9±2.1, attitude 19.5±4.3 and risk perception 18.6±3.3 versus 3.4±1.5, 15.6±5.5 and 15.4±4.3 respectively), whereas smokers reported a fairly high level of perceived stress and depression (perceived vulnerability). Conclusion: Noticing the side effects of tobacco use and the high prevalence of incorrect perceived WP smoking beliefs among students, provision of educational programs for the correction of the beliefs of students regarding WP smoking is recommended.

Abstract 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.

Abstract 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.