Health Education and Health Promotion

Abstract Aims: Physical inactivity and a sedentary lifestyle increase the risk of all-cause mortality. This study aimed to assess the impact of a theory-based education on PA among female health volunteers in Iran by applying the Theory of Planned Behavior.
Materials & Methods: This randomized controlled trial was conducted on female health volunteers in Shushtar, Iran, from March to December 2016. One hundred ten participants were selected by purposive sampling, and they were randomized into intervention and control groups based on a 1:1 ratio in a single block. The intervention included three educational sessions and a walking program. A multi-section questionnaire containing items on TPB constructs, the international physical activity questionnaire, and the physiological cost index (PCI- an objective measure of PA) was used to collect the data at baseline and six-month follow-up assessments. Then the data were compared within and between groups using t-test and paired test using SPSS 19 software.
Findings: All 110 ‘Health Volunteers’ (55 in each group) were entered into the study. The mean±SD age of participants was 35.65±10.25 years. The results obtained from the analysis showed that the educational program improved attitude towards PA, perceived behavioral control, intention, behavior, and PCI among the intervention group (p<0.001). However, no significant changes occurred in the control group regarding the study variables (p>0.05).
Conclusion: The TPB-directed educational program improved physical activity and physiological cost index. The study framework might be used as a practical template for interventions aimed at improving physical activity among female health volunteers.

Abstract Aims: The high prevalence of Cesarean section (CS) is a global health concern globally, especially in Iran. The current study aimed to evaluate the effect of a Theory of Planned Behavior (TPB) based educational intervention on preventing elective cesareans.
Materials & Methods: An interventional study (NCT02929875) was conducted on a sample of 100 nulliparous pregnant women attending health care centers in Kermanshah, Iran, 2016. Women were randomly selected and assigned into either intervention or control groups on a 1:1 basis. The intervention group received a theory-based (Theory of Planned Behavior) health education intervention, while the control group received only standard care. A questionnaire containing items on TPB constructs, including attitude, subjective norms, perceived behavioral control, and intention, was used to collect baseline and 1-month follow-up assessments. Each woman also received a phone call after childbirth to record their delivery method. Data were analyzed using SPSS version 15 at a significance level of p<0.05. The paired t-test, the independent t-test, the chi-square, and ANCOVA were used for data analysis.
Findings: The results revealed significant differences in scores of attitude, subjective norms, perceived behavioral control, and behavioral intention in the intervention group before and after the intervention (p<0.05). Additionally, the intervention group chose elective cesarean less than the control group (p<0.05). The risk of having an elective cesarean section in the intervention group was about one-fifth of the control group (RR= 0.21; CI=0.4197 to 0.0018).
Conclusion: According to this randomized control trial results, the TPB-based education improved the TPB constructs and NVD rates by providing education to women and their close friends or relatives during pregnancy.

Abstract Aims: Mass media are among the most important tools for enhancing health information and health promotion in any country. Among the different types of mass media, news agencies are the primary source of health information. The present study examines health coverage in news agencies and implements and evaluates an intervention to improve health promotion news coverage.
Methods: The explanatory sequential mixed-method study includes five phases, including quantitative content analysis of news agencies, semi-structured interviews, intervention, and evaluation of the intervention, and synthesis of the recommendations. Four news agencies utilizing the purposeful sampling method would be selected and divided into two cases and two control groups. Primary outcomes: awareness-raising and enhancing the knowledge, attitude, and performance of health journalists and improving the communication between the media and the health sectors. Secondary outcomes: increasing the quality and quantity of public health (health protection, prevention, education, and promotion) related news agencies coverage. In the Fifth phase, utilizing the results of the four phases, a practical recommendation will be proposed for creating health-promoting media.
Perspective: This result would provide a more holistic approach to understanding the current situation, generating more effective and comprehensive strategies to utilize the potential of news agencies for health promotion and creating health-promoting news agencies.

Abstract Aims: Depression during pregnancy has a significant impact on both mother and fetus. This study aimed to determine the frequency of depression and associated factors among primigravid women.
Materials & Methods: This was a cross-sectional study involving 255 pregnant women attending a hospital in Tehran from October 2017 to February 2018. A demographic and clinical questionnaire, the Postpartum Depression Literacy Scale (PoDLiS) and the Edinburgh Postnatal Depression Scale (EPDS), given to a convenient sample of primigravid women attending the antenatal clinic, were completed. chi-square test, t-test and logistic regression analysis were used to analyze the data and SPSS version 22.0 was used for its analysis (p<0.05).
Findings: The prevalence of depression during pregnancy was 17.3% (n=255). The results of the t-test and chi-square test showed that depression was significantly associated with age (p=0.008), marriage age (p=0.018), economic status (p=0.050), family history of depression (p<0.001), marital satisfaction (p<0.001), ability to recognize postpartum depression (p=0.019) and attitudes about postpartum depression (p=0.042). Further analysis by logistic regression analysis revealed that family history of depression [AOR=7.89, 95% CI, p=0.002] and less satisfaction with husband [AOR=3.24, 95% CI, p=0.021] was significantly associated with depression.
Conclusion: The findings showed that a high percentage of women were depressed. Also, having a family history of depression and less satisfied with the husband were the strongest factors related to depression. It seems that educational interventions and counseling may need to be conducted on high-risk mothers to promote their mental health status.

Abstract Aim: Breast cancer is the most common cancer in women.The Health Education Campaign (HEC) is an important educational strategy for breast cancer screening. The aim of this study was to investigate the effect of the (HEC) based training on the knowledge, attitudes, and practices of women, regarding breast cancer screening methods.
Materials & Methods: This was a pre- and post-quasi-experimental study conducted among 200 women over 20 years in Mazandaran Province. A self-made 34-item questionnaire was used to collect the data. A pretest was performed before the educational intervention and a posttest was conducted 12 weeks after the intervention. The data were analyzed by logistic regression, Pearson correlation coefficient, and one way ANOVA, using SPSS 22.
Findings: The mean age of the women was 35.16 years. Based on paired t-test, the difference in the mean scores of knowledge and attitudes regarding screening methods in the women was significant (p≤0.0001) before and after the intervention. Also, based on the macnemar test, the difference between the early detection of breast self-examination (BSE) and clinical breast examination (CBE) was significant in the women studied before and after the educational intervention.
Conclusion: According to the results of the study, the intervention had been able to change the knowledge, attitudes, and behaviors of women regarding breast cancer and early detection methods.