Health Education and Health Promotion

Abstract Stunting in children under five remains a critical public health problem in Indonesia, particularly in rural areas where access to optimal complementary feeding practices and health literacy are limited. The study was conducted in Bone Regency, Indonesia. Aim: This study aimed to develop and validate a predictive model to identify infants aged 6–12 months at risk of stunting (LAZ < -2) using maternal behavioral determinants and feeding indicators. Methods: A cross-sectional design was used to combine online questionnaire responses from 401 mothers with anthropometric data. The model incorporated constructs from the Health Belief Model (HBM)—including perceived severity, benefits, barriers, self-efficacy, and cues to action—in feeding based on WHO/UNICEF criteria (MDD, MMF, MAD). Structural equation modeling (PLS-SEM) was applied to test direct and indirect pathways to risk classification. Findings: The study showed that feeding practices were the strongest direct predictor of stunting risk (β = 0.537, p < 0.001). Mediation analysis confirmed that barriers indirectly increased risk through their negative impact on feeding behavior. The model demonstrated acceptable fit (SRMR = 0.061) and explained substantial variance in the primary outcomes (R² = 0.825 for Intention, 0.526 for Feeding Practices, and 0.542 for Risk). Conclusion: These findings suggest that targeting maternal beliefs and behavioral intentions can increase complementary feeding and reduce the risk of stunting. The intervention focused on reducing perceived barriers, strengthening self-efficacy, and ensuring timely cues to action. Community health centers can play a critical role in operationalizing this strategy at scale.

Abstract Aims: This study aimed to examine the determinants of antibiotic self-medication behavior among health workers using the health belief model in 2024.
Instrument & Methods: This cross-sectional study was performed on 146 health workers in the southern region of Tehran. A standardized questionnaire based on the health belief model was used to gather demographic information and evaluate health belief model constructs related to self-medication practices. Data analysis included t-tests, ANOVA, correlation analysis, and linear regression.
Findings: The majority of participants were female (90%), with a mean age of 37.78 years. The average score for antibiotic self-medication behavior was 86.04%. Notably, women demonstrated a higher behavior score than men, and having health insurance was associated with an increased behavior score. Significant associations were found between education level, age, number of children, and self-medication behavior. Linear regression analysis indicated that all health belief model constructs (knowledge, perceived susceptibility, severity, benefits, barriers, and self-efficacy) influenced appropriate antibiotic consumption behavior, with knowledge exhibiting the strongest effect.
Conclusion: Knowledge, self-efficacy, perceived susceptibility, severity, benefits, and barriers influence correct antibiotic consumption behavior among health workers.

Abstract Aims: Given that the skin is the body’s largest organ, it is not surprising that skin cancer is considered the most prevalent type of cancer among humans. This study aimed to investigate the behavior of students at Khomein University of Medical Sciences regarding the use of sunscreen to prevent skin cancer based on the health belief model.
Instrument & Methods: This cross-sectional study was conducted with students of Khomein University of Medical Sciences in Markazi Province in central Iran from February to January 2024. Given the small student population, a census sampling method was used, resulting in the participation of 353 students. The research tool comprised a demographic information questionnaire, along with a researcher-made questionnaire on the use of sunscreen in skin cancer prevention based on the health belief model. Data analysis was performed using STATA 17 software, employing descriptive statistics and simple and multiple linear regression analyses, with a significance level set at α=0.05.
Findings: A one-unit increase in the scores of perceived benefits, perceived barriers, cues to action, and perceived self-efficacy led to increases of 0.13 (95% CI=0.05, 0.26; p=0.041), 0.10 (95% CI=0.02, 0.17; p=0.007), 0.14 (95% CI=0.07, 0.22; p≤0.001), and 0.18 (95% CI=0.07, 0.29; p=0.001) in the mean behavioral score.
Conclusion: Gender, socioeconomic status, parental occupation, and level of education are associated with the adoption of sunscreen use behavior and perceived benefits, cues to action, and self-efficacy are strong predictors of sunscreen use.

Abstract Aims: This research aimed to evaluate the effectiveness of educational interventions based on the health belief model in enhancing hypoglycemia prevention skills among individuals with diabetes mellitus.
Materials & Methods: This quasi-experimental study utilized a two-group pre-test and post-test framework. Seventy-two participants were recruited through purposive sampling and divided equally into intervention and control groups, with 36 individuals in each group. The intervention group received education through a health belief model-guided mobile application, while the control group utilized a pocketbook for educational purposes. Participants’ skills in preventing hypoglycemia were assessed before and after a two-month intervention period using a validated questionnaire. Data were analyzed using paired and independent t-tests, with statistical significance set at p<0.05.
Findings: The intervention group demonstrated a notable improvement in hypoglycemia prevention skills, with mean scores increasing from 48.11±6.17 at baseline to 55.89±6.92 post-intervention (p=0.0001). In contrast, the control group showed only a modest increase, from 43.17±4.75 to 45.39±5.93 (p=0.0001). Post-intervention comparisons revealed a statistically significant difference in skill levels between the two groups (p=0.0001).
Conclusion: The health belief model-based education model effectively improves the ability of diabetes mellitus patients to prevent hypoglycemia.

Abstract Aims: Head lice infestation is a common and significant health issue among students and in school settings. It is particularly more prevalent in children aged 5-13 years. This study aimed to investigate the determinants of preventive behaviors against pediculosis based on the theoretical framework of the health belief model among students in the urban areas of Heris County.
Instrument & Methods: This descriptive-analytical correlational study was conducted with 1,000 students in urban schools in Heris County, East Azerbaijan. Data were collected through a census of all fourth and fifth-grade students in elementary schools. The research instrument was a questionnaire designed based on the health belief model, which had been validated, and its reliability was confirmed in previous studies. After the students completed the questionnaires, the data were analyzed using SPSS 16 by ANOVA and multiple linear regression.
Findings: Fourth-grade students demonstrated higher awareness (p=0.027) compared to fifth-grade students. Perceived susceptibility (p=0.001) and perceived barriers (p=0.004) were significantly (p=0.0001) higher in individuals with no history of pediculosis infestation compared to those with a history of pediculosis infestation. Except for the perceived severity construct, all components of the health belief model had a significant correlation with preventive behaviors against pediculosis. Furthermore, awareness (p=0.0001), self-efficacy (p=0.0001), perceived barriers (p=0.0001), gender (p=0.0001), and maternal education (p=0.024) were identified as key predictors of these behaviors, and these parameters collectively accounted for 21.5% of the variance in behavior changes (R²=0.215).
Conclusion: Awareness, self-efficacy, and perceived barriers play a significant role in adopting preventive behaviors against pediculosis infestation.

Abstract Aims: Hypertension is a critical health condition requiring consistent medical adherence to prevent complications. This study aimed to evaluate the effects of a cardiovascular risk assessment and an educational intervention grounded in the Health Belief Model (HBM) on medication adherence among patients with hypertension.
Materials & Methods: A semi-experimental study was conducted with three groups: a combined risk assessment and education group, a risk assessment-only group, and a control group, each consisting of 40 patients. Cardiovascular risk was individually assessed in both intervention groups using the Framingham model, with risk categories (low, moderate, high) explained to personalize the intervention and enhance perceived susceptibility. Additionally, patients in the combined intervention group received an educational booklet structured around HBM components. All participants completed questionnaires measuring knowledge, HBM constructs, the Morisky Medication Adherence Questionnaire, and treatment compliance (measured by the ratio of consumed to prescribed medications) at baseline and after three months. Data analysis was performed using SPSS software version 26.
Findings: The three groups were demographically comparable. Over time, the combined intervention group showed significant improvements in all HBM constructs. The risk assessment-only group demonstrated improvements in perceived barriers, perceived benefits, self-efficacy, and awareness. Both intervention groups exhibited enhanced treatment compliance and medication adherence compared to the control group.
Conclusion: The combined educational and risk assessment intervention proved more effective in improving awareness and strengthening HBM constructs than risk assessment alone.

Abstract Aims: Osteoporosis is one of the most common diseases among women, and dietary patterns, especially during adolescence, significantly impact its occurrence and prevention. The present study examined the determinants of osteoporosis in female students at the first secondary school level in Ilam City based on the health belief model.
Instrument & Methods: This cross-sectional study involved 819 participants selected by a two-stage cluster random sampling approach. Data were collected using a 52-item researcher-developed questionnaire based on the health belief model and analyzed using descriptive tests, Pearson’s correlation, multiple linear regression, one-way analysis of variance, and Chi-square test by SPSS 22 software.
Findings: The average age of participants was 13.72±0.97 years, with an age range of 12 to 16 years. Also, 22.2% of participants had a family history of osteoporosis. Additionally, 29.2% and 22.6% of the participants reported a history of calcium and vitamin D supplement intake in the last month, respectively. The health belief model constructs accounted for a total of 18.9% of the variance in behavior. Perceived barriers and perceived self-efficacy were identified as the most important predictors of behavior, while other constructs were not significant predictors despite showing significant correlations with behavior.
Conclusion: The constructs of self-efficacy and perceived barriers directly affected nutritional behavior preventing osteoporosis among teenage girls in Ilam City, while another construct had an indirect effect.

Abstract Aims: Hypoglycemia is a frequent complication in patients with type 2 diabetes mellitus. By providing education, awareness among diabetic patients could be increased to prevent hypoglycemia. Indonesia has yet to widely implement smartphone-based education programs for hypoglycemia prevention. This study aimed to assess the feasibility of a smartphone application-based diabetes education model, developed using the health belief model and social cognitive theory, to enhance the ability of diabetes mellitus patients to detect hypoglycemia.
Materials & Methods: This design and development research utilized a pre-test and post-test design without a control group and was done on 64 diabetics between May and September 2023. Statistical analyses were performed using the paired t-test.
Findings: The mean patient's score on the ability to prevent hypoglycemia was 45.13 before the intervention. After the intervention, the patient's ability increased by 3.21 to reach 48.34. The paired t-test yielded a p-value of 0.0001, indicating a significant difference in the ability to detect hypoglycemia before and after the intervention.
Conclusion: Nursing Education Diabetic Therapeutic Application (NEDTA) was declared feasible to use in detecting hypoglycemia.

Abstract Aims: This study aimed to investigate the effect of a health education program on empowering mothers to prevent home accidents among rural children under five years old in Ilam County.
Materials & Methods: This research was a randomized controlled trial involving 88 mothers with children under five years old attending healthcare houses in Ilam County in 2022-2023 who were randomly assigned to the intervention and control groups. A one-month online educational intervention was implemented for the intervention group using the WhatsApp application, while the control group received no education. Data were collected using a questionnaire assessing the constructs of the health belief model regarding home accidents in children, completed online by the participants at baseline and three months later. Data were analyzed using SPSS 16 software, employing an independent sample t-test and paired sample t-test.
Findings: No significant difference was found between the two groups in the mean scores of the health belief model constructs regarding preventing home accidents in the pre-test phase (p>0.05). The results of the independent sample t-test showed a significant increase in the mean scores of health belief model constructs in the intervention group compared to the control group after a three-month follow-up (p<0.05).
Conclusion: Designing interventions based on the health belief model effectively empowers mothers to prevent accidents in rural children under five years old.

Abstract Aims: This study aimed to investigate the effect of a blended educational intervention based on the health belief model (HBM) about COVID-19 on teachers' preventive behavior.
Materials & Methods: A randomized controlled trial was conducted on female teachers in four districts affiliated with Education Organization Karaj Iran. Then, one of these two districts was assigned to the intervention group (n=70) and the other to the control group (n=70) by the lottery method. The educational intervention was conducted via three online platforms. Our intervention was named BEHTA. It included a specifically designed website, holding virtual and group discussion classes, and using a popular social network messenger.
Findings: The results showed that there was no significant difference between the intervention and control groups before training (p>0.05) but immediately and 12 weeks after training, the two groups had a statistically significant difference in all constructs (p<0.05). In the control group, the mean score of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy did not differ significantly (p>0.05), but the mean score of behavior decreased (p=0.027).
Conclusion: The educational intervention improves all constructs regarding COVID-19 in the intervention group.

Abstract Aims: Climate change is a global challenge that has already had a detrimental impact on the environment and human health, leading to increased magnitude and frequency of extreme weather events such as heat waves, droughts, and flooding. This study aimed to investigate the efficacy of the expanded health belief model related to the perceived benefits of climate change on collegians at the university.
Materials & Methods: This experimental randomized controlled trial was conducted at the College of Education for Pure Sciences in AL-Nasiriyah City, Iraq, from October 4th, 2022 to January 3rd, 2023. All 144 students entered the study by census method and were randomly divided into two study and control groups. A questionnaire consisting of two parts; demographic data and health benefits of adopting the anti-climate change behavior scale. Data was analyzed in SPSS 21 software by Chi-square and independent T-tests.
Findings: The perceived benefit had no significant difference between the control (29.17±8.82) and the study (29.52±8.05) groups in the pre-test (p>0.05). The study group's perceived benefit in post-test I was increased to 52.31±11.31, which was significantly (p<0.05) higher than the control group (29.49±8.07). Also, the study group's perceived benefit in post-test II was 51.89±11.60, which was significantly (p<0.05) higher than the control group (30.14±8.98). There was no statistically significant difference between study groups in the pre-test period (t=0.349; p=0.727). There were statistically significant differences between the study groups at the post-test I (t=8.276; p=0.001) and II periods (t=8.895; p=0.001).
Conclusion: The administered expanded health belief model increases the perceived benefits of enhancing the climate change counteraction in collegians.

Abstract Aims: COVID-19 Vaccination Hesitancy is a public health concern in the world. The present study aimed to determine the prevalence of vaccination hesitancy and its relevant factors using the health belief model among people in northeast Iran.
Instrument & Methods: The present cross-sectional study examined 626 people using convenience sampling. Data were collected through an online survey using a questionnaire based on the health belief model at intervals of 10 September 2021 and 15 October 2021. Data were analyzed by using SPSS 16.
Findings: Overall, 70.6% of the samples reported that they would use the vaccine for free after it becomes available. Health belief model constructs predicted 40% of the variance of vaccination behavioral intention. The results indicated that the perceived barriers were significantly related to using the vaccine, thereby reducing the probability of using the vaccine by 10% (Relative Risk Ratio=0.90, 95% CI: 0.82-0.99). Perceived benefits (Relative Risk Ratio =1.21, 95% CI: 1.11-1.32), perceived susceptibility (Relative Risk Ratio =1.54, 95% Cl: 1.23-1.92), and behavioral intention (Relative Risk Ratio =3.06, 95% CI: 2.23-4.20) had a significant relationship with the probability of using the vaccine.
Conclusion: About one-third of the participants had COVID-19 vaccination hesitancy. Interventions are necessary to increase compliance with vaccination, especially among people with low education levels. The health belief model constructs have a high power of predicting hesitancy and acceptance of COVID-19 vaccination and can be used in intervention programs.

Abstract Aims: This study aimed to design and psychometric a tool for measuring the knowledge, beliefs, and behavior of teachers regarding COVID-19 preventive behaviors.
Instrument & Methods: The goal was to create a tool that may be used to create an educational intervention that promotes preventive behaviors. A 60-item scale regarding COVID-19 preventive behaviors was developed upon literature review. Then, face and content validity were evaluated using quantitative and qualitative methods, through the involvement of the participants and expert panel. The internal consistency and reliability were assessed and approved using Cronbach's alpha index and test-retest.
Findings: The face and content validity of the primarily developed scale was confirmed by item impacts of 1.5, 0.49 CVR, and 0.79 CVI, and the number of items dropped to 60. The reliability of the instrument was approved by Cronbach's alpha of 0.67 to 0.95 and a correlation coefficient of 0.65 to 0.93.
Conclusion: Based on the results, the scale that was developed using the constructs of the HBM for COVID-19 preventive behaviors among teachers had appropriate validity and reliability.

Abstract Aims: COVID-19 outbreak in China affected all age groups. Among these groups, pregnant women are among the most important ones. This study aimed to investigate the effect of educational intervention in terms of the pattern of health beliefs to promote preventive behaviors against COVID-19 among pregnant women.
Material & Methods: This descriptive study was performed as an intervention on pregnant women in Qom in 2021. One hundred-six women were chosen by multi-stage sampling. The pre-test questionnaire was electronically given to the target group, and the educational protocol was provided to the group for a 2-month duration during several virtual sessions through videos, posters, and pamphlets. Thereafter, the questionnaire was completed again by all the individuals. The required data were collected in SPSS 20 software and then analyzed by t-test.
Findings: Before conducting the educational intervention in terms of some variables, including age, education, occupation, spouse occupation, number of abortions, number of deliveries, weeks of pregnancy, illness during pregnancy, family illness, relatives, and death in family members due to diseases, no statistically significant difference was found between the intervention and control groups (p>0.05). After conducting the educational intervention, a significant difference was observed in the intervention group in terms of all constructs of the health belief model compared to the control group (p<0.05).
Conclusion: The results of this study support the effectiveness of the intervention based on the health belief model in promoting preventive behaviors against COVID-19.

Abstract 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.

Abstract Aims: Influenza is an acute respiratory viral infection that can induce severe complications, hospitalization, and even death among older adults. Seasonal influenza vaccination has been proposed for its prevention. This study aimed to determine the related factors of influenza vaccination among Iranian older adults based on the health belief model.
Instrument & Methods: In this cross-sectional study, 206 participants 65 and older were selected from Yazd city, Iran, in 2019. A random cluster sampling was used. The data collection tool was a questionnaire based on the Health Belief Model constructs. The data were analyzed by SPSS 16 software using the Chi-square test, Pearson correlation coefficient, and logistic regression.
Findings: Only 24.3% of the participants had got a seasonal influenza vaccine over the past year, and 58.3% had received at least one dose of seasonal influenza vaccine from the age of 65. Knowledge (OR=1.27; CI=1.03-1.55), perceived susceptibility (OR=1.18; CI=1.04-1.33), and cues to action (OR=1.52; CI=1.16-1.98) were statistically significant predictors of seasonal influenza vaccination.
Conclusion: The cues to action stood as the strongest predictor of seasonal influenza vaccination, which should be addressed in health promotion intervention programs in the elderly.

Abstract Aims: Health care providers are considered as the pioneer forces of the health system. Thus, it is necessary to promote the health of this group in society by creating proper nutritional behaviors, especially the consumption of dairy products. This study was conducted to investigate the determinants of dairy use status and effective factors on consumption behaviors based on the Health Belief Model among health care providers of health centers.
Instrument & Methods: Throughout this descriptive-analytical study, 303 health care providers who work in the health centers of Urmia were included in the study by the census sampling method. The data collection instruments were researcher-made reliable and validated questionnaires in three sections of personal profile, consumption status of different types of dairy, and health belief model. Data were collected using structured interviews, then analyzed by SPSS 24 and the descriptive-analytical tests (ANOVA and Linear Regression).
Findings: The mean±SD age of the participants was 38.57±6.36 years. Among the Health Belief Model structures, the dimension of self-efficiency showed a significant relationship with the score of the dairy consumption behavior (p=0.0001). Additionally, there was a meaningful, significant relationship between the mean score of dairy consumption behavior with occupational status, marital status, and ethnicity (p<0.05). According to the linear regression test totally, the health belief model structures indicated 20% of the variance of the dairy consumption behavior. The predicting power of perceived self-efficiency was more than other structures of the model.
Conclusion: Perceived self-efficacy predicted the behavior of dairy consumption in the studied health care providers.

Abstract Aims: Dental caries in preschool children continues to be an important health problem in most countries. This study aimed to determine the effect of education to mothers based on the health belief model on decreasing the dental plaque index of 3–6 years old children.
Materials & Methods: This experimental study was conducted on 88 mothers and their 3–6-years old children (N_Total=176) referred to the Health Care Center No. 1 in Ilam in 2015. Participants were randomly selected using a random number and randomly assigned to either intervention or control groups on a 1:1 ratio basis. A three-part questionnaire was used. Three training sessions were given to the intervention group; each lasted for one hour once a week. At one-month follow-up, the post-test questionnaires were administered to both groups. A trained dentist assessed the oral health status of children using O’Leary plaque index with a dental mirror and a probe in broad daylight. SPSS 26 was used for data analysis, and the chi-square and T-test were applied to compare the data.
Findings: The mean ages of mothers and their children were 31.28±5.63 years and 4.5±1.56 years, respectively. Despite the similarity of groups at the beginning of the study (p>0.05), significant differences were found between groups in follow-up (p≤0.001) and between before intervention and follow-up in the intervention group (p≤0.001) in all health belief model constructs, oral health practice, and the plaque index.
Conclusion: Providing mothers with oral health education for their children can promote their beliefs and behavior relating to brushing their children’s teeth, and decreasing the plaque index.

Abstract Aims: This study aimed to determine the relationship between the constructs of Health Belief Model (HBM) and doing daily exercise to prevent cardiovascular diseases (CVDs) among the employees of Ilam University of medical sciences in Iran.
Instrument & Methods: About 294 employees of Ilam University of medical sciences participated in this cross-sectional study after providing a written consent form in 2017. The tool to collect data was an HBM-ISCS questionnaire, which was applied. Eventually, the obtained data were analyzed using SPSS 16 and logistic regression.
Findings: The results showed that 72.4% of participants did not exercise daily, and the Mean±SD of their daily exercise was 8.08±1.51min. Logistic regression showed that the possibility of daily exercise per unit of increase in perceived barriers decreased by about 10%, while every unit of increase in the self-efficacy score resulted in the possibility of 1.12 times more doing daily exercise. The possibility of doing daily exercise among men was 2 times more than in women, and among the personnel of financial/administrative department, it was about 2.5 times more than in the employees of health care department. Accordingly, the possibility of doing exercise decreased by about 8% per unit of increase in work experience.
Conclusion: The amount of doing daily exercise among the participants of this study was low, and implementing interventions commensurate with the results of this study and based on HBM can be effective in improving the amount of doing daily exercise in them.

Abstract Aims: The prevalence of Diabetes type 2 has been increased significantly during recent years. So, prevention is necessary from adolescence. This study aimed to investigate the effect of Health Belief Model-based education on preventive behaviors of Diabetes type 2 in male adolescences.
Materials & Methods: This semi-experimental study was conducted on 208 secondary school students of Hamadan city (104 students in an experimental group and 104 students in a control group) in 2018, who were selected using the stratified-proportional sampling method. Data were collected using a researcher-developed questionnaire including demographic, awareness, model constructions, and preventive behavior. Afterward, an educational intervention was implemented in the experimental group based on Health Belief Model in four 45-60 minute sessions. After one month, the data were recollected from the two groups and analyzed using Chi-square, t-test, and linear regression by SPSS 16 software.
Findings: Comparing the scores of awareness, Health Belief Model constructs, and student’s preventive practices revealed no statistically significant differences between the two groups at the beginning of the study (p>0.05). However, after the intervention, significant differences were observed between the two groups regarding awareness, the Health Belief Model constructs, and student’s preventive practices (p<0.05). Linear regression analysis indicated that self-efficacy was the most important independent predictor of type-2 diabetes-preventative behavior (p<0.05).
Conclusion: Health Belief Model-based education is effective in promoting type-2 diabetes prevention behaviors in students.

Abstract Aims: One of the most important factors in public health is oral and dental health. Determining the level of knowledge and attitude and the applicable criteria are effective factors in reducing dental problems. This study was conducted to determine the effective factors on oral hygiene based on the Health Belief Model (HBM) in students of Paramedicine, Qazvin University of Medical Sciences.
Materials & Methods: This is a descriptive-analytical. The present study was conducted on 300 students that were selected by using a multi-stage random sampling method. The data collection tool was based on a standard questionnaire of health belief model. The obtained data were analyzed by SPSS 20 software, descriptive statistics, and Pearson coefficient tests, variance analysis, Turkey test, and linear regression logistic regression was taken as a significant level of 0.05.
Findings: The mean of health behaviors among students was moderate (52.38±5.95). The regression analysis showed that constructs perceived barriers, self-efficacy and perceived benefits predict tooth decay prevention behaviors (p≤0.05). Pearson's test showed a positive and significant relationship between perceived barriers and behavior (r=-0.471, p=0.00).
Conclusion: In order to promote health behaviors among the student’s perceived barrier self-efficacy and perceived benefits, as the most important predictors of student behavior for holding educational courses should be used.

Abstract Aims: As adolescents constitute around 20% of the total population and near 90% of them are living in developing countries, they need much attention. Moreover, they need to meet their raised nutritional needs because of physiological and sexual growth otherwise, they will susceptible to poor nutritional status. The ultimate goal of the present study was evaluating health literacy and eating habits of adolescent girls before and after a nutrition education program.
Materials & Methods: The intervention study was implemented on 64 adolescent girls aged between 13-15 years from two governmental girls' high school in Mashhad, Iran. Questionnaires included food frequency, health belief model (HBM), and health literacy (HL) implemented in three stages, before intervention as a pretest, immediately after intervention and two months later for reassessment.
Findings: Nutrition education intervention has considerably improved HL and eating habits of adolescent girls. After intervention HL of girls improved from 1.75±1.07 to 4.96±0.96 and their healthy nutritional behavior improved from 1.65±4.92 to 20.62±1.33. After educational interventions, all HBM constructs and awareness of girls increased significantly.
Conclusion: The results of the present study indicated that education based on health belief model positively affected students’ health literacy and nutritional behaviors.

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 Aim: Pediculosis is a common serious infection and one of the public health problems in different countries. The aim of this study is to determine the effect of education on the preventive behaviors of pediculosis based on the Health Belief Model (HBM) in female students in Mashhad.
Methods: This quasi-experimental study was conducted on 60 seventh grade female students in Mashhad, in two groups. Cluster sampling was performed using the HBM in 2016. For gathering data, the questionnaire consisting of demographic variables and the HBM, which was implemented to both groups before, immediately after, and two months after the education. SPSS19 software and t-test, Freedman, MannWittny, Chi-square and Pierson’s correlation tests were used to analyze the data.
Findings: Before the intervention, there was a significant difference between the two groups in terms of all the structures (p>0/05), but after the intervention, a significant difference was observed only in terms of knowledge, perceived susceptibility and severity, perceived benefits and obstacles, efficacy and behavior (p<0/05). The correlation coefficient between the preventive behaviors of pediculosis and obstacles was found to be significant (p<0/001, r=0/499).
Conclusion: Health education program based on HBM can prevent pediculosis and be effective in female students.

Abstract Aim: Breast cancer is the most common type of cancer in Iranian women. Clinical nurses and midwives are supposed to be at high risk of the disease. The present study aimed at comparing the knowledge and health beliefs of Iranian nurses and midwives about breast cancer screening using Health Belief Model (HBM). Methods: In this cross-sectional study, 100 nurses and 60 midwives working in teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences (Yazd, Iran) were selected via convenience sampling. Three questionnaires were used to collect data including a demographic questionnaire, the Breast Cancer Knowledge Test, and Champion’s Revised Health Belief Model Scale. Data were analyzed using SPSS-11.0 for Windows. Findings: According to the independent t-test results, the mean knowledge scores of the two groups were significantly different (p<0.05). There was no significant difference in mean health belief scores between the two groups (p>0.05). Spearman’s rank correlation coefficient revealed a significant direct correlation between knowledge and health beliefs in both nurses and midwives (P=0.018; r=0.18). The same test suggested knowledge to have significant direct correlation with benefits of mammography (P=0.01; r=0.2), benefits of breast self-awareness (P<0.001; r=0.4), cues to action (P=0.001; r=0.2), and self-efficacy (P<0.001; r=0.3). Conclusion: There are some risk factors including unhealthy life-style behaviours, exposure to night light, and consequently, disruption in circadian rhythm, and that job stress can threaten the health of nurses and midwives. Thus, it is important to determine their perceived barriers of screening behaviours based on HBM.